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Making the Future Fair: Theories of Justice for Stem Cell Research

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Stem Cell Research:
Ethics, Translations and Transmissions
Northwestern University
An NIH Center of Excellence in Stem Cell Research
Center for
Bioethics
Science
and Society
Laurie Zoloth, Ph.D
Northwestern University Feinberg School of
Medicine, Center for Bioethics, Science and
Society
Plan of talk
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Ethical Issues in International Stem Cell Research
List of first, second and current ethical concerns
Why we must now focus on justice
Description of theories of justice
Description of historical solutions in resource allocation
Proposals for fairness
One Critical Note about Veracity as the basis for all
theory (both in science and in philosophy)
Gratitude
Northwestern University Feinberg School of
Medicine, Center for Bioethics, Science and
Society
The First Years of Human Stem Cell Research—
a brief review of where we’ve been
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Raised three sorts of questions in ethics:
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Origins : the cells raised issues of moral status of
embryo
Process: Donations of eggs and sperm needed
raised issues of informed consent
Telos: Long term goals raised issues of the telos
or good ends of the idea itself
Northwestern University Feinberg School of
Medicine, Center for Bioethics, Science and
Society
The Next Questions concerned
Somatic Cell Nuclear Transfer
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Raises new issues—cloning
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Violation of order considered natural or divine
Species and boundaries
Slippery slope concerns
Northwestern University Feinberg School of
Medicine, Center for Bioethics, Science and
Society
Core arguments against basic research
in human stem cells
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Slopes are slippery and the future is thus
dangerous
Can not use the bodies of others even for good
Money and the marketplace are inherently
corrupting
Nature is both fixed and sacred
DNA is ipsity—once established destroying it
amounts to killing
Suffering and finitide defines humanity
Women could face particular abuse
Northwestern University Feinberg School of
Medicine, Center for Bioethics, Science and
Society
That the more we learn about this
Northwestern University Feinberg School of
Medicine, Center for Bioethics, Science and
Society
The better able we are to relieve
human suffering
Northwestern University Feinberg School of
Medicine, Center for Bioethics, Science and
Society
What have we learned so far?
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Some questions are not resolvable
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Some are merely very difficult to resolve
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Some have just not yet been resolved in a
temporal sense.
Northwestern University Feinberg School of
Medicine, Center for Bioethics, Science and
Society
But of all the lessons we learned one
thing.
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Do not lie
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For if you lie about the facts
Or hype the results
Or hype the fear
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Then real discourse cannot happen.
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Northwestern University Feinberg School of
Medicine, Center for Bioethics, Science and
Society
Koreagate: Not too early to tell
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That lying has had a devastating effect on
the process
That international co-operation is made
more difficult
That the entire process of bioethics is at
issue
That bioethics must make its own demands
Northwestern University Feinberg School of
Medicine, Center for Bioethics, Science and
Society
What it Means to Have Duties
As in Kantian Moral Imperatives
As in Religious Commands
That is the key question.
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Isn’t the problem the moral status of the
human embryo?
Northwestern University Feinberg School of
Medicine, Center for Bioethics, Science and
Society
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No.
Northwestern University Feinberg School of
Medicine, Center for Bioethics, Science and
Society
Stem cell science raises important
ethical questions
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Even if we cannot decide about moral
status
Which we cannot: for it is not a scientific
question in its present form and in the
present world.
Northwestern University Feinberg School of
Medicine, Center for Bioethics, Science and
Society
I. 3 interesting Questions in biology
and in ethics
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What does it mean to be human?
What does it mean to be free?
What must I do about the suffering of the
other?
Northwestern University Feinberg School of
Medicine, Center for Bioethics, Science and
Society
II. A Particular history
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1970s: ability to deconstruct process of human
reproduction
idea that infertility is a disease with a treatment
Creation of a genuinely new entity: an unenabled
human embryo
In a country with a long history of interest in moral
status issues
And Asilomar, which encouraged bioethicists
Northwestern University Feinberg School of
Medicine, Center for Bioethics, Science and
Society
What policymakers actually need to
ask:
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Are there reasons in principle why performing the
basic research should be impermissible?
