Stem Cell Research

Research ethics committees must sometimes deliberate about objects that do not fit nicely into any existing category. This is currently the case with the “gastruloid,” which is a self-assembling blob of cells that resembles a human embryo. The resemblance makes it tempting to group it with other members of that kind, and thus to ask whether gastruloids really are embryos. But fitting an ambiguous object into an existing category with well-worn pathways in research ethics, like the embryo, is only a (...) temporary fix. The bigger problem is that we no longer know what an embryo is. We haven’t had a non-absurd definition of ‘embryo’ for several decades and without a well-defined comparison class, asking whether gastruloids belong to the morally relevant class of things we call embryos is to ask a question without an answer. What’s the alternative? A better approach needs to avoid what I’ll refer to as “the potentiality trap” and, instead, rely on the emergence of morally salient facts about gastruloids and other synthetic embryos. (shrink)

To determine when the life of a human organism begins, Mark T. Brown has developed the somatic integration definition of life. Derived from diagnostic criteria for human death, Brown’s account requires the presence of a life‐regulation internal control system for an entity to be considered a living organism. According to Brown, the earliest point at which a developing human could satisfy this requirement is at the beginning of the fetal stage, and so the embryo is not regarded as a living (...) human organism. This, Brown claims, has significant bioethical implications for both abortion and embryo experimentation. Here, we dispute the cogency of Brown’s derivation. Diagnostic criteria for death are used to determine when an organism irreversibly ceases functioning as an integrated whole, and may vary significantly depending on how developed the organism is. Brown’s definition is derived from a specific definition of death applicable to postnatal human beings, which is insufficient for generating a general definition for human organismal life. We have also examined the bioethical implications of Brown’s view, and have concluded that they are not as significant as he believes. Whether the embryo is classified as a human organism is of peripheral interest—a far more morally relevant question is whether the embryo is a biological individual with an identity that is capable of persisting during development. (shrink)

A crucial question in reproductive ethics is whether a human being’s life begins at conception – if it does not, it is more difficult to argue that early embryos possess substantial moral status. I...

The debate on the question of the moral status of human beings and the boundaries of the moral community has long been dominated by the antagonism between personism and speciesism: either certain mental properties or membership of the human species is considered morally crucial. In this article, I argue that both schools of thought are equally implausible in major respects, and that these shortcomings arise from the same reason in both cases: a biological notion of being human. By contrast, I (...) show to what extent being human is morally relevant in a non‐biological sense. I establish the living human form as the essential criterion for belonging to the moral community, and defend it against a number of possible objections. This new morphological approach is capable of capturing essential elements of personism and speciesism without sharing their faults, and of reconstructing widespread moral intuitions. (shrink)

