By Nonie Arora

Medicine is about more than difficult diagnoses and cutting-edge research. Research and treatments often raise tricky moral questions.

Jeremy Sugarman Credit: Berman Institute for Bioethics

Dr. Jeremy Sugarman, the founding director for the Trent Center for Bioethics, returned to campus last week to give a talk on the ethics of stem cell research and treatment for the Humanities in Medicine Lecture Series.

“Stem cells are a hot topic that have captured the imagination of people around the world,” he said.

“Is it better to use leftover embryos from IVF or to create them for research?” Sugarman asked. He said there is little consensus on this issue, and the question remains whether there is a moral distinction between discarded embryos or those created for research purposes. There is also the thorny issue of whether it is morally acceptable to destroy embryos to create human embryonic stem cells, said Sugarman, who is now at the Berman Institute for Bioethics at Johns Hopkins University.

Amidst the controversy surrounding the moral status of embryos, there has also been scientific controversy within the stem cell field. Sugarman spoke of Hwang Woo-Suk, who claimed to have cloned human embryos and extracted their stem cells. However, his data was fabricated, Sugarman said. Sugarman elicited laughs from the packed audience when he joked about Woo-Suk’s former title “Supreme Scientist of Korea,” an honor that was later revoked. The laughter was tempered by the understanding of how unethical it is to fake any research, but especially on this scale. Still, Sugarman says Woo-Suk’s example serves to show the effectiveness of peer review in realizing false claims.

Human Embryonic Stem Cells. Source: "Follow the Money – The Politics of Embryonic Stem Cell Research." Russo E, PLoS Biology Vol. 3/7/2005, e234

Another issue many people are concerned about are chimeras – organisms that have parts from two different genetic lines. Already, bone marrow transplants create human-to-human chimeras, Sugarman explained. Some people have qualms about combining materials from human and non-human animals.

Other countries differ from the U.S. in policies on what can be done with human embryonic stem cells. For instance, in Germany it is a criminal offense to destroy an embryo to create a human embryonic stem cell line. It is also illegal for a German citizen to do such work abroad, Sugarman said. He brought up this point to illustrate why local oversight within academic institutions is necessary to not only make sure that research is “ethically and scientifically sound” but to also be certain that researchers are being protected.

Ethics in delivering care is equally important. “The desire for access to investigational treatments abounds, especially for devastating disorders,” according to Sugarman. But this is no reason for unsafe treatments to be delivered to patients. “It turns out some stem cell-based interventions are being delivered to patients without sufficient published data regarding safety or efficacy,” he explained.

Ultimately, scientific and commercial interests will be considered along with the hopes of patients and politicians when it comes to stem cell research and treatments, Sugarman said.