To put the problem very clearly, you destroy human life
in order to save human lives.
That puts the finger on the problem in a sort of brutal way
because you cannot deny that you destroy the blastocyst.
So in a sense you destroy a potential human life.
The status of humanity and human life has been the subject
of thought and debate and discussion for millennia really.
Our philosophical approaches owe a lot
to Aristotle and Aquinas.
They recognised that there was something special about the human being,
but they weren't sure
when that specialness or when the personhood came into being.
Few would deny the potential for medical research
from research into embryonic and adult stem cells.
The big ethical question is: Should we be using embryos to do this?
What is the moral status of the early human embryo?
Is it fully a person or what?
The Catholic Church, when it looks at embryonic stem cell research,
sees the same issues in place as there are in abortion.
It is all about when life begins
and what protection we offer to all human beings.
We can never set aside a subset of humanity and say
they are not deserving of protection.
The Islamic perspective
of the status of the embryo,
I would think you could recognise four different stages.
Firstly, the embryo outside the womb,
then the embryo when it is implanted into the womb,
then a gestation of six to eight weeks
when the foetus is fully formed,
and finally, most importantly,
is 120 days after conception
when ensoulment takes place,
and that is a very important milestone.
For some people, the early embryo has no status
and it is a matter of duty that you should be doing research
in order to save human life.
The scales weigh very heavily on one side.
The opposite position is that there is no balance at all
because you cannot do research on what is seen as being a human being.
In between these two there is a question of balance.
How far would you be justified
in destroying what could be a human being
if you created the right conditions for the embryo to be implanted
but you nonetheless decided to do research on it instead?
What justifies research?
The sanctity of life
and the protection of the embryo are not the only values.
Those who suffer from incurable diseases,
they also have interests that need to be looked after
and there is a moral obligation to cure diseases,
to relieve suffering and to restore health.
I have Parkinson's disease
and that may one day be treatable
by the applications of stem cell research
and I think that the broader issue is about getting society
into a better, more healthy perspective.
Allowing people to live their full lives in their families
with the benefit of good medicine wherever that may come from.
Everything changes when somebody has one of these disorders.
It is not just the patient that is suffering.
The whole family gets drawn into the problem as well
and I think it is incumbent upon us to try and find a solution
that benefits the patient and the wider family as well.
If we consider the suffering of people
with diabetes, Parkinson's, Alzheimer's
and a few other, so far incurable diseases,
then... Especially diabetes is a large group.
These are diseases
almost everybody knows somebody who suffers from,
so there is a big potential to actually cure diseases
that have never been curable in the past.
We can't ever find something
that can counterbalance the direct killing of a life,
and when we destroy an embryo to get embryonic stem cells
that is exactly what we do. We must protect all life.
I know from my own experience of becoming disabled
that it is very easy to look at a situation through one set of spectacles,
then when you are given another set of spectacles you see it all differently.
We would pay a price of working on some human embryos
but the benefit would come back in the treatment of society itself.
But there is always a cost, and whatever scientists want to do,
it is much easier if we accept there is a cost
and get on with it in a carefully regulated context.
While the question of how we begin as a human being and how we develop
is an old issue,
it was only when embryos became available outside the womb
that the present questions became asked,
and this led the Government to set up the Warnock Committee in the 1980s,
which looked in considerable detail at the moral and ethical issues
surrounding the human embryo
and to what extent research might or might not be permitted.
Single-celled embryos, most of these,
most of our fertilised embryos, don't end up as babies at all.
They are lost at an early stage before you would even notice you were pregnant.
Those embryos that are fertilised and do go on to become babies
may not become just one baby but two or more.
They can be identical twins or triplets.
So what we have at the beginning of the embryonic development, fertilisation,
is something that could be no, one, two or more babies.
So I think it is very difficult to call that a person.
The main conclusion of the Warnock Committee
was that the human embryo deserves more respect than that given to human tissues,
but should not be given the respect due to actual persons
until about 14 days,
and after 14 days a so called primitive streak begins.
Here is the beginning of sentience, consciousness, the beginning of organs
and beyond this point one should therefore not research.
The majority view was
that you could use surplus embryos from IVF treatments to do research.
During in vitro fertilisation the eggs are fertilised in a dish,
and there they can develop to what's called the blastocyst stage.
They can't develop into a baby without being transferred into a woman's body
and then implanted in the womb.
Embryonic stem cells are made from these early blastocysts,
which consist of around 100-200 cells and are no bigger than a grain of sand.
During the IVF procedures
there are a number of extra embryos
which are not implanted into the mother
and are actually kept frozen in special freezers.
For example, in many countries there are many thousands,
even 30 or 50 thousand over-exceeding embryos
which are kept in these freezers,
and basically they are kept there for ever and ever
without any use.
You have on the one hand an embryo
which would otherwise be thrown away
or stored indefinitely,
and on the other hand people who almost everybody knows
who suffer from really debilitating and serious diseases.
So for me that is a big argument
in favour of using embryonic stem cells.
There is also the danger of hype.
