Category Archives: Ohio Stem Cells

Replacing joints like knees or hips can relieve pain and boost quality of life. But these surgeries demand lengthy rehabs and may not restore full function.

Al Perez, 62, wanted to avoid such a procedure if at all possible. And after conducting some research, he discovered Jason Dragoo, MD. Dragoo is leading a study that is examining whether stem cell therapy can improve cartilage growth and decrease inflammation caused by osteoarthritis in the knee.

After 15 years of laboratory research, we have optimized our ability to harvest stem cells from the body and can unleash their potential to improve patients with conditions such as osteoarthritis. After all of this time in the laboratory, we are finally ready for human clinical trials to begin, Dragoo said in a recent Stanford Medicine News article.

The cells are extracted from the knee during surgery. They are then processed and returned to the knee, to help with healing. The article explains:

Perez is one of 100 patients who are expected to undergo the procedure. The trial surgeries started at Stanford in the summer of 2016 and are being performed at other national medical centers such as Harvard University, Rush University in Chicago and Ohio State University. After 100 patients have completed the procedure, the researchers will start evaluating whether those who received the stem cell treatments are better off than those who received the standard treatments.

Results are expected in late 2018.

For Perez, the procedure was a success. He can water ski and golf without suffering severe pain. Many other patients are also doing well, Dragoo said.

We believe this technique will yield more positive results than standard arthroscopy because we are using cell therapy to help the body heal itself, Dragoo said. We hope this may save many patients from having to undergo knee replacement.

Previously: Iron-supplement-slurping stem cells can be transplanted, then tracked to make sure theyre making new kneesPhoto by Eric Kayne

Read more from the original source:
Researchers explore possible alternative to knee replacement - Scope (blog)

Denise Sautters CantonRep.com staff writer

"Faster! Faster!" Emerie Wanzer said as she swung on the brand new swing set that was made especially for her.

Being able to swing in the sunshine and feel the fresh air around her is a must for the 5-year-old Emmie, as she is known to family and friends.

She has often watched as her four brothers played soccer in the back yard, or rode off on their bikes to adventures she couldn't even imagine. When Emmie was 2, she laid down for a nap and when she awakened, her life was changed. After a lengthy stay at Akron Children's Hospital, Emmie was diagnosed withLongitudinally Extensive Transverse Myelitis, a condition that happens when the coverings that protect nerve cells in a certain area of your spinal cord are damaged. It left her paralyzed.

Thanks to Wishes Can Happen, a local organization that provides wishes to seriously ill children in Northeast Ohio, Emmie can now swing to her heart's content, as long as someone's there to push. With four brothers, her parents, grandparents and a nurse, that won't be difficult.

Emmie

Emmie's world started changing in 2014.

"It was the day after Easter," said her mom, Kari. "It was a normal day. We took her brotherto preschool, went shopping, got some lunch and came home. She laid down for a nap. When she woke up, she was having trouble moving her arms. Initially, I thought she slept on her arms wrong, that maybe she had a pinched nerve. I really didn't know what to think."

As the pain and paralyzation continued, she called her husband, Jeremy, a local dentist, to see what he thought.

"I told him I was really worried, that I didn't know what happened," she said, noting they decided to take her to Akron Children's. "I was worried about moving her because it could have been a neck injury so we called 911. When they came, they were really concerned because at that point she could only do worm like movements with her core. "

The doctors did not give the Wanzers a diagnosis at first, but ran a battery of tests, X-rays and CAT scans, but nothing showed up. While the family was there, Emmie started going into respiratory failure. They put her on a ventilator and took her to get a magnetic resonance imaging scan. After a few more tests, the Wanzers got the diagnosis.

Emmie is paralyzed from the neck down as a result of theLongitudinally Extensive Transverse Myelitis.Her brain and brain stem are not affected, but it has affected multiple areas of the spinal cord. She was in the hospital from April through August that year. Initially, she had no movement, but there is always a chance for more recovery.Emmie had to learn to eat and speak again following surgery to insert a tracheostomy tube to help her breathe. Her head movement is pretty complete now. The potential is there for her, but most recovery comes within the first two years, according to her mom.

Moving forward

Emmie is strong, and smart, said her nurse, Amy McKeown of Plain Township.

"Every day, she amazes me, to see the things she can do, the things she has overcome," McKeown said. "She doesn't let anything stop her from learning or doing anything she wants to do, and to see her on that swing and the smile on her face just melts my heart."

Emmie just finished her kindergarten year at Strausser Elementary School in Jackson Township. McKeown attends school with her to provide one-on-one care while she is there, but, she said, Emmy does everything else herself.

"The school and kids have been very good to her," said Wanzer, who admitted she was apprehensive at the idea of her daughter going to a regular school, but her worries were for naught. "The kids were slightly curious and wanted to know what this or that did, but they were very accepting and she made new friends. Emmie is really shy, but being with the other kids there, she has really come out of her shell. Her teacher made sure she was always included in whatever the class was doing. Even the physical education teacher made her feel included. When the kids were playing soccer, the teacher provided a ball Emmie could push around with her chair."

In addition to going to regular school, Emmie also joined a dance class, which has helped her come out of her shell. There is another girl in her dance class that has the same condition, so she knows she is not alone, said her mom. In addition to dancing, for which her dance team did a halftime show this past year for the Cleveland Cavaliers, she is also an artist and has done several pieces her mom and dad have hanging in an art gallery at their home.

She uses mouth adaptors to draw, write, and use a computer to play games and study. She also loves to read books using a special stand to hold the book. Her power chair, which resembles a souped up motorcycle she drives with her head, provides her the opportunity to come and go as she pleases.

It was so popular in school this past year, Wanzer said, that a couple of her peers asked for one for Christmas.

Wishes

"We were first approached by Make aWish, but Emmie was only 2 and although we talked about different things, she said she wanted a swing," said Wanzer, a pharmacist who stopped working to care for her daughter. "They ran into all kinds of issues and could not get a swing. Wishes Can Happen came in and asked about a wish. They said they could get a swing to accommodate her wheelchair, that they had done it before, and here it is."

Typically, said Mark Vandegrift, a volunteer for Wishes Can Happen, wishes are granted to seriously ill children primarily in Stark County, but are available to children throughout Northeastern Ohio. The organization tries to give the kids whatever they want. A lift for Emmie is in the works to make it easier for her to get to the swing. If the lift doesn't work, she might get a ramp.

"This has been a collaboration between a couple of local charitable organizations, Wishes Can Happen and Lowe's, which has their own charitable program," said Vandegrift. "It donated all of the time and material to do landscaping for the entire house."

Wishes is financed entirely through donor support. The nonprofit has no paid employees, only volunteers.

Lowe's provided landscaping, planting pink flowers around the patio because pink is Emmie's favorite color.

"Pink is my life," she said.

Reach Denise at 330-580-8321 or denise.sautters@cantonrep.com. On Twitter:@dsauttersREP

See more here:
Jackson Twp.'s Emmie Wanzer loves her new wheelchair swing provided by Wishes Can Happen Wanzer - Canton Repository

USC News In the first evidence of a natural intervention triggering stem cell-based regeneration of an organ or system, a study in the June 5 issue of the Cell Stem Cell shows that cycles of prolonged fasting not only protect against immune system damage a major side effect of chemotherapy but also induce immune system regeneration, shifting stem cells from a dormant state to a state of self-renewal.

In both mice and a Phase 1 human clinical trial involving patients receiving chemotherapy, long periods of not eating significantly lowered white blood cell counts. In mice, fasting cycles then flipped a regenerative switch, changing the signaling pathways for hematopoietic stem cells, which are responsible for the generation of blood and immune systems, the research showed. We could not predict that prolonged fasting would have such a remarkable effect in promoting stem cell-based regeneration of the hematopoietic system.

Valter Longo

The study has major implications for healthier aging, in which immune system decline contributes to increased susceptibility to disease as people age. By outlining how prolonged fasting cycles periods of no food for two to four days at a time over the course of six months kill older and damaged immune cells and generate new ones, the research also has implications for chemotherapy tolerance and for those with a wide range of immune system deficiencies, including autoimmunity disorders.

We could not predict that prolonged fasting would have such a remarkable effect in promoting stem cell-based regeneration of the hematopoietic system, said corresponding author Valter Longo, Edna M. Jones Professor of Gerontology and the Biological Sciences at the USC Davis School of Gerontologyand director of the USC Longevity Institute. Longo has a joint appointment at the USC Dornsife College of Letters, Arts and Sciences.

