Another Step Down the Slippery Slope?
Emory researchers weigh the ethics and benefits of human fetal tissue research
By Hal Jacobs
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As researchers and ethicists at Emory University venture into the arena of human fetal tissue research, they seem fully aware of how close they are to an explosive controversy. At this exact moment, the potential is everything-the potential for victims suffering from agonizing diseases and injuries, as well as the potential to further alienate those who believe human life is sacred from the moment of conception. And somewhere in the middle, Emory academics are questioning whether the university community, administrators, and Board of Trustees are ready to answer some difficult questions-particularly if faculty in this area of research (and the controversial field of human stem cell research) begin making headline news.
Research using human fetal tissue has been around for decades. But, in the words of Andre Nahmias, professor of pathology and laboratory medicine and director of the Division of Pediatric Infectious Diseases, Epidemiology and Immunology in the School of Medicine, "You must really want to do it to justify the problems you face."
A five-year federal funding moratorium on human fetal tissue research was lifted by executive order in 1993; federal funding on live human embryo research is still banned. With grant subsidies dependent on the changing political tides in Washington, some researchers and schools are understandably reluctant to enter the area without substantial private funding. Another complication with the research is the difficulty of obtaining human fetal tissue in the United States. No large-scale organization exists for its collection and distribution in this country, although there are international sources such as Moscow's International Institute of Biological Medicine. In the mid-1990s, two million abortions were performed in Moscow alone, compared to 1.5 million abortions in the entire United States. Further complicating collection and distribution is the need for tissue from six- to nine-week elective abortions-spontaneous abortions carry a higher risk of abnormal fetal material and deteriorated tissue. Thus, tissue collection becomes mired in "abortion politics."
Despite these problems, faculty at the School of Medicine contacted for this article consider the scientific and medical potential important enough to justify the administrative headaches. In 1965, Nahmias obtained tissue from England to use in his research on human development. Stephen Warren, a professor of biochemistry, used human fetal tissue in conjunction with a European group to analyze the function of the fragile-X gene, defects in which cause mental retardation. Michael Lindsay, an associate professor of obstetrics and gynecology, says he personally knows of two ongoing research projects: one using fetal tissue for the treatment of Parkinsonism, the other using umbilical cord blood for stem cell transplantation. Donald Stein, dean of the Graduate School of Arts and Sciences, has worked in the area of fetal tissue research and addressed the issue in his 1995 co-authored book, Brain Repair.
Researchers are enthusiastic over studies that show promise for using human fetal tissue transplantation to treat patients with Parkinson's disease, diabetes, Huntington's disease, Alzheimer's disease, spinal cord injuries, cancer, and sickle-cell anemia. Cells from a six- to nine-week-old fetus are relatively undifferentiated and more likely to function normally in a recipient. Thus, in the case of Parkinson's disease, healthy cells selected from aborted fetuses are grafted into the patient's brain and integrate into the damaged area, providing dopamine to replenish lost supplies.
But the use of aborted fetuses is anathema to those religious organizations that hold all human life sacred. Observes Robert Rich, professor of medicine and microbiology and immunology and executive associate dean of research and strategic initiatives in the School of Medicine, "There is absolutely no compromise between the people who believe cells lying in a petri dish have the potential to be human invested in them, and the people who see the cells as a useful medical resource."
Because fetuses are obtained from elective abortions, some religious leaders are concerned that when a woman chooses to terminate her pregnancy, the knowledge that she is donating her fetus to scientific research may make it easier for her to validate her abortion decision.
"Donors may think of it this way: 'A good result of a bad deed,' " explains Nick Fotion, an Emory philosophy professor who has served on the university's Human Investigations Committee for the last fifteen years.
"Some religions believe this leads man another step down the slippery slope: fetus donation leads to more abortions, less respect for human life, and then to other grave sins against humanity, such as cloning and euthanasia."
Barry Shur, professor and chair of cell biology, points out that recombinant-DNA technology brought out the public's worst fears in the mid-'70s. Critics warned that the research would lead to laboratory-created diseases that would seriously disrupt human civilization. "But scientists proved they were able to police themselves by creating a moratorium on research until they resolved ethical issues and released guidelines on research. [The worst fears] turned out to be overreaction. The research led to new drugs, not laboratory monsters. There is no Holy Grail when it comes to working with human tissue. We need it as a tool to gain more information."
Some wonder whether Emory's historic ties to the United Methodist Church come into conflict with the university's scientific research. But during his last thirty years at Emory, Nahmias says he doesn't remember any such clash. "I support human fetal research if done ethically with good planning," he says. "But you must really want to do it to justify the problems you face."
"No doubt this will be a controversial question not unlike the issues surrounding Yerkes animal research," says Kathleen Kinlaw, program director in health care ethics at Emory's Center for Ethics in Public Policy and the Professions.
"But should we shy away from human fetal tissue research because of the controversy? Probably not. We should invite ethicists, religion/theology faculty, sociologists, anthropologists, and philosophers to join clinicians and researchers to question the impact and consider the full breadth of personal and social issues involved."
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