This book introduces readers to the many arguments and controversies concerning abortion. While it argues for ethical and legal positions on the issues, it focuses on how to think about the issues, not just what to think about them. It is an ideal resource to improve your understanding of what people think, why they think that and whether their (and your) arguments are good or bad, and why. It's ideal for classroom use, discussion groups, organizational learning, and personal reading. -/- (...) From the Preface -/- To many people, abortion is an issue for which discussions and debates are frustrating and fruitless: it seems like no progress will ever be made towards any understanding, much less resolution or even compromise. -/- Judgments like these, however, are premature because some basic techniques from critical thinking, such as carefully defining words and testing definitions, stating the full structure of arguments so each step of the reasoning can be examined, and comparing the strengths and weaknesses of different explanations can help us make progress towards these goals. -/- When emotions run high, we sometimes need to step back and use a passion for calm, cool, critical thinking. This helps us better understand the positions and arguments of people who see things differently from us, as well as our own positions and arguments. And we can use critical thinking skills help to try to figure out which positions are best, in terms of being supported by good arguments: after all, we might have much to learn from other people, sometimes that our own views should change, for the better. -/- Here we use basic critical thinking skills to argue that abortion is typically not morally wrong. We begin with less morally-controversial claims: adults, children and babies are wrong to kill and wrong to kill, fundamentally, because they, we, are conscious, aware and have feelings. We argue that since early fetuses entirely lack these characteristics, they are not inherently wrong to kill and so most abortions are not morally wrong, since most abortions are done early in pregnancy, before consciousness and feeling develop in the fetus. -/- Furthermore, since the right to life is not the right to someone else’s body, fetuses might not have the right to the pregnant woman’s body—which she has the right to—and so she has the right to not allow the fetus use of her body. This further justifies abortion, at least, until technology allows for the removal of fetuses to other wombs. Since morally permissible actions should be legal, abortions should be legal: it is an injustice to criminalizing actions that are not wrong. -/- In the course of arguing for these claims, we: 1. discuss how to best define abortion; 2. dismiss many common “question-begging” arguments that merely assume their conclusions, instead of giving genuine reasons for them; 3. refute some often-heard “everyday arguments” about abortion, on all sides; explain why the most influential philosophical arguments against abortion are unsuccessful; 4. provide some positive arguments that at least early abortions are not wrong; 5. briefly discuss the ethics and legality of later abortions, and more. -/- This essay is not a “how to win an argument” piece or a tract or any kind of apologetics. It is not designed to help anyone “win” debates: everybody “wins” on this issue when we calmly and respectfully engage arguments with care, charity, honesty and humility. This book is merely a reasoned, systematic introduction to the issues that we hope models these skills and virtues. Its discussion should not be taken as absolute “proof” of anything: much more needs to be understood and carefully discussed—always. (shrink)

The clonal evolution model and the cancer stem cell model are two independent models of cancers, yet recent data shows intersections between the two models. This article explores the impacts of the CSC model on the CE model. I show that CSC restriction, which depends on CSC frequency in cancer cell populations and on the probability of dedifferentiation of cancer non-stem cells into CSCs, can favor or impede some patterns of evolution and some processes of evolution. Taking CSC restriction into (...) account for the CE model thus has implications for the way in which we understand the patterns and processes of evolution, and can also provide new leads for therapeutic interventions. (shrink)

Der moralische Status menschlicher Embryonen ist und bleibt umstritten. Zugleich gibt es immer neue und tiefergehende biotechnologische Möglichkeiten, Embryonen zu manipulieren. Das betrifft insbesondere ihr Entwicklungspotential und die klare Zuordnung zur menschlichen Spezies. Dieses Buch untersucht, welche Auswirkungen diese neuen Manipulationsmöglichkeiten auf die Tragfähigkeit der Argumente haben, mit denen ein herausgehobener moralischer Status des Embryos begründet werden soll: die Potentialitäts- und Speziesargumente. In den Beiträgen werden aktuelle Entwicklungen in der Forschung mit Embryonen zusammengetragen und insbesondere folgende Fragen diskutiert: Was bedeuten (...) diese Entwicklungen für die Potentialitäts- und Speziesargumente – und damit letztendlich auch für den moralischen Status der so manipulierten Embryonen? Können die zentralen embryoethischen Argumente angesichts der neuen biotechnologischen Eingriffsmöglichkeiten überhaupt aufrechterhalten werden? Sind alle Varianten der Argumente betroffen oder nur einige? Können und müssen sie möglicherweise reformuliert oder neu gedacht werden? (shrink)

This article discusses what is involved in having full moral status, as opposed to a lesser degree of moral status and surveys different views of the grounds of moral status as well as the arguments for attributing a particular degree of moral status on the basis of those grounds.

