Report on Liver Cell Transplantation Using Human Fetal Liver Cells.

In an era of organ shortage, human fetuses donated after medically indicated abortion could be considered a potential liver donor for hepatic cell isolation. We investigated transplantation of fetal liver cells as a strategy to support liver functionality in end-stage liver disease. Here, we report our protocol of human fetal liver cells (hFLC) isolation in fetuses from 17 to 22 gestational weeks, and our clinical procedure of hFLC transplantation through the splenic artery.

Reflexive research ethics in fetal tissue xenotransplantation research.

For biomedical research in which the only involvement of the human subject is the provision of tissue or organ samples, a blanket consent, i.e., consent to use the tissue for anything researchers wish to do, is considered by many to be adequate for legal and Institutional Review Board (IRB) requirements. Alternatively, a detailed informed consent provides patients or study participants with more thorough information about the research topic. We document here the beliefs and opinions of the research staff on informed consent and the discussion-based reflexive research ethics process that we employed in our fetal tissue xenotransplantion research on the impact of environmental exposures on fetal development. Reflexive research ethics entails the continued adjustment of research practice according to relational and reflexive understandings of what might be beneficent or harmful. Such reflexivity is not solely an individual endeavor, but rather a collective relationship between all actors in the research process.

Research and complicity: the case of Julius Hallervorden.

The charge of complicity has been raised in debates over the ethics of fetal tissue transplantation and embryonic stem cell research. However, the applicability of the concept of complicity to these types of research is neither clear nor uncontroversial. This article discusses the historical case of Julius Hallervorden, a distinguished German neuropathologist who conducted research on brains of mentally handicapped patients killed in the context of the Nazi 'euthanasia' programme. It is argued that this case constitutes a paradigm of complicity in research that is useful in assessing complicity in contemporary research ethics.

Constructing an ethical framework for embryo donation to research: is it time for a restricted consent policy?

An Ethics & Policy Workshop was held with 20 invited UK stakeholders to consider whether embryo donors should be able to restrict the future use of human embryonic stem cells (hESCs) created from their embryos. Participants cited tensions between pure altruism and a more reciprocal basis for donation; and between basic research (in which genetic material would never form part of another living being) and treatment applications. Two restriction models were suggested to acknowledge specific ethical issues raised by hESCs' use in research and treatments: (1) a two tier system: hESCs with unrestricted consent could go to the UK Stem Cell Bank; those with restricted consent could be used in individual labs which could guarantee to honour the restrictions, and Bank deposit would not be required. (2) a three category system: restrictions could include (i) basic hESC research; (ii) hESC research and treatment; no gamete derivation (iii) 'unrestricted' hESC research and treatment.

Human embryonic stem cell research: an Australian perspective.

A conscience vote of individual parliamentarians in the Australian government last month regarding amendments to current legislation regulating human embryonic stem cell research yielded a surprising outcome. Despite opposition by the Australian Prime Minister, the Senate and House of Representatives voted to adopt the recommendations of the Lockhart Review and approve human somatic cell nuclear transfer, thus providing a consistent national policy for all researchers in Australia.

Moral arguments on the use of ovarian tissue from aborted foetuses in infertility treatment.

The possibility of using eggs from an aborted foetus in IVF treatment has recently arisen after researchers presented work in which they managed to keep alive in the laboratory ovarian tissue taken from second and third trimester aborted foetuses for several weeks. Several ethical concerns and arguments have been raised. Some of them are general anti-abortion arguments while others relate to the use of eggs or ovarian tissue of aborted female foetuses in infertility treatment. In this article we will argue that most of the arguments for prohibiting the use of ovarian tissue from aborted foetuses in fertility treatment are not sufficient to provide ethical grounds for banning such a practice.

Stem cells: public policy and ethics.

