Kennedy Institute of Ethics Journal

In “Moral Complicity in Induced Pluripotent Stem Cell Research” (MCIPS) (Brown 2009), I sketched the moral complicity implications of alternative national stem cell policies with respect to direct reprogramming techniques that appear to result in pluripotent stem cells derived from skin cells, hair cells, and possibly other somatic cells. This aspect of the stem cell debate was considered from the perspective of those who are pro embryo life and who attribute to human embryos a complete set of basic human rights, including a stringent right to life; and from the perspective of advocates of embryonic stem cell research who do not recognize full moral equivalence between human embryos and human children and who do not ascribe to human embryos an inviolable right to life. The moral complicity concerns of embryonic stem cell research advocates focus upon the scope of medical beneficence with respect to patients whose quality of life and personal autonomy are negatively impacted by the interval between the time when they might have gotten effective medical treatment through unimpeded stem cell science and the time at which stem cell science constrained by pro embryo life moral complicity concerns arrives at a similar destination. The moral complicity concerns of embryo life proponents focus upon noncooperation in past and future destruction of human embryos in order to derive in vitro embryonic stem cell lines.

Among the policy alternatives considered were proposals that would be responsive to the possibility that induced pluripotent stem cells (iPSC) at some point may provide a source of stem cell lines that would substitute for human embryonic stem [End Page 206] cell (hESC) lines in cell replacement therapy. If functional equivalence between iPSC lines and hESC lines for cell replacement purposes were confirmed, a national stem cell research policy might be crafted that could accommodate the central moral complicity concerns both of persons who are embryo life advocates and of advocates of embryonic stem cell research. Policy alternatives considered in MCIPS included those based upon the assumption that currently existing embryonic stem cell lines are sufficient to conduct iPSC/hESC functional equivalence studies and policy options based upon the assumption that currently existing hESC lines fall short of what would be required for methodologically sound validation studies. The moral complicity implications for those who are embryo life advocates of both sets of policies were outlined, as were the moral complicity implications of alternative policies for embryonic stem cell research advocates. Since moral complicity concerns are one factor that those who formulate national stem cell policy should consider, MCIPS was an attempt to provide some guidance to policymakers with respect to how alternative policies accommodate or fail to accommodate the moral complicity concerns of various constituencies.

In a 2008 article, Malcolm Byrnes (2008, p. 286) appears to consider both empirical assumptions regarding the sufficiency of existing stem cell lines for meaningful functional equivalence studies, and for that reason I drew upon his paper to frame the moral complicity implications for advocates of embryo life of national stem cell policy based upon either assumption. In his paper, Byrnes refers both to stem cell scientists who “suggest” that the hESC lines approved by President Bush in 2001 are sufficient and to stem cell scientists who believe that more hESC lines are needed. Based on my reading of his paper, I erroneously included Byrnes in the group who were willing to consider new hESC derivations in order to complete functional equivalence studies. However, my description of the moral complicity implications for advocates of embryo life of policies that enable new hESC derivations was an exercise in contingency planning, and certainly not intended as “a condemnation” of Byrnes (2009, p. 203). Similarly, what Byrnes (2009, p. 204) sees as “ironic” is simply a description later in my paper of policy options based upon an alternative factual assumption.

Byrnes’s position seems to be that existing hESC lines are sufficient to conduct iPSC/hESC functional equivalence studies and that no additional hESC lines should be derived. Although it appears that I did mischaracterize Byrnes’s view of the permissibility of deriving additional hESC lines for equivalence studies, I think my interpretation was...