William M. Briggs

Statistician to the Stars!

Is It Moral To Use Embryonic Stem Cells In Cancer Therapy?

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From an anonymous reader comes this question:

Situation: Doctor is referring me to an oncologist because I may have Myeloma. Note that I have not yet gone for additional screening. Internet is useless in looking for statistics on false positives. I am in the dark.

Problem: Indications are that actual death results from not being able to take the pain anymore. So I have been sentenced to death by agony.

Ethical dilemma: Some websites indicate total remission from a stem cell replacement process. So, if a doctor of medicine tells me I can live a long time by using murdered baby stem cells, how should I morally respond?

Myeloma is blood cancer and stem cell therapy is one of the treatment options, one which is not always indicated. Hematopoietic stem cells are those which make blood in the marrow. Only 1 or so out of 10,000 cells in the marrow are HSCs. According to the NIH guide,

The longevity of short-term stem cells for humans is not firmly established. A true stem cell, capable of self-renewal, must be able to renew itself for the entire lifespan of an organism. It is these long-term replicating HSCs that are most important for developing HSC-based cell therapies. Unfortunately, to date, researchers cannot distinguish the long-term from the short-term cells when they are removed from the bloodstream or bone marrow.

The study by Child and others “High-Dose Chemotherapy with Hematopoietic Stem-Cell Rescue for Multiple Myeloma” is, as far as I can tell (and I am not a physician), typical. They say, “High-dose therapy with supporting autologous stem-cell transplantation remains a controversial treatment for cancer. In multiple myeloma, first-line regimens incorporating high-dose therapy yield higher remission rates than do conventional-dose treatments, but evidence that this translates into improved survival is limited.” Their statistics show wee p-values for slightly longer survival times for high-dose therapies. The conventional-dose was a standard therapy of chemotherapy (cycling through drugs over a set time). The high-dose had chemo plus HSC replacement.

Where do the HSCs come from? The NIH says they used to come from bone marrow donors, but that now “doctors now prefer to harvest donor cells from peripheral, circulating blood [from donors].” Umbilical cord blood and the placenta are “rich” sources. Cancer kids injected with HSCs harvested from these latter sources do okay; some “have now lived in excess of eight years”. No panacea, then.

Now some HSCs are taken from “tissues of fetal animals”—and this includes human animals. “Gallacher and others reported finding HSCs circulating in the blood of 12- to 18-week aborted human fetuses that was rich in HSCs.” Yet some embryonic stem cells “can now be cultured in the lab”.

Amounts are important. “Doctors are rarely able to extract more than a few million HSCs from a placenta and umbilical cord—too few to use in a transplant for an adult,” but which might be sufficient for a child. From my understanding, sufficient amounts cannot be taken from aborted babies for direct use in therapy or transplants, although any amount can be used in research.

Those are the facts. Now the morals. Killing an enwombed baby is taking the life of an innocent human being, and it is therefore immoral (and sinful) no matter what. In the past—and this is important—the bodies of the slaughtered were used in research, and this research led to knowledge of how to culture stem cells in the absence of fresh meat.

Some conclusions can now be had. If a therapy directly uses aborted babies, it is immoral. I mean, if your doctor, at your behest, put in an order at Planned Parenthood for such-and-such number of corpses for use in your therapy, it is immoral. You cannot kill an innocent to save your life. If a therapy indirectly uses aborted babies such that corpses are required to “tune” research for your therapy, it is immoral. For instance, your replacement HSC source are not aborted corpses, but these are needed in the process to test this or that, then the therapy is immoral.

Now some knowledge already exists because of previous abortions. Using this knowledge is not immoral, as long as it does not provide temptation (for you or others) to collect new corpses to gain new knowledge. Those who order murders are as immoral as murderers. The same argument holds for stem cell cultures that might have, in the past, originated in baby corpses. As long as this happened before, without your desire for it, and it won’t create temptation or facilitate the occasion of future killing, then you’re acting morally.

Of course, there’s a fine line there. I’m not sure where exactly to draw it generally. What causes sufficient temptation depends on the individual circumstance.

The therapies provided by HSC replacement do not always lead to greatly extended life over conventional drug therapies, and they often provide no additional benefit. Also, all of the therapies that I have been able to discover here in the USA do not directly use blood taken from aborted corpses. If this is right, you can’t be tempted. Blood taken from babies that died naturally (miscarriages or other misfortunes) can be used. Note also that even if HSC therapy gave complete remission, it changes nothing above.