When you starve, the system tries to save energy, and one of the things it can do to save energy is to recycle a lot of the immune cells that are not needed, especially those that may be damaged, Longo said. What we started noticing in both our human work and animal work is that the white blood cell count goes down with prolonged fasting. Then when you re-feed, the blood cells come back. So we started thinking, well, where does it come from?

Prolonged fasting forces the body to use stores of glucose, fat and ketones, but it also breaks down a significant portion of white blood cells. Longo likens the effect to lightening a plane of excess cargo.

During each cycle of fasting, this depletion of white blood cells induces changes that trigger stem cell-based regeneration of new immune system cells. In particular, prolonged fasting reduced the enzyme PKA, an effect previously discovered by the Longo team to extend longevity in simple organisms and which has been linked in other research to the regulation of stem cell self-renewal and pluripotency that is, the potential for one cell to develop into many different cell types. Prolonged fasting also lowered levels of IGF-1, a growth-factor hormone that Longo and others have linked to aging, tumor progression and cancer risk.

PKA is the key gene that needs to shut down in order for these stem cells to switch into regenerative mode. It gives the OK for stem cells to go ahead and begin proliferating and rebuild the entire system, explained Longo, noting the potential of clinical applications that mimic the effects of prolonged fasting to rejuvenate the immune system. And the good news is that the body got rid of the parts of the system that might be damaged or old, the inefficient parts, during the fasting. Now, if you start with a system heavily damaged by chemotherapy or aging, fasting cycles can generate, literally, a new immune system.

Prolonged fasting also protected against toxicity in a pilot clinical trial in which a small group of patients fasted for a 72-hour period prior to chemotherapy, extending Longos influential past research.

While chemotherapy saves lives, it causes significant collateral damage to the immune system. The results of this study suggest that fasting may mitigate some of the harmful effects of chemotherapy, said co-author Tanya Dorff, assistant professor of clinical medicine at the USC Norris Comprehensive Cancer Center and Hospital. More clinical studies are needed, and any such dietary intervention should be undertaken only under the guidance of a physician.

We are investigating the possibility that these effects are applicable to many different systems and organs, not just the immune system, said Longo, whose lab is in the process of conducting further research on controlled dietary interventions and stem cell regeneration in both animal and clinical studies.

The study was supported by the National Institute of Aging of the National Institutes of Health (grant numbers AG20642, AG025135, P01AG34906). The clinical trial was supported by the V Foundation and the National Cancer Institute of the National Institutes of Health (P30CA014089).

Chia Wei-Cheng of USC Davis was first author of the study. Gregor Adams, Xiaoying Zhou and Ben Lam of the Eli and Edythe Broad Center for Regenerative Medicine and Stem Cell Research at USC; Laura Perin and Stefano Da Sacco of the Saban Research Institute at Childrens Hospital Los Angeles; Min Wei of USC Davis; Mario Mirisola of the University of Palermo; Dorff and David Quinn of the Keck School of Medicine of USC; and John Kopchick of Ohio University were co-authors of the study.

1. Fasting helps protect against brain disease:

Researchers at the National Institute on Aging in Baltimore have found evidence that fasting for one or two days a week can prevent the effects of Alzheimer and Parkinsons disease. Research also found that cutting the daily intake to 500 calories a day for two days out of the seven can show clear beneficial effects for the brain.

2. Fasting cuts your risk of heart disease and diabetes:

Regularly going a day without food reduces your risk of heart disease and diabetes. Studies show that fasting releases a significant surge in human growth hormone, which is associated with speeding up metabolism and burning off fat. Shedding fat is known to cut the risk of heart disease and diabetes. Doctors are even starting to consider fasting as a treatment.

3. Fasting effectively treats cancer in human cells:

A study from the scientific journal of aging found that cancer patients who included fasting into their therapy perceived fewer side effects from chemotherapy. All tests conducted so far show that fasting improves survival, slow tumor growth and limit the spread of tumors. The National Institute on Aging has also studied one type of breast cancer in detail to further understand the effects of fasting on cancer. As a result of fasting, the cancer cells tried to make new proteins and took other steps to keep growing and dividing. As a result of these steps, which in turn led to a number of other steps, damaging free radical molecules were created which broke down the cancer cells own DNA and caused their destruction! Its cellular suicide, the cancer cell is trying to replace all of the stuff missing in the bloodstream that it needs to survive after a period of fasting, but cant. In turn, it tries to create them and this leads to its own destruction

Source: USC News

Collective Evolution

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> Get The Free Cookbook

See the article here:
Scientists Discover That Fasting Triggers Stem Cell ...

Russell T. Daley, Graduate Student, California State University, Long Beach December 13, 2000

presented to: Institute for Applied and Professional Ethics Ohio University April 28, 2001

This research is of such fundamental importance that all responsible citizens should be aware of its implications. Dr. Shirley J. Wright, Ph.D., Assistant Professor of Biology, University of Dayton:

INTRODUCTION

Biomedical sciences are progressing at staggering rate. This fact is no more evident than in the burgeoning field of stem cell research where therapeutic applications such as tissue and organ transplantation are being developed. These therapies have the potential to save millions of lives and greatly reduce human suffering. The ethical dilemma lies in the fact that much of the research requires the destruction of human embryos. Unfortunately, when faced with such choices, our standard ethical frameworks seem to demand opposing and intractable positions. The goal of this paper is to find a common ground from which we as a society may reasonably and faithfully deliberate about embryonic stem (ES) cell research. In the paper I will (1) identify and evaluate the main arguments both for and against this research, (2) explore the central question of moral status, (3) consider the application of Mary Anne Warrens multi-criterial approach to the moral status of the embryo, and (4) offer some initial policy recommendations.

In order to arrive at any conclusions which hold the hope of widespread support, the nature of this discussion requires a careful accounting of disparate views and a respectful handling of the sometimes emotionally charged responses. Sadly the current public debate on this topic has become more of a political process than a philosophical one. Notwithstanding the valiant efforts of some of the best minds in our country and abroad, as represented in the National Institute of Health (NIH), the Presidents National Bioethics Advisory Commission (NBAC), and the Senate Appropriations Committee (SAC) Hearings, the ethical divide seems unbridgeable. While the NBACs reportto President Clinton is complex in its recommendations and subtle in its reasoning, I believe the NBAC stops short of providing clear direction for the future. Not only does the NBAC offer an incomplete defense of its position, but in some respects it seems to have fallen prey to the political process and not offered recommendations which are true to the hearts and minds of the participants. This deficiency reflects the difficulty suggested by Kevin Wildes, of creating ethically sensitive public policy in a society that is secular and morally pluralistic. Based on this challenge, it must be accepted that no matter what decision is made some persons will not agree. We should recognize in this process that not all religious or philosophical values will be realized in a pluralistic society. Rawls says, There is no social world without loss: that is, no social world that does not exclude some ways of life that realize in special ways certain fundamental values.

BREAKING THE STALEMATE

It should be recognized that much of the recent debate over ES cell research has focused on the use of ES cells collected from cadaveric fetal tissue and unused IVF embryos. Attempts by philosophers, lawyers, and scientists alike to justify ES cell research have centered on issues such as lack of complicity with abortion or the best use of unwanted materials. However, these attempts have not answered the critics of ES cell research and have left us in an ethical stalemate. John Robertson and the NBAC stop their arguments at the point of non-complicity because they believe that they have justified the immediate concerns of this research and answered the critics. They choose to address only the less problematicsources for ES cell research, however, in doing so they avoid the deeper debate and fail to set a direction for the future. How can we bridge the divide? First, we must seek to reduce some of the distorting power of the fears and prejudices that surround this debate. This can be done by gaining a common understanding and usage of such terms as human being, person, right to life, and even embryo. I contend that these terms can be sorted out within the context of a framework for moral status and our answers to the ethical dilemma presented by ES cell research will turn on the question of how we ought to understand the moral status of the embryo. Thus, I intend to focus my attention on the deeper problem: What is the moral status of the embryo, and how is it to be weighed against other relevant concerns?

THE STANDARD ARGUMENTS ON BOTH SIDES

The main argument for ES cell research is that it will reduce human suffering and promote human well being, or the common good, by curing or eliminating many illnesses. The debilitating effects of such diseases as diabetes, Parkinsons, and Alzheimers (to mention only a few) may potentially be eradicated through the therapeutic applications offered by ES cell research. ES cell research is touted by many to be the most probable and quickest way to attain these therapies due to the undifferentiated nature of the stem cells as well as the ability of ES cells to overcome immunological concerns. Thus, it is research with ES cells versus adult cells which should be pursued. Any harms caused by the destruction of human embryos will be outweighed by the goods attained in the relief of human suffering. However, social utility is not always a sufficient grounding to justify actions. Except for hard-line, classical utilitarians, most agree that there are some moral constraints on the promotion of the common good. Issues such as justice, human rights, or respect for persons often mitigate social utility.

