Ethics

The pursuit of stem cell research, with respect to the particular use of embryonic stem cells, has generated fierce ethical debates both domestically and internationally.  Although this debate has at times been characterized as perhaps the greatest scientific debate of modern times, a careful review of the literature demonstrates that the opposition to the use of embryonic stem cells is both overstated and unpersuasive when viewed against the potential medical and economic benefits and the when viewed more particularly from a bioethical perspective involving medical professionals such as nurses.   The opposition to the use of embryonic stem cells has tended with very few exceptions to have been rooted in religious doctrines and ethical perspectives.  What has not been properly discussed has been the fact that not all institutionalized religions oppose the use of embryonic stem cells, not all ethical theorists are unsettled by the use of these types of stem cells, and the fact that many modern states have constitutional provisions explicitly intended to separate religious doctrine and public policy.  In addition to this reality, the manner in which the religious opposition has been exaggerated and improperly characterized, there are also sound medical reasons and absolute economic imperatives for incorporating the use of embryonic stem cell research into the larger stem cell research context.  This essay will argue that the objections to the use of embryonic stem cells, while based on deeply personal reasons to those making those objections, are simply not supported by the legal, medical, and economic times in which the debate is occurring, that the religious objections have been grossly exaggerated, and that professional responsibility counsels in favor of embryonic stem cell research because of the potential medical benefits.

Religious Objections Exaggerated
As a preliminary matter, although it is an established principle to respect a variety of different religious perspectives in a free society, it is also a well-established principle that religion often inhibits the formulation and implementation of sound public policy decisions.  History is littered with incidents where religious institutions have dominated national policies and the results have rarely been positive in either a scientific sense or a social sense.  This history, regarding religious interference in scientific matters, has led one leading scholar in the embryonic stem cell debate to suggest that Its possible that these embryonic stem cells may lead to great things in the future. But in the here and now, religious conservatives see their destruction as nothing more than a high-tech form of cannibalism HYPERLINK httpwww.questiaschool.comPM.qstaod111451259(Bellomo, 2006, p. 1).  The rhetoric employed, as it can be seen, seems hardly conducive to rational debate or to compromise.  Even a cursory examination of the religious critiques of embryonic stem cell research, and the scope of the religious organizations issuing critiques, demonstrates that the religious conservatives are a minority segment of the larger population and that they do not speak for all Christian religious institutions and affiliations let alone for citizens more generally.

One leading religious theorist, for instance, has acknowledged this division among religious opinion while simultaneously advocating a ban on the use of embryonic stem cells.  One of the most notable religious institutions that has broken ranks with other religious objectors is the venerable Church of Scotland indeed, it has been noted rather subtly in the literature that the Church of Scotland has made certain doctrinal concessions. Specifically, although it still argues against the use of embryonic stem cells for human cloning, it has come out in support of the use of embryonic stem cells that may benefit human reproduction, noting that
Insofar as God--argued the Scottish church--created human embryos for the end of human reproduction, such embryos, within the 14-day period, should only be used for research serving human reproduction. But since embryos created by therapeutic cloning have never served the end of reproduction, they can be used for medical research and the production of embryonic stem cells.

The main point, for purposes of this papers thesis, is that the political rhetoric on both sides is too extreme and misleading.  Religious opinion is hardly monolithic and many people with some form of faith support the use of embryonic stem cells in certain limited circumstances.  Moreover, some of the criticisms and cautions that have been attributed to strictly religious perspectives are in fact more nuanced ethical paradigms.  The criticisms emanating from religious institutions and religious academic journals must therefore be scrutinized closely to determine whether the commentary is of a religious nature or an ethical and philosophical commentary divorced from strict religious doctrine.  One excellent example of this type of ethical approach in a religious journal argues that
Our ethical reflection on human embryonic stem cell research and therapeutic cloning leads to the conclusion that these new techniques are in conflict with ethical norms, because they use early human life as a means to achieve an external end. This conclusion does not deny the good ethical reasons which can be named in favour of such techniques. Certainly there can be no doubt about the high ethical value that medical efforts to alleviate human suffering enjoy. Indeed, in the biblical tradition, human beings are never simply called to accept passively their fate, but rather to shape it with the abilities which God has given them.

The notions, in short, that there are uniform religious bases for opposing the use of embryonic stem cells or that religions are unified in their condemnation are simply wrong.  It would be more accurate to argue that certain religious factions are sternly opposed to this type of research whereas other factions support it entirely or in limited circumstances.  Religion is not a persuasive basis upon which to completely prohibit the use of embryonic stem cells.  There is also, in the United States of America at least, a constitutional reason for tempering the extant to which religious organizations are allowed to influence these types of public policy debates to be sure, in America, conservative religious organizations have exerted a substantial influence on public policy with respect to the use of embryonic stem cells.  It has been generally agreed, for example, that In the United States, the legal status of the human embryo has been a widely debated and highly political topic since the U.S. Supreme Court decision in Roe v. Wade.   Bowing to pressure, President Bush imposed federal funding limits with respect to the use of embryonic stem cells.  The issue is made even more volatile because embryonic stem cell research typically involves both the alleged creation of life and its subsequent destruction whereas abortion deals only with the destruction of life element.  These distinctions notwithstanding, it has always been a guiding principle in the United States of America that church and state ought to operate in fundamentally different spheres.  One American congressman, linking this separation principle to the embryonic stem cell debate, has argued that this is not mere politics, but the imposition of religious beliefs, a deeper matter violating the established order of separation of church and state .

