Morality and Federal Funding Associated with Embryonic and Adult Stem Cell Research

What is your personal moral standpoint on stem cell research? In today`s society, it is hard to differentiate between morally correct and politically correct, the line is often blurred in view. The intent of this research is to further scientific advancements but the price to pay is stepping across a couple personal boundaries. Angela Campbell wrote an interesting article for the American Journal of Law and Medicine in Boston outlining the biggest controversial topic of today pointing out, Worldwide, legislators and policy makers have struggled to craft meaningful and ethical parameters for the regulation of this new and evolving area of biotechnology (Campbell, 2005). This statement states a grave dilemma on ever resolving past the issue and finding a solution for technological advances. While very few of the following points hit on the federal funding issues most citizens have put forth more energy on pushing morals rather than funding. Many of the clinical trials discussed were ran all over the world and outline many different researchers' ideas on stem cell research and their data findings and research methodology on this growing scientific exploration. Citizens and the government are at a standstill on whether to morally agree upon and federally fund stem cell research even though the research can potentially kill unborn embryos and is putting the government at a split decision on supporting the issue.

There are many types of ways to perform stem cell research. The first study goes over a popular way of getting stem cells, mesenchymal transplantation. Blanc started a study which was a prospective registration study to include all patients consecutively treated with mesenchymal stem cells in the participating centres of the European Group for Blood and Bone Marrow Transplantation mesenchymal stem cell consortium (Blanc, 2008). This type of treatment is known to help people with GVHD who had trouble with other stem cell transplants. There are many ways to try to intake stem cells as shown in the study most patients received ciclosporin combined with either four doses of intravenous methotrexate or mycophenolate mofetil. In patients receiving cord-blood transplantation, ciclosporin was combined with prednisolone. Recipients of haemopoietic stem cells from unrelated donors were treated with antithymocyte globulin, antilymphocyte globulin, or alemtuzumab (Blanc, 2008). In this instance where there are many patients receiving different versions of stem cells there are many different types of results such as 92 infusions of mesenchymal stem cells were given; 27 patients had one infusion, while 28 had two or more (figure 1, table 3). Of the 28 patients treated with multiple infusions, 15 received cells derived from two or more donors. No patients had acute side-effects either during or after infusion; and none have had late side-effects so far. Median time from transplantation of haemopoietic stem cells to infusion of mesenchymal stem cells was 103 days (Blanc, 2008). Transplantation can be one of the hardest ways to extract stem cells and insert into the patient, but this way of research is growing and having outstanding results. This study shows a lot of hope for a positive outlook of stem cell research because none of the patients had side effects or late showing side effects like other injections might show after a certain amount of time.

Study two goes over tissue transplant used to attempt to treat Parkinson's disease. There are a large number of participants willing to participate in stem cell research studies. For instance, more than 350 patients worldwide have received fetal ventral mesencephalic (FVM) tissue transplants in various open-label and in two double-blind, randomized, placebo-controlled clinical trials with variable results. In one placebo-controlled clinical trial, some improvements in all 10 subjects <60 years of age was observed. 1 The other clinical trial failed to meet its clinical end point, with no overall marked improvement in the motor features of 34 patients with Parkinson's disease (Master, 2007). With clinical trials there is always a chance that the results may completely fail. There was a study done by Master where In two clinical cases, FVM tissue transplantation has also led to a 70% beneficial reduction or full cessation of parkinsonian drugs. Although several studies show some improvement in motor behavior in participants after surgery, long-term assessment shows that such treatments are not fully effective in all patients with Parkinson's disease, with 34 subjects showing no overall improvement after transplantation. Two Side effects such as the development of postoperative dyskinesias (abnormal involuntary movements and postures) have also been reported in 56.5% of patients who were taken off drugs and are a major concern Master, 2007). Most patients had a positive experience and succeeded in the clinical trial than patients that saw little to no improvement.