What contextual factors should be taken into
account an do any of these prevent development
and use of the research?
What purposes, techniques or applications would be
permissible and under what circumstances?
What procedures, structures, involving what
policies, should be used to decide on appropriate
techniques and uses?
Northwestern University Feinberg School of
Medicine, Center for Bioethics, Science and
Society
171 Bills debated in first months of
2005 at the state level in the US
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15 on umbilical cord blood banking
156 on committed (“adult”) cells, hES or
cloning
14 enacted into law
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A “New Federalism”
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Northwestern University Feinberg School of
Medicine, Center for Bioethics, Science and
Society
Separation Compromise Emerges
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Election of 2004
Stem Cell Policy, 2005
Northwestern University Feinberg School of
Medicine, Center for Bioethics, Science and
Society
Stem cells debate draws on classic
tropes and borders debates
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Borders of democracy-> moral status of the other
Borders of Nature-> Fixed? Tamed? Normative?
Borders of mortality and suffering, contingency
Danger -> slopes, precaution, dual use, mistakes
Justice-> access, fairness, money and markets
A synedoche for modernity—a trigger for
fundamental return(s)
Northwestern University Feinberg School of
Medicine, Center for Bioethics, Science and
Society
Issues Considered by National Academy
of Sciences in the United States
1)
2)
3)
4)
5)
6)
7)
Recruitment of donors of blastocysts, gametes, or somatic cells
informed consent
financial incentives
conflicts of interest
donor confidentiality
risks associated with oocyte retrieval
handling of genetic information arising from the research
Characterization and standardization of stem cells
Safe handling and storage of blastocysts and stem cell material
Conditions for transfer of such material among laboratories
Appropriate uses of hES cells in research or therapy
Limitations on the use of hES cells
Safeguards against misuse
Northwestern University Feinberg School of
Medicine, Center for Bioethics, Science and
Society
Guidelines for Human Embryonic Stem Cell Research
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Use local IRBs
Use existing BABs
Create new oversight groupings at local
level
Statewide boards
National oversight (raises other risks)
Northwestern University Feinberg School of
Medicine, Center for Bioethics, Science and
Society
Knowles:
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“By creating the California Institute for
Regenerative Medicine (CIRM) as a central
body to distribute these funds, and within it,
the Independent Citizen's Oversight
Committee (ICOC) as a governing body to
evaluate who receives them, the state has
effectively created its own National
Institutes of Health. “
Northwestern University Feinberg School of
Medicine, Center for Bioethics, Science and
Society
The Real NIH is shaken by new forces
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Hurricanes
Basic flattening before hurricanes
Aging population, risk of infectious disease
Private model, HSA, and
entrepreneurialism
Northwestern University Feinberg School of
Medicine, Center for Bioethics, Science and
Society
How to regulate? Despite the
appearance of a regulatory vacuum
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Protections in place include:
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federal human-subject research protection
FDA protections
Health Insurance Portability and Accountability
patient privacy rules.
RAC guidelines
Apply to any research supported in whole or in
part by federal funds or at institutions that have
pledged to follow federal regulations.
ASRM guidelines
Northwestern University Feinberg School of
Medicine, Center for Bioethics, Science and
Society
New Phase Begins: Establishment of
Banks for hES lines
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Earlier Questions marked by contention
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Largely issues of faith
Issues of significant disagreement with low
likelihood of solution
Search for determinate answers for largely
indeterminate problems (see Nature, Oct 16)
Northwestern University Feinberg School of
Medicine, Center for Bioethics, Science and
Society
Moving from theory to praxis
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Will create immediate justice issues
Need for a UNOS or lottery system
Northwestern University Feinberg School of
Medicine, Center for Bioethics, Science and
Society
Justice is prior to freedom
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Levinas’s claim
Need I mention once again that truth is a
prerequisite to justice
Northwestern University Feinberg School of
Medicine, Center for Bioethics, Science and
Society
The Question of Justice
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How does a society decide what is just?
In a world of scarcity, how ought a society justly
distribute scarce goods and services?