Do not despair. Many myelomas, it seems, are not painful and some, at early stages, do not require treatment. I’m not giving you medical advice nor am I advising you to avoid seeking a physician. I’m sure the readers of this blog will say a prayer for you.

30 Comments

  1. Is it moral to spend money on a Star Wars movie, that could have been used to feed a starving child? Is it moral to buy a Lexus when a Ford Focus would’ve sufficed? Is it moral to spend dollars on extravagant medical intervention prolonging the life of a 70-year-old man that could’ve been spent saving the life of a 5-year-old? Is it moral to completely lie to children about Santa Claus? The answers are no, no, no, and no. (MOST of what we do in our waking lives is not moral.)

  2. This is an interesting dilemma. If you reword the dilemma to “I can recover from cancer if my next door neighbor is killed and his stem cells harvested for me”, virtually no one would agree with that. If we move to “I can recover from cancer if a person in a vegetative state is killed and his stem cells harvested for me”, that becomes more difficult. If we move to “I can recover from cancer if a fetus is killed and harvested and the stem cells harvested for me”, the number who agree goes up dramatically. In all three cases, a human being is killed. It’s kind of like fighting a war with drones, where the army never sees the people it kills and it’s not up close and personal. If no one saw the human being killed or you can convince yourself “it’s not really a human being”, it’s much easier.

    Another way to look at this:
    What if we could clone Neanderthals and then kill them and take their organs for transplant? What if their stem cells worked for cancer treatment? Can we kill them and use the stem cells? They are not actually human beings–not homo sapiens, anyway. Would that be morally correct?

    Shecky: Proper question–is it moral to kill a child and sell its organs for money to see Star Wars? Is it morally correct to kill a store clerk in order to steal cigarettes? Is it moral to lie to your son telling him he can go 150 mph around “dead man’s curve”?

    Your moral dilemmas do not include killing a human in order to save another or to get what we want or lies that can result in death. Until they do, you are simply pointing out immoral acts. Are you arguing that all violation of morals are equal? Killing versus theft are both immoral and therefore there’s no difference between the two?

  3. Shecky,

    No, the answers to your questions are more complex. If the question is, “Is each of these acts as morally superior as possible?” the answer will be, “no.” If the question is, “is it absolutely immoral?” then the answer will still be, “no” (with the possible exception of lying about Santa Claus).

    “The poor you will always have with you.” There is no absolute moral requirement to bankrupt yourself and society helping the poor and sick. Indeed, if we did this – spending every spare cent not used directly for food, clothing and shelter on the poor and the sick, then we would have a very poor standard of living for all, and very bad health care for all. It is good to give some of what superabounds, and it would be wicked to do nothing to help. But your view is itself immoral for the far greater good (and goods) it would destroy. And it is all the more immoral if, as you seem to suggest, it leads people to conclude that there is no point bothering over moral questions generally, since we already do so poorly.

  4. Ha!
    Shecky, sure your last initial isn’t “G”?

  5. Speaking of which, I’m sure I can’t understand why anyone would lie to a child, telling him Santa Claus doesn’t exist. I suppose for those parents who do tell the truth some of the details about Sant might be fudged a bit, but is that really lying?

  6. acricketchirps: I have to agree with Shecky that telling a child there is a Santa Claus is a lie and should not be done. There is nothing wrong with eliminating Santa and just teaching children the actually reason for the celebration (hint: It’s not shopping at the mall or going to Grandma’s house). Children can still receive gifts, give gifts and they can learn to be well-behaved because it’s the right thing to do, not because “Santa” is watching.

  7. There is a teaching of the Catholic Church about morality that may be applicable here, “The principle of the double effect”, that is if an act has two consequences, one morally good, the other morally bad.
    The quote is from the “Dictionary of Catholic Terms”:
    “The principle that says it is morally allowable to perform an act that has at least two effects, one good and one bad. It may be used under the following conditions: 1. the act to be done must be good in itself or at least morally indifferent; by the act to be done is meant the deed itself taken independently of its consequences; 2. the good effect must not be obtained by means of the evil effect; the evil must be only an incidental by-product and not an actual factor in the accomplishment of the good; 3. the evil effect must not be intended for itself but only permitted; all bad will must be excluded form the act; 4. there must be a proportionately grave reason for permitting the evil effect. At least the good and evil effects should be nearly equivalent. All four conditions must be fulfilled. If any one of them is not satisfied, the act is morally wrong.”
    Also, what is not said in this, but is said in the Catechism, is that the evil effect may be foreseen, but not intended. A common example is that of a cancerous uterus that has to be removed and in so doing a fetus will be killed. The death of the fetus is foreseen, but not intended. Another example is self-defense: killing someone who intends to kill you is foreseen but not intended.