Any analysis of the religious features of this debate must acknowledge certain realities if the debate is constitute something more than partisan politics or religious warfare through proxy.  First, religious opinion is extraordinarily diverse and some religious institutions and many lay followers actually favor the use of embryonic stem cells in certain circumstances.  Second, many of the criticisms attributed to religious organizations are in reality bio-ethical commentaries that rely of ethical paradigms related to but independent of religious doctrine.  Finally, the principle of a separation of church and state explicitly provides that diverse religious views must be tolerated without being imposed.  Overall, the religious objections have been greatly exaggerated and used for political gains as well as for the imposition of religious beliefs not shared by many people.  This is not meant to suggest that religious groups should not be allowed to voice their opinions, for any free society must give free air to all opinions, but simply that the religious basis for objecting to the use of embryonic stem cells is an inadequate basis upon which to make either public policy decisions or ethical decisions that affect free societies.

Potential Benefits  Medically and Economically
In addition to rejecting religious objections to the use of embryonic stem cells, this paper also argues that the potential medical benefits and the associated competitive economic issues justify the expanded use of embryonic stem cells. First, the primary argument in favor of the use of embryonic stem cells has concentrated on the potential medical and health applications.  These potential medical applications are fundamentally of a regenerative nature and hold out some promise that once untreatable diseases can some day be reversed.  The potential applications are extraordinarily broad and include such diseases as human genetic disorders, stem cell therapies such as bone marrow transplants, blindness, deafness, diabetes, injuries to the spinal cord, and much more.  The potential applications, it would appear, are limited only by the scientific imagination.  It is important to note, however, that many of these medical applications are merely theoretical and have not been perfected.  The question thus becomes whether the use of embryonic stem cells, which have been shown to be able to renew themselves and differentiate into different types of cells, is justified with reference to these potential medical applications.  The answer must be a resounding yes.  The entire history of medicine, whether of a biological or chemical orientation, has always been about understanding and manipulating the natural world in ways that can alleviate medical suffering.  It has been argued that there is promising research regarding the extraction of preexisting embryonic cells that do not implicate the creation and destruction of life issues directly and that there is therefore plenty of time to wait for these refined research methods while attaining the same medical benefits in the longer term.  Such an argument ignores the nature of the competitive market economies around the world and the fact that innovations in biotechnology may lay the scientific and economic foundations for the next economic expansion much as the internet and the railroads did before.

The economic arguments in favor of the use of embryonic stem cells, even in the short term, are extraordinarily persuasive.  It has been noted that the current economic environment makes the economic arguments more compelling in this respect, one international legal commentator emphasizing the potential economic benefits of such research has noted that
The disparities among the laws of the various countries could have a profound impact on embryonic stem cell research, particularly in the United States. Specifically, the rigidity of the current U.S. policy may cost the United States its best and brightest researchers as well as its grip on a newly developing industry that promises new life to a sagging economy.

The economic risks are substantial given the fact that other countries are not as constrained by religious and ethical considerations as is true in the United States.  The very real fear, and one justified by economic history, is that scientists, jobs, and technology will follow the science as a result, limitations on the use of embryonic stem cells is very probably going to put America at a competitive economic disadvantage.

Bioethics, Utilitarianism, and Professional Responsibility
As a nursing professional, there are more specific ethical considerations related to ones bioethical perspective and related ethical obligations related to professional responsibility.  Terminology is sometimes confusing, given that some ethical concepts are used interchangeable when they do not mean precisely the same thing, but for purposes of this paper and the stem cell research issue, Bioethics is the subdiscipline of applied ethics that studies the moral questions surrounding biology, medicine, and the health professions in general.  As a more narrowly conceived type of applied ethics, which functions to grapple with a variety of difficult medical research issues such as the ethical issues raised by stem cell research , cloning, euthanasia, and  clinical drug trials, bioethical paradigms depend on underlying assumptions.  In my view, believing that professional responsibility means easing pain and suffering for the most patients possible, a utilitarian ethical orientation seems preferable to one predicated on religious assumptions or absolutist conclusions.  More specifically, as one bioethical scholar has argued with respect to nursing in particular, Utilitarianism can keep us mindful of the importance of the consequences of our actions, the effect these actions have on others, and the duty to minimize suffering.  Professional responsibility demands caring for patients in the most effective manner possible and utilitarianism favors maximizing the ability to care for the largest amount of patients possible in order to execute ones professional responsibilities.  Therefore, from the bioethical and professional responsibility points of view, it seems best to allow and to pursue embryonic stem cell research in an effort to ease human suffering.

Conclusion and Personal Opinion
In the final analysis, though reasonable people may quite reasonably disagree about the propriety of using embryonic stem cells, the best approach is to allow such research.  The religious objections have been greatly exaggerated and many people with religious convictions actually support such research.  In addition, there are medical and economic imperatives that strongly favor the use of embryonic stem cells.  The time has come to throw all of our resources behind stem cell research by including embryonic stem cells in this type of research.