In light of the particular and poignant crisis of
health care what would be the language of such
choices,
How can state can be accountable for justice
How can an international community reflect on
justice?
Northwestern University Feinberg School of
Medicine, Center for Bioethics, Science and
Society
Statement of problem
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How can we set in place a fair and just
system of access to the good ends of
medicine?
Using a fair and just process that protects
donors and recipients?
And aiming for fair and just goals for
humanity?
Northwestern University Feinberg School of
Medicine, Center for Bioethics, Science and
Society
Standard candidates for material
principles of distribution
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numerical equality
need
individual effort
social contribution
merit or desert
Northwestern University Feinberg School of
Medicine, Center for Bioethics, Science and
Society
Theories come from material
principles
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Different theories of justice placed different
emphasis on these material principles,
Can accept combinations of material
principles
Understanding a particular theory of justice
began by critically examining the theoretical
justification of the selection of material
principles
Northwestern University Feinberg School of
Medicine, Center for Bioethics, Science and
Society
And from principles of liberal
democracy
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All liberal theories shared in common the
presuppositions of the liberal tradition,
all rested on the assurance of the primacy of the
individual the individual person, with liberty, rights,
duties, and the ability to engage in voluntary
consent, existed prior to the social contract itself.
the social contract that is entered into by rational
free agents operating from an original position
that was either historical or hypothetical, that
created the liberal state
Northwestern University Feinberg School of
Medicine, Center for Bioethics, Science and
Society
Libertarian theory
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liberty, private property, and entitlement.
the problem of ownership
the rights of each individual to own his or her own resources.
According to the classic Lockean theory, the labor power of
the individual, his actual work, was "mixed" with the natural
resources, land, and water to create wealth that the individual
then owned.
The ownership of the harvested crops was brought into
being by virtue of the individual's creation of this commodity
where none existed before.
Northwestern University Feinberg School of
Medicine, Center for Bioethics, Science and
Society
Problems
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Are free first holdings really free?
What of physical or genetic injustice?
Does the end not really not matter---could
one accumulate nearly all the resources if
done fairly?
Northwestern University Feinberg School of
Medicine, Center for Bioethics, Science and
Society
Utilitarianism
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“All action is for the sake of some end, and
rules of action, it seems natural to suppose,
must take their whole character and color
from the end to which they are subservient.
. . . When we are engaged in a pursuit, a
clear and precise conception of what we
are pursuing would seem to be the first
thing we need, instead of the last we are to
look forward to”
 John Stuart Mill
Northwestern University Feinberg School of
Medicine, Center for Bioethics, Science and
Society
Based in Consequences
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Greatest happiness for greatest number
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pleasure and the freedom from pain, are the only
things desirable as ends; and that all desirable
things (which are as numerous in the utilitarian as
in any other schemes) are desirable either for the
pleasure inherent in themselves, or as a means to
the promotion of pleasure and the prevention of
pain.
Northwestern University Feinberg School of
Medicine, Center for Bioethics, Science and
Society
Not rights based
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liberty was not a right unless it was justified
by its utility to a society that was secure.
Claims of merit, claims of prior social
contract, conflicting appeals, and material
principles of justice were ultimately
subjective and hence did not give a
consistent account of justice.
Northwestern University Feinberg School of
Medicine, Center for Bioethics, Science and
Society
Problems
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Majority v minority
What is good?
Evil
Fate of individual
Northwestern University Feinberg School of
Medicine, Center for Bioethics, Science and
Society
Deontology: Duties
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There is a world of others to whom promises are made and
to whom duties are owed.
And underlying norms and presumptions,
Duties create the means of being
In the context of relationships
With attendant obligations that guide our acts.
For some deontologists there were certain acts (truth telling,
promise keeping) that contained moral worth distinct from
their impact on consequences--independent of the net
happiness, pleasure, or difficulties the fulfillment of the
obligation would bring.
Northwestern University Feinberg School of
Medicine, Center for Bioethics, Science and
Society
Kant
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“nothing is left but the conformity of actions
to universal law as such and this alone
must serve the will as its principle. That is
to say, I ought never to act except in such a
way that I can also will that my maxim
should become a universal law.”
