There is a debate surrounding the idea of stem cell research and the ethical relevance that it may or may not have as a treatment option. Stem cells can be derived from many sources, but the most common source is embryonic stem cells. These types of cells come from blastocysts that are most often between 3 and 5 days old. Because of this, stem cell research has faced a lot of controversy due to the argument about when life begins. People have their opinions, but some choose to utilize stem cells as treatment options for various diseases. An article published in Science Direct discussed how this could be a treatment option for those with neurodegenerative disorders. The purpose of stem cell treatment is to generate healthy cells that can ultimately replace ones that have been damaged or have died. Stem cells are cells from which any other type of cell can be derived, including cardiac, blood, muscle, and nerve cells. In the case of neurodegenerative disorders, stem cells are used to help create new nerve cells which would hopefully slow down the progression of the disease.
The ethical debate surrounding stem cell therapy as a treatment for neurodegenerative disorders has more to do with the decision to do so and less to do with the action of stem cell therapy itself. With this type of disorder, it usually affects the decision-making capacity of the patient. Therefore, it is difficult to explain the mechanism and possible side effects of the proposed treatment to the patient. Because of this, the patient is not fully aware of what could possibly happen to them, which puts a lot of pressure on the family to make a decision that they think the patient would approve of. On one hand, it makes sense to have stem cell treatment utilized as a treatment option. If there is a possibility that it could help someone feel better, then it seems like the ethical thing to do. However, on the other hand, that treatment could be something that the patient does not want. In many cases, the patient does not have the mental capacity to make that decision for themselves, which could add to the argument that you are forcing treatment on someone who may not want that. If something like stem cell therapy has been proven to be successful in a clinical setting, is it truly ethical to have a patient undergo this treatment without them fully understanding what is going on?
Barker, R. A., & Beaufort, I. de. (2013, May 7). Scientific and ethical issues related to stem cell research and interventions in neurodegenerative disorders of the brain. Progress in Neurobiology. Retrieved November 16, 2022, from https://www.sciencedirect.com/science/article/pii/S0301008213000397
Mayo Foundation for Medical Education and Research. (2022, March 19). Stem Cells: What they are and what they do. Mayo Clinic. Retrieved November 16, 2022, from https://www.mayoclinic.org/tests-procedures/bone-marrow-transplant/in-depth/stem-cells/art-20048117
The ethical debate on cognitive status is a very interesting topic when discussing neurodegenerative diseases as a whole. Diseases affecting individual's cognition create a unique scenario in practice as a lot of decision making would rely on input from the affected individuals family/friends as self reports of cognition would become increasingly more difficult to rely on as the disease progresses. Furthermore, research on prevention, intervention, or methods of management have yet to provide compelling solutions for some of these diseases. As such, I wanted to know how stem cells can be utilized in practice to decrease or mitigate the effect of degenerative diseases, specifically in Alzheimer’s Disease (AD). As you mentioned, the use of stem cells in degenerative diseases could prevent mechanisms that kill cells and/or could allow for the creation of new cells in tissue that doesn’t normally regenerate new cells. In this application, it is critical to understand the pathology related to the disease. For example, AD has four distinct features related to its progression: increased Tau, increased amyloid plaque, activated microglia, and structural atrophy (Duncan & Valenzuela, 2017). The progressive nature of AD could allow for mitigation if stem cell therapy was applied early in the cascade of events leading to the accumulation of said features. In the AD model, stem cell therapy would likely be most beneficial with respect to neurosynaptic loss (Duncan & Valenzuela, 2017). If successful, what effect would this have on the other features? I think this adds to your point that medical decision making for those affected by neurodegenerative diseases is ethically challenging especially when treatment options vary by individual, by disease status, etc.
ReplyDeleteDuncan, T., & Valenzuela, M. (2017). Alzheimer’s disease, dementia, and stem cell therapy. Stem Cell Research & Therapy, 8, 111. https://doi.org/10.1186/s13287-017-0567-5