Guidelines on embryo storage prioritise 'respect for the embryo' above the wishes of the women whose labour and tissue have gone into creating the embryo in the first place, effectively making women and the female body disappear. In this article I draw a parallel between this phenomenon relating to embryo storage and other instances of a similar phenomenon that I have called 'the lady vanishes', particularly in stem cell and 'mitochondrial transfer' research. I suggest that a modified property regime could (...) protect women's interests in embryo storage, making a parallel with the Yearworth case, in which it was recognised that men had limited but actionable interests in their stored sperm.. (shrink)

Ontologies of living things are increasingly grounded on the concepts and practices of current life science. Biological development is a process, undergone by living things, which begins with a single cell and (in an important class of cases) ends with formation of a multicellular organism. The process of development is thus prima facie central for ideas about biological individuality and organismality. However, recent accounts of these concepts do not engage developmental biology. This paper aims to fill the gap, proposing the (...) lineage view of stem cells as an ontological framework for conceptualizing organismal development. This account is grounded on experimental practices of stem cell research, with emphasis on new techniques for generating biological organization in vitro. On the lineage view, a stem cell is the starting point of a cell lineage with a specific organismal source, time-interval of existence, and ‘tree topology’ of branch-points linking the stem to developmental termini. The concept of ‘enkapsis’ accommodates the cell-organism relation within the lineage view; this hierarchical notion is further explicated by considering the methods and results of stem cell experiments. Results of this examination include a (partial) characterization of stem cells’ developmental versatility, and the context-dependence of developmental processes involving stem cells. (shrink)

I argue against the view that modern biology has undermined traditional moral rules, including the prohibition of abortion and restrictions on human embryonic stem cell research, by blurring the distinction between humans and other animals. I argue that this view depends on the false premise that an organism can be wronged only if the organism has conscious interests. I then defend a rule against harvesting stem cells in a way that kills an organism with a rational nature. Finally, I apply (...) this rule to proposals about altered nuclear transfer and animal-human chimeras. (shrink)

It is common in bioethical discussion to present thought experiments or cases in order to construct an argument. Some thought experiments are quite illuminating, and ethical theorizing will often appeal at some point to one’s intuitions. But there are cases in which thought experiments are useless or do not contribute to the argument. This article considers cases presented in the context of stem cell research that are destructive of human embryos. I argue that certain popular cases that are meant to (...) motivate the view that such research is permissible either are dialectically useless or do not contribute to the argument. By dialectically useless, I mean that the cases analyzed here yield intuitions in people who are already committed to the permissibility of such research. I end with some reflections that challenge the reliability of our intuitions on applied ethics issues by suggesting that thought experiments in this field are dubious from the start. My argument should not be read to support moral skepticism but to urge that our inquiries on applied issues requires certain intellectual virtues. (shrink)

When does a developing human being acquire moral status? I outline three different positions based on substance ontology that attempt to solve the question by locating some morally salient event in the process of human development question. In the second section, I consider some specific empirical objections to one of these positions, refute them, and then show how similar objections and responses would generalize to the other substance-based positions on the question. The crucial finding is that all the attempts to (...) answer the question that involve substance ontology need to appeal to dispositions. (shrink)

Embryonic stem cell research holds great promise for biomedical research, but involves the destruction of human embryos. Katrien Devolder explores the tension between the view that embryos should never be deliberately harmed, and the view that such research must go forward. She provides an in-depth analysis of major attempts to resolve the problem.

Each of the 13 articles in this collection wrestles with intricate metaphysical and moral aspects of the widespread belief that a thing’s potential—what it could, would, might, or will be, but isn’t yet—matters for how we should treat that thing. As John Lizza explains in his lucid introduction, the articles are grouped into three parts according to their aims and theoretical constraints. In this review, I briefly summarize and offer some critical discussion of each part.