Northwestern University Feinberg School of
Medicine, Center for Bioethics, Science and
Society
Social Contract Theory
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Based on equality of shares as in John Rawls
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“Each person possesses an inviolability founded
on justice that even the welfare of society as a
whole cannot override.
justice denies that the loss of freedom for some is
made right by a greater good shared by others.
Therefore in a just society the liberties of equal
citizenship are taken as settled; the rights secured
by justice are not subject to political bargaining or
to the calculus of social interests.”
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Northwestern University Feinberg School of
Medicine, Center for Bioethics, Science and
Society
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First Principle: Each person is to have an
equal right to the most extensive total
system of equal basic liberties compatible
with a similar system of liberty for all
Northwestern University Feinberg School of
Medicine, Center for Bioethics, Science and
Society
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Second Principle: social and economic
inequalities are to be arranged so that they
are both:
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a. to the greatest benefit of the least advantaged,
b. attached to positions open to all under
conditions of fair equality of opportunity
Northwestern University Feinberg School of
Medicine, Center for Bioethics, Science and
Society
Egalitarian Theories of Justice
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each of us had inescapable and essential rights and
obligations toward one another that could not be ignored
rights, obligations, duties, and needs arose from
something we shared as persons,
common to all
must be respected by all.
commitment to equality
ability to make rational choices that honored this
equality were at the heart of this theory of justice.
Northwestern University Feinberg School of
Medicine, Center for Bioethics, Science and
Society
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First among these duties was the notion
that justice was rooted in equality, an
equality due on the basis
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of shared human embodiment and
participation in a mutually consensual human
society.
Northwestern University Feinberg School of
Medicine, Center for Bioethics, Science and
Society
A basic decent minimum.
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This basic decent minimum was an
assessment of a quantifiable human
necessity
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constituted the share to which all persons were
entitled by virtue of their personhood alone
not because of merit or desert.
Northwestern University Feinberg School of
Medicine, Center for Bioethics, Science and
Society
All these theories share these qualities:
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Must be applicable: Any theory, to be
ultimately credible, must address certain
social imperatives: cultural norms,
economic limits, and the power of the state.
Rooted in mortality and rooted in scarcity
Theory for rational beings
Northwestern University Feinberg School of
Medicine, Center for Bioethics, Science and
Society
All faced challenges in the late 20th
century
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Feminist in North America
Liberation Theology in Latin America
Post- Modernist in Europe
Northwestern University Feinberg School of
Medicine, Center for Bioethics, Science and
Society
But were the basis for many health
care dilemmas
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3 Classic lifeboat problems in all
technological advances
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First use will be risky and dangerous
Will quickly be available to a small elite
Will move from desire to need to entitlement
Northwestern University Feinberg School of
Medicine, Center for Bioethics, Science and
Society
No Formal Rationing Plan until
Medicine becomes a Public Act
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Prior idea was individuals tending to
individuals
Family based care
Hospices of the Knights Templar
Village healers
First come, first served
Northwestern University Feinberg School of
Medicine, Center for Bioethics, Science and
Society
American Civil War
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Whitman notes first come, first served
model
Some use of rank
Occasional compassionate attention to
child soldiers
Northwestern University Feinberg School of
Medicine, Center for Bioethics, Science and
Society
“Triage” in Crimean War, WWI
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French surgeons
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Florence Nightingale
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Technology (in this case of killing) forced
treatment changes
Northwestern University Feinberg School of
Medicine, Center for Bioethics, Science and
Society
Idea is that scarcity is made
transparent
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Rational planning and order is based on
logical theory
System planned in advance
Choices based on clinical assessment
Northwestern University Feinberg School of
Medicine, Center for Bioethics, Science and
Society
Priorities vary
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In War: need for activities to resume as
quickly as possible—