Debate on the regulation of human stem cells needs to bring together scientific, ethical and policy considerations if it is to be adequately informed. Scientific issues of importance include the relevance of the environment in appreciating the extent of stem cell plasticity, and the relative potential of embryonic and adult stem cells to produce other cell types. An awareness that blastocysts (early embryos) and stem cells in the laboratory are pluripotential and not totipotential has implications for ethical and policy debate. The regulations on stem cell research are reviewed, showing that four positions have emerged. Position A corresponds to the prohibition of all embryo research, position B confines the use of embryonic stem cells to those currently in existence and therefore extracted prior to some specified date, position C allows for the use and ongoing isolation of embryonic stem cells from surplus in vitro fertilization embryos, and position D approves of the creation of human embryos specifically for research. Position B which has been adopted by the United States, Germany, and Australia (with subtle differences between them) and which is regarded as a compromise position, is critiqued. This is principally on the basis that, in spite of claims made about it, the ongoing destruction of human embryos will continue. This is because these countries allow in vitro fertilization programs, inherent within which is embryo destruction. It is argued that position C would be a more consistent ethical position for these countries. The possibility of moving to position D is also raised.

The cellular repair of the brain in Parkinson's disease--past, present and future.

Damage to the central nervous system was once considered irreparable. However, there is now growing optimism that neural transplant therapies may one day enable complete circuit reconstruction and thus functional benefit for patients with neurodegenerative conditions such as Parkinson's disease (PD), and perhaps even those with more widespread damage such as stroke patients. Indeed, since the late 1980s hundreds of patients with Parkinson's disease have received allografts of dopamine-rich embryonic human neural tissue. The grafted tissue has been shown to survive and ameliorate many of the symptoms of the disease, both in the clinical setting and in animal models of the disease. However, practical problems associated with tissue procurement and storage, and ethical concerns over using aborted human fetal tissue have fuelled a search for alternative sources of suitable material for grafting. In particular, stem cells and xenogeneic embryonic dopamine-rich neural tissue are being explored, both of which bring their own practical and ethical dilemmas. Here we review the progress made in neural transplantation, both in the laboratory and in the clinic with particular attention to the development of stem cell and xenogeneic tissue based therapy.

Sham surgery: an ethical analysis.

Surgical clinical trials have seldom used a "sham" or placebo surgical procedure as a control, owing to ethical concerns. Recently, several ethical commentators have argued that sham surgery is either inherently or presumptively unethical. In this article I contend that these arguments are mistaken, and that there are no sound ethical reasons for an absolute prohibition of sham surgery in clinical trials. Reflecting on three cases of sham surgery, especially on the recently reported results of a sham-controlled trial of arthroscopic surgery for arthritis of the knee, I present an ethical analysis that focuses on the methodological rationale for use of sham surgery, risk-benefit assessment, and informed consent.

Medical ethics in the neurosciences.

Doctors in India are heirs to a long tradition of ethics from their own forebears and from those from the West. This paper discusses ethical aspects of topics of relevance to neurological scientists such as brain death, neural transplant and whole brain transplant. Many other topics such as ethics in research, patients with AIDS, patients in a persistent vegetative state and euthanasia deserve similar consideration and debate.

Cloning and stem cells: processes, politics, and policy.

The creation of good science policy requires an understanding of the scientific technologic processes as well as an appreciation of the "politicization process" and contemporary politics. This article encompasses a review of nuclear transfer and stem cell technologies and advances against a backdrop of the politicization of science. The combination of these forces has rendered it almost impossible to develop true consensus on what any national policy regarding nuclear transfer should look like. Careful consideration of the multidimensional nature of these technologies and the myriad of social, economic, and cultural factors they will impact demands, however, that, at the very least, a national dialogue be instituted in an effort to frame good policy pertaining to nuclear transfer and stem cell research.

Ethics of research and the pregnant patient.

In this chapter, we address ethical issues in research involving fetuses and pregnant women, with particular attention to the emerging issue of gene-transfer research. Ethical analyses and arguments are based on the concept of the fetus as a patient. The implications of this concept for the ethics of fetal research are identified. The discussion of gene-transfer research extends those implications to address issues concerning informed consent, assessment of potential fetal and neonatal morbidity in study design, prenatal diagnosis after gene transfer, selection criteria based on abortion preference, science by press conference, germline risks, and public oversight.