This third study goes over injection of stem cells and the difference between intracoronary (i.c) injection and intramyocardial (i.m) injection and their separate advantages. Mathiasien performed a study on each way to transplant stem cells and there was [A]n open, nonrandomized study involving autologous BMMNCs injected intracoronary (ic.) in ten ST-elevation-MI (STEMI) patients demonstrated increased LVEF, enhanced LV systolic function and reduced scar tissue after 3 months [71], and the same group recently reported 5-year data on an open, nonrandomized study involving 62 ic. treated patients with MI The positive effects found in the first study were reproduced and found stable after 5 years'' follow-up. In addition, there was improved exercise capacity and reduced mortality (Mathiasien, 2009). These results are a big improvement from other stem cell injections especially the high rate of patient's standards after the follow up. Other studies using im. injection for delivery have used the NOGA XP system for mapping of the LV and to guide the injections, usually in the border area between normal and dead endocardial tissue [83]. Although im. injection of skeletal myoblasts has been demonstrated to have a proarrythmogenic effect [48,69,70], im. injection of BM stem cells and angiogenic genes have been reported to be safe without arrhythmias or death (Mathiasien, 2009). These studies with i.m. injection is positive as well but the i.c. study seems to have more substantial evidence and a better life span after treatment. Most people believe The optimal delivery method of the cells to the myocardium has yet to be determined. For MSCs the im. delivery method appears to be preferable to the ic. method, at least until reports on microvascular occlusions, owing to the rather large size of MSCs, have been investigated further (Mathiasien, 2009). There may be better long-term effects from i.c. but in the i.m. study there are more scientists involved in this injection technique and more scientist using this method. Along with each way to perform stem cell research come many potential life long risks.

Morally, many people are concerned with the destruction of embryos and the many risks associated with stem cell research. The many risks that come with stem cell research is why this topic is such a huge controversial topic today. Many people must weigh out the option and make sure in their heart and mind that the reward of scientific advancement is a big enough gain to possibly lose a life. Aside from the scientific research, many people form their own opinions to not let stem cell research continue to be an afterthought for research but stand up to a flawed system. Scientist time and time again have said stem cell research to be dangerous and not always succeed. Many scientists attempt using embryonic stem cell and The embryos used in this kind of research are typically donated by individuals or couples who conceived them by in- vitro fertilization (IVF) in the context of receiving assisted reproduction treatment, but who no longer need or want them for such a purpose (Snead, 2011). The main controversy is over is it okay to destroy a human embryo in order to gain important stem cells for extensive research that can help the world of science. This research can help yield regenerative substance and help bioethics make technological advances such as: cloning, embryonic stem cells and possibly immortality. While many embryos in such clinics get used and create life Hundreds of thousands of embryos stored in the U.S. in invitro fertilization clinics will not be used for reproductive purposes and will eventually be destroyed. I believe that it is ethical to use these extra embryos for research that could save lives when they are freely donated for that express purpose (Sharockman, 2010). The question of morality is answered by using untouched and unneeded embryos that, without science would be destroyed anyways. With a new age advancement in stem cell research there are many unknowns such as short- and long-term lifelong risks. With any research there can always be risks but with stem cell research such manipulated stem cells might integrate into unintended tissues, differentiate or de-differentiate into unintended cell types, or fail to function appropriately (Lo, 2008). These stem cells can attach to other organs and unintentionally fail the research. With risks comes rewards and stem cell research can tremendously change the way we see untreatable diseases and give patients answers and hope with their disease.

With stem cell research being relatively new in the sense of being able to research the positive and negatives towards patients. One major disease that can be possibly cured is patients that have issues with GVHD bone marrow stem cells injection can possibly cure this disease. In this instance Blanc describes that Mesenchymal stem cells derived from bone marrow might be a safe and effective treatment for patients with severe, acute GVHD who do not respond to corticosteroids and other immunosuppressive therapies (Blanc, 2008). People who have an irritation from one type of stem cell might take better to another type. Stem cells taken from bone marrow have had a better chance of helping then allogenic stem cell transplantation, which is stem cells from umbilical cord blood. Another major disease that can possibly be cured from stem cell research is heart disease. There have been many Clinical studies on stem cell therapy for cardiac regeneration (which) have shown significant improvements in ventricular pump function, ventricular remodeling, myocardial perfusion, exercise potential and clinical symptoms compared with conventionally treated control groups (Mathiasen, 2009). These studies can change the meaning of heart issues and breaking the wall of no return. Haemopoietic stem cell transplantation hit a high standard regarding treating autoimmune diseases. One treatment process explained treating someone with an autoimmune disease and talks further about One of the first diseases to be cured by this approach was aplastic anaemia - the prototype haematological autoimmune disease [64]. A large proportion of these patients have now survived for over 20 years and 90% of them have returned to work [15] - an important 'gold standard' by which allogeneic HSCT in non-haematological autoimmune diseases will be measured (Moore, 2001). When working with stem cell research and specifically transplantation there are many risk such as: disease from the body that was left over or disease from the stem cell being transplanted. Hitting a Gold standard in any way is an achievement but in the future of medicine it is important to hit milestones so that scientist are sure of releasing information to the world to be tested. There are many ways that stem cell therapy can help many diseases and some more than stem cell injection. With many diseases running rampant there is always hope for clinical trial patients and their potential treatment from stem cell research.

