Sections in this issue outline (in order)
1 What they said. 2 The issue at a glance. 3 Background. 4 Internet information links. 5 and 6 Arguments for / against. 7 Further implications on this issue. 8 Newspaper items used in the compilation of the outline.

Dictionary
To activate the in-built dictionary linked to this issue outline, double-click on any word in the body of the text (IE only).

Analysis help
Students and others can read a guide to analysing the language of the news media by clicking the graphic at right.

Age and Australian items
To list all Echo-indexed items on this topic for 2002, click the graphic at right

Sydney Morning Herald items
To list items indexed by the NSW State Library's Infoquick, click the graphic at right

Should stem cells be taken from 'spare' human embryos for use in medical research?

What they said ...
'I can't for the life of me see a moral difference between that [the thawing of the embryos] and the use of embryos in research'
Mr John Howard, Australian Prime Minister

'John Howard [fails] to understand the gulf separating the natural death of an embryo and its exploitation in a laboratory'
Christopher Pearson, editor of the Adelaide Review and a former speechwriter for Prime Minister John Howard

The issue at a glance
On April 5, 2002, the Council of Australian Governments agreed to a set of guidelines that would determine how Australia's research using human embryos would be conducted.
The most significant element in these guidelines is that they represent a shift in the position adopted by the Prime Minister, Mr John Howard. Mr Howard had previously opposed stem cells being harvested from 'spare' embryos created as part of the IVF process. Over the weeks prior to April 5th the Prime Minister changed his mind and decided this harvesting would be permitted under the proposed guidelines. However, only currently existing embryos would be allowed to be used for this purpose.
These guidelines will still have to be passed by federal Parliament before they become law. Both the Liberal Party and the Labor Party will allow their members a conscience vote on the issue.
There has been a vigorous media debate over whether embryos should be used in this manner and where the acceptance of such use might ultimately lead us. This debate is certain to continue.

Background
a) Proposed guidelines for determining how research involving human embryos will be conducted
Human cloning, therapeutic or reproductive, is to be banned.
Embryonic stem cell research using cells derived from surplus IVF embryos will be allowed when
i) the owners of the embryos give their approval,
ii) research is conducted only on existing embryos.
There is to be a bam on the creation of embryos for research.
Embryonic stem cell research is to be overseen by the National health and Medical Research Council.
These stem cell research guidelines will be reviewed in three years.

b) What are stem cells?
Most human cells are differentiated. This means they are of a specific type and have a specific function. What makes stem cells so important is that they are either undifferentiated or are far less differentiated than the majority of cells. This means, that depending on the type of stem cell they are, they can either develop into one of many types of cell or, if more restricted, into a narrower variety of cells. Stem cells that have the potential to develop into one of many cells are called pluripotent. Those that can develop into one of a narrower variety of cells are called multipotent.

c) What makes stem cells potentially important in the treatment of disease and injury?
i) Probably the most far-reaching potential application of human pluripotent stem cells is the generation of cells and tissue that could be used for so-called "cell therapies."
Many diseases and disorders result from disruption of cellular function or destruction of tissues of the body. Today, donated organs and tissues are often used to replace ailing or destroyed tissue. Unfortunately, the number of people suffering from these disorders far outstrips the number of organs available for transplantation.
Pluripotent stem cells, stimulated to develop into specialised cells, offer the possibility of a renewable source of replacement cells and tissue to treat many diseases and disabilities, including Parkinson's and Alzheimer's diseases, spinal cord injury, stroke, burns, heart disease, diabetes, osteoarthritis and rheumatoid arthritis.

ii) Pluripotent stem cells could also help scientists understand the complex events that occur during human development. A major goal of this work would be to study the cellular decision-making process that results in cell specialisation. Turning genes on and off is central to this process, but not much is known about these "decision-making" genes or what turns them on or off.
Some of the most serious medical conditions, such as cancer and birth defects, are due to abnormal cell specialisation and cell division. A better understanding of normal cell processes could allow medical scientists to better understand the fundamental errors that cause these often-deadly illnesses.

