(6) Some risks, ethical issues, concerns in using stem cells in medicine and future research

Unwanted diseases

Transplanted stem cells divide very quickly and if the speed of cell division cannot be controlled inside a patient a tumor (tumour) may develop.

Cultured stem cells can show similarities with cancer cells.

After many cell divisions you can get mutations changing the genetic character of the cell - so how might affect the cell's behaviour? Will it increase the chance of rejection by the patient's immune system? Might it cause cancerous growths?

Inside the stem cells, viruses can co-exist with their host. If, unknowingly, donor stem cells are infected with a virus, this virus can be passed on to the patient under treatment worsening their condition - a case of unwanted disease transmission!

 

Transplant rejection - perhaps the single biggest problem in applying stem cell treatments.

The stem cells from a storage bank come from different people and often will not perfectly match a the patients cells and so the patient's immune system will respond in a negative way.

In other words, if the transplanted cells/tissues/organs aren't grown using the patient's own stem cells, the patient's body might recognise the donor cells as 'foreign' and trigger the usual immune response to attack and remove invasive cells.

The clinicians will do their best to match the donated stem cells with the patient's body cells.

Quite often, the transplant patient has to take drugs to suppress the body's natural immune response and avoid rejection of the donated cells, but this makes the patient more susceptible to other diseases.

The problem of rejection can be minimised by using the patient's own stem cells from somewhere else in the body - the idea being the body's immune system will recognise them as non-foreign and not offer a response.

 

Stem cell research and its applications are very controversial

This is despite the obvious great medical benefit to individual patients of using stem cell therapy and therapeutic cloning.

Stem cell research is necessary to find out more how to use this new area of medicine and how to develop and extend the range of effective medical treatments,

BUT, public education about stem cell research and applications is essential because of the moral and ethical implications of this new biotechnology.

The use of embryonic stem cells, obtained from a living human embryo, is especially controversial.

Moral question: Is it morally right or wrong to use embryonic stem cells for research or treatments?

Is it right to create an embryo for research or medical treatments that you will ultimately destroy after extracting stem cells?

Ethical question-issues: We need, as a society, to ethically discuss reasons whether the use of embryonic stem cells is right or wrong.

'Pros and cons': We have to weigh up the potential medical benefits from successful stem cell treatments versus the moral and ethical objection of such procedures.

Do the medical benefits outweigh moral and ethical objections.

Also, should patients be given false hope by giving/requesting an unproven stem cell based medical treatment?

The ethical issue of using embryos for medical purposes is abhorrent to some people who would argue that human embryos shouldn't be used to provide stem cells because the embryo is destroyed in the process - removing one that had the potential for human life.

People, perhaps of a particular religious belief, argue that life begins at conception and the embryo has rights like any other human being. So, where does a human life really begin? Your choice?

This is the argument of 'potential life' versus help for seriously ill 'living people' i.e. each embryo has the potential to develop into a human being, but equally potently, using embryonic stem cells might save a life.

In other words the rights of suffering patients overrides the rights of the embryo - would you deny blind people to the right to see again?

It is possible to use unwanted embryos from fertility clinics (IVF) because there is no other source of universal stem cells and these unwanted embryos would be destroyed.

(IVF: Fertility treatments involving in-vitro fertilisation)

The unwanted embryos often come from fertility clinics and would be destroyed if not used for research purposes - but this argument would not satisfy campaigners want to completely ban the use of human embryos.

Many campaigners believe scientific research should be directed towards finding and developing other sources of stem cells and avoid the use of human embryos.

Stem cell research is allowed in some countries like the UK, but there are very strict rules and guidelines as to how it can be carried out.

UK law does now allow embryos to be created for scientific research.

Stem cell research is completely banned in some countries.

However, there are stocks of stem cells that scientists can use to continue their research without involving the use of more embryos - this is allowed in the UK but not in the USA.

As already mentioned, another possible source of stem cells is blood left in the umbilical cord and placenta after a baby is born.

Cord blood is easy to collect and store and avoids the ethical issues involved with using stem cells from embryos.

Scientists have managed to remove human skin cells and reprogrammed them to become like embryonic cells.

This gets around some of the ethical issues discussed above about the use of stem cell transplants from embryonic tissue.