  8. “Also, what is not said in this, but is said in the Catechism, is that the evil effect may be foreseen, but not intended. A common example is that of a cancerous uterus that has to be removed and in so doing a fetus will be killed. The death of the fetus is foreseen, but not intended. Another example is self-defense: killing someone who intends to kill you is foreseen but not intended.”

    Any reasonably foreseeable consequence of your actions is what you intend by those actions. The quoted paragraph is simply a way of evading responsibility. As is the vicarious redemption, deathbed repentance, etc., at the core of Christian moral teaching.

  9. lee philips..a naive interpretation.

  10. Easy answer: yes it is moral.

  11. Shecky is wrong on each of her points.
    She gets all tangled in the details.
    Fortunately her questions may be cleaned up and presented with out the dross.

    1)Is it moral to spend money on A that could have gone to B? Answer, Yes. The issue “Is spending money moral?” The selection of the benefit from the transaction out of differing options is a matter of preference.
    2) Is it moral to buy C when D would suffice? Answer Yes, The issue is degree of benefit which is not a morality issue, but again preference.
    3) Is it moral to spend money on E, that could have been spent on F? Answer, Yes, Same issue in # 1& 2.
    4) Can it be moral to lie? Answer Yes, this depends on whether the intent or effect of the lie was to cause harm. Admittedly most cases of lying are harmful.
    Perpetuating a cultural myth in not harmful on it’s face.

  12. Yes it it moral.

    Benchmark: Medieval, and later, Europe & later the U.S. — corpses could be robbed from graves and used to further medical research. The Catholic Church had no objection. The Church didn’t object when then-socially stratified society limited such use to corpses of the poor only.

    See: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2633446/

    A corpse, dead for whatever reason, but not dead from someone’s intent to exploit the corpse, has been “harvested” for greater good without Catholic Church opposition, consistent with Church policy. Presently, embryonic stem cells are available because a fetus was aborted (sometimes naturally) for reasons having nothing to do with stem cells. These fetus’s were not killed to harvest stem cells. Thus, these ex-individuals, corpses, are like their Medieval predecessors, ripe for secondary use for greater good.

    Of course, now, compared to Medieval periods of history, the Catholic Church is espousing a different view, allowing the use of adult stem cells but not those of fetus’s killed for convenience of the would-be mother…that out of consideration for the dignity of the individual (easy to look up on-line & verify). …. just another example of official Church doctrine evolving with the mood of the times….

    Which leads to the real moral question:

    Suppose someone murdered a fetus with the motive of harvesting stem cells for their use … murder, clearly, and it seems morally wrong to reward that murderer by giving them the sought-for goods. However, that fetus is just as dead…would harvesting those stem cells for some innocent in need (e.g. an anonymous patient on a waiting list) be immoral?

    The issue feared is that fetus’s might be bred & slaughters for parts…but absent that [blatantly obviously moral situation] precedent suggests secondary use is just fine. Or was until the Church changed its mind. Again.

  13. Ken: I found this discussion of the church and dissections http://www.telegraph.co.uk/comment/columnists/christopherhowse/5496340/False-myth-of-the-anatomy-lesson.html
    It is from the Telegraph, so I don’t know how accurate it is. There does seem to be some disagreement concerning interpretation of the bull by Pope Boniface VIII.
    Refer to my first question–if I kill my neighbor and then use his stem cells to cure my cancer, is that okay? Why he died doesn’t matter, right? What if I kill my neighbor knowing he’s an organ donor and he is the right match for my child? Maybe you can’t give the organ to my child because he benefits from the murder, but what about another needy child who could benefit? Why waste an organ, right?