iii) Human pluripotent stem cell research could also change the way drugs are developed and tested. For example, new medications could be initially tested using human cell lines. This would not replace testing in whole animals and testing in human beings, but it would streamline the process of drug development. Only the drugs that are both safe and appear to have a beneficial effect in cell line testing would graduate to further testing in laboratory animals and human subjects.

d) Where are stem cells found in human development?
i) Embryonic stem cells
Human development begins when a sperm fertilises an egg and creates a single cell that has the potential to form an entire organism. This fertilized egg is totipotent, meaning that its potential is total.
Approximately four days after fertilization and after several cycles of cell division, these totipotent cells begin to specialize, forming a hollow sphere of cells, called a blastocyst. The blastocyst has an outer layer of cells and inside the hollow sphere there is a cluster of cells called the inner cell mass.
The outer layer of cells will go on to form the placenta and other supporting tissues needed for fetal development in the uterus. The inner cell mass cells will go on to form virtually all of the tissues of the human body. Although the inner cell mass cells can form virtually every type of cell found in the human body, they cannot form an organism because they are unable to give rise to the placenta and supporting tissues necessary for development in the human uterus.
These inner cell mass cells are pluripotent embryonic stem cells, that is, they can give rise to many types of cells but not all types of cells necessary for foetal development.
The pluripotent stem cells undergo further specialization into stem cells that are committed to give rise to cells that have a particular function. Examples of this include blood stem cells that give rise to red blood cells, white blood cells and platelets; and skin stem cells that give rise to the various types of skin cells. These more specialised stem cells are called multipotent embryonic stem cells.

ii) Adult stem cells
While stem cells are formed during early human development, multipotent stem cells are also found in children and adults, for example, the blood stem cell. Blood stem cells reside in the bone marrow of every child and adult, and in fact, they can be found in very small numbers circulating in the blood stream. Blood stem cells perform the critical role of continually replenishing our supply of blood cells - red blood cells, white blood cells, and platelets - throughout life. A person cannot survive without blood stem cells.
Multipotent stem cells have not been found for all types of adult tissue, but discoveries in this area of research are increasing. For example, until recently, it was thought that stem cells were not present in the adult nervous system, but, in recent years, neuronal stem cells have been isolated from the rat and mouse nervous systems. The experience in humans is more limited. In humans, neuronal stem cells have been isolated from foetal tissue and a kind of cell that may be a neuronal stem cell has been isolated from adult brain tissue that was surgically removed for the treatment of epilepsy.
Until recently, there was little evidence in mammals that multipotent cells such as blood stem cells could change course and produce skin cells, liver cells or any cell other than a specific type of blood cell; however, research in animals is leading scientists to question this view.
In animals, it has been shown that some adult stem cells previously thought to be committed to the development of one line of specialised cells are able to develop into other types of specialised cells. For example, recent experiments in mice suggest that when neural stem cells were placed into the bone marrow, they appeared to produce a variety of blood cell types.

e) Where are pluripotent embryonic stem cells harvested?
i) 'Spare' IVF embryos
Pluripotent stem cells are isolated directly from the inner cell mass of human embryos at the blastocyst stage.
The embryos used for this purpose are usually those produced for invitro-fertilisation but not implanted in the mother's uterus.
Extra embryos are produced in case the family want later children or the first implantation does not result in a successful pregnancy. These 'spare' embryos are frozen until they are required.
In many jurisdictions, including Victoria, if the 'spare' embryos are not implanted after a specified period they must be destroyed.
To create human embryonic stem cells for research, some of the 'spare' embryo's blastocyst cells are isolated, harvested and allowed to grow in a separate dish. To turn them into long-lasting stem cell lines, the cells are fed special growth factors.
The embryo is destroyed in the process.

ii) Aborted embryos
In some countries stem cells have been harvested from aborted embryos. Using this source of embryonic stem cells does not appear to have been proposed in Australia.