The main argument against ES cell research is that embryos should never be destroyed based on the principle of respect for life. Upon conception embryos are alive and have the unequivocal right to maintain that life. Whether one is using left-over IVF embryos ready to be discarded or the fetal tissue remains from elective abortions, any intentional destruction of an embryo cannot be justified. In effect, those arguing against ES cell research are saying that embryos have the moral status of persons and so should not be killed regardless of the extent of human benefit. As Richard Salzman says, some diseases are better than the cure. There is some truth in that statement. But even for objectors to ES cell research it does seem that closely held values are at times over-ridden in the name of other closely held values. As regards valuing life, we certainly risk life in the pursuit of ending human rights atrocities. So the question is how much truth is there in Salzmans statement and how does this notion relate to the question of the limits on ES cell research.

An additional question which must be addressed in evaluating the argument against ES cell research is what is meant by Respect for life. This principle is best understood as one which values life among other values. This is, however, not the vein in which the opponents of ES cell research are using this principle. When they invoke respect for life in their argument, they are really meaning sanctity of life which is a principle holding life as the highest value, in fact, as a sacred and non-violable value. The pitfalls of this type of move will become more evident in the next section as we look closer at approaches to moral status.

Arguing against ES cell research, some suggest that it is incomprehensible to be able to offer the embryo profound respect or dignity and then be prepared to kill it. This question of respect for the embryo is an important one to address if we hope to find common ground in this debate. How much respect is due the embryo? If the embryo is due respect, how can we most appropriately demonstrate this? I believe a clear understanding of the embryos moral status will help us answer these questions and help us face the dilemma of offering the embryo respect while still being willing to destroy it.

IS THE EMBRYO PERSON, PROPERTY, OR SOMETHING ELSE?

The notion of moral status represents an approach of specifying those things towards which we believe we have moral obligations and identifying some of what we believe those obligations to be. Any theory of moral status cannot be expected to answer all relevant questions about obligations since many of our obligations are based on contributing factors which are situational or contextual. However, a theory of moral status that can be accepted and agreed upon by a diverse audience will take us a long way towards practical decision making.

Relative to the moral status of the human embryo there three positions of which two are commonly held and one is somewhat revisionist:

Embryo as property

Embryo as person

Embryo as transient

The embryo as property view, can only be held if no moral status is attributed to the embryo. The most obvious avenue to reaching this view is one that Singer or Hare might take within a preference satisfaction utilitarian framework. Here the claim would be that since the embryo has no preferences or interests, it has no claim to moral status. However, our common-sense tells us that there is something about the embryo which instills it with value. This is not to say we must resort to speciesism (following Singer, i.e., it is not the specifically human quality of the embryo that makes it worthy of some degree of protection), but that there seems some incongruity in dealing with human beings purely as if their rights were dependent upon a scientific account of their developmental stage (e.g., passing the eight cell stage, developing the primitive streak, etc.). In fact opponents of ES cell research draw our attention to our disposition to protect the vulnerable who may not yet have developed. The embryo seems both developing and vulnerable. Singer says it is not vulnerable because no harm can be done to it. But the harms many are concerned with are the harms to justice and human rights which a strict utilitarianism seems unable to account for. One of the greatest advantages of the account of moral status I plan to offer is its ability to take a fundamental preference satisfying ethical framework and still compensate for fundamental human rights.

This type of approach, using a single criterion as the basis for establishing moral status, is called uni-criterial by Mary Anne Warren in her book Moral Status: Obligations to Persons and Other Living Things. The embryo as person view can also be classified in this manner as it likewise relies on a strict adherence to a uni-criterial notion of moral status. The approach taken in the embryo as person view is that since the embryo is alive, and life is the singular necessary and sufficient condition for the attribution of moral status, then the embryo has full moral status. Warren skillfully maps out the standard uni-criterial approaches to moral status and the pitfalls of each. Warren discusses three uni-criterial approaches, each of which focuses on a certain intrinsic property: (1) life, (2) sentience, and (3) personhood. Many philosophers have argued for one or another of these properties to be necessary and sufficient for the attribution of full moral status. Warren argues that each represents a notion which is sufficient for some moral status, but will fail as a sole criterion for full moral status. She argues persuasively that taken individually each, ?leads to consequences that are intuitively implausible and pragmatically unacceptable. I will briefly examine some of these consequences and illustrate the problem of a uni-criterial approach as I examine a recent statement against ES cell research by a prominent advocacy group.

AN ARGUMENT AGAINST ES CELL RESEARCH

The Concerned Women for America (CWA) make a standard argument against embryonic stem cell research:

Human embryos are humans and therefore, persons and when an embryo is destroyed, a human life is extinguished? The underlying utilitarian belief that some humans need to be sacrificed for the betterment of others is morally and ethically wrong. The rationale used to justify the destruction of embryos for the advancements in medical research and development is the same used to justify the syphilis experiments conducted on African-Americans in Tuskeegee, Alabama? (and in the) medical research Nazi doctors performed in Dachau and Auschwitz.? We do not have the license to engage in lethal experimentation, just as we may not experiment on death row prisoners or harvest their organs without their consent.

As Peter Singer points out,

The syllogism goes like this:

Every human being has a right to life.

A human embryo is a human being.

Therefore, the human embryo has a right to life.

The inadequacy of the standard argument is brought to light in a comparison of the nature of the term human being and its use in each of the two premises of the standard argument against ES cell research. To make the argument hold, the sense of human being as used in the first premise is not the same as the sense of human being as used in the second premise. Singer calls this an equivocation of the arguments primary term. The use of the term human being in the second premise is biological in nature (it has human DNA, it is of Homo Sapiens), the use of the term human being in the first premise (to claim a right to life) is strictly relative to the moral qualities and is, thus, normative in nature. Therefore, the standard argument fails due to the equivocation of the term human being. In getting clear about our use of the terms human being and person we can create clarity amid unwitting attempts at obfuscation.

Many philosophers, as far back as Locke, would claim that a human being has rights, but that being human is not a necessary and sufficient condition for having personhood. Being human is a biological condition, being a human being or, more to use more exacting language, having personhood is a normative condition. The questions then becomes: What are the necessary and sufficient conditions for moral status and how do they apply to the human embryo? I will address these questions in the subsequent sections of this paper.

BIOLOGY NOT UNIMPORTANT

Within this debate on ES cell research, a great deal of time and energy is spent among scientists and philosophers debating the biological issues of the embryo such as numerical continutiy and many arguments are made both for and against designating the embryo as a person in the name of science. While I suggest that the issues which will aid our progression to consensus on this topic do not lie in biology, science can aid our normative attribution of moral status for the embryo. Some ES cell research proponents, including myself, use scientific information to suggest that it is appropriate to wait until at least fourteen days after conception to claim numerical continuity, since it is only then that totipotency has been lost. Additionally, it is only sometime after fourteen days from conception that the development of the primitive streak (which marks the development of neural receptors) signals the development of any potential for sentience. It is at this point of establishing identity and sentience (qualities we believe to be important on a developmental view of the embryo) that I suggest we should become more concerned with the embryos interests and rights. This is a position which I believe is tenable, but we should acknowledge that it is a normative decision we are making and not a scientific decision. Furthermore, if we are to hold such a position, we must be clear as to how sentience and its attainment effect our attributions of moral status. I will address these issues in the next section.

MULTI-CRITERIAL APPROACH

If the embryo is not property and the embryo is not a person, then it must be something else. What this something else is can be reflected in the position of the embryo as transient (Position #3 above). The validity of this position will be born out in a review and application of Warrens multi-criterial approach to moral status. To understand this approach, we must understand how she establishes each level of her criteria for moral status and why any one of the three standard intrinsic properties fail as the singular criterion for establishing moral status. It is important to note that Warren acknowledges that this approach is a common-sense morality. While not all of these principles are used consciously by everyone, she contends that thoughtful peoplewill make reasoned arguments that are supported by these principles. She admits that, None of these principles is deducible from empirical facts, or from analytic truths about moral terms or concepts; yet each is defensible in common-sense ways.

