This blog post examines the ethical and medical issues surrounding embryonic stem cell research and explores whether IPS cells can serve as a realistic and perfect alternative.
The debate over embryonic stem cells is one of the most significant social issues in science today. Stem cells extracted from the embryonic stage can differentiate into all types of tissue cells within the body, such as liver, heart, or bone cells, holding great potential for organ transplants and treating incurable diseases. However, embryonic stem cell research raises ethical concerns due to its use of embryos. Additionally, the issue of side effects arising after treatment remains a limitation of the research. The author of this book, Michael Sandel, primarily argues that there are no problems with embryonic stem cell research from an ethical standpoint and that the research is therefore justified. However, I disagree with Sandel’s position. Therefore, in this essay, I will refute several of Sandel’s arguments and present additional grounds for opposition to demonstrate that embryonic stem cell research is not justified. Subsequently, I will propose alternatives for organ transplants and treatments for incurable diseases.
The first argument Sandel presents in favor of embryonic stem cell research is that an embryo cannot be considered a person. An embryo lacks identifiable human characteristics or forms, such as specific bodily organs or tissues. Furthermore, if we define a person solely based on two characteristics—that the embryo is composed of human cells and is alive—then one might argue that human skin cells should also be considered human. While I do not believe this argument is entirely incorrect, I still think there are sufficient reasons to respect the embryo as a living being. The most significant factor in determining an embryo’s moral status is its ‘potential to develop into a human being.’ While acknowledging that an embryo is not yet human, it possesses the potential to become human, which distinguishes it from skin cells. Although an embryo cannot become a human being on its own without a mother, from the perspective that all humans begin as embryos, there is sufficient reason to respect embryos even if they are not yet human.
Sandel cited the following rationale: most embryos used in embryonic stem cell research are surplus embryos generated in fertility clinics. One study surveyed the number of unused, frozen surplus embryos in fertility clinics by country, finding approximately 400,000 in the United States, 50,000 in the United Kingdom, and 70,000 in Australia. Using these embryos for research means that what would ultimately be discarded can instead be used to treat incurable diseases, making it true that ‘nothing is wasted’. However, I believe there are problems with this argument. The first is the ethical issue surrounding the very fact that surplus embryos are created in fertility clinics. These embryos are created by producing more embryos than are initially needed for implantation. This implies that if only the necessary number of embryos were created for implantation, no surplus would exist. In fact, Germany prohibits creating more embryos than needed for implantation as a matter of policy, preventing surplus embryos. Ultimately, the issue of embryos in fertility clinics is a matter of national policy, not one that can avoid ethical concerns.
As evident from the above, Sandel’s arguments primarily focus on ethical aspects. Now, I wish to present that embryonic stem cell research also carries significant risks from a medical perspective. First, embryonic stem cells carry a high potential for cancer development during the treatment process. Embryonic stem cells are undifferentiated stem cells before they differentiate into specific cell types. They are induced to differentiate into cells suitable for therapeutic purposes. However, during this process, some cells differentiate into unintended cell types. These cells can induce tumors, which in severe cases can lead to cancer. Second, there is the problem of significant side effects after treatment. According to a report in the New England Journal of Medicine in August 2001, side effects such as persistent seizures and involuntary arm movements occurred during the treatment of Parkinson’s disease patients using stem cells. Thus, embryonic stem cells present not only ethical issues but also significant medical problems. Continuing research on embryonic stem cells while carrying so many problems is not justified.
Therefore, I oppose embryonic stem cells and simultaneously propose induced pluripotent stem cells (IPS cells) as an alternative. Stem cells can be broadly categorized into embryonic stem cells, adult stem cells, and IPS cells. Among these, IPS cells are also called ‘reprogrammed stem cells,’ a term that encapsulates the process of creating them. IPS cells are created by introducing specific genes into an adult somatic cell, effectively turning back the biological clock to restore the cell to a primitive stem cell state. As evident from this description, IPS cells do not utilize embryos and thus offer an alternative to all the ethical issues arising from embryonic stem cells. IPS cells represent a relatively recent breakthrough in stem cell research and advanced medical technology. In 2012, Professor Shinya Yamanaka of Japan and Sir John Gurdon of the UK were awarded the Nobel Prize in Physiology or Medicine for their research on extracting IPS cells from mice. This achievement came a mere six years after their paper was published. The short timeframe between the paper’s publication and the Nobel Prize win signifies that IPS cells are recognized as a viable, rational alternative in stem cell research, which had been stagnant due to ethical issues, and that their potential is significant.
Let’s examine the current state of stem cell research in Korea. Embryonic stem cell research in Korea, which had been restricted since the 2004 Hwang Woo-suk paper fabrication scandal, has recently been approved and resumed. However, even this research is conducted under intensive monitoring by the Ministry of Health and within a limited number of embryos, facing persistent opposition from the Ministry of Gender Equality and Family and religious groups. Within these constraints, resolving the potential for cancer development or other side effects will be difficult to achieve in the near term, thus further delaying the realization of treatments for incurable diseases. Research on IPS cells, however, does not raise ethical issues and can therefore proceed actively without such constraints. Genes inducing dedifferentiation, such as TAZ, continue to be discovered. Furthermore, IPS cells utilize the patient’s own somatic cells, meaning they are known to avoid immune rejection in organ transplants. These outcomes demonstrate the potential for IPS cell advancement. If embryonic stem cell research were halted and efforts concentrated on IPS cells, even greater results would follow. Unlike embryonic stem cells, which retain ethical concerns even when research succeeds and leads to actual treatments, this approach would yield outcomes satisfying to all.
Of course, IPS cells also have several limitations. A research team at the University of California, San Diego announced the discovery of mutant cells during the processes preceding, during, and after reprogramming. Daughter cells produced by the division of these mutant cells grow faster than normal cells, potentially leading to tumors and cancer. Therefore, IPS cells also require rigorous research before clinical application. Another issue is the frequent occurrence of chromosomal abnormalities. When chromosomal abnormalities arise, the human immune system triggers a response to eliminate the abnormal cells. This can cause tissue rejection reactions, leading to various adverse effects on the body. While such side effects can also occur with embryonic stem cells, they are more severe with IPS cells, presenting a significant limitation.
Embryonic stem cells possess the significant advantage of being able to differentiate into all cell types. Consequently, they have been the focus of active research due to their potential for treating incurable diseases. However, since IPS cells can also function as primitive stem cells, and if these cells possess the same capabilities as embryonic stem cells, it raises the question of whether research on ethically problematic embryonic stem cells must necessarily continue. Of course, IPS cells also have limitations; research on them is not as advanced as on embryonic stem cells, meaning side effects could potentially be more severe. However, side effects can be resolved through further research. Therefore, if the goal is to solve problems related to treating incurable diseases, research conducted in a manner acceptable to the majority of society seems more appropriate. Consequently, embryonic stem cells should be replaced by IPS cells as the alternative for research.