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First attention to most lightly wounded
Least resources on most critical, likely to die, or
complex
Northwestern University Feinberg School of
Medicine, Center for Bioethics, Science and
Society
Historical Rationing of Penicillin
WWII
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Introduction in wartime framed the first use
Triage was based on ability to restore ill to
battle
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Syphilis before battle infection
Not routinely given in life threatening cases
Northwestern University Feinberg School of
Medicine, Center for Bioethics, Science and
Society
Kidney Hemodialysis Machines
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First use monitored by Ethics Boards
(“leading citizens”)
Difficult and class based results
Ended up funding everyone
Northwestern University Feinberg School of
Medicine, Center for Bioethics, Science and
Society
Lottery systems for rare drug protocols
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All patients considered equally at risk
Main consideration was appearance of
utter fairness
Northwestern University Feinberg School of
Medicine, Center for Bioethics, Science and
Society
United National Organ Sharing:UNOS
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Developed for a ranking system for solid
tissue cadaveric organs
Has expanded for living organ donors
Based on medical need
Geography a factor
Must first be able to be listed
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Able to pay in some fashion
Able to care for self in the eyes of the boards
Northwestern University Feinberg School of
Medicine, Center for Bioethics, Science and
Society
HeLa cells—how pure research
distributes
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Mrs. Henrietta Lane’s tumor removed in
cancer surgery
No consent or knowledge to family
Pure transformation to commodity as cell
line
Free use in all labs
Northwestern University Feinberg School of
Medicine, Center for Bioethics, Science and
Society
Flu vaccine systems set in place by
the CDC in 2004-2005
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Idea of �high risk’ category
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Likely to die if aquired upper respiratory illness
and pnuemonia
Or likely to affect fetus
Or in historical life boat catagory
Northwestern University Feinberg School of
Medicine, Center for Bioethics, Science and
Society
Statement of problem
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How can we set in place a fair and just
system of access to the good ends of
medicine?
Using a fair and just process that protects
donors and recipients?
And aiming for fair and just goals for
humanity?
Northwestern University Feinberg School of
Medicine, Center for Bioethics, Science and
Society
When we live in an unjust world?
Northwestern University Feinberg School of
Medicine, Center for Bioethics, Science and
Society
Stem Cell Libraries (note: not
“banking”)
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Theory is a source for most MHC (HLA)
lines in a given population
Need justice in how donations (not
deposits) are made
In how withdraw fairly
Northwestern University Feinberg School of
Medicine, Center for Bioethics, Science and
Society
Four problems
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How to make donation fair and just from
egg donors?
How to distribute lines to researchers so
research is just?
How to do clinical trials justly?
How to distribute or trade fairly when
therapies are discovered and verified?
Northwestern University Feinberg School of
Medicine, Center for Bioethics, Science and
Society
A theory of donation
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Stem cells reveal certain veracities
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Humans are pluripotent at the cellular level
Healing is a complex and self organizing system
Abundance is structured into nature
People have an abundance of gametes—more
than they could even possibly need as
individuals
Northwestern University Feinberg School of
Medicine, Center for Bioethics, Science and
Society
Organ donation remind us of an
ontology: the neighbor is the self
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That the self may be (literally) for the other
Which is the bases for much of ethics and
religious morality
Note: Emmanuel Levinas—”the very skin of
the self if needed.”
A theory of hospitality grounds our duty
Northwestern University Feinberg School of
Medicine, Center for Bioethics, Science and
Society
Egg donations may offer another
chance to know this
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Egg donation as altrusim
Hence, not as a commodity but a gift
And, in the sense of the Hebrew Scripture,
a justice making act (tzedakah)
Northwestern University Feinberg School of
Medicine, Center for Bioethics, Science and
Society
Philosophic problems in giving
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Are women really free moral agents?
Can the state compel altruism?
What about free markets?
How to avoid coercion?
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Hard coercion as in prostitution (cash for use of
body)
Soft coercion as in family pressure or desperation
(love/approval for use of body)
Northwestern University Feinberg School of
Medicine, Center for Bioethics, Science and
Society
Cannot avoid coercion
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In fact, it may be a constraint on all human
existence
And this is a good thing!