I have previously argued that stem cell experiments cannot demonstrate that a single cell is a stem cell. Laplane and others dispute this claim, citing experiments that identify stem cells at the singlecell level. This paper rebuts the counterexample, arguing that the alleged ‘crucial stem cell experiments’ do not measure self-renewal for a single cell, do not establish a single cell’s differentiation potential, and, if interpreted as providing results about single cells, fall into epistemic circularity. I then discuss the source (...) of the dispute, locating it in differences between philosophical and experimental perspectives. (shrink)

Sarah Franklin’s Biological relatives: IVF, stem cells, and the future of kinship and Charis Thompson’s Good science: the ethical choreography of stem cell research, examine recently normalized biotechnologies. Franklin’s monograph extends her previous work on in vitro fertilization , deconstructing the success of a technology that, she argues, has grown “curiouser and curiouser” while taking hold in scientific and social life. IVF in its diverse aspects becomes a lens for scrutinizing our ambivalence about new technology, which Franklin articulates by putting (...) disparate literatures into conversation: feminist science studies, political economy, fine art, and more. Thompson’s Good science focuses more concretely on the first decade of human pluripotent stem cell research, tracing the field from the innovation of cultured human embryonic stem cells through Bush-era policy debates, to current acceptance of stem cell research as a part of the scientific and policy landscape. Th .. (shrink)

This chapter brings a philosophical perspective to the concept of stem cell. Three general questions both clarify the concept of stem cell and emphasize its ambiguities: (1) How should we define stem cells? (2) What makes them different from non-stem cells? (3) What is their ontology? (i.e. what kind of property is “stemness”?) Following this last question, the Chapter distinguishes four conceptions of stem cells and highlights their respective consequences for the cancer stem cell theory. Determining what kind of property (...) stemness is, in what context, is an urgent question, at least for therapeutic strategies against cancers. I hope that this chapter also illustrates how philosophy can be useful to biology. -/- The Chapter starts by clarifying the notions of self-renewal and differentiation. This leads to the question “can we (and if so, how) distinguish stem cells from non-stem cells through these two properties?”. From that will follow an interrogation on whether stem cells belong to a natural kind. On this issue, biologists and philosophers have framed the following alternative: either the concept of stem cell refers to entities (the cells that belong to the stem cell natural kind) or it refers to a transient and reversible cell state. I will argue that four conceptions of stemness should be distinguished rather than two. Finally, I will develop the case of the cancer stem cell (CSC) theory in order to show why it is crucial to answer the ontological question: some therapies might or might not be efficient depending on what stemness is. (shrink)

Reprogramming technologies show that cellular identity can be reprogrammed, challenging the classical conception of cell differentiation as an irreversible process. If non-stem cells can be reprogrammed into stem cells, then what is it to be a stem cell, and what kind of property is stemness? This article addresses this question both philosophically and biologically, states the different possibilities, and illustrates their potential consequences for science with the example of anti-cancer therapies.

This case study deals with the regulation of human embryonic stem-cell research in Brazil. It aims to analyze the process that led to the authorization, in 2005, of the use of stem cells obtained from so-called supernumerary embryos for purposes of research and therapy. We argue that the pro-research lobby in Brazil had considerable success because it framed the issue by referring to Brazil’s peculiar policy background in the fields of assisted reproduction and embryo research. Moreover, this group of actors (...) strategically avoided associating hESC research with abortion, highlighting the humanitarian aspects of this kind of research, rather than the motto of freedom of scientific research. Finally, it was able to rely on the judgment of a fairly progressive Supreme Court, which was also sensitive to public opinion at a time of ‘court activism’ or the ‘judicialization of politics’ in Brazil. (shrink)

Patient-funded trials are gaining traction as a means of accelerating clinical translation. However, such trials sidestep mechanisms that promote rigor, relevance, efficiency, and fairness. We recommend that funding bodies or research institutions establish mechanisms for merit review of patient-funded trials, and we offer some basic criteria for evaluating PFT protocols.

