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Embryonic Stem Cell Research
In recent times the research of embryonic stem cells has caused much debate. From the scientific use of such cells to the moral questions surrounding the research. There is much hope in the scientific field that embryonic stem cell use will add in the cure of diabetes, Alzheimers, Parkinson's, sickle cell anemia and many other diseases. The moral debate is the use of a potential life that requires at some point in ending it. What will be discussed here is the procedure of Embryonic stem cell use, as well as other sources of stem cells and the Islamic position on such use, which at this point is not totally clear. Embryonic stem cells come from a fertilized egg less than a week old. "the embryo forms a structure called a blastocyst. Consisting of merely 140 cells, this hollow, fluid-filled sphere is made up of two types of cells: Those which form the ‘shell’ of the sphere and those located within the ‘shell.’"(1) The cells that are within the shell are removed and the embryo dies. The embryos are donated from fertility clinics, these embryos would be those not implanted normally and if not donated for research would be left to die on their own. Embryonic stem cells are so greatly looked at because "The stem cell is a unique and essential cell type found in animals. Many kinds of stem cells are found in the body, with some more differentiated, or committed, to a particular function than others. In other words, when stem cells divide, some of the progeny mature into cells of a specific type (heart, muscle, blood, or brain cells), while others remain stem cells, ready to repair some of the everyday wear and tear undergone by our bodies. These stem cells are capable of continually reproducing themselves and serve to renew tissue throughout an individual's life."(1) The ability to mass produce stem cells to specific human cells would allow easier treatments with diseases caused by particular cells. For instance, Parkinson's Disease is caused due to the damage of particular cells. It would be much easier to replace the damaged cells with those cells grown from the embryo. And other areas of disease such as heart disease in which cells are damaged can be helped with the introduction of healthy cells. It is important to note that these clusters of cells, if implanted would not result in a pregnancy. They would fail to implant and fail to develop into a fetus, because the cells are taken out of the blastocyst the fetus would not form. There are several moral questions that are raised by opponents of embryonic stem cell use. The main objective is the killing of the potential human being, this objective was raised by Dr. Najim Abdul Wahid when I presented the question. "...because in order to do that you have to stop growing the embryo at some stage and continue with the specified cell which is in this case neuron stem cell. And no to any other specified cells. I have been involved personally in the discussion with our Jordan as well as Saudi Arabia's Sheikh's and Ulema in seperate meetings and both did not authorize such research or even treatment because this such work in fact kills a promising growing human being regardless of the motive or the cure of other human being." (2) This does raise several questions: A. Is an embryo at such an early stage considered a human life in Islam? B. If so is allowing the otherwise unused embryo allowed to die a form of abortion? C. If it is not seen as a form of abortion, and the embryo is not considered a form of human life than why such objections for embryonic stem cell research? According to Dr. Najim Abdul Wahid in a metting in Kuwait in 1985 "...the embryo had been considered as respected since time of fertilization but to be considered as human being only after two weeks of fertilization i.e after implantaion so they accept all types of contraception during such period such as IUD wich will not allow inplantation to occur." (3) According to Ibn hajar Al Asqalani and Ibn Al Qaim human life only occurs when the nervous system is developed in the embryo and when voluntary movements have started. Prior to that, the embryo has only a vegetative life. And according to Abu Hamid Al Ghazali argued that although ensoulment occurs at a latter stage, the life of the embryo should be respected from the time of fertilization. (4) According to a synopsis held in 1987 the majority held that fertilized ova are not held to be sacred by the Shariah at all, and are not respected until they become embedded in the uterine wall. There was also a minority view that fertilization of the ovum is the first phase of the human being and honoured by Allah. (5) Since there is a view that the embryo is to be respected like other forms of human life the question now becomes if they are allowed to die on their own is this a form of abortion? According to Dr. Najim Abdul Wahid this is not a form of abortion. So it appears that this "killing of potential life" is seen much differntly when it comes to using an embryo for research vs letting the embryo willingly die on its own. For this is what is suggested by those who oppose freezing unused embryos. There are