To begin with, Warren recognizes that we do value life and she acknowledges the merits of the Sanctity of Life principle. The notion of reverence for life or Sanctity of Life (as the principle is more often called) as the sole conferring principle of moral status was purported by Albert Schweitzer. While he was recognized as a great humanitarian, the legacy he left behind in the dogmatic appeal to reverence for life represents much of the intractability found within the stem cell debate. The key to the reverence for life notion is that all living organisms have moral status and have it in exactly the same amount. This is because life is the ultimate, absolute value which all organisms share equally. However, application of this strict and absolute principle quickly wanes to absurdity when we realize that many of our normal daily functions cannot occur without some destruction of life; e.g., cleaning the kitchen floor results in the wrongful killing of micro-organisms, our daily diets (even if vegetarian) result in the morally unacceptable death of plants.

While some (including the Concerned Women for America) have tried to re-shape the Sanctity of Life principle by saying it is only relevant to human life, those seeking to hold this general principle of life as ultimate and absolute have some vicious obstacles to overcome. In order to be true to the sanctity of life principle, one may be forced to accept that any attempt to make such qualifications as only human life matters could result in the untenable outcome of allowing other qualifications. Thus, one objection to such a qualifier is that to allow only human life to be absolute causes us to allow the principle to be denigrated such that some life is not worth living. Though this is just the point of the CWA and others, the problem is that this could be the case whether the living creature is an animal, a child, an elderly person, or a disabled person. Such denigration of the value of life is unacceptable even to the proponents of the Sanctity of Life principle. As Schweitzer claims, there can be no qualifiers to the type of life we are talking about. Another problem with this is the charge, made by Singer, of speciesism (referenced above). Fundamentally, the objection is that it seems problematic as humans to claim our humanness as the qualifier to attain full moral status. It is common for people hold that animals have some rights and those rights are defined by the nature of our obligations which are based on some level of moral status. Thus, the sanctity of human life as a uni-criterial principle is not a sufficient ground for establishing either partial or full moral status.

In Schweitzers view any actions that harm living things are wrong. Warren recognizes the value in this notion and converts the Sanctity of Life principle to her first of seven principles which she calls Respect for Life. Life is a sufficient condition for some moral status, but is not a sufficient condition for full moral status. Thus, all living entities are given some moral status, but not full moral status. This principle treats all harms done to living things as undesirable, other things being equal, and imputes no wrongdoing to those who harm living things when there are morally sound reasons for doing so. However, Warren recognizes, as do some Sanctity of Life proponents, that no right is absolute and that the right to life can be overridden with sufficient justification. This notion re-iterates problem with the uni-criterial Sanctity of Life position in that such justifications (i.e., when to override a right to life) cannot be determined solely on the attribution of life, since all life is valued equally. Such determinations, Warren claims, can only be achieved within the context of the full compliment of the multi-criterial principles.

Next, Warren analyzes the principle of sentience as a uni-criterial approach to moral status. To do this, Warren launches an attack on one of her own mentors, Peter Singer, himself a preference utilitarian. Singers ethics rely upon the sole criterion of sentience for gaining full moral status. However, Warren effectively demonstrates how this notion of sentience is unacceptable as the singular criterion in the establishment of moral status. Of the four objections to this approach that Warren explicates, the most compelling to me is what she calls the Human Rights Objection. Fundamentally, this objection is that the sentience view on moral status provides no basis for ascribing strong moral rights to individual human beings, or even animals. The charge, says Warren, is that utilitarianism regards individual beings as mere receptacles for utility; if a greater quantity of utility can be produced by sacrificing some individuals for the benefit of others, then there is no utilitarian objection to doing this. However, rights are considered by many to override utilitarian considerations. Warren quotes Ronald Dworkin, If someone has the right to something, then it is wrong?to deny him even though it would be in the general interest to do so. Singer doubts that this is a problem for his preference satisfying notion of utilitarianism. He contends that, ?the only right his theory attributes to (humans and) animals is the right to equal consideration of comparable interests.

Warren converts Singers principle of sentience into the second of her interrelated concepts and calls it the Anti-Cruelty Principle. Sentience becomes sufficient for some moral status, but not sufficient for full moral status. She states that, Sentient beings are not to be killed or subjected to pain or suffering, unless there is no other feasible way of furthering goals that are consistent (with all the other principles) and important to human beings or other entities that have a stronger moral status than can be based on sentience alone. This principle supports our instinctive capacity for empathy. If we view our own pain as objectively bad, then logical consistency requires that we apply this principle to others.

Personhood is the third uni-criterial, intrinsic principle debunked by Warren. She makes the distinction between, (1) the maximalist definitions of personhood which makes moral agency(or at least potential for it) a necessary condition for being a person; and (2) the minimalist definitions which do not require moral agency, but only some capacity for thought and self-awareness. Kants view of personhood is that of the maximalist. The obvious objection to this is that we have already established that the mere existence of sentience makes one worthy of some moral status. Even John Rawls, who attempts to defend Kants maximalist definition, rejects personhood as a necessary condition for having moral rights and holds only that it is sufficient. Kants notion of personhood restricts the moral community to eliminate sentient beings without moral agency; an action many animal rights and disability rights activists are sure question. Warren, however, rescues the principle of personhood with her third and fourth principles: the Agents Rights Principle and the Human Rights Principle. The former holds that moral agents have full and equal basic moral rights, including the rights to life and liberty. The latter holds that within the limits of their own capacities, human beings who are capable of sentience but not of moral agency have the same moral rights as do moral agents.

I believe these last moves by Warren offer a methodology with which a utilitarian framework can be created. Since I take utilitarianism to be a most understandable, practical, and defensible position, I encountered Warrens work with great pleasure. The greatest objection I have always had towards utilitarianism has been its inability to account for human rights. But how, you may ask, can a utilitarian model account for moral rights such as liberty, justice, and equality when practical necessity dictates otherwise or the expected gain in the greatest happiness is sacrificed? Warrens answer is that this is done based on a utilitarian argument that the Agents Rights principle has long-term social value and good. Thus, there are utilitarian reasons for adopting a non-classical utilitarian principle.

It must be remembered that moral rights are not absolute in that they may be overridden at times. Take self-defense or war as examples. We may adamantly support a reverence for life, but allow an action which causes the death of another. Most holders of the Sanctity of Life principle will hold that killing an intruder to save ones husband, daughter, or ones self is somehow morally permissible. Whatever the justification is, it is still a justification to override the principle. Likewise, I have rarely heard the right to life contingent standing up against military involvement to end such atrocities as ethnic cleansing. Interestingly, proponents of reverence for life (or Sanctity of Life) as a uni-criterial principle, are resistant to the generalizing of these applications to a formal theory. Thankfully, Warren is not so resistant. She says the key is that, the precise content of any moral right can only be delineated through discussion and deliberation, in which all legitimate interests receive equitable consideration.

Building upon her theory, Warren borrows from such figures as the environmental ethicist, J. Baird Callicott and feminist ethicist, Nel Noddings, to introduce two relational rather than intrinsic properties: (1) membership within the social or biotic community, and (2) emotional connectedness. Warren then captures these two relational properties which she believes are important to moral status in her three remaining principles.

5. The Ecological Principle: Living things that are not moral agents, but that are important to the ecosystems of which they are a part have?a stronger moral status than could be based upon their intrinsic properties alone(e.g., species and habitats).

6. The Interspecific Principle: ?non-human members of mixed social communities have a stronger moral status than could be based upon their intrinsic properties alone.

7. The Transitivity of Respect Principle: ?to the extent that it is feasible and morally permissible, moral agents should respect one anothers attributions of moral status.

She notes that none of these relational principles can diminish the moral status gained through the employment of any of the preceding, intrinsic principles, but that they can enhance moral status. She holds that neither of these two relational properties represent a necessary and sufficient basis for moral status, but that the theories which value these properties contain insights that need to be incorporated into an adequate account of moral status. This adequate account, therefore, will be multi-criterial.

MULTI-CRITERIAL APPLICATION

In the application of this multi-criterial approach to moral status, Warren cautions us that the first four principles represent only moral floors, not ceilings on moral status. Furthermore, a complete and accurate understanding of moral status cannot be gained until a complete review of all the interrelated principles are balanced against one another and the practical implications of each are considered. In applying this model to our topic of ES cell research and the proposed destruction of early embryos (this is the name I will use for embryos prior to the fourteenth day after conception), a full accounting of each of Warrens principles is enlightening and empowering.