Recent arguments on the ethics of stem cell research have taken a novel approach to the question of the moral status of the embryo. One influential argument focuses on a property that the embryo is said to possess—namely, the property of being an entity with a rational nature or, less controversially, an entity that has the potential to acquire a rational nature—and claims that this property is also possessed by a somatic cell. Since nobody seriously thinks that we have a (...) duty to preserve the countless such cells we wash off our body every day in the shower, the argument is intended as a reductio ad absurdum of the claim that the embryo should be afforded the same moral status as a fully developed human being. This article argues that this argument is not successful and that it consequently plays into the hands of those who oppose embryonic stem cell research. It is therefore better to abandon this argument and focus instead on the different argument that potentiality, as such, is not a sufficient ground for the creation of moral obligations towards the embryo. (shrink)

Recent breakthroughs in stem cell differentiation and reprogramming suggest that functional human gametes could soon be created in vitro. While the ethical debate on the uses of in vitro generated gametes (IVG) was originally constrained by the fact that they could be derived only from embryonic stem cell lines, the advent of somatic cell reprogramming, with the possibility to easily derive human induced pluripotent stem cells from any individual, affords now a major leap in the feasibility of IVG derivation and (...) in the scope of their potential applications. In this paper we develop an ethical framework, rooted in recent scientific evidence, to support a robust experimental pipeline that could enable the first-in-human use of IVG. We then apply this framework to the following objectives: (1) a clarification of the genetic parenting options afforded by IVG, along with their ethical underpinnings; (2) a defence of the use of IVG to remedy infertility, broadening their scope to same-sex couples; (3) an assessment of the most far-reaching implications of IVG for multiplex parenting. These include, first, the liberation of parenting roles from the constraints of biological generations in vivo, allowing multiple individuals to engage in genetic parenting together, thus blurring the distinction between biological and social generations. Second, we discuss the conflation of IVG with sequencing technology and its implications for the possibility that prospective parents may choose among a hitherto unprecedented number of potential children. In view of these perspectives, we argue that, contrary to the exhausted paradigm according to which society lags behind science, IVG may represent instead a salient and most visible instance where biotechnological ingenuity could be used in pursuit of social experimentation. (shrink)

I am grateful to the authors who commented on my article (Piotrowska 2014) for their careful examination of my argument. They have presented a variety of stimulating ideas and suggestions, with which I largely agree and which I would like to discuss further, but in the interest of brevity, I shall try to concentrate only on points of contention.

Human–nonhuman chimeras have been the focus of ethical controversies for more than a decade, yet some related issues remain unaddressed. For example, little has been said about the relationship between the origin of transferred cells and the morally relevant capacities to which they may give rise. Consider, for example, a developing mouse fetus that receives a brain stem cell transplant from a human and another that receives a brain stem cell transplant from a dolphin. If both chimeras acquire morally relevant (...) capacities as a result of transplantation, and if those capacities are indistinguishable, should the difference in cell origin matter to how we classify these creatures? I argue that if morally relevant capacities are easy to detect, cell origin is irrelevant to how the chimera ought to be treated. However, if such capacities are hard to detect, cell origin should play a role in considerations about how to treat the chimera. (shrink)

In his discussion of in vitrogametogenesis, Rob Sparrow claims that an ethical barrier to development of this technology is that many jurisdictions currently prohibit the practice of creating embryos solely for the purpose of research. However, he suggests that this ethical barrier will soon be eroded, in view of the fact that in vitro gametogenesis could serve as a powerful new technology to overcome infertility. In this commentary, I argue that Sparrow is being overly optimistic in his analysis here. I (...) claim that the debate over so-called compromise positions in the human embryonic stem cell debate suggests that the purpose of the research for which a research embryo is created is unlikely to be considered as having any significant bearing on the moral permissibility of the practice for those who oppose it. Even though in vitro gametogenesis could serve as a powerful new technology to overcome infertility, I argue that opponents of the practice of creating embryos solely for research purposes would still view the creation of research embryos that the development of in vitro gametogenesis would require, as being incompatible with affording the embryo proper moral respect. I conclude by suggesting that Sparrow's analysis of the potential benefits of in vitro gametogenesis provides us with further reasons to scrutinise the unconvincing arguments that are often cited in favour of prohibiting the practice of creating embryos solely for research purposes. (shrink)