iii) Therapeutic cloning.
Another potential source of embryonic stem cells would be through therapeutic cloning. Therapeutic cloning is the creation of a clone for treatment purposes, where there is no intention that the clone will ever reach maturity. This is distinguished from reproductive cloning where a clone is produced and allowed to survive to maturity.
In cloning studies with animals, the nucleus has been removed from an egg cell and then replaced with the nucleus from a somatic cell (a cell of the body which is not a sperm or egg cell) taken from another animal of the same species. The resulting fused cell has the potential to develop into an entire animal with the same genotype as the animal from which the somatic cell was taken. The clone develops to form a blastocyst from which embryonic stem cells can be harvested.
This method of creating stem cells has been suggested as a way of overcoming the problems of tissue rejection. If the stem cells were used to treat the animal or human from which the somatic cell had been taken there should be no rejection of the transplanted cells as they would have the same genotype.

f) The current legal situation in Australia
Human reproductive cloning is about to be banned nationally under the federal Gene Technology Act. However, there are no federal laws governing other aspects of embryonic research.
National Health and Medical Research Council guidelines allow accessing spare IVF embryos under strict conditions.
All research that destroys human embryos is banned under state laws in Victoria. South Australia and Western Australia have recently liberalised their laws to remove such a ban. There is no relevant legislation in the other Australian states and territories.

Internet information
Perhaps the most useful single source for information about the stem cell debate in Australia is the House of Representatives Standing Committee on Legal and Constitutional Affairs report on 'Human Cloning: scientific, ethical and regulatory aspects of human cloning and stem cell research'
This is a fine source giving detailed technical information as well as canvassing the full range of positions on the various issue raised.
At 267 pages it is a lengthy report, however it is clearly indexed and the reader is easily able to refer only to areas of particular interest.
Australian House of Representatives committee recommended a ban on human reproductive cloning but voted in favour of wide-ranging research on stem cells, although with a three-year moratorium on the creation of cloned human embryos for therapeutic use.
This report is presented as a PDF file and requires Adobe Acrobat reader.
The report, also known as the Andrew's report for its chairman, Dr Kevin Andrews, the federal Minister for Aging, can be found at http://www.aph.gov.au/house/committee/laca/humancloning/report.pdf

On April 9, 2001, ABC Radio National's Health Report presented a detailed interview with Dr. Alan Trounson, Professor of Obstetrics and Gynaecology, Monash University and then Deputy Director of the Monash Institute of Reproduction and Development, Dr. Ole Isaacson Parkinson's Research Center, Harvard Medical School and Dr. Ronald McKay U.S. National Institutes of Health.
All three men are heavily involved in stem cell research and give detailed information on directions the research is taking as well as explanations of what is involved.
The report is titled, 'Stem Cell Research - Separating the Hype from the Reality'. It can be found at http://www.abc.net.au/rn/talks/8.30/helthrpt/stories/s274746.htm

On April 5, 2002, the ABC Science in the News presented a detailed report on the arguments for and against the use of embryonic stem cells. This is a very useful treatment canvassing a wide range of expert opinion.
It is titled, 'Scientists divided on stem cells' and can be found at http://www.abc.net.au/science/news/stories/s520417.htm

On April 11, 2002, ABC TV's Science program, Catalyst, devoted an edition to Stem Cells. A full transcript of the program can be found at http://www.abc.net.au/catalyst/stories/s528800.htm#transcript
The program includes comments from Professor Alan Trounson and Dr Peter Mountford. It considers both the advantages and the disadvantages of embryonic and adult stem cell therapy.

The ABC Science Lab feature pages have a detailed report on stem cells. Though it has a bias in favour of researching and using embryonic stem cells it is clear and detailed. It has a number of useful diagrams and gives a summary of the state of the debate in both Great Britain and the United States.
It is titled 'Cloning around with stem cells' and can be found at http://www.abc.net.au/science/slab/stemcells/default.htm

The US Department of Health and Human Services' National Institute of Health has produced a detailed explanatory primary giving detailed information about stem cells, the sources from which they can be derived and the uses to which they can be put.
The source is titled 'Stem Cells: A Primer'. The rather enthusiastic language in which the 'primer' is written suggests a bias in favour of the use of embryonic stem cells. This primer is the source of much of the information presented in the background section of this issue outline, though the language in which the information is presented has been appropriately modified.
The primer can be found at http://www.nih.gov/news/stemcell/primer.htm

