Etiese perspektiewe op die gebruik van embrionale weefsel vir terapeutiese doeleindes

Crous, Liesl (2004-12)

Thesis (MPhil)--University of Stellenbosch, 2004.

Thesis

ENGLISH ABSTRACT: The progress that has been made over the last decade in the field of medical technology, has made it possible to treat medical conditions today, that was considered incurable before. In the medical field there are three milestones in particular which has led to important new discoveries. These are the charting of the human genome, the development of cloning techniques, and the discovery that stem cells could be used in the treatment of a great number of illnesses, as well as the regeneration of sick or damaged tissue. The development of these therapies are, however, morally controversial. The main reason for this is the fact that in most cases, these techniques involve research on, or the use of, embryonic cells. The reason why many people believe that it is morally problematic to use embryo tissue for research and/or therapeutic purposes, is because embryonic cells have the potential to develop into fully independent human persons. It is, however, also this characteristic of these cells which makes them so suitable for use in stem cell therapies: Because certain types of stem cells, especially stem cells that are found in embryos in an early stage of development, have not yet differentiated into specific cell types, they can be used to repair any cell type in a person with a compatible tissue type. The reason for this is that undifferentiated stem cells have the potential to change into any cell type found in the human body. The question that arises when a decision about the moral acceptability of these therapies has to be made is whether one can say that an existing person who happens to be ill, has a higher moral standing than an embryo. The only way in which the use of embryo tissue could be morally justified, would thus be if it could be proved that the moral standing of an embryo is not equal to the moral standing of a person. The other important consideration that has to be taken into account when the moral acceptability of these therapies has to be taken into account is the fact that it is possible to harvest stem cells from a number of sources. Some of these sources of stem cells are less controversial than others. The discussion of the moral problems arising from the use of embryo tissue for therapeutic purposes, would thus, in this thesis, focus to a large extent on determining what the moral status of the embryo might be. The different positions with respect to the moral standing of the embryo will be discussed in the light of arguments for, as well as against the use of embryo tissue for therapeutic purposes. An explanation will also be given of therapies for which the use of embryo tissue might be needed, at present as well as in the future. The potential gains for people suffering from certain conditions, could possibly serve as a justification for destroying embryos for therapeutic uses. The main purpose of this thesis is to be able to give morally justifiable reasons for the therapeutic use of embryo tissue. The specific conditions that would have to be met to make these therapies morally justifiable will also be explained.

AFRIKAANSE OPSOMMING: Die vordering wat die afgelope dekade gemaak is ten opsigte van mediese tegnologie, het tot gevolg gehad dat dit vandag moontlik is om siektetoestande te behandel wat voorheen as ongeneeslik beskou is. Daar is veral drie belangrike mylpale wat in die mediese veld tot belangrike nuwe ontdekkings gelei het, naamlik die kartering van die menslike genoom, die ontwikkeling van kloningstegnieke, en die ontdekking dat stamselle gebruik kan word vir die behandeling van 'n groot aantal siektetoestande, asook die regenereering van siek of beskadigde weefsel. Die ontwikkeling van hierdie terapieë is egter moreel kontroversieel. Die rede hiervoor is dat hierdie tegnieke in die meeste gevalle navorsing op, of die gebruik van embrionale selle behels. Die rede waarom baie mense van mening is dat dit moreel problematies is om embrionale weefsel vir navorsing enlofterapeutiese doeleindes te gebruik, is omdat embrionale selle die potensiaal het om te ontwikkel tot volwaardige persone. Dit is egter ook hierdie eienskap van hierdie selle wat hulle so geskik maak vir terapeutiese doeleindes: Omdat sekere tipes stamselle, veral stamselle wat verkry word van embrio's wat in 'n vroeë stadium van ontwikkeling verkeer, nog nie gedifferensieer is wat seltipe betrefnie, kan hulle gebruik word om enige seltipe in die liggaam van 'n persoon met 'n verenigbare weefseltipe te herstel. Die rede hiervoor is dat ongedifferensieerde stamselle die potensiaal het om in enige seltipe wat in die menslike liggaam voorkom, te verander. Die vraag wat ontstaan wanneer daar besluit moet word oor die morele aanvaarbaarheid van hierdie terapieë, is of daar gesê kan word dat 'n reeds bestaande persoon wat siek is, 'n hoër morele status sou hê as 'n embrio. Die enigste manier waarop die gebruik van embrionale selle moreel regverdigbaar sou wees, sou dus wees indien daar bewys kan word dat die morele status van 'n embrio nie gelykstaande is aan die morele status van 'n persoon nie. Die ander belangrike oorweging wat in ag geneem moet word wanneer die morele aanvaarbaarheid van hierdie terapieë beoordeel moet word, is dat dit moontlik is om stamselle te verkry uit 'n verskeidenheid bronne. Sommige van hierdie bronne van stamselle is moreel minder kontroversieel as ander. Die bespreking van die morele problematiek rondom die gebruik van embrionale weefsel VIr terapeutiese doeleindes in hierdie tesis, sal dus tot 'n groot mate fokus op die bepaling van die morele status van die embrio. Die verskillende standpunte oor die morele status van die embrio sal bespreek word in die lig van argumente vir, sowel as teen die gebruik van embrionale weefsel vir terapeutiese doeleindes. Daar salook 'n verduideliking gegee word van watter tipe terapieë waarvoor die gebruik van embrionale weefsel nodig sou wees, tans en in die toekoms moontlik sou wees. Die potensiële baat wat siek persone uit hierdie terapieë sou kon vind, sou moontlik ook as 'n regverdiging vir die vernietiging van embrio's vir terapeutiese doeleindes kon dien. Die uiteindelike doel van hierdie tesis is om moreel regverdigbare redes te kan gee vir die terapeutiese gebruik van embrionale weefsel. Die spesifieke voorwaardes wat nagekom sou moes word om hierdie terapieë moreel regverdigbaar te maak, salook verduidelik word.

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