Clearly early embryos are endowed with life and, therefore, deserve respect and some level of moral status. Nevertheless, these early embryos do not have either the capacity for sentience or moral agency. So they cannot be considered to have full moral status. The failure by many in this debate, including Singer, is the failure to ascribe some moral status or moral value to the early embryo. Even if the early embryo does not have full moral status, it certainly should have some moral status based on its attribute of being alive. This status, however, is not for itself in the Kantian sense, nor merely for instrumental value, but for the intrinsic value of the abstract notion of life. John Robertson calls this value the symbolic value of life. This missing distinction, Robertson says, between the intrinsic and the symbolic valuation of the embryo is at the heart of the debate over abortion and embryo research. While Steinbock calls this missing distinction one between moral status and moral value, Warren has done justice to both perspectives and perhaps has employed a more broadly appealing language.

The Respect for Life principle calls us to value and sustain all life, other things being equal. However, in the case of ES cell research and its potential therapeutic applications, other things are not equal. The symbolic cost associated to allowing the destruction of human embryos in ES cell research is primarily the undesirable capacity to diffuse or obscure the value we hold in this intrinsic property of life. The intrinsic costs associated to not allowing the destruction of early embryos in ES cell research at minimum are that millions of persons with full moral status will die and even more will suffer significant physical and psychological pain. This expansive claim can be made because o other means currently exists, or will exist, in the foreseeable future which can alleviate the suffering and death that ES cell therapies have the proven capacity to do. Thus, the benefits of ES cell research far outweigh the symbolic costs incurred from the destruction of life that is without full moral status. The key here is that this symbolic value and the interests of those with this lower moral status should not take precedence over the interests of those with full moral status, i.e., those gaining higher levels of moral status based on the principles of Anti-Cruelty and Agents Rights or Human Rights.

Within the Interspecific Principle, embryos may gain a higher level of moral status based on their social relationship to human beings, but only if such relationships exist. If research embryos are created through IVF or somatic cell nuclear transfer (SCNT) techniques using donated gametes or cells, then such relationships would not exist. Thus, the basis for creation of research embryos for use in ES cell research is established. For embryos with such social relationships, their enhanced status cannot override the interests of parents who can claim full moral status. Yet the questions of how to show the proper respect to specific embryos should be addressed. If parents or donors take offense at such destruction based on the symbolic value of life, it would be morally objectionable to force such destruction. By observing the Transitivity of Respect principle in this manner we do not lose the opportunity for ES cell research. One reason is that since other embryos will be available for use in ES cell research, the potential benefits of ES cell therapies are not necessarily foregone. Therefore, ES cell research may continue even though the symbolic value of life in some embryos will be protected by allowing for the respectful disposal of such embryos. Thus, the Interspecific Principle may, but does not always, enhance the embryos moral status to a point where it is morally objectionable to destroy the embryo.

Within the Transitivity of Respect Principle, policy makers and philosophers alike should take into consideration the religious and traditionally held viewpoints of others towards these early embryos, but only where it is feasible or morally permissible to do so. In this case, I argue that it is morally impermissible to forgo the potential benefits to hundreds of millions of sentient, moral agents to whom we are obligated to seek the relief of pain and suffering. The relative costs and benefits of such decisions were briefly outlined above. However, one may ask, based on the Transitivity of Respect Principle, why it is not feasible to not take certain actions supporting ES cell research. I believe there are numerous valid responses.

First, we must recognizing that since ES cell research is not illegal in this country, it will continue in the private sector without significant legal or moral consequence. Thus, from a practical perspective, reaching common ground on embryonic moral status is a central component to answering the question of whether to allow federal funding for ES cell research. The lack of such federal funds will (1) slow research advances by keeping universities and key research teams out of the process, (2) eliminate government (NIH) oversight which would provide regulation and monitoring ensuring that embryos, donors, and patients are given the respect they deserve, and (3) will slow the development of many clinical applications since private companies will only pursue those activities or products which will quickly produce products and profits. If we were to either allow the private sector to conduct this research without the support of federal funding or to wait for the unlikely development of some other less objectionable means to cure such diseases such as Parkinsons, diabetes, and Alzheimers, millions more people will experience much more death and suffering than if we were to allow federal funding. Thus, accepting the application of the other multi-criterial principles as articulated above, this faster road to cure is necessarily more ethical based on our ability (1) to alleviate the death and suffering of more persons and (2) to more adequately protect the interests of those with full moral status.

SOME LIKELY OBJECTIONS

Instrumental Use: Opponents of ES cell research (and particularly opponents of the creation of embryos for this research) who take a deontological position, will likely suggest that it is wrong to use embryos as a mere means to our ends rather than as ends in themselves. The argument claims that since in destroying the embryo we are using this life or this human being as a means towards some others end, then it is wrong to destroy the embryo. The response by advocates of ES cell research is that the embryo is not a sentient, rational, autonomous, or moral agent so it does not have full moral status, and, thus, cannot be considered as being used. In other words, it is impossible to instrumentalize (i.e., being inappropriately used as a means to anothers end) something which does not have full moral status. For example, using the multi-criterial approach, bricks may be used to build a house or a horse used to plow a field, but neither the bricks or the horse are instrumentalized. Likewise, using the full application of the multi-criterial principles, early embryos may be used to advance ES cell research, but the early embryos are not instrumentalized.

Potentiality: The Kantian objector, though, may seek some common ground and respond that it is the potential or viability of the embryo which must be respected. While I do not have sufficient space to address this concern completely, I will briefly mention a few responses. If we accept this potentiality distinction, we will have returned to the ill-fated debate of the evolving biological standards of potential which can be taken to extremes. For instance, is the oocyte a potential person warranting full moral status? If so, then we must do everything we can to ensure its fertilization, development, and birth. In fact, any missed opportunity to have sexual relations is a wrongful act since, in the eyes of the Kantian objector, we are not honoring our highest value of life. So at what point is a potential person established? Maintaining my earlier position, I suggest that this is a normative decision aided by science and such decision could be some point around 14 days from conception. More to the point, if the IVF embryo is a potential person, then it is morally impermissible to discard unwanted or unneeded IVF embryos. Enactment of such a requirement to bring to fruition all IVF embryos is not only impractical and implausible, but, I suspect, would not be supported by even the staunchest Kantian objectors.

Inherent disrespect to life / Slippery Slope: This objection is simply that once we start down the path of the creation of life only to destroy it for others purposes or benefits, then we will never be able to set an end to the dangers imposed on our right to life. It is suggested here that since the proponents of ES cell research justify early embryo destruction and disregard the embryos inherent moral status, the inevitable result will be diminished respect for persons generally. What follows, for this objector, is that such justification of early embryo destruction will result in a rationale which could justify harmful experiments on other human subjects. While some slippery slope arguments I suspect are valid due to the logical nature of the move from one situation to another, the current argument is clearly more psychological in nature. It is an argument essentially that in taking current actions our emotions and moral sensibilities will become desensitized to the wrongfulness of certain future and unforeseen actions which are clearly wrong. The practical answer to such psychological slippery slope arguments is cooperative deliberation geared towards establishing legislative boundaries against those future, feared actions. However, the most forceful response to the slippery slope objector is that no such justification for the harming or destroying of human subjects can occur within the application of the full compliment of the multi-criterial principles. The Agents Rights and Human Rights principles will protect the human subjects with which the objector is concerned. Such human subjects have full moral status which cannot be diminished. Therefore, any harm to a human subject which may be justified will require an entirely different rationale than was used for the destruction of the early embryo. Such justification will have to meet a much higher standard and does not follow logically or psychologically from the decision to conduct ES cell research. Thus, the slippery slope objectors concern seems to be unwarranted in this instance. Nevertheless, the objector may still contend that I have not answered the question of specifically how to balance all of the interests and rights of those concerned. However, as I suggested above, no theory of moral status will give such answers outside of the context of the specific situation. The nature of the common ground I am seeking is one upon which we can collectively engage in such deliberations and the multi-criterial approach offers just such a ground. Thus, shortly I will offer some initial recommendations meant to be used as a start to our dialogue on how to balance interests and show respect.