CNN report titled 'Bush to allow limited stem cell funding' and published on August 10, 2001, outlines the position on federal funding of stem cell research taken by the United States president.
Mr Bush decided that research on currently existing stem cell lines would be funded but refused to sanction using additional stem cells taken frozen IVF embryos. The America president's position is thus a more conservative one than that favoured by the Australian Prime Minister, Mr Howard.
The American president also indicated that in the year 2001 his government would direct $US250 million toward research into the use of adult stem cells. This research is seen as promising and ethically unproblematic.
This article can be found at http://www.cnn.com/2001/ALLPOLITICS/08/09/stem.cell.bush/index.html

Do No Harm; The Coalition of Americans for Research Ethics is a national coalition of researchers, health care professionals, bioethicists, legal professionals, and others dedicated to the promotion of scientific research and health care that does no harm to human life. The Coalition has a section of its website that presents articles either arguing against the use of embryonic stem cells or arguing in favour of the use of adult stem cells. An index of these articles can be found at http://www.stemcellresearch.org/

Arguments in favour of stem cells be taken from 'spare' human embryos for use in medical research

1. Human embryo stem cell research will assist in finding cures for a number of serious diseases
Herald Sun commentator Robyn Riley has summarised the potential benefits to be derived from stem cell research. She notes that those who stand to gain are 'ordinary people with cancer and Parkinson's disease, people with damaged spinal cords, Alzheimer's disease and sufferers of strokes and epilepsy.
For them stem cell research holds the potential of a cure and that has to be better than no hope at all.
Stem cells are the starters for new nerve, muscle and other tissues and the theory is that bodies damaged by illness and injury could be "repaired" by introducing new stem cells.
One day this research could cure heart disease, cancer, diabetes and a range of brain and spinal-cord injuries.'

2. Surplus human embryos are already produced in the invitro fertilisation process
It has been noted that holding some embryos in reserve has become the norm in the invitro-fertilisation process. Dr John McBain, chairman of the Melbourne IVF Group, notes, 'The development of embryo freezing allowed IVF doctors to stop transferring four, five, or six embryos at a time ... The consequent reduction in multiple pregnancy rates has dramatically reduced the incidence of premature delivery and the need for neonatal intensive care.'
Professor Julian Savulescu, the director of the ethics program at the Murdoch Children's Research Institute, has further noted that storing embryos for later implantation reduces the 'risk to the woman of numerous attempts to obtain eggs from her body, which can cause illness or death.'
Professor Savulescu concludes, 'That's why we have about 70,000 frozen embryos in Australia.'
Supporters of some of these embryos being used in stem cell research argue that those that are not implanted will ultimately be destroyed. In Victoria, for example, embryos that are not to be implanted must be destroyed after five years.
This is the argument put by Professor Savulescu. 'These embryos have to be destroyed after five years, so we are not talking about destructive research.
What we are talking about is using the products of cells that would otherwise be destroyed and that, to me, is just like the case where a child has been killed ... in, say, a car accident, and we decide to use the organs for transplantation.'
The Queensland premier, Peter Beattie, has argued similarly, 'In-vitro fertilisation produces excess embryos that are not implanted or donated. Presently, these excess embryos are allowed to die.
I believe that in certain strictly controlled circumstances ... stem cells could be taken from those excess embryos that would otherwise be allowed to die.
Not one extra embryo would die as a result of this, but many children and adults might live as a result of successful research.'