The many diseases that can potentially be cured from stem cell research would help the future of medical medicine tremendously and give people hope in a cure. Main wrote a great report on innovative medicine stating: We need to provide opportunities for innovative medicine on compassionate grounds but prevent over-enthusiasts from providing unproven and potentially unsafe procedures (Main, 2014). There are many opportunities available for stem cell research and it is so important to find a treatment for many life altering diseases but vise versa also important to keep patients safe and aware of the bad outcomes. Some research can take anywhere from one to five years and maybe more to see a true difference. Many articles are written everyday reporting the hope for the future of medicine. Some of These reports have led millions of people worldwide to hope that regenerative medicine is about to revolutionize biomedicine: either through transplantation of cells grown in the laboratory, or by finding ways to stimulate a patient's intrinsic stem cells to repair diseased and damaged organs (Main, 2014). The impending future for medicine includes in some way shape or form stem cells to change the way we tackle diseases. There are many ways to utilize stem cells. As Main stated either way the world looks at disease, stem cell research mixed with technological advances, will change the future of medicine forever. The treatment of diseases using stem cell research plays a big part in whether the federal government will be involved with funding stem cell research.

Before looking to future federal funding we first must look at the last couple decades at the history of federal funding and this will reveal what the future holds for government participation. Federal funding is more important than most people think about because without money, medical advances will not exist and continue to grow in the future. There have been many bans on federal funding and the zero effects on private clinics. Looking into the history of the government participation mainly started In 1997 President Clinton issued an executive order banning the use of federal funds for stem cell research. However, such a ban has little effect on private fertility clinics. For twenty years, the federal government has refused to provide funds for research on IVF, but that has not stopped the hundreds of privately-financed IVF clinics from creating tens of thousands of babies (Annas, 2002). This had zero affect on private fertility clinics and scientist whom decided to use their personal funds to continue research. When these scientists want to personally fund research and decide to practice stem cell research how they want the government still has control over how they go forth performing research. There are many people that feel this ban should be practiced by all states and Eleven states have laws regulating research and/or experimentation on conceptuses, embryos, fetuses or unborn children that use broad enough language to apply to early embryos. It should be noted, however, that these bans would not apply once the techniques are no longer considered to be research and instead are thought of as standard practice (Annas, 2002). There is a fine line to be drawn between research to ban and practice to be appreciated. Federal funding does not seem to hold water when it comes differentiating between the two. Politics have governed stem cell research more than science. The new president has the most control over what happens with further research. Now we must look at the current presidencies ideas on lifting the ban on embryonic stem cell research. With our current presidential candidate, we must get his views and hope to get answers for the future of stem cell research. Trump has made many statements about stem cell research Trump himself has said he opposes abortion; a related issue Momentum has shifted to experimentation with other kinds of stem cells not derived from embryos. Artificially created stem cells called induced pluripotent stem cells, or IPS cells, act like embryonic cells, but are created from adult cells, such as skin cells (Fikes,2016). Trump has made many stances that he is against abortion and that is why he is on the side of transforming stem cells for science but using adult stem cells instead of embryonic. On the other side of the world they have different stances on whether the government should be involved. The U.S. is behind when it comes to stem cell research behind other countries. We as a country have a long way to go in healthcare before reaching other rising countries. When interviewers talked with members of the Brazil government they stated, Members of this stem cell network were disappointed when their funding was discontinued in 2005, but a new network, the National Network of Cell Therapy, was funded in 2008, showing a renewed government commitment to stem cell research (McMahon, 2010). Other countries around the world have different point of views on stem cell research and whether the governments involvement is crucial. Federal funding has a huge potential to help push stem cell research in the right direction and help to change the world of modern medicine.

Whether we can move along towards research or away from it a decision needs to be made on if embryonic stem cell research is morally sound and deserves to be federally funded, so we can move forward as a whole and make technologically advances for the better. There are many ways to perform stem cell research such as transplantation, injection and many more as the years and technology advances. The risk of injury and death in any technological greatness is almost always a guarantee. There are many severe illnesses that stem cell research can treat and cure with years to come. The question of federal funding needs to be revised and made concrete, so the next presidential candidate can not create a ban or bring down a ban without permission. Federal funding may be a bigger element to the growth of research than most people put into question. How are we supposed to move forward in research if the next president will swoop in and change the rules and ban certain research from continuing. Originally in 1977 we were supposed to move forward, then Clinton came into office and set up bans on research. What will the future bring if the next president that comes into office every four years has a different view and different political side on whether to push towards or away from medical advances due to political and moral thoughts on abortion and the human body? A big part of continuing to federal fund research is for people who cannot get it in the states go across the border and risk being botched and new diseases. Federal funding will help to lower the risks of crossing the boarder for stem cell research and bringing back brand-new undiagnosed diseases to this country. These statements above should improve the decisions or at least resolve the issue associated with the morality and federal funding of stem cell research.

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