However we can support compassionate
donation, and avoid payment
Northwestern University Feinberg School of
Medicine, Center for Bioethics, Science and
Society
New NU research toward egg
maturation in cancer survivors
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Northwestern University (“Joseph Project”)
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NuBorn
NuAge
Northwestern University Feinberg School of
Medicine, Center for Bioethics, Science and
Society
Philosophic problems in receiving
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Need a system of triage
Based on prior UNOS system
Should follow from an international discussion
within stem cell community
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Investigators
Patients
Need to research how economies of fair trade can
be supported with experimental economics
Northwestern University Feinberg School of
Medicine, Center for Bioethics, Science and
Society
What is new or distinctive about hES
lines?—unsolved challenges!
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First use risky but desperately needed?
Demand outweighs supply?
Distribution in a world with uneven access
to basic decent minimum of other social
and health care needs
Americans face a unique problem in
developed world (uninsured)
Northwestern University Feinberg School of
Medicine, Center for Bioethics, Science and
Society
Like penicillin, offers hope for cure
and not treatment
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Net savings if successful in millions of
cases of chronic disability
Technology may allow for wide distribution
without expensive treatment centers
Spinal cord injury as first target
Offers the chance to be both a donor and
recipient
Northwestern University Feinberg School of
Medicine, Center for Bioethics, Science and
Society
New philosophical opportunities
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Rational creatures allow systems of justice
Plasticity of the creature allows systems of
justice as well
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a duty of reversibility
a duty to heal
Human duties movement
Northwestern University Feinberg School of
Medicine, Center for Bioethics, Science and
Society
NAS Guidelines: Donations of blastocysts,
oocytes, sperm and somatic cells
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Should always be reviewed by an Institutional Review Board
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Should be governed by informed consent of all donors
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Separation of decision to donate from all clinical decisions
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No payments to donors beyond reimbursement
of direct expenses
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No purchase or sale of donated materials
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Protection of donor privacy
Northwestern University Feinberg School of
Medicine, Center for Bioethics, Science and
Society
Guidelines for Human Embryonic Stem Cell Research
NAS Recommendations for Oversight of Human
Embryonic Stem (hES) Cell Research
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Local oversight - each institution should
establish an Embryonic Stem Cell Research
Oversight (ESCRO) committee to review and
monitor all proposals to conduct hES cell
research.
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The committee should include representatives of
the public and persons with expertise in
developmental biology, stem cell research,
molecular biology, assisted reproduction, and
ethical and legal issues in hES cell research.
Northwestern University Feinberg School of
Medicine, Center for Bioethics, Science and
Society
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A national panel should be established to
assess
periodically the adequacy of the guidelines
and to
provide a forum for a continuing discussion of
issues involved in hES cell research.
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politically independent and without conflicts of interest
respected in the lay and scientific communities
able to call on suitable expertise to support this effort.
Northwestern University Feinberg School of
Medicine, Center for Bioethics, Science and
Society
International System needs
international forum
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UN?
Council of Stem Cell Centers?
Northwestern University Feinberg School of
Medicine, Center for Bioethics, Science and
Society
Conclusions
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Unique opportunity for new theory of justice
based on:
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Classic theologies: shared stewardship of land
Actual physiologies of plasticity
The gift relationship that also grounds society
The principle of Hospitality even with moral
strangers
Northwestern University Feinberg School of
Medicine, Center for Bioethics, Science and
Society
Conclusions:
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All science is political and is thus like free
speech (with permission and limits) for:
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Basic medical research is always about the other understood as
the self—
And carries both an overt text and a covert text that “pokes holes
in the fabric of what we know.”
Science advances are ontological, and hence, allow for a new
self-social interaction (Thomas Jefferson)
Hence, research—even if on the molecules of the cells of the
body will be understood as a social act.
