Horst-Dietrich Elvers, Burkhard Jandrig, and Christof Tannert write:
The Nature News story “Simple switch turns cells embryonic” (Nature 447, 618-619; 2007) presents the results of three independent research teams showing that normal skin cells can be reprogrammed to an embryonic state in mice. If this can be successfully adapted to human cells, the creation of human germ cells out of these pluripotent cells should be possible (as was indicated already by Huebner et al. Science 300, 1251-1256, 2003). Now, the road seems to be prepared to create human tissues for therapeutic purposes without using or destructing human embryos. This is, doubtless, an important progress for the whole field of regenerative medicine and avoids many morally questionable decisions, which so far have led to an international mix of regulatory frameworks. Therefore it is not surprising that excitement is overall huge at the moment.
The published results seem to indicate that the ethical problems of human embryo research are solved now.
The New York Times cited Richard Doerflinger, the United States Conference of Catholic Bishops’ spokesman on stem cell issues, who said that it “raises no serious moral problem, because it creates embryoniclike stem cells without creating, harming or destroying human lives at any stage” (http://www.nytimes.com/2007/06/07/science/07cell.html). DIE ZEIT, Germany’s most popular weekly newspaper, headed “This is a breakthrough! […] Is the ethical dilemma of this branch of research finally solved now?” (http://www.zeit.de/online/2007/24/stammzellen?from=24hNL).
But, with philosophical ethics this is true only in part (if at all). Moreover, the hidden question concerning the moral state of the human embryo is not even touched. It may become temporarily neglected at the most, though, but will come up again concerning other questions in biomedicine. Most prominent, the developmental biology of human embryos and their pathologic deviations can be investigated only by using human embryos, and most likely some of these investigations cannot avoid the destruction of the embryo. Hence, the ethical problem as such is only bypassed – but far from being solved. Furthermore, we suggest not being lopsided: the creation of an embryo out of other adult cells (such as skin cells) provokes the genuine ethical question why these adult cells should not have the same human dignity as an embryo?
Altogether, the ongoing ethical discussions around the artificial creation of human embryos concern the question whether human embryos are human beings yet, and, spoken more strictly, whether they are genuine embryos even if they have been created in the test tube (cf. Tannert, EMBO Rep. 7, 238-240, 2006). Therefore it remains on the agenda whether it is legitimate to use them for purposes of therapeutic cloning, since it refers to a long overdue decision about the dignity of man, not just in terms of born, but of unborn human beings. As far as those issues are not solved yet as such, biomedicine will ever again enter a thin ice by suppressing hot potatoes, instead of proactively encountering them. Instead of trying to avoid complex discussions, we should bring to mind that unless the important ethical and social questions on top of the agenda are not successfully tackled, biomedicine will ever be concerned with its own justification.
Horst-Dietrich Elvers, Burkhard Jandrig, Christof Tannert
Max Delbrueck Center for Molecular Medicine (MDC) Berlin-Buch, Unit Bioethics and Science Communication, Robert Roessle Strasse 10, D-13125 Berlin, Germany, E-mail: firstname.lastname@example.org