others who object to the use of the embryonic stem cells for other reasons such as Sheikh Al Salami who states: "I believe that once the egg reaches 8/32 divisions and the parents no longer have a use for it, it should be destroyed. I also believe that it is risky for a doctor to transplant cells which can grow to a full human being, carrying all the properties and genes of a human being." (6) So the objection is not really about killing a potential human being but actually using the cells from something which carries the properties and genees of a human being. It is important to note that Sheikh Al Salami does agree that unused embryo should be preserved rather than outrightly destroyed. This would bring one to the question is using the genes of a human under different circumstances allowed? According to a seminar organised in association with the Islamic Fiqh Academy, Jeddah, the World Health Organisation Regional Office, Alexandria, and the Islamic Education, Science and Culture Organisation (ISESCO), in October1998. "The Seminar agreed that genetic engineering may be used in the prevention, treatment or alleviation of diseases, whether in the form of genetic surgery in which genes are replaced by other genes or genes are implanted in the patient's cells, or when genes are planted in another body to obtain larger amounts of the same gene to be used in the treatment of certain diseases." (7) Not all disagree with the use of unused embryos for stem cell research "Dr Abdullah Hussain Basalamah has pointed out that at the point when a fertilised egg has reached stage 8 and has divided into 32 cells only, no limbs or organs are yet formed. He does not think that, at least at present, it is possible to use surplus eggs for organ transplant, although it is possible to use some of their cells. He believes that transplanting such cells is far better than destroying them, which would be comparable to infanticide." (8) It is important to note that when the issue of freezing unused embroys for future use, following all Islamic guidelines for implantation is suggested, the answer by many is to not allow freezing but allow the embryo to die on its own. Dr. Najim Abdul Wahid, when asked, presented this view: "...yes it is quite clear that many fatwas which instruct the couple to not freeze the unused embryos but to allow them to die on their own. The fear is the misuse of the frozen embryos" (1) Also according to the Islamic Fiqh Association in Jeddah in association with the Medical Fiqh meeting in Kuwait in the year 2000 "If there are excess embryo in any shape or form, they will be left without medical intervention to end its life naturally" (9) Thus allowing the embryo to die on its own is not refuted on the stance that it is killing the potential human being. I personally am unsure as to what the difference is, although some may argue the the use of embryonic stem cells are killing the unused embryo by man by means of taking the cells. However allowing the embryo to die is also done by the means of man by not taking any steps to save the potential human being. There are other means to acquire stem cells to use in treatment of diseases. One of which is the use of cord and placenta blood. The blood of these two sources are rich in stem cells and are currently being used to treat a wide variety of diseases . The blood can be banked privately by a family, or in some areas it can easily be donated for use to others. This option is perfectly halal for all Muslim couples who wisht to either bank or donate the unbilical and placenta blood. However with infertile couples this may not be an option for donation. There is also the use of adult stem cells which are also being currently used and researched. For many this shows that the use of embryonic stem cells are not needed. And that since other options are available, or at least becoming available, than the one which is in a moral limbo should be left aside. The use of these adult cells for treatment would be halal in most instances. However using these cells in an blastocyst, which nullifies the rejection from the body of such cells since they are ones own cells to begin with, would raise other questions among Muslims. As the research on all sides grows and more questions are asked and answered would more than likely determine the outcome of the muslims view on such research and stem cell use. Considering that there are such an array of views on this issue amongst muslims it would be for the couple with the unused embryos to decide which they agree with and what route the wish to take. There is no clear directive from Qur'an or ahadith so the issue is left open to ijtihad.
(1)National Bioethics Advisory Commission, "Ethical Issues in Human Stem Cell Research," Executive Summary (Rockville, MD: September 1999) (2) Answered in first question posed to Dr. Ajim Abdul Wahid (4) Contemporary Topics in Islamic Medicine by Dr. Mohammed Ali albar (5) http://www.islamset.com/bioethics/vision.html#6 (6) http://www.islamset.com/bioethics/organ/salami.html#2 (7) http://www.islamset.com/bioethics/genetics.html (8) http://www.islamset.com/bioethics/organ/salami.html#2
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