Northwestern University Feinberg School of
Medicine, Center for Bioethics, Science and
Society
Public Science creates a Moral
Economy
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Public Funding will be key, for only if there
is public funding can there be frank and
open oversight and regulation
Need to allow for public access to all cures
All citizens need to reflect on the ethical
choices science raises
And science and the public are both moral
witness to how the future will be shared
Northwestern University Feinberg School of
Medicine, Center for Bioethics, Science and
Society
Not a “Bank” but a “Grange”
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Co-op model based on fair trade
Storehouse with shares based on
stewardship
Neighbors in need versus customers
Northwestern University Feinberg School of
Medicine, Center for Bioethics, Science and
Society
Not a “Bank” but a “Library”
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Language will be important
Northwestern University Feinberg School of
Medicine, Center for Bioethics, Science and
Society
The ethical question of stem cell research
also is a deontological question
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If I have a duty to heal the suffering other,
Then how should I judge things or persons
that block that duty or moral action?
Is it warranted to block the moral action of
healing to avoid the destruction of a
blastocyst?
Northwestern University Feinberg School of
Medicine, Center for Bioethics, Science and
Society
But please remember that it is not the
key question
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Because the debate about stem cells is often seems to
turn around the debate about abortion
This is a conceptual error (sorry) but a probable one
Takes us away from justice, the poor, or actual women,
but has been important
And it is a fundamental theological dispute
This being the case—is there anything more to say
about moral status?
Hence: The search for agreement-aka “the third way.”
Northwestern University Feinberg School of
Medicine, Center for Bioethics, Science and
Society
Is this controversy sufficient to stop a
moral agent from her duty?
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No: because it is the (valid and unassailable)
problem of one religious group—separation
principle
No: because of justice consideration on where to
spend research social goods
No: because the power of this duty grounds
medicine
No: because several other civic compromises
exist (including Bush’s plan)
Northwestern University Feinberg School of
Medicine, Center for Bioethics, Science and
Society
Final Premise: Practical Matters
Matter
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Long held tradition (religions) and practice
(clinical) offer far clearer models for discursive
community praxis.
Basic science should proceed in all directions.
Funding for particular projects about faith
communities should be supported by these
communities.
Therapies and basic research ought not wait for
social consensus.
Northwestern University Feinberg School of
Medicine, Center for Bioethics, Science and
Society
How to respond? : One Idea from One
Moral Philosopher
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Healing is at the Moral Center of the Universe
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it is the core of most religions and the call of
prophets consider our duty
it is the core of what stem cells do in the human
body
It is good for the country
Freedom of research is an enabling idea in
democracies
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Northwestern University Feinberg School of
Medicine, Center for Bioethics, Science and
Society
Now: Can we please ask the question
of Justice?
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Stem cell research will proceed (new lines,
new methods, emergence of clinical trials
protocols, etc)
The deeper questions are ones of justice
and access: like all health care, an
unfinished project
Northwestern University Feinberg School of
Medicine, Center for Bioethics, Science and
Society
A Commercial for Bioethics
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You must always tell the truth and be prepared to
verify it with repeatable data
Our trust in you requires transparency and
veracity.
A note about absolute veracity in Jewish Law:
while it is permitted to tell the bride she is
beautiful, science and ethics is a different matter.
“Tell the truth and stand up for all humanity”
Sydney Brenner, Science , 2004.
Northwestern University Feinberg School of
Medicine, Center for Bioethics, Science and
Society
acknowledgments
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From Northwestern
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Teresa Woodruff: Cancer Genetics
John Kessler: Stem Cell Research NIH Center
of Excellence
Mary Hendrix, CMH and Northwestern
Rex Chisholm, Genetic Medicine
Lynne Keasling, Kelloge School and
Economics
Kelly Mayo, Biology
Jonathon Moreno University of Virginia and NAS
Richard Hayes, MIT and NAS
Len Zon, Harvard University, HHMI
Doug Melton, Harvard University, HHMI
Irv Weisman, Stanford University
Ronald McKay, NIH
Nissim Benvenisty Hebrew University, Jerusalem
Rudolph Jaenisch, MIT
Suzanne Holland, University of Puget Sound
Karen Lebacqz, Pacific School of Religion, emertius
Roger Pederson, Cambridge Knowledge Research Center
Woo-Suk Hwang, Seoul National University,
Gerald Schatten, University of Pittsburg
Northwestern University Feinberg School of
Medicine, Center for Bioethics, Science and
Society
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