3. State laws prohibiting the use of human embryo stem cells for research are currently being bypassed
In states where harvesting embryo stem cells is currently prohibited, research still continues through the use of imported stems cells which have been obtained by the destruction of surplus IVF embryos.
It has been argued that it is a legal and ethical nonsense to allow research on embryos obtained via a process that is declared illegal. Either the research should stop or the process should be made legal. Supporters of stem cell research argue that the process of harvesting stem cells from embryos should be made legal.
Victorian premier, Steve Bracks, has made this point. 'Research has been conducted for some time in Victoria on imported stem cell lines. However, under present state legislation, excess embryos that are created as part of an infertility treatment cycle are stored and then destroyed after five years. They cannot be used for research.
I am supportive of this research and believe a situation where embryos are destroyed overseas and then used in Victoria, but cannot be destroyed here and used for research, to be unacceptable and unsustainable.'

4. The stem cells are taken at a very early stage of the embryo's development
James Walker, a commentator for The Australian, has made this point. Mr Walker writes, '... because at the earliest stage of its development the embryo is no more than a collection of undifferentiated or blank cells, it warrants little more recognition than any other isolated human cell or tissue.'
Margaret Wertheim, writing in The Age, has made the point at greater length. 'ESC (embryonic stem cell) researchers typically use embryos that are less than seven days old, at which stage the fertilised egg has multiplied into a ball of just a few hundred cells.
Embryonic stem cells begin to form at around the 100-cell stage, when we see the development of what is called the blastocyst. Researchers don't want to wait too long after this point to cull stem cells because, otherwise, these multipotent cells begin to differentiate, and undifferentiation is precisely what they are looking for.
Where is it written in the Judaeo-Christian scriptures that the human person begins at the blastocyst? A person, by definition surely, is a quintessentially differentiated entity. How can a ball of 100 or so indistinguishable cells be said to constitute such a being? A potential person perhaps, but surely not an actual person.'

5. The stem cells are taken before the embryo is independently viable
Margaret Wertheim, writing in The Age, has made this point. 'No blastocyst is viable on its own - it needs a healthy womb, proper nourishment and a lot of luck to grow into a mature human form. Many fertilised eggs in naturally occurring pregnancies are spontaneously aborted and get nowhere near to full term.
If a single-celled fertilised egg, which is utterly incapable of surviving on its own, is a fully-fledged person, then why not extend that definition to an unfertilised egg? Or a sperm?'

6. The rights of human beings currently in existence should have precedence over those of potential or undeveloped human beings
This point has been made by a number of commentators on this issue, especially the relatives of those suffering with conditions for which stem cell therapy offers a hope of treatment. Mrs Kay Wilson, whose husband suffers with motor neurone disease, has written in a letter published in The Age on March 28, 2002, 'I can't see that frozen cells in a test tube destined for the bin are more sanctified than loving human beings who are dying of conditions that at present are incurable.'
Professor Julian Savulescu, the director of the ethics program at the Murdoch Children's Research Institute, has noted, 'I often hear that taking these cells from embryos is failing to respect human dignity. But is it respect of human dignity to allow people to wither in nursing homes, unable to swallow, speak or move while the frozen embryos that offer hope for an end to so many illnesses and afflictions are simply destroyed?'
A similar point was made in a letter from Greg Wharton published in The Age on March 27, 2002. Mr Wharton stated, 'The embryonic material exists. It is going to be destroyed anyway. Why not gain benefit for fellow human beings?'

7. Restricting the use of human embryo stem cells will inhibit research in Australia
Researcher Peter Mountford, who runs Stem Cell Sciences, has claimed that the apparent decision to ban therapeutic cloning was 'bad news for Australia'. Dr Mountford has suggested that it would leave Australia behind the rest of the world as therapeutic cloning is allowed in Britain.
Some researchers in the field have suggested that they may be forced to leave Australia to pursue their work if Australian laws restricting embryo research were not liberalised.
Apparently in response to such suggestions, New South Wales premier, Mr Bob Carr, has stated, 'I'm not going to see our best medical researchers driven out of this state by a short-sighted federal position on this issue ... I, for one, will work hard to make sure they have what they need.'

