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Stem cell research is a relatively new playing field. Scientists and researchers are hopeful that breakthroughs in stem cell research will be made in order to treat and possibly cure several serious diseases. Although there are debates and controversies surrounding such research, many countries have developed legislation in order to govern this issue. However, South Africa is not among these pioneering nations as this country does not have any definite, specific laws regarding stem cell research. This assignment will deal with the various factors that may influence decisions on stem cell research legislation, and whether South Africa should pass legislation to allow stem cell research or not.
Stem cells are the foundation and building blocks for the human body. The stem cells inside an embryo will eventually develop into every cell, organ and tissue in the foetus's body. They are pluripotent which enables them to replicate to create more stem cells, and also to differentiate to give rise to many different and more specialised cell types in the body. (Unknown, Information on Stem Cell Research, 2010) .
The Different Types of Stem Cells
There are two types of commonly known stem cells, Human Embryonic Stem Cells (HESC or unlimited stem cells), and Adult Stem Cells (ASC or limited stem cells).
HESC are currently harvested, with the patient's permission, from leftover 3-5 day old embryos which are usually discarded by fertility clinics. These embryos have been clinically created and exist entirely outside of the body (in vitro). They are called unlimited stem cells because they can develop into any kind of cell type or tissue. (Unknown, 2009)
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Diagram showing embryonic stem cells that originate as inner mass cells within a blastocyst and then have the potential to become any tissue in the body
(Image taken from : http://science.howstuffworks.com/cellular-microscopic-biology/stem-cell.htm/printable )
ASC are found throughout the body, after embryonic development. They are found mainly in adult bone marrow (in mature individuals) and in umbilical cord blood (of the foetus). ASC multiply by cell division to replenish dying cells and to regenerate damaged tissues. (Unknown, 2009)
Diagram showing the development of adult stem cells from extracted bone marrow
(Image taken from: http://news.bbc.co.uk/2/shared/spl/hi/pop_ups/03/health_stem_cell_guide/html/4.stm)
Ethics on Stem Cell Research - Various Viewpoints
There have been many ethical debates concerning stem cell research, the main one focusing on embryonic stem cell research as it requires the destruction of an embryo in order to harvest the stem cells.
Many people believe that an embryo is equivalent to an early-aged human life, and that embryonic stem cell research is tantamount to murder. Others believe that embryos only have the potential for life, as they may not even survive in the womb. As more than a third of zygotes don't implant after conception, far more embryos are lost due to chance than are proposed to be used for embryonic stem cell research or treatments. The three religions that have made their views on stem cell research known, follows:
Church Views on Embryonic Stem Cell Research
-The Baptist Church: opposes embryonic stem cell research because the "Bible teaches that human beings are made in the image and likeness of God (Gen. 1:27; 9:6) and protectable human life begins at fertilization." (SBC Resolutions : Resolution On Human Embryonic And Stem Cell Research, 1999)
-The Catholic Church believes that "the killing of innocent human creatures, even if carried out to help others, constitutes an absolutely unacceptable act." (On Embryonic Stem Cell Research, Unknown)
-The Lutheran Church believes that:
'Embryos are not, as some claim, 'potential human beings' but are totally and fully human in every way although in the early process of physical development (Jer. 1:5). The Christian is called to defend life at all stages of development and in all conditions because it is a gift from God (Luke 1:41, 44; Psalm 139:16; Is. 49:1, 5). Embryonic stem cell research necessarily involves the intentional destruction of human beings, and therefore must be rejected as morally objectionable. Governmental leaders should be urged to reject using public funds for research that deliberately and intentionally kills human beings.' (A Statement on the Proposed Missouri Stem Cell Research and Cures Initiative, 2006)
Thus it is shown conclusively that Christians oppose embryonic stem cell research.
Islamic Views on Embryonic Stem Cell Research
Islamic scholars believe that because the embryo (pre-embryo from IVF) is not in its natural environment, i.e. the womb, it would not have been able to become a human being. Therefore, they believe that at the stage at which embryos are used to harvest stem cells, the embryo is not human and does not have a soul as yet. Their view is that there is nothing wrong in doing research, especially if it has a potential to cure and alleviate disease. However, Muslims believe that it is important that embryos are not misused and that the embryos used for stem cell research are those discarded by fertility clinics. They emphasise that embryos should not be produced just for stem cell research. (Siddiqi, Unknown)
Jewish Views on Embryonic Stem Cell Research
Judaism has similar views to that of Islam. Judaism allows for the destruction of pre-embryos. Stem cell research is allowed because stem cells have the potential to save lives of people who have already been born. However, like Islam, Judaism would oppose the deliberate production of embryos in order to destroy them for research. (Eisenberg, 2001)
Among three religions in South Africa, Christianity is the one that opposes embryonic stem cell research with the belief that embryos should be protected as they are considered as living, human beings. However, the other two religions, Islam and Judaism, both believe that embryonic stem cell research is permissible because it has the potential to save the lives of many, already living people. Both these religions believe that the embryos used to harvest stem cells must be those that would have been discarded even if they weren't to be used in research. All three religions support adult stem cell research.
The following pie chart shows that Christians comprise the highest percentage group of the population, and since Christianity opposes embryonic stem cell research, it is understood that the majority of the South African population would in fact oppose such research.
