Katrien Devolder

Preimplantation HLA typing: having children to save our loved ones

Preimplantation tissue typing has been proposed as a method for creating a tissue matched child that can serve as a haematopoietic stem cell donor to save its sick sibling in need of a stem cell transplant. Despite recent promising results, many people have expressed their disapproval of this method. This paper addresses the main concerns of these critics: the risk of preimplantation genetic diagnosis (PGD) for the child to be born; the intention to have a donor child; the limits that should be placed on what may be done to the donor child, and whether the intended recipient can be someone other than a sibling. The author will show that these concerns do not constitute a sufficient ground to forbid people to use this technique to save not only a sibling, but also any other loved one’s life. Finally, the author briefly deals with two alternative scenarios: the creation of a human leukocyte antigen (HLA) matched child as an insurance policy, and the banking of HLA matched embryos.

Creating and sacrificing embryos for stem cells

The compromise position that accepts the use and derivation of stem cells from spare in vitro fertilisation embryos but opposes the creation of embryos for these purposes is a very weak ethical position. This paper argues that whatever the basis is on which defenders of this viewpoint accord intrinsic value to the embryo, once they accept the creation and sacrifice of embryos to benefit infertile people with a child-wish, they do not have a sound moral argument to condemn the creation and sacrifice of embryos to benefit ill and injured people.

Coercion, Incarceration, and Chemical Castration: An Argument From Autonomy

In several jurisdictions, sex offenders may be offered chemical castration as an alternative to further incarceration. In some, agreement to chemical castration may be made a formal condition of parole or release. In others, refusal to undergo chemical castration can increase the likelihood of further incarceration though no formal link is made between the two. Offering chemical castration as an alternative to further incarceration is often said to be partially coercive, thus rendering the offender’s consent invalid. The dominant response to this objection has been to argue that any coercion present in such cases is compatible with valid consent. In this article, we take a different tack, arguing that, even if consent would not be valid, offering chemical castration will often be supported by the very considerations that underpin concerns about consent: considerations of autonomy. This is because offering chemical castration will often increase the offender’s autonomy, both at the time the offer is made and in the future.

What’s in a name? Embryos, entities, and ANTities in the stem cell debate

This paper discusses two proposals to the US Presidents Council on Bioethics that try to overcome the issue of killing embryos in embryonic stem (ES) cell research and argues that neither of them can hold good as a compromise solution. The author argues that (1) the groups of people for which the compromises are intended neither need nor want the two compromises, (2) the US government and other governments of countries with restrictive regulation on ES cell research have not provided a clear and sound justification to take into account minority views on the protection of human life to such a considerable extent as to constrain the freedom of research in the area of stem cell research, and (3) the best way to deal with these issues is to accept that many people and most governments adopt a gradualist and variable viewpoint on the human embryo which implies that embryos can be sacrificed for good reasons and to try to find other, less constraining, ways to take into account minority views on the embryo. Finally, another more efficient and time and money sparing compromise will be proposed for those who accept IVF, a majority in most societies.

The Moral Imperative to Conduct Embryonic Stem Cell and Cloning Research

a) protect adequately human life in the application of life sciences b) prohibit all forms of human cloning inasmuch as they are incompatible with human dignity and the protection of human life c) prohibit the application of genetic engineering techniques that may be contrary to human dignity d) prevent the exploitation of women in the application of life sciences e) adopt and implement national legislation to bring into effect paragraphs a to d f) take into account the pressing global issues such as HIV/AIDS, tuberculosis, and malaria, which affect in particular the developing countries. We will argue that cloning research does not exploit women (as d implies) and does address global health problems (not as f implies). More importantly, we will argue that it is immoral to prohibit all forms of cloning (as b suggests) and that national legislation is required to ban reproductive cloning but not therapeutic cloning (and that e is too broad). This declaration fails to take account of new research into cloning and of the distinction between cloning research for the purposes of regenerative medicine (self-transplantation) and cloning research for the purposes of developing what we call cellular models of human disease. This second application is immune to virtually all objections to cloning research. 2 The United Nations should withdraw its unethical Declaration on Human Cloning. The Declaration is as immoral as it is lethal, or so we shall argue.

