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Making a market for human embryos?
Now that the race is on to unlock the secrets of human embryonic stem cells, there is an important new raw material that will be the key to stem cell research-the supply of human embryos. The best source for stem cells seems to be human embryos, and the process that yields the cells also destroys the embryo. Because of sensitivity over the status of human embryos and federal law that prohibits tax dollars from being used for embryo research, the U.S. National Institutes of Health (NIH) has proposed that it will fund research on stem cells but won't fund the collection of the stem cells themselves. This leaves private companies to act as suppliers of stem cells. Where will the embryos come from, what limits should there be on embryo use, and how close are we to a market in human embryos?
New use for 'spare' embryos
There are many thousands of human embryos frozen at infertility clinics, left over from in vitro fertilization (IVF) efforts for infertile couples. These so-called "spare" embryos are created when a woman's eggs are collected during infertility treatment. Since human eggs cannot be frozen and then later thawed for fertilization, all the eggs collected must be fertilized, and the embryos not transferred to a woman's womb ending up frozen for later use. But many end up unused and left with an uncertain future-remaining frozen indefinitely, being donated to other needy infertile couples (an uncommon practice), being donated for research, or being thawed and discarded. Given the choice between leaving embryos frozen or discarding them, many couples may see the value of donating embryos for research.
Why not make new embryos?
Even with a potential supply of many thousands of spare embryos, there may still be reason for making new embryos, not because the supply of stem cells is too limited but because of the need for unique genetic characteristics. For instance, in research on therapeutic uses of stem cells such as growing organs for transplant or creating cells to treat spinal cord injury, the cells would need to match the immune system of the eventual patient. This might require creating an embryo with a closely matched immune system if none existed in the spare embryo supply. The gold standard would be an embryo with an identical immune system, and that could be accomplished by cloning-creating embryos that are the genetic twins of patients. An expert panel in England has recently advocated allowing just such an approach, though "therapeutic cloning" is not likely to occur anytime soon in the United States.
Private supplier, public buyer
With the expected demand for human embryos created by expanding stem cell research around the world, are we creating a new market in human embryos? U.S. policy paying for research on stem cells that avoids paying for their collection begs the question, since the government is effectively the market maker--a public buyer creating a demand to be filled by private suppliers. Those suppliers will need embryos to provide stem cells, and safeguards will be necessary to prevent a market from emerging in the embryos themselves. NIH policy attempts to address these concerns with requirements that embryo donors can receive no benefit. This includes bans on payment for embryos and on the donation of embryos for the purpose of receiving medical benefit from their use. How these prohibitions will be worked out and enforced is not yet clear, but they will be important in preventing unacceptable incentives for embryo donation or creation.
The explosion of stem cell research means demand for human embryos will only increase, and we need only look to reproductive medicine to see what the future may hold. Embryo donation must avoid what has become the accepted practice of selling human eggs to the highest bidder, with ads for egg donors offering upwards of $50,000. The potential benefits of stem cell research are staggering, but they can't come at the cost of commodifying human embryos or the donors from which they come.
"Ethics Matters" Archive
where you'll find other columns from Jeffrey Kahn
on a wide range of bioethics topics.
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