(Pie chart adapted from http://en.wikipedia.org/wiki/Religion_in_South_Africa)
Funding needed for Stem Cell Research
Stem cell research requires vast amounts of money in order to advance and it is often brought to question whether the South African government will be able to provide the necessary funding for scientists and researchers. For example, in the USA, $300 million dollars is allocated each year, and spread over 100 institutions in the state of California for stem cell research. (Palca, 2007) This money is acquired from tax-payers and in a country like South Africa; it would be very difficult to get such huge amounts from tax-payers. There are many reasons as to why this is, mainly because South Africa is still a developing country and many citizens live in poverty. There may also be many people who object to aiding in the funding of stem cell research.
Funding may be provided by private investors. However, this could result in research being restricted according to the dictates of such companies i.e. Research may be limited to certain diseases. Furthermore, the fruits of privatised stem cell research may only serve the elite or those on medical aid, not filtering down to those on the ground, unless government begins to play an active role.
Potential Uses of Stem Cells
There are many potential uses and advantages to stem cell research. These are:
It provides medical benefits in the field of regenerative medicine. (Pillai, Unknown) e.g. Embryonic stem cells can be used to regrow damaged nerves in people who are paralysed. (Solway, 2007)
Limbs and organs could be grown from stem cells and then used in transplants. (Pillai, Unknown) Transplantable organs are scarce. Many people need organ transplants for their survival, and so they could be helped.
There is great potential for discovering treatments and cures to many diseases like Parkinson's disease, spinal cord injuries, diabetes and many more. (Pillai, Unknown)
Potential drugs can be tested without using animal or human testers. (Pillai, Unknown)
It will help scientists to learn about human growth and cell development
Stem cell laws in South Africa
Stem cell laws are the rules governing the sources, research and uses of stem cells. (Unknown, 2010)
In 2004, South Africa became the first African nation to create a stem cell bank. (Unknown, 2010) However, there are no complete laws on how researchers should conduct their research, as South Africa is operating in a 'regulatory vacuum' - there are no limitations set in place. Many issues surrounding stem cells have not been debated and specific legislation regarding stem cells is lacking. (Pepper, 2009)
The Department of Health has published several draft regulations but none of them are currently in force. This absence of regulations could lead to many potential problems, some of which are already being experienced by South African citizens. Because of the lack of regulations, many people are practicing medically untested methods of stem cell treatment.
For example, eight South African patients thought that they were receiving stem cell therapy for spinal cord injury. However, five of them were told that they had to travel overseas to receive the treatment. Without travelling and accommodation expenses, they were made to pay R122 500 per treatment. Four of them received rabbit stem cells and one received autologous stem cell treatment, i.e. he was treated with cells from his own body. The three patients that remained in South Africa were given stem cells from an unknown source, and from sheep. All patients remained the same as before their treatments, none of their conditions improved. One of the patients developed the locked-in syndrome, a condition in which a person is awake and aware, but cannot communicate because all voluntary muscles are paralysed (besides the eyes). This table shows that many people have the potential to be financially exploited, and undergo unethical practices because of the lack of laws regarding stem cells and stem cell therapy. From this point of view, there is a definite need for stem cell laws in order to prevent cases like the above.
Table to Show Results of 8 South African Patients who
Received 'Stem Cell' Therapy for Spinal Cord Injury
Number of patients who had to travel overseas
Average cost per treatment (excluding travel fares and accommodation)
Source of stem cells:
Rabbit stem cells
Autologous stem cells
Sheep stem cells
-Via lumbar puncture
-1 patient subsequently developed the locked-in syndrome
-The others remained the same as before their therapies
(Skeen & Pepper - unpublished paper presented at the 7th SASHSCT - Johannesburg, 30-31 January 2009
Stem Cell Laws in the USA
In America, there is no federal law banning stem cell research. In 2003, a law permitting human cloning for the purpose of developing and harvesting human stem cells was passed.Â Human embryos are allowed to be cloned, implanted into a womb and then aborted for the use of medical research. However, over the course of a few years, various political figures in America have had differing views on stem cell research. Bill Clinton and George W Bush opposed embryonic stem cell research completely. Bush went so far as to ban the use of federal funding for any stem cell research. He did so due to ideological reasons and this indicates that stem cell laws and funding do rely and depend on the view of the nation. However, Barack Obama recently removed these
restrictions. (Stem cell laws and policy in the United States, 2010)
There are many factors which may influence the decision to pass legislation to allow stem cell research. There is a definite need for laws to govern what researchers may or may not do; as there is potential for unethical activities, such as evasion of the truth by companies who promise miraculous recoveries to vulnerable patients. The possibilities and advantages that stem cell research may bring seems to outweigh the fact that many South Africans may oppose it. Thousands of South Africans could potentially be helped by stem cell therapies and so there needs to be facilitation for stem cell research. However, this will only be achieved with a specific regulatory environment.
The political party in power inevitably has the option to pass or veto bills and regulations regarding stem cell research. Currently, the ANC has no standpoint on the matter. Many draft regulations have been proposed by the Department of Health, but none of these are in force. It will therefore be a long time before the government provides proper guidelines dealing with stem cell research.
The examples cited in the above report make it clear that criminals take advantage of desperate patients who could potentially be helped with legitimate stem cell research. Proactive legislation will ensure that the lifesaving benefits of this field can be passed on to the people who need it most, and greatly limits the types of confidence tricks that can be played when such research is forced to stay in the shadows.
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