Human embryonic stem cell research in transplantation and regenerative medicine : a principlist assessment

Abstract

ENGLISH ABSTRACT: Bioethics and scientific literature present transplantation and regenerative medicine as the next frontier for medical practice. The status of global disease burden also indicates that traditional approaches to medical services may be outdated. Use of medicinal drugs that alter the metabolism of cells may not successfully tackle the insurgent noncommunicable disease that target and destroy human organs. Moreover, cadaveric organ transplantation is facing logistical and ethical challenges that has led to the limitation of its efficacy in fighting disease. Stem cell research, particularly, that which involves the use of human embryonic stem cells (hESC) has been hailed as the answer to debilitating medical conditions, including organ failure. Pluripotent stem cells derived from embryonic organisms can be used to regenerate failing tissues and organs. However, bioethical literature point to the opposition towards hESC research because of the process which involves the destruction of human embryos. Many consider embryonic destruction a morally undesirable behaviour. Traditional theories of morality, on the other hand, have only managed to heighten the debate on the embryonic personhood thereby stalling progress of hESC research. This thesis demonstrates that the stalemate created by the debates on the personhood and moral status of the embryo need not stifle the potentially beneficial research. It therefore offers Principlism as an ethical framework approach for assessing the moral suitability of hESC research. The study finds that hESC research, though morally contentious, has potential for saving lives and relieving human suffering. It therefore recommends rapid progress on the research while advocating for a research focus that gradually reduces reliance on human embryos as primary subjects of research. Finally, the research recommends that a multi-disciplinary approach to tackling the challenges of bioethics, particularly, those related to scientific advancement.

AFRIKAANSE OPSOMMING: In bio-etiek en wetenskaplike literatuur word oorplantings- en regeneratiewe medisyne as die volgende grensverskuiwende stap vir mediese praktyke aangedien. Die status van die wêreldwye siektelas dui ook daarop dat tradisionele benaderings tot mediese dienste moontlik verouderd mag wees. Die gebruik van medisyne wat die metabolisme van selle verander, sal moontlik nie die agressiewe nie-oordraagbare siekte wat die menslike organe teiken en vernietig, suksesvol aanpak nie. Verder ervaar kadawer-orgaanoorplanting logistieke en etiese uitdagings wat gelei het tot die beperking van die effektiwiteit daarvan om siektes te beveg. Stamselnavorsing wat veral gebruik maak van menslike embrioniese stamselle (MES), word wyd beskou as die antwoord op ernstige siektes, insluitend orgaanversaking. Pluripotente stamselle wat van embrionale organismes afkomstig is, kan gebruik word vir die herstel van beskadigde weefsel en organe. Bio-etiese literatuur dui egter op die teenkanting teen MESnavorsing vanweë die vernietiging van menslike embrio's in die proses. Baie individue en instellings beskou die vernietiging vam embrios as immoreel. Tradisionele moraliteitsteorieë het aan die ander kand slegs daarin geslaag om die debat oor die embrionale lewe te intensifeer, en sodoende die vordering van MES-navorsing te stuit. Hierdie tesis demonstreer dat die dooiepunt wat ontstaan deur die debatte oor die menswees en morele status van die embrio nie die potensiële voordelige navorsing hoef te onderdruk nie. Dit doen “Principlism” as etiese raamwerk en benadering vir die beoordeling van die morele geskiktheid van MES-navorsing aan die hand. Die studie bevind dat MES-navorsing, alhoewel moreel omstrede, wel die potensiaal het om lewens te red en menslike lyding te verlig. Dit beveel dus aan om spoedige vordering in hierdie navorsing te bewerkstellig, asook om klem te plaas op 'n navorsingsfokus wat geleidelik die afhanklikheid van menslike embrio's as primêre navorsingsubjekte verminder. Laastens beveel die navorsing 'n multidissiplinêre benadering aan om die uitdagings van Bio-etiek aan te pak, veral die wat verband hou met wetenskaplike vooruitgang.