Complicity in stem cell research: the case of induced pluripotent stem cells

Many who object to human embryonic stem cell (hESC) research because they believe it involves complicity in embryo destruction have welcomed induced pluripotent stem cell (iPSC) research as an ethical alternative. This opinion article aims to show that complicity arguments against hESC research are prima facie inconsistent with accepting iPSC research as it is currently done. Those who oppose hESC research on grounds of complicity should either (i) oppose iPSC research as well, (ii) advocate a radical change in the way iPSC research is done, (iii) demonstrate that complicity arguments against iPSC research are weaker than those against hESC research or (iv) reject complicity arguments against both hESC and iPSC research, either by adopting a more limited conception of complicity that allows acceptance of some hESC research, or by accepting that destroying embryos for important scientific research is not wrong.

Procreative altruism: beyond individualism in reproductive selection.

Existing debate on procreative selection focuses on the well-being of the future child. However, selection decisions can also have significant effects on the well-being of others. Moreover, these effects may run in opposing directions; some traits conducive to the well-being of the selected child may be harmful to others, whereas other traits that limit the child’s well-being may preserve or increase that of others. Prominent selection principles defended to date instruct parents to select a child, of the possible children they could have, likely to have a good (or nonbad) life, but they do not instruct parents to independently take the well-being of others into account. We refer to these principles as individualistic selection principles. We propose a new selection principle—Procreative Altruism—according to which parents have significant moral reason to select a child whose existence can be expected to contribute more to (or detract less from) the well-being of others than any alternative child they could have. We present the case for adopting Procreative Altruism alongside any of the major individualistic selection principles proposed to date and defend this two-principle model against a range of objections.

To be, or not to be?: Are induced pluripotent stem cells potential babies, and does it matter?

In July 2009, two research groups independently reported the first successful generation of adult mice from induced pluripotent stem cells (iPSCs; Kang et al , 2009; Zhao et al , 2009). These experiments are part of ongoing research into the differences and similarities between iPSCs—which are derived from normal somatic cells by the activation of certain key genes—and embryonic stem cells (ESCs). If iPSCs are found to be similar to ESCs in terms of their ability to differentiate into any cell type, it might make the use of the latter in research redundant in the long term. This would be beneficial to biomedical research on stem cells and their medical use, as iPSCs are likely to be cheap and easy to produce and would circumvent many of the ethical issues posed by research using human ESCs (hESCs). However, the very same research results might raise ethical challenges for those who accept iPSC research but reject hESC research as ethically objectionable: similarities could cast doubt on one of the main arguments against hESC research, that of ‘potentiality’. > If iPSCs are found to be similar to ESCs in terms of their ability to differentiate into any cell type, it might make the latters use in research redundant in the long term To create mice from iPSCs, the authors of both 2009 publications used a technique called tetraploid complementation. This method has been used successfully with mouse ESCs to produce viable mice and is the most stringent test of the pluripotency of stem cells. It involves creating tetraploid embryos by fusing the blastomeres of two‐cell‐stage embryos. As they have twice the normal number of chromosomes, tetraploid embryos cannot develop normally and do not result in an animal. The tetraploid embryos are grown to the blastocyst stage, injected with mouse ESCs and implanted in the …

Compromise and Moral Complicity in the Embryonic Stem Cell Debate

In September 2004, Italy’s health minister, Girolamo Sirchia, hailed the successful treatment of a five-year-old boy with thalassaemia, an inherited form of life-threatening anaemia. The therapy involved transplanting stem cells of the umbilical cord blood of the boy’s newborn twin siblings. The minister hoped to use this case to convince the Italian public of the potential of non-embryo-derived stem cells and to justify the contentious Italian law on assisted reproduction. However, soon after his ‘triumph’ it became known that the twin pregnancy was realised with IVF and the selection of embryos through PGD and HLA typing, in a hospital in Turkey, techniques which Sirchia considers as immoral and which are outlawed by the Italian government.2

U.S. Complicity and Japan's Wartime Medical Atrocities: Time for a Response

Shortly before and during the Second World War, Japanese doctors and medical researchers conducted large-scale human experiments in occupied China that were at least as gruesome as those conducted by Nazi doctors. Japan never officially acknowledged the occurrence of the experiments, never tried any of the perpetrators, and never provided compensation to the victims or issued an apology. Building on work by Jing-Bao Nie, this article argues that the U.S. government is heavily complicit in this grave injustice, and should respond in an appropriate way in order to reduce this complicity, as well as to avoid complicity in future unethical medical experiments. It also calls on other U.S. institutions, in particular the Presidential Commission for the Study of Bioethical Issues, to urge the government to respond, or to at least inform the public and initiate a debate about this dark page of American and Japanese history.