The debate concerning the moral permissibility of using human embryos in human embryonic stem cell (hESC) research has long centred on the question of the embryo's supposed right to life. However, in focussing only on this question, many opponents to hESC research have escaped rigorous scrutiny by making vague and unfounded appeals to the concept of moral respect in order to justify their opposition to certain hESC practices. In this paper, I offer a critical analysis of the concept of moral (...) respect, and its use to support the intuitively appealing principle of proportionality in hESC research. I argue that if proponents of this principle are to justify its adoption by appealing to the concept of moral respect, they must explain two things concerning the nature of the moral respect owed to embryos. First, they must explain which particular aspect of the embryo is morally relevant, and why. Second, they must explain why some uses of embryos in research fail to acknowledge what is morally relevant about the embryo, and thereby involve a violation of the moral respect that they are due. I shall show that providing such explanations may be more difficult than it first appears. (shrink)

In this article, I present a new interpretation of the pro-life view on the status of early human embryos. In my understanding, this position is based not on presumptions about the ontological status of embryos and their developmental capabilities but on the specific criteria of rational decisions under uncertainty and on a cautious response to the ambiguous status of embryos. This view, which uses the decision theory model of moral reasoning, promises to reconcile the uncertainty about the ontological status of (...) embryos with the certainty about normative obligations. I will demonstrate that my interpretation of the pro-life view, although seeming to be stronger than the standard one, has limited scope and cannot be used to limit destructive research on human embryos. (shrink)

Recent advances in reprogramming technology do not bypass the ethical challenge of embryo sacrifice. Induced pluripotent stem cell (iPS) research has been and almost certainly will continue to be conducted within the context of embryo sacrifice. If human embryos have moral status as human beings, then participation in iPS research renders one morally complicit in their destruction; if human embryos have moral status as mere precursors of human beings, then advocacy of iPS research policy that is inhibited by embryo sacrifice (...) concerns renders one morally complicit in avoidable harms to persons. Steps may be taken to address these complicity concerns, but in the final analysis there is no alternative to achieving clarity with respect to the moral status of the human embryo. (shrink)

No abstract available. First paragraph: In this issue’s target article, Stier and Schoene-Siefert purport to ‘depotentialize’ the argument from potentiality based on their claim that any human cell may be “converted” into a morally significant entity, and consequently, the argument from potentiality finally succumbs to a reductio ad absurdum. I aim to convey two reasons for skepticism about the innocuousness of the notion of cell convertibility, and hence, the cogency of their argument.

This paper explores how current United States policies for funding nonreproductive cloning are justified and argues against that justification. I show that a common conceptual framework underlies the national prohibition on the use of public funds for cloning research, which I call the simple argument. This argument rests on two premises: that research harming human embryos is unethical and that embryos produced via fertilization are identical to those produced via cloning. In response to the simple argument, I challenge the latter (...) premise. I demonstrate there are important ontological differences between human embryos (produced via fertilization) and clone embryos (produced via cloning). After considering the implications my argument has for the morality of publicly funding cloning for potential therapeutic purposes and potential responses to my position, I conclude that such funding is not only ethically permissible, but also humane national policy. (shrink)

I defend the argument that if embryo loss in stem cell research is morally problematic, then embryo loss in in vivo conception is similarly morally problematic. According to a recent challenge to this argument, we can distinguish between in vivo embryo loss and the in vitro embryo loss of stem cell research by appealing to the doctrine of double effect. I argue that this challenge fails to show that in vivo embryo loss is a mere unintended side effect while in (...) vitro embryo loss is an intended means and that, even if we refine the challenge by appealing to Michael Bratman's three roles of intention, the distinction is still unwarranted. (shrink)