See also (part 5) The potential uses of stem cells, particularly in medicine

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Key points

Based on the syllabus-specifications for students taking the AQA, Edexcel and OCR GCSE level biology examinations (~US grades 9-10).

Summary of ideas

Stem Cells: Risks, Ethical Issues, and Future Research Concerns

Risks of Using Stem Cells

Stem cell therapy and research offer incredible potential but come with various risks, including:

Medical Risks

• Tumour Formation and Uncontrolled Growth: Stem cells have the ability to divide indefinitely, which increases the risk of tumours or uncontrolled cell growth (a condition similar to cancer).

• Immune Rejection: In cases where stem cells are transplanted from a donor, the recipient's immune system may reject them, leading to inflammation or failure of the treatment.

• Infection Transmission: If stem cells are derived from patients or donors and are not carefully screened, they may carry infections that could be passed on to recipients.

• Differentiation Issues: Stem cells may differentiate into unintended cell types or fail to integrate properly into the tissue they are supposed to repair.

• Short-Term & Long-Term Side Effects: Some patients may experience unexpected complications from experimental stem cell therapies, including organ damage.

Technical and Scientific Risks

• Difficulty in Controlling Cell Behaviour: Scientists struggle to ensure stem cells develop as expected once transplanted into a patient.

• Unpredictable Outcomes: Research is still developing, and outcomes from stem cell treatments are not always consistent or effective.

• High Cost & Accessibility Issues: Stem cell treatments and research require expensive technology, limiting their availability to only those who can afford them.

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Ethical Issues in Using Stem Cells

Many ethical concerns arise regarding the use of stem cells, particularly embryonic stem cells.

Embryonic Stem Cell Controversy

• Destruction of Embryos: Embryonic stem cells are derived from early-stage embryos (often from excess embryos created during IVF). Since this process requires destroying an embryo, some people argue that it is unethical.

• Religious & Moral Beliefs: Many religious groups oppose embryonic stem cell use, arguing that life begins at conception and destroying embryos is akin to ending a life.

• Legal & Policy Debates: Laws regulating stem cell research vary across different countries, with some banning embryonic stem cell research completely.

Consent and Rights

• Informed Consent: If stem cells are taken from adult donors or umbilical cords, proper consent from donors is needed. Ethical concerns arise if stem cells are harvested without full understanding or agreement from the donor.

• Exploitation Risks: Some worry that poor individuals may be coerced into donating stem cells, or that wealthy patients may have greater access to these treatments than others.

• Use in Human Cloning: Some fear that stem cell technology could eventually lead to human cloning, which raises serious ethical dilemmas.

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Concerns About Future Stem Cell Research

Future stem cell research offers exciting possibilities but also presents concerns:

Potential Benefits

• Treating Currently Incurable Diseases: Stem cell research may lead to cures for conditions like Parkinson’s disease, Alzheimer's, diabetes, and spinal cord injuries.

• Reducing Organ Transplant Waiting Lists: Scientists hope to grow replacement organs using stem cells, reducing reliance on donors.

• Advances in Regenerative Medicine: Stem cells may lead to revolutionary treatments that regenerate damaged tissues, such as heart or brain tissue.

Future Ethical & Social Concerns

• Genetic Engineering & Modification: As stem cell research progresses, concerns over genetic editing (such as using CRISPR technology) arise, leading to debates about ethical boundaries in modifying human cells.

• Human-Animal Hybrid Research: Some scientists experiment with inserting human stem cells into animals, which raises concerns about creating organisms with human-like traits.

• Access & Fair Distribution: If stem cell treatments become widespread, ensuring global access and affordability will be a challenge.

• Long-Term Effects: The long-term consequences of stem cell therapies are still unknown, raising concerns about safety decades after treatment.

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Exam tips

• Understand both benefits and risks—examiners often ask about advantages and disadvantages of stem cells.

• Use specific examples in answers, e.g., "Stem cell therapy could help treat Parkinson’s disease, but it carries the risk of uncontrolled cell growth."

• Be familiar with ethical debates, particularly embryonic vs. adult stem cells.

• Explain how future research could solve current limitations while introducing new concerns.

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Summary of learning objectives and key words or phrases

Describe and explain some risks and concerns in using stem cells for medical treatment and future research for stem uses in medicine.

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