Means Matter: While the common ground provided by a multi-criterial account of moral status may have helped us get to the point of gaining a reasonable consensus as to the use of some embryos in ES cell research, some objectors may still be uncomfortable with the creation of embryos either by IVF or somactic cell (SCNT) techniques. The objection is that the means of obtaining the embryos matters. Notwithstanding the fact that the promotion of creating embryos for research purposes (i.e., therapeutic cloning) is not a new idea nor has it even usually met with condemnation from review boards, the reasons for allowing such techniques should be articulated. One reason for allowing therapeutic human cloning is the issue of histocompatibility. The problem is that stem cells from donors may lack immunological compatibility with the recipients. Thus, a practical way around such difficulties is to clone the recipients own DNA, culture the resulting stem cells, and obtain completely compatible tissue for transplantation. Turning to therapeutic chimera cloning (see Appendix for definition), there is an underlying objection and intuitive objection to hybrid embryo creation based on the concern for mixing genes across species and the uncertainty of risks involved. One reason to allow such means as therapeutic chimera cloning is the reduction of potentially coercive forces on women to donate gametes. Since obtaining oocytes from women is a difficult and somewhat painful procedure, the availability of these gametes will relieve any potential feelings of pressure by women to donate their eggs. On a more practical note, Advanced Cell Technologies work has shown that the use of cow ova results in only a minimal and inconsequential DNA mixing. Using the nuclear DNA from a human and the mitochondrial DNA from the cow results in less than one millionth of the DNA of the resultant hybrid embryo being bovine. Such presence is of no consquence in the acquisition of the stem cells which will, in fact, have no bovine DNA. Furthermore, the use of animal proteins to create drugs such as insulin and the use of animal genes or cells to create transplantable organs or tissue (e.g., man in Albany, New York injected with fetal pig cells to repair spinal cord as reported in Associated Press on April 24, 2001) are widely accepted practices. It is hard to see a significant difference from these practices when compared to the creation of hybrid embryos for the derivation of human stem cells.

INDICATIONS OF COMMON GROUND

While there are those on the anti-abortion front who oppose any embryo destruction for any purposes, there are many other anti-abortion activists who hold that it is ethical to destroy the embryo or fetus under certain circumstances. Examples include when the life of the mother is at stake or the conception of the fetus is a result of rape or incest. Clearly, here, there are other ideals which are highly valued which trump the right to life of the fetus. In these examples, moral deliberations are over rights to life for mothers as well as the dignity and respect of women. Holding dear either of these values does not logically entail the diminishment of the embryos or fetus moral status, but it does reflect a willingness to balance whatever status it does have against other competing values. This would represent a recognition that the embryos right to life, if it exists, is not absolute. If the majority of those engaged in this moral deliberation can agree on this point, then the foundations of the common ground I am seeking have already been laid.

DEMONSTRATING RESPECT

If we can agree that the embryo does not hold exactly the same moral status as an adult human, but that the embryo has some status and deserves respect, then the question is what actions and restrictions will most effectively demonstrate sufficient respect for human embryos. No ethical system will give us the answer to this question. The obligations of moral duty cannot pinpoint the specifics that are needed here nor can a strict utilitarian calculus do the work. The answers will only come from collaborative deliberation seeking to balance reasonable and supportable views. The reference points for these answers will be diverse and include personal preferences, religious perspectives, emotional paradigms (e.g., the level of passion one holds for the symbolic value of embryos), and medical beliefs (e.g., how beneficial and/or necessary this stem cell research will be). Some will want more respect for embryos, others will want less. Our goal is to find a common enough ground which the majority of us can accept.

HOW TO SHOW RESPECT

My recommendations for ways to demonstrate appropriate respect for the embryo based on its moral status are as follows:

Place a limit on the time frame in which destruction of embryos for research purposes is allowed. I suggest 14 days after conception which is before the primitive streak begins developing and, thus, well before any possibility of sentience begins. This is also the point which is believed to be the last opportunity for twinning and, thus, before distinct individuation.

Place limits on the type of research allowed to include only such work that can show substantial benefit to the health of others and that can claim that human embryos are essential to the research.

Ensure informed consent for donors whether of gametes, frozen embryos, or fetal tissue. This regulation reflects the concern for individual autonomy and concern for the emotional well-being of those persons involved.

Ensure the decisions to abort fetuses or discard IVF embryos is separate and distinct from decision to donate to ES cell research. This policy reflects a shared goal to ensure that abortion or destruction will not be increased solely as a result of the opportunity to do some good with the donation of fetal tissue or IVF embryos. It aims at not legitimizing the acts solely through such subsequent actions. Any decision to abort a viable fetus should be neither induced or coerced by the possibility of benefit in donation.

Require the review by a national oversight body of research protocols whether the research is publicly or privately funded. This body should also be given the flexibility to adapt to future findings so as to avoid the bureaucratic delays that come in constantly refining legislation through the Congress.

Disallow the commercialization of spare IVF embryos, fetal tissue, or created embryos. This action will not only protect the status of our respect for life in general, but it will, importantly, guard against the exploitation of poor women who see donation of ova, embryos, or fetal tissue as a means to financial reward.

Prohibition of donation of fetal tissue to a specified recipient while allowing the donation of IVF embryos to a specified recipient. Such a measure further demonstrates the enhanced moral status of the developing fetus to that of the pre-14 day old embryo.

Clearly, both the Respect for Life and Transitivity of Respect Principles can further be heeded by assuring objectors that cloning of either human or hybrid embryos will not be used for reproductive cloning (bringing the embryo to personhood), but only for therapeutic cloning.

CONCLUSION

A clear and common understanding of the language we use and of our attributions of moral status will be of the highest importance to the success of our search for a common ground in this ES cell research debate. While I believe the moral imperative of compassion drives ES cell research, there are multiple values and goals which I recommend we appeal to in our deliberations. Mary Anne Warrens multi-criterial approach enables us, through common-sense justifications, to embrace and honor these various and important values. If it is true that ES cell therapies have the potential to alleviate ill-health and to protect the lives of more than half of the worlds populationwhile not wrongfully impinging upon the interests or rights of others, then it is our duty to pursue this research in a vigorous, yet disciplined, manner. To unnecessarily prevent or delay such a valuable line of research is to act unethically.

ENDNOTES

Wright, Shirley J., Human Embryonic Stem-Cell Research: Science and Ethics, American Scientist, Vol. 87, July-August, 1999, pg. 352

For those unfamiliar with the terms and nature of this field, a Stem Cell Primer is placed in the Appendix I

As an example, note General Counsel to the NIH, Harriet Raabs, decision to circumvent the current legislative ban on embryo research (See Timeline in Appendix II). Even the NBAC suggests that the derivation and use of embryonic stem cells are not distinct ethical activities.

NBAC, Ethical Issues in Stem Cell Research, Executive Summary, September, 1999, http://www.bioethics.gov

Wildes, Kevin WM, S.J., The Stem Cell Report, America, Vol. 181, Issue 11, October 16, 1999, pg. 12

Rawls, John, Political Liberalism (New York: Columbia University Press, 1993), pg. 197

Generally, these arguments attempt to establish the ethical permissibility of such measures based on the lack of complicity in the destruction of the fetus or embryo. See: Robertson, John, Ethics and Policy in Embryonic Stem Cell Research, Journal of the Kennedy Institute of Ethics, June, 1999, pg. 112-116. While John Robertson makes sound arguments for the weakness of this complicity in the destruction of embryos when using fetal tissue or spare IVF embryos, the fundamental question remains as to the moral status of the embryo.

NBAC, Ethical Issues in Stem Cell Research, Executive Summary, May, 1999, Draft Report, Chapter 5, Pg. 6

I will not address in the issue of adult stem cells and cord blood stem cells as alternatives to ES cells. The reason is that these sources have not been shown to offer commensurate potentiality with ES cells. Nevertheless, there are still scientists working with adult stem cells who are reporting a greater ability for the cells to differentiate than was once thought possible. (See: Lewis, Ricki, Human Mesenchymal Stem Cells Differentiate in the Lab, The Scientist Vol. 13, No. 8, April 12, 1999.) Adult stem cells have demonstrated the ability to become several cell types. Though some scientists have predicted that the need for fetal cells as a source of stem cells for medical research may soon be eclipsed by the more readily available and less controversial adult stem cells, (See: Josephson, Deborah, Adult Stem Cells may be Redefinable, British Medical Journal 1999, 318:282) opponents of ES cell research cling to and overextend such claims by suggesting that there is no practical need to continue research with the ethically more questionable sources. Unfortunately, there is no scientific agreement on the potential of adult stem cells and most evidence suggests that diverse clinical applications using adult stem cells will not only take much longer to develop, but are also much less likely to ever occur at all. Even the NBAC, after extensive testimony from scientists, has concluded that adult stem cells represent an approach that will be scientifically and technically limited, and in some cases, the anatomic source of the cells might preclude easy or safe access. (See: NBAC, Ethical Issues in Human Stem Cell Research, May, 1999, Draft Report, Chapter 5, pg. 5.) The bottom line is that it is too early to make any definitive claims on this issue.

Congressional Testimony, Committee on Appropriations, Stem Cell Research, April 26, 2000, FDCH Congressional Testimony, Richard Salzman, Item No. 131243019310 from eMediaWorks, Inc.