Bettina Schöne-Seifert and Marco Stier present a host of detailed and intriguing arguments to the effect that potentiality arguments have to be viewed as outdated due to developments in stem cell research, in particular the possibility of re-setting the development potential of differentiated cells, such as skin cells. However, their argument leaves them without an explanation of the intuitive difference between skin cells and human beings, which seems to be based on the assumption that a skin cell is merely part (...) of a human organism, while an embryo is at some point a human organism. An appropriately designed concept of the human organism can explain the difference, but also has the potential of re-dividing the argumentative landscape along familiar lines. (shrink)

ZusammenfassungIn der Debatte um die embryonale Stammzellenforschung führen die Verfechter der Würde des Embryos gerne eine Gemeinsamkeit von Embryonen und reversibel Komatösen an: Beide sind bloß potentiell Personen. Wenn aber Komatösen fraglos personale Würde zukommt, weshalb sollte man sie Embryonen absprechen? In ihrem AufsatzIn dubio pro embryone kombinieren G. Damschen und D. Schönecker diese Analogie mit einem Vorsichtsargument: Weil die Analogie zumindest gute Gründe für die Annahme biete, Embryonen komme eine menschliche Würde zu, sei angesichts der Schwere des möglichen Unrechts (...) die embryonale Stammzellenforschung nicht zu verantworten. Im Folgenden möchte ich darlegen, weshalb die Analogie nicht ausreicht, um ein solches Vorsichtsargument zu etablieren. In einem ersten Schritt soll gezeigt werden, wie man der Analogie begegnen kann, weshalb das entsprechende Argument also nicht zwingend ist. Um ein Vorsichtsargument zu begründen, würde es allerdings genügen, wenn die Analogie „hinlänglich plausible“ Gründe zugunsten der Würde von Embryonen liefert. In einem zweiten Schritt soll daher – aufbauend auf allgemeinen Überlegungen zum Vorsichtsargument – dargelegt werden, dass die Analogie selbst unter dieser Annahme nicht überzeugen kann. (shrink)

To determine the knowledge, attitude, and ethical concerns of medical students and graduates with regard to Embryonic Stem Cell (ESC) research. This questionnaire based descriptive study was conducted at the Civil Hospital Karachi (CHK), Pakistan from February to July 2008. A well structured questionnaire was administered to medical students and graduate doctors, which included their demographic profile as well as questions in line with the study objective. Informed consent was taken and full confidentiality was assured to the participants. Data were (...) entered in a Statistical Package for Social Sciences (SPSS version.12) and analyzed. A total of 204 male and 216 female medical students and doctors were administered questionnaires out of which 105 males (51.4%) and 108 females (50%) were aware of the embryonic stem cell research and its ethical implications. Forty percent males and 47% of females were of the opinion that life begins at conception. Forty-six percent males and 39% females were in favor of stem cell research while only 31% males and 28% females supported the ESC research. Less than 1/3 of students supported using frozen embryos for research purposes while more than 2/3 indicated that they were unlikely to support abortion for stem cell research purposes. The majority of the students were in favor of stem cell research with some reservations regarding ESC research. A sizeable number of students withheld their views, reflecting their poor understanding of medical ethics. The result of the study indicates a need for incorporating bioethics into the medical curriculum. (shrink)

Given their heterogeneity and lack of defining markers, it is surprising that multipotent mesenchymal stem/stromal cells (MSCs) have attracted so much translational attention, especially as increasing evidence points to their predominant effect being not by donor differentiation but via paracrine mediators and exosomes. Achieving long-term MSC donor chimerism for treatment of chronic disease remains a challenge, requiring enhanced MSC homing/engraftment properties and manipulation of niches to direct MSC behaviour. Meanwhile advances in nanoparticle technology are furthering the development of MSCs as (...) vehicles for targeted drug delivery. For treatment of acute injuries, systemic cell-free exosome delivery may ultimately displace current emphasis on empiric donor-cell transplantation for anti-inflammatory, immunomodulatory and repair-promoting effects. Exploration of potential clinical sources of MSCs has led to increased utilisation of perinatal MSCs in allogeneic clinical trials, reflecting their ease of collection and developmentally advantageous properties. (shrink)