A Discussion Paper
Human Stem Cell Research: Opportunities for Health and Ethical Perspectives
Chairperson:
Janet Rossant: Professor, University of Toronto, Department of Medical Genetics & Microbiology; Joint Head, Program in Development and Fetal Health, Samuel Lunenfeld Research Institute of Mount Sinai Hospital; (developmental genetics).
Françoise Baylis: Associate Professor, Dalhousie University, Departments of Bioethics and Philosophy; (healthcare ethics and policy).
Timothy Caulfield: Associate Professor, University of Alberta; Research Director, Health Law Institute, University of Alberta, (health law and policy).
Roger Gosden: Professor & Research Director of the Division of Reproductive Biology, McGill University; (reproductive biology).
Keith Humphries: Professor, University of British Columbia, Department of Medicine; Scientist, BC Cancer Agency, Terry Fox Laboratory; (hematopoietic stem cell biology).
Gregory Korbutt: Assistant Professor, University of Alberta, Department of Surgery; Director, Human Islet Quality Control Laboratory, University of Alberta; (islet cell transplantation).
Anne McLaren : Principal Research Associate, The Wellcome/CRC Institute of Cancer and Developmental Biology, Cambridge U.K.; (reproductive and developmental biology).
Marcel Mélançon : Professeur chercheur en bioéthique, Université du Québec à Chicoutimi; (bioethics and genetic technology).
Samuel Weiss: Professor, University of Calgary, Department of Cell Biology and Anatomy; (neural stem cell biology).
Dr. Barbara Beckett: Research Associate, Ottawa Hospital Research Institute; (rapporteur for the Working Group).
Stem cells are cells found in developing animals and to a lesser extent in adults, that have a unique property: the ability to proliferate and remain undifferentiated (self renewal), and the ability to differentiate into more specialized tissues. Stem cells have a wide range of "potency", ranging from embryonic stem (ES) cells that are capable of differentiating into all cell types (pluripotent cells), to stem cells found in adult tissues such as brain, muscle, and blood, that have a more limited range (restricted potency). Recent evidence that adult stem cells may have broader potency than first thought raises possibilities for reprogramming adult stem cells for tissue-based repair.
It is the ability of stem cells to multiply and develop into different cell types that has generated the recent excitement in the scientific community and in the media relating to their therapeutic potential. Once their differentiation pathways are understood and methods are developed for growing these cells in large numbers, it may be possible to develop cell replacement therapies to treat injuries and a wide range of genetic and degenerative diseases. These conditions include spinal cord injury, Alzheimer's disease, Parkinson's disease, muscular dystrophies, diabetes, arthritis, and heart disease. At this stage it is not clear whether adult stem cells or embryonic stem cells are going to be the best source of cells for therapeutic purposes. However, the proven pluripotency and indefinite self-renewal capacity of ES cells, as evidenced by studies in mice, makes them an exciting prospect for future cell-based therapies.
A scientific milestone was reached in 1998 when human embryonic stem cell-like lines were established. These were derived from early human embryos created by in vitro fertilization for infertility treatments but no longer needed, or from human fetal material following elective abortion. The use of both these cell types is very controversial because of the moral, ethical, and legal issues relating to their source.
In recognition of the great clinical and scientific opportunities and the unique ethical challenges relating to the use of human stem cells, a number of countries have commissioned in-depth studies of the issues, informed by extensive consultation. On the basis of these studies, guidelines for human stem cell research have been drawn up in the U.S. and the U.K. In Canada, a report was published in 1998 providing guidance for research involving human reproductive tissues and embryos (Tri-Council Policy Statement: Ethical Conduct for Research Involving Humans). However, this makes no specific reference to research with stem cells.
Canada has some of the world's pre-eminent stem cell researchers, and a rich history of research achievements in the field. Given appropriate guidelines, drawn up with consideration for Canada's unique legal and cultural environment, Canadian scientists are poised to make important contributions that could lead to breakthroughs in the treatment of many debilitating diseases.
Objectives
In view of this, an ad hoc working group of experts in health research, ethics, and law has been assembled by the President to assist CIHR in setting policies for funding future research involving stem cells of a pluripotent nature obtained from human embryonic or fetal sources, and to consider how CIHR might contribute to the development of a coordinated national policy in this area.
The working group will:
This process has now begun. A first consultation session was held in Ottawa on November 22nd where the following items were discussed.
November 22nd consultation - Items discussed
The working group plans to have a discussion document ready for circulation in the near future.
Useful links
Tri-Council Policy Statement: Ethical Conduct for Research Involving Humans
National Bioethics Advisory Council (NBAC) Report (USA)
National Institutes of Health (NIH), USA (for more information on stem cell research and therapeutic potential as well as the NIH guidelines)
Department of Health, Chief Medical Officer's Expert Group, Donaldson Report (U.K)
The European Group on Ethics in Science and New Technologies (European Commission)