Here, I am leaving aside the argument from potential, i.e., that the embryo has the potential for preferences and interests and so should be considered to have them in fact. There is not sufficient room in this paper to fully address this objection, though I will return to it briefly near the conclusion.

Warren, Mary Anne, Moral Status: Obligations to Persons and Other Living Things (Clarendon Press Oxford, 1997)

Vick, Hannah, Embryonic Stem Cell Research: Ethically Wrong Treatment of the Tiniest of Humans, Concerned Women for America, May, 2000, http://www.cwfa.org/library/life/2000-05_pp_stem-cell.shtml, pg. 3

Singer, Peter and Kuhse, Helga, Individuals, humans and persons: The Issue of Moral Status, Embryo Experimentation, Legal Ethical and Social Issues (Cambridge University Press, 1993) pg. 69

Preference utilitarianism is a modification on classical utilitarianism which attempts to answer the objection that utilitarianism that attainment of pleasure and freedom from pain are the only things that people value. Preference utilitarians define utility as the satisfaction of individual preferences. Further, Singer claims that all valid moral claims can be derived from a single principle; the principle of equal consideration of comparable interests of all sentient beings. See Warren pg. 65

Moral agents are defined by Rawls as, Rational beings with their own ends, capable of a sense of justice. See A Theory of Justice. (Cambridge, Mass.: Harvard University Press, 1971)

Robertson, John, Ethics and Policy in Embryonic Stem Cell Research, Journal of the Kennedy Institute of Ethics, June, 1999, pg. 117

The US Ethics Advisory Board (1973), The British Human Fertilization Authority (1993), the Canadian Royal Commision on New Reproductive Technology (1993), the World Health Organization (1995), and the Austrailian Academy of Science (1997), the Clinton Administration (1998), and the British Parliament (2001) have all approved therapeutic cloning of embryos for research. (Some references from Erik Parens commisioned paper for the NBAC, What has the President asked of the NBAC? On the Ethics and Politics of Embryonic Stem Cell Research. 05/03/99, pg. 12)

Congressional Testimony, Committee on Appropriations, Stem Cell Research, December 2, 1998, S. Hrg. 105-939, pg. 22

These recommendations are the result of my reflections on recommendations made by various review boards and committees, including the NBAC, coupled with the multi-criterial account of the embryos moral status.

McGee, Glenn and Caplan, Arthur, The Ethics of Politics and Small Sacrifices in Stem Cell Research, Kennedy Institute of Ethics Journal, June, 1999, pg. 153

Appendix I

STEM CELL PRIMER

Go here to see the original:
Stem-Cells | The Institute for Applied & Professional Ethics

UH Cleveland Medical Centers Stem Cell Transplant Program has received international recognition by the Foundation for the Accreditation of Cellular Therapy (FACT). Learn more.

University Hospitals Stem Cell Transplant Program offers excellence in cancer treatment for pediatric and adult patients. Located at UH Seidman Cancer Center in Cleveland, Ohio, the Stem Cell Transplant Program provides the latest innovations with superior outcomes for patients with leukemia, lymphoma and other hematologic (blood) types of cancer.

Experts in the Stem Cell Transplant Program provide specialized treatments, aiming to find the best therapy for each patient.

Our comprehensive program offers cord blood, blood, and marrow transplants for a range of hematologic cancers and other disorders using either the patients own stem cells or those donated by a family member or unrelated volunteer.

At UH Seidman Cancer Center, we take pride in offering a comprehensive approach to cancer treatment. Patients who seek care have access to a multidisciplinary team that includes:

After meeting with the patient, our experts develop a highly unique treatment plan based on each individuals specific needs and preferences. Transplant patients are evaluated and cared for by a team whose objective is to increase coordination of care and improve outcomes. Our team also works closely with the Blood and Bone Marrow Transplant Centerat University Hospitals Rainbow Babies & Childrens Hospital to treat children with hematologic cancers and other blood disorders.

As an affiliate of the National Marrow Donor Program, our bone marrow transplant program is among the most accomplished and respected nationwide. Some of the UH Stem Cell Transplant Programs accomplishments include the following:

Other accomplishments in the field of stem cell therapy include:

In addition, we are aggressively pursuing innovative treatment developments through stem cell therapy clinical trials combining chemotherapy, radiation therapy, biological therapy and stem cell transplantation.

Read this article:
Stem Cell Transplant Program - Cleveland, Ohio

Summary: Investigators in Ohio are recruiting 24 people with relapsing forms of MS for a study of the safety and tolerability of transplanting ones own mesenchymal stem cells (derived from bone marrow). The study is being conducted at Cleveland Clinic Mellen MS Center, University Hospitals Case Medical Center, and the National Center for Stem Cell and Regenerative Medicine, all in Cleveland. This first trial of these cells for MS in the U.S. is supported by the Congressionally Directed Medical Research Programs, a program funded through the Defense Department, thanks in large part to the tireless work of MS activists across the country who helped to secure the funding. Please note: This study involves numerous visits to the study site.

Rationale: There are many types of stem cells, and varying degrees of research and knowledge about different types of stem cells and their potential usefulness for treating MS. At present, there has been no proven therapy for MS that uses stem cells. Read moreabout stem cells in MS.

One type of procedure that has been explored for several years in MS is called autologous hematopoietic (blood cell-producing) stem cell transplantation. This procedure has been used in attempts to reboot the immune system. These stem cells (derived from the bone marrow or blood) are stored, and the rest of the individuals immune cells are destroyed by chemotherapy or radiation or both. Then the stored stem cells are reintroduced by injection. Eventually they grow and repopulate the body with immune cells. The hope of that as yet experimental procedure is that the new immune cells will no longer attack myelin or other brain tissue, so that the person has perhaps a completely new immune system.

Another line of stem cell research in MS relates to efforts to repair nervous system damage. This research is in its infancy, and there is no evidence yet that any types of stem cells can reverse MS damage or restore function. There are a few known research studies being conducted by researchers who are attempting in a controlled fashion to safely test the ability of mesenchymal stem cells to treat MS damage.

Mesenchymal stem cells, which are present in many tissues of the body, potentially have the ability both to treat immune disorders and promote tissue repair. This phase I clinical trial in Cleveland is testing the ability of an individuals own mesenchymal stem cells isolated from the bone marrow to both inhibit immune mechanisms and to augment intrinsic tissue repair processes in people with relapsing forms of MS. Unlike previous bone marrow transplant studies, in this study the persons immune cells are not destroyed before the stem cells are infused. This study is supported by the Congressionally Directed Medical Research Programs, a program funded through the Defense Department, thanks in large part to the tireless work of MS activists across the country who helped to secure the funding.

Eligibility and Details: Participants should be ages 18 to 55, and have a diagnosis of relapsing MS, with active disease during the previous 24 months. This study involves numerous criteria for including or excluding participants. Further details can be obtained from http://clinicaltrials.gov (search for study# NCT00813969) or the contacts below.

The treatment involves a single intravenous infusion of mesenchymal stem cells that have been previously removed from the participants bone marrow and expanded in the laboratory. The study involves several safety assessments, blood tests, neurologic assessments, MRI scans and others tests over six months.

The primary goal of the study is to determine the feasibility, safety and tolerability of the procedure. Secondary goals include assessing the effects on MS disease activity and severity, as measured by clinical, MRI, and other testing.

Contact: To learn more about the enrollment criteria for this study, and to find out if you are eligible to participate, please contact:

Sarah Planchon Pope, PhD Program Manager planchs@ccf.org 216-636-1232

OR

Cynthia Schwanger, RN, MSCN, CCRP Research Nurse schwanc@ccf.org 216-445-5788

Download a brochure that discusses issues to think about when considering enrolling in an MS clinical trial (PDF).

Multiple sclerosis is an unpredictable, often disabling disease of the central nervous system that disrupts the flow of information within the brain, and between the brain and body. Symptoms range from numbness and tingling to blindness and paralysis. The progress, severity and specific symptoms of MS in any one person cannot yet be predicted, but advances in research and treatment are leading to better understanding and moving us closer to a world free of MS. Most people with MS are diagnosed between the ages of 20 and 50, with at least two to three times more women than men being diagnosed with the disease. MS affects more than 2.3 million people worldwide.

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Update: Ohio Stem Cell Study Recruiting People with MS ...

Exploradio: Cleveland's growing stem cell scene

The next breakthrough in medicine could come from a small group of entrepreneurs in Northeast Ohio. Stem cell research has a long-history in Cleveland, but the region is having a hard time building a biotech industry around it.