    Do the women who have the abortions consent to this use of the fetus? Is there a form they sign saying the clinic can chop up the fetus and distribute as needed? Women in England were angry when they found out the hospital was burning aborted fetuses along with biowaste. (Yes, this is a very schizophrenic reaction—on one hand it’s not human, yet it is regarded as such in this situation, even by the person who made the “not human” claim.)

  14. Sheri, I think you have a typo. You must have meant to say that telling a child there is no Santa Claus is a lie and should not be done. I agree.

  15. “Children can still receive gifts, give gifts and they can learn to be well-behaved because it’s the right thing to do, not because “Santa” is watching.”

    That’s true. But it doesn’t prove that Santa Claus isn’t watching. It doesn’t hurt to remind then he is.

  16. acricketchirps: Nope, I meant precisely what I typed. I’m still mad at the Grinch for not keeping all those presents. I cheered for Scrooge before he went soft. I have never told a child Santa exists and don’t intend to start now. I make it point not to lie to children or promise something I cannot deliver.

    As Scully on the XFiles would say, Santa Claus is not watching because there is no Santa Claus. (Okay, she was talking about there not being any vampires, but the same holds for Santa.)

  17. Sheri, you’ve completely lost me. You’re talking as though Scrooge (Not real–Boz made him up) and Grinch (Not real–Geisel made HIM up) were real and Santa Claus (real) weren’t.

  18. I’m going to plead agnostic on the existence of vampires.

  19. acricketchirps:
    None of those things mentioned are real—not Scrooge, not the Grinch, and not Santa Claus.
    Does that help?

  20. Dumbfounded! You don’t know that Santa Clause is real? You must be having me on.

  21. I believe I was very clear. Are you “having me on”?

  22. Of course not. Do you believe in any of angels, fairies, the Blessed Virgin Mary, demiurge, ghosts, demons, God, Oliver Twist?

  23. (That last one WAS a joke)

  24. Even if I believed in chemtrails, no moon landing, leprechauns and haunted houses, that would have no bearing on the accuracy of my statement about Santa. We’re veering into logical fallacy territory here.

  25. No, no. I wasn’t trying to prove anything. I was just trying to reckon what kind of person doesn’t know that Santa Claus exists.

  26. That would be me. I’m not going to change my answer or statement no matter how many times you reword and re-ask the question. I do not believe in Santa Claus.

  27. Consider this:
    “Gazzaniga and Sperry’s split-brain research is now legendary. One of their child participants, Paul S, had a fully functional language center in both hemispheres. This allowed the researchers to question each side of the brain. When they asked the right side what their patient wanted to be when he grew up, he replied “an automobile racer.” When they posed the same question to the left, however, he responded “a draftsman.” Another patient pulled down his pants with the left hand and back up with the right in a continuing struggle. On a different occasion, this same patient’s left hand made an attempt to strike the unsuspecting wife as the right hand grabbed the villainous limp to stop it.”
    https://www.psychologytoday.com/blog/the-superhuman-mind/201211/split-brains

    We really don’t know what parts of the brain do what. The patient could still move his limbs, independently, so the same patterns as before were not used in at least part of the movement unless all electrical patterns are confined to one hemisphere. If this is true, brain injury should totally remove a particular action, but children often learn to walk and speak after damage to the speech and motion parts of the brain (that which we identify as such)>

    Arguments about handedness are similar to arguments about autism. Autism is “incurable”, therefore, if the child “recovers”, he never was autistic. Circular reasoning and way to preserve the incurable nature of autism that was preached by the psychiatric community. Yes, you can argue that any right handed person who switches to the left is actually left-handed. Except that when one loses the right hand and then learns to use the left, that clearly indicates BOTH hands can be used equally well if one has no choice. There is choice and the ability to change from the original choice if need be.

    It might be valid to argue everyone is ambidextrous and that society pushes right-handedness so people conform. The same could be true of sexuality—everyone is bisexual. This would not be a logical fallacy, but it does mean people choose which impulse to act on. I doubt most people would accept this argument, but it is the only non-fallacious argument for how someone can be a practicing homosexual and then a practicing heterosexual without invoking circular reasoning.

  28. Sheri: Gotcha. We’ll have to agree to disagree.

  29. And thanks for introducing me to chemtrails. Cool. Never heard of them before. (Don’t believe in ’em, btw)

  30. Also cool, about the split brain stuff. Reminds me of Steve Martin being half Lily Tomlin and half himself in Carl Reiner’s All of Me.

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