We talk as if the therapy was almost there
and I think there is a long way to go before we have a functioning therapy.
It is one thing to be able to grow a dopamine-producing cell
and another thing to implant it
in the brain of a patient suffering from Parkinson's
in such a way that it is safe, that it grows and that it cures the disease.
We have been working with Parkinson's among other neurological diseases
for many years.
What we have done, starting almost 20 years ago now,
is experiments using human fetal tissue.
They can produce dopamine
and you can have functional effects
and improve patients,
some with dramatic improvement.
And this is some kind of proof of concept studies,
which of course are promising
or form a promising basis for the stem cell therapies.
There are many attempts now to generate large numbers
of dopamine neurons from stem cells to transplant in patients.
You can see huge developments and improvements.
Not quickly, not next week, but there is a long-term benefit
for people with Parkinson's disease, like I have.
What we are doing now is to prepare for the next step,
namely to develop a stem-cell-based therapy,
which I think is several years ahead
because we don't really know what is the best stem-cell source
to produce dopamine yet.
One of the things that is problematic about the debate is
that it focuses so much on the status of the embryo and the rights of the embryo
and so little on the needs of the patients
and so little on the access to the treatments and the justice question.
Who pays and who benefits?
And then of course there are questions that have to do with commercialisation
and intellectual property rights,
patentability of stem cells and stem-cell lines.
There are a variety of issues that need to be discussed
and need to be discussed early.
When I look at the legislation in Europe,
there are some countries
which forbid embryonic stem cell research
but they allow abortion
and they allow contraceptive pills, for example,
and I think that ethics should strive to be consistent.
In Italy, abortion is allowed
so it is not clear why there should be
so much emphasis now on embryonic stem cells.
We do not understand exactly why the law should be so restrictive.
This is creating a sort of
public fear, even within the scientific community,
to the point that there are very few groups in Italy
that are working on human embryonic stem cells.
To my knowledge there are only three groups,
although there are groups that are working on embryonic stem cells,
but in a more hidden way.
They don't want to say it openly and publicly.
I think this is a big damage
that one could do to science,
because in this way science is not open, it is not free.
Definitely this is influencing
the development of science and also the perception of science.
The countries which have a restrictive point of view
towards embryonic stem cell research...
How will they react
if and when the countries which have permissive legislation
will finally find
the possible treatments for the patients?
They should not be able to forbid their patients
from using the therapies.
The patients should have the freedom to choose
where they want to be treated and what kind of treatment they want to receive.
The UK regulatory framework in the Human Fertilisation and Embryology Act
has worked very hard to take on board all of these issues.
Not just the original ones but the new ones raised by stem cells and cloning.
And what you have got is a regulatory framework respected across the world,
but also challenged because for many it goes too far.
So if you are a scientist watching this,
just simply having the law allow you to do things
isn't the only question you should be asking yourself.
Ethically, what should I do?
Should I be saying "yes" to cloned embryos or creating embryos
even if the law allows it? These are not questions that are uncontroversial.
Regulation, we believe,
does not absolve people from the activities they pursue.
They have to think through the issues themselves.
Is what I am doing ethical? Is it good?
It may seem like a good objective
but am I using good means?
Sometimes these discussions become so theoretical.
A hundred healthy people are sitting there
discussing the ethical aspects of stem cell research.
When you see these patients who have severe diseases...
I have seen patients who come to me
when they are young with minor signs,
and you see this chronic degeneration.
Within a period of 10 years or even shorter they are just...
They just cannot move,
they are just dying.
So if this would help the patients,
I think on balance
it is justified to use the stem cells.
But you need to think about these issues for yourself
and take personal responsibility,
because when we talk about public morality,
when we talk about public spending,
then we cannot avoid talking about consequences.
And the consequences are always consequences for someone.
What would be the consequences of this, that or the other option
for your children, their children and grandchildren?
What sort of world would you want to hand over to them?
Think about that and then make up your mind.
Speaking as a gynaecologist and a Muslim,
I would personally advocate the use of stem cell technology research,
provided that the embryos are obtained
according to the ethics of Sharia law.
I am a Catholic
I was brought up to respect life from the very moment that it was created.
Stem cell research in my eyes
is the ending of a human being's life and that is always wrong.
I would like to see stem cell research provide a solution
that would be a full-time cure for people with Parkinson's disease.
Embryonic stem cells
know how to do every single cell type of the body organism.
So all secrets are there, we just have to discover them.
We are now talking about therapies
that could
become useful treatments for patients where we have very little to offer.
My personal point of view is
that it is the patient's voice that should be heard
and they should be really involved in the decision-making.
I would be unhappy about the idea of simply creating an embryo for stem cells.
It seems to be too instrumental.
But to use one that is going to be destroyed
because it is no longer needed in IVF treatment seems appropriate.
I am both a Christian and a scientist
and I think that
weighing up the potential benefits of embryonic stem cell research
against the idea
that single-celled embryos
are not really equivalent to a person,
with the same rights as an adult or a baby,
then I think that embryonic stem cell research is justified.
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