In this week's Exploradio, WKSU's Jeff St.Clair looks at the science and business of stem cell therapy. Read more

Case Western Reserve University Hosts Cancer Stem Cell Conference

All this week, researchers from across the world are gathering in Cleveland to attend Case Western Reserve University's cancer stem cell conference. For Ohio Public Radio, WCPN's Anne Glausser brings us an update on this field of science and how it is informing new cancer therapies.

"[Cancer stem cells] are the drivers," Gerson says. "They're the fundamental reason that we can't cure cancer today and why new treatments that are designed to first get rid of the bulk of the tumor and then immediately come back and go after the cancer stem cell are so important." Read more

NCRM Instrument Featured in Nature Biotechnology Article

A photograph of the "X-Evo Instrument" at the NCRM's OH-Alive Platform for robotic media preparation and automated cell culture. was featured the August 2014 issue of Nature Biotechnology article. The article discusses what governmental agencies can do to lower the risk of cell therapies and the enterprises commercializing them. Read More

Stem Cells Hold Keys to Body's Plan

Case Western Reserve researchers have discovered landmarks within pluripotent stem cells that guide how they develop to serve different purposes within the body. This breakthrough offers promise that scientists eventually will be able to direct stem cells in ways that prevent disease or repair damage from injury or illness. The study and its results appear in the June 5 edition of the journal Cell Stem Cell. Read more

NCRM Receives Ohio Third Frontier Grant for Therapeutic Cell Center

The Ohio Third Frontier Commission unanimously awarded Case Western Reserve University National Center for Regenerative Medicine (NCRM), $2.4 million for its OH-Alive Innovator Platform: A Process and Manufacturing Platform for Cell Therapy. These funds must be matched by NCRM and its collaborators so this represents a total investment of $4.8 million. The OH-Alive platform will help advance Ohio as one of the leading regions for stem cell therapy in the country by establishing a facility that will provide expertise in determining optimized conditions for producing stem cells for therapeutic purposes. Read more

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National Center For Regenerative Medicine

By working in the industry as a research and laboratory assistant, Alex Potoczak of Ohio talks about umbilical stem cell research, cord blood and it's benefits.

Alex was credited with some publications including an abstract submitted to the American Society of Hematology based on his research into cancerous T-All cell lines. Alex Potoczak Ohio has a deep rooted interest in stem cell research and has devoted much of his collegiate and post-grad career to researching cures and cord blood. He worked closely with laboratories and medical records systems at North Coast Obstetrics and Gynecology. Cord blood is a sample of blood taken from a newborn baby's umbilical cord. It is a rich source of stem cells, which are hematopoietic, meaning they are precursors to blood cells. Stem Cell Research has been used to treat certain diseases of the blood and immune system. Diseases of red blood cells are inherited diseases, the immune system, and certain metabolic abnormalities. Patients with lymphoma, myelodysplasia, and severe aplastic anemia have also been successfully transplanted with cord blood. The way Cord blood is collected is by removing it from the umbilical cord vein attached to the placenta after the umbilical cord has been detached from the newborn. Cord blood and its stem cells use its hematopoietic qualities to help with genetic disorders. One unit of cord blood lacks stem cells in a quantity sufficient to treat an adult patient. The placenta is a much better source of stem cells since it contains up to ten times more than cord blood. Alex Potoczak of Ohio is an experienced graduate level laboratory researcher with an emphasis on umbilical cord stem cell research. He has worked at Case Western University and University Hospitals of Cleveland under the supervision of Dr. Mary Laughlin and Dr. Nick Greco. Also, Alex played baseball at Hamilton College where he is majoring in Economics and minored in Biology. He scored a 790 on his SAT II scores in Biology and Math, which highlights his high intelligence and creative thinking. He also received PSAT National Merit accolades as a semifinalist. Alex has unique hobbies and interests, such as Oceanography and how it relates to alternative energy. In his free time Alex organized and coordinates fundraisers at Hamilton College for the Jimmy V Foundation, Medical Ministry International, College Relay for Life and local student government. He is also very passionate about the legal system, technology, sports, philanthropy, and politics. He is a member of Hamilton College's Colleges Against Cancer, Hamilton College Republicans and Hamilton College chapter of Delta Chi Fraternity. For more details visit at: - https://alexpotoczakohio.wordpress.com/

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Alex Potoczak of Ohio Praises Umbilical Stem Cell Research ...

Dr. Mark A. Foglietti (pronouned 'Fuhl-yetti) was born Steubenville, Ohio and raised in Mingo Junction, Ohio. He attended Ohio State University in Columbus, Ohio where he received his Bachelors of Science Degree and completed one year of post-graduate work in microbiology and virology. He then went to Medical School at Ohio University, where he currently serves as a Clinical Professor in Plastic and Reconstructive Surgery. The Ohio University College of Osteopathic Medicine is nationally recognized as one of the top physician training programs in the country.

Dr. Foglietti returned to the Columbus area to fulfill a one-year rotating internship at Doctor's Hospital where he stayed to finish his training in general surgery. As a general surgery resident, he was accepted into the plastic surgery residency at The Plastic Surgery Institute of Des Moines Iowa, under the direction of the internationally acclaimed plastic surgeon Dr. James O. Stallings, M.D. During his time in Iowa, Dr. Foglietti served as a resident and as the Chief Resident of the program. To further enhance his plastic and reconstructive surgery knowledge, he completed an additional fellowship in cosmetic surgery and reconstructive surgery of the breast, in Cleveland Ohio under the direction of Dr. Melvyn I. Dinner and Dr. J. Sheldon Artz.

With 17 years of higher education, medical, and surgical training behind him, Dr. Foglietti started his career by joining Drs. Dinner and Artz at The Center for Plastic Surgery. He soon became board certified in both plastic and reconstructive surgery and in general surgery, later co-founding the Woodlands Center for Plastic Surgery, located in Sagamore Hills, Ohio.

Dr. Foglietti founded the Cosmetic Surgery Institute in Beachwood, Ohio in 2000. He established himself as an educator and leader in his field both locally and nationally. He is a member of The American Osteopathic Association, The American Medical Association and their respective local organizations. He is a past president and board member of the Cleveland Academy of Osteopathic Medicine, and serves nationally on the Board of Governors for The American College of Osteopathic Surgeons. As a Fellow of the A.C.O.S., he is also a past President of the Plastic and Reconstructive Surgery Discipline, and serves nationally as a board examiner. Dr. Foglietti was the Chief of staff, and Chief of Plastic Surgery at Mt. Sinai Medical Center East. He is also Director of the plastic and reconstructive surgery residency at the Cleveland Clinic Health System Hospital, Meridia Southpointe.

For over a decade, Dr. Foglietti has published numerous papers in a variety of internationally recognized medical and scientific journals. Keeping up to date on all of the latest surgical techniques, and newest technology, Dr. Foglietti has been given significant local and national television exposure, (ABC, CBS, NBC, FOX, CNN, and The Discovery Channel) for bringing new advancements to the Cleveland medical market. He has also been recognized for his advanced treatment of burn victims internationally and for his assistance in the treatment of the Afghanistan Freedom Fighters, for which he received an award from Washington D.C. in 1988.

Dr. Foglietti has been featured in Cleveland magazine, Northern Ohio Live, The Plain Dealer, The Canton Repository, as well as a number of other newspapers for his improvements in plastic and reconstructive surgery. As an inventor, Dr. Foglietti holds three U.S. Patents on improved breast implants for surgical use. He strives to remain on the cutting edge of medicine to serve his patients in the most up-to-date, personalized, and holistic manner possible. Dr. Foglietti has also recently received a registered trademark for the Foglietti Natural Vector Facelift Technique from the US Patent and Trademark Office in Washington DC in November 09.

Dr. Foglietti has been recognized for treatment of the Haiti earthquake victims for a medical mission in February 2010. He has also completed medical missions to Columbia in pediatric burn surgery, 2013 and 2014. He is a recipient of the Ohio University Hertiage College of Ostepathic Medicine's Distinguished service award. He is also national faculty for Allergan Corporation and considered one of the elite injectors in the United States. He is the co founder of the Ohio Stem Cell Treatment Center of Cleveland, Ohio. http://www.ohiostemcelltreatmentcenter.com

Vision Statement: To be internationally recognized for the highest quality cosmetic surgery and aesthetic services.

Mission Statement:

To provide exemplary care through technology, skills and attitudes which create an exceptional experience that fosters lasting loyalty.

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Dr. Foglietti | Ohio Stem Cell Treatment Center of Cleveland