8. Therapeutic cloning should not be seen as morally objectionable
It has been argued that should the liberalisation of Australian laws on embryo research result in therapeutic cloning, this should not be rejected. Supporters of therapeutic cloning claim it is a fundamentally different undertaking to reproductive cloning. Unlike reproductive cloning it does not involve the creation of a replica human life with the intention to bring it to maturity. Also, unlike reproductive cloning, it does not involve motives such as personal vanity and a desire for self-perpetuation. Rather, the supporters of therapeutic cloning claim, the clone would not be allowed to develop beyond the blastocyst stage and would be used as a source of matching stem cells for the treatment of the person who had donated the somatic cell that helped to create it. The clone's purpose would only ever be curative.
Professor Alan Trounson, director of Monash University's Institute of Reproduction and Development, has posed the following theoretical situation, 'If a woman wanted to make her own embryonic stem cells from her own eggs, why would you interfere in that process?'
Professor Trounson further asks, 'If a mother wanted to make embryonic stem cells for her sick child, would you really interfere?'

Arguments against stem cells be taken from 'spare' human embryos for use in medical research
1. Embryonic human life should not be treated as a commodity
Those who hold this position argue that all human life is unique and valuable and that no human life should be treated as an exploitable property. Guy Barnett, a Liberal Senator from Tasmania, has made this point explicitly. Mr Barnett has stated, 'A human embryo is not a commodity to be sold, or a resource for experimentation, exploitation or research.'
According to this point of view, all human life deserves respect and no human life should be sacrificed to serve another end. Mr Barnett thus states, 'I cannot support a proposal which devalues life and shows disrespect for the uniqueness and "specialness" of human life. The ends do not justify the means.'
The same point has been made by Dr Warwick Neville, a research fellow with the Australian Catholic Bishops Conference. Dr Neville has stated, 'As a matter of principle, human life at any and every stage of development ought not to be treated as a commercially exploitable commodity. It is an offence to human dignity to treat any member of the human family as a means to an end ...'
Some critics of stem cell harvesting from frozen embryos have also argued that these embryos were never created so as to be property. Peter Coghlan of the school of philosophy, Australian Catholic University, Fitzroy, has stated, 'The embryos that were created when IVF first began had a very different meaning. They were looked on with wonder and cherished as the potential children of infertile couples. And the couples themselves did not own their spare embryos as we own pieces of property, or possess them as we possess our kidneys or corneas. Their relationship to their embryos was more like guardianship than ownership.'

2. There are already enough stem cells available for experimentation
It has been claimed that even for those scientists interested in embryonic stem cell research, there are sufficient stems cells already available for this purpose without the need to harvest more from frozen embryos.
A number of researchers, including Professor Alan Trounson, gave evidence to the House of Representatives committee that there were already enough stem cells available for their experimentation.
For example, stem cell lines being used for experimentation in Victoria, where their harvesting from embryos is currently illegal, have been imported from overseas. As the cells are said to be 'immortal', in the sense that it is possible to continue growing them indefinitely, opponents of further harvesting argue that there should be no need to take cells from other embryos.
It has further been noted that it is possible to create embryonic stem cells without having to destroy an embryo to do so.
One of the processes that enable stem cells to be harvested without the destruction of an embryonic life is parthenogenesis. Normally a fertilised egg gets one set of chromosomes from the mother and one from the father. In parthenogenesis the 'embryo' is created from two maternal cells and so is unviable, that it, it is incapable of developing into a foetus. However, it can develop to the point where stem cells are produced.
Another process that might enable the production of a stem-cell-like cell is ooplasmic transfer. Here the cytoplasm (material surrounding the nucleus of a cell) is taken from a human egg cell and then injected into an ordinary differentiated cell, such as a skin cell. The new cytoplasm seems to neutralise the adult cell so that it functions like a stem cell with the capacity to turn into any type of body cell.

3. There are significant risks associated with embryonic stem cell therapy
There are two major risks associated with embryonic stem cells being used to treat conditions such as leukaemia or spinal cord injury. One is rejection and the other is the possible development of tumours.
Unless stem cells were taken from embryos cloned from the patient, any person treated with embryonic stem cells would be receiving foreign tissue. Thus, though these cells might have the ability to develop into the type of cell required to treat a particular condition, the patient's body would still see them as foreign and would reject