David Caldwell October, 2013

DR. CAPPECHI LECTURE

The Promise of Embryonic Stem Cell Therapy: Euphoria or Ethical Quagmire? Speaking as an advocate of stem cell research and the medical potential that it advances, Dr. Cappechi addressed the students of Salt Lake Community College some time ago. In his presentation he began by educating the students about the nature and aims of stem cell research. He noted the moral dilemma that American society is facing in regard to the methods of this research and put forth his view concerning it, briefly touching on the political policies affecting it. He finished his remarks with a synopsis of his background and some general advice on how to best approach this moral dilemma in society in order to further the research and minimize ethical issues. In relation to stem cell research, he discussed why mice are often used in genetic experiments: they are mammals, which makes them physiologically similar to humans, and they also share 99 percent of our genes. He described how we can copy a fluorescent gene in jellyfish onto a particular gene in a mouse to discover the relevance of the gene through the associated phenotype (p. 44, phenotype: the observable characteristics of a person). We can then discover how the genes play into the polygenic traits of mice through breeding the manipulated parent mice, and can correlate that information to humans because of the genetic affinities of mice and humans (p. 48, polygenic trait: a trait that is influenced by many genes). In general, the lecture coincided most directly with chapter two of the textbook. The bulk of the lecture, of course, was more directly concerned with stem cells, which chapter two of the textbook briefly references as a stage in the germinal period between a zygote and about the eight-cell stage (p. 58). This is describing the normal process inside the body; but according to the lecture, when the process occurs outside of the female body (in vitro), without being connected to the signals from the uterus through implantation (p. 59, implantation, the process by which the developing placenta connects to the uterus), the stem cells can reach a size of 200 or more without differentiating (p. 58, differentiation, the stage when cells begin to specialize, taking different

forms and reproducing at various rates) into the specialized cells to form the distinct parts of an embryo that would grow into a fetus. There is both an ethical question and a moral dilemma regarding the methods of embryonic stem cell research. The moral dilemma is the promise of embryonic stem cell therapy that comes at the expense of ethics. The ethical question is simply whether or not the original organism or thing from which the stem cells are taken is akin to a human. If it is not, then there is no ethical consideration and no moral dilemma; but if it is then there is an absolute ethical imperative and an impossible moral dilemma. Dr. Cappechi apparently sees more of an imperative with the moral dilemma than with the ethical question. He used both a nuanced approach to the ethical question combined with a circumvention technique to try to satisfy the moral dilemma. First, he used a nuanced approach to the ethical question. Throughout his lecture he maintained that there is an ethical consideration and that you are, in a sense, killing. He repeated this on occasion, also saying that in the process of isolating the cells from living embryos, you are disrupting, and in a sense, killing that embryo. But he was careful to qualify what he meant by this: the development from embryo to become a fetus to become a child will never occur in [a microbiological] culture because such development necessitates implantation. What he was saying, essentially, is that we are killing something that never had a chance for survival. With the circumvention of the issue he was essentially passing on the ethical issue in order to satisfy the moral dilemma. It was an absolving of personal responsibility regarding the ethics of the situation. He noted that in fertility clinics, about 20,000 embryos are being discarded every year. If an embryo is akin to a human, then this is, of course, a large ethical concern of its own. He framed the problem as an opportunity though, saying The ethical question is: should we discard those, or can we use those to isolate stem cells, which we can then use. This is an instance of circumventing the ethical consideration in favor of a solution to the moral dilemma.

At other times he implied that there really is no ethical consideration, or else a very minimal one. He noted that human reproduction is not very efficient, and that the embryo is miscarried more often than it is born. While he stated that the percentage is very difficult to estimate, the textbook puts the estimation of conceptions that fail to implant at about 60 percent (p. 59). In mentioning this, he implied that the process of harvesting embryonic stem cells is a trifling matter in view of the natural occurrences in human reproduction, and especially in relation to the enormous benefit it provides to medical science. Dr. Cappechi gave some advice to the audience before closing his remarks, which deserves some criticism. Ill only briefly mention one aspect of that advice. His first piece of advice was to generate as much information and knowledge as possible. He told the audience that informationknowledgeis never evil in itself. It is the application of that information and knowledge that (pause) it can be good, or it can be bad. And that takes wisdom then you can decide: good application or bad application. Clearly, good and bad is not limited to the application of knowledge though; certainly, the acquisition of knowledge and information can be just as good or bad as the application of it, if the methods do, in fact, violate ethics. The tone of the presentation was set by Dr. Cappechi posing an existential question: Where do we come from? and answering strictly in biological terms: From a sperm and an egg. Whether in jest or not, Im not sure whether that is appropriate in a university setting where we ought to look at matters from multiple disciplines. However, I appreciate Dr. Cappechis experience and the insight he offered into his own knowledge and opinions. While I would place more emphasis on the ethical issues that face our society in regard to both the methods of research and the application of that knowledge toward scientific achievements, it is near impossible to not applaud such achievement when it is applied to saving a person from a cancerfrom certain death from the cancerthrough a bone marrow transplant. I am aware of such a person. From a purely emotional view, this is much easier to identify with than the killing, in a sense of an eight cell or two hundred cell organism that many people do not identify with as even being human. That is the moral dilemma for those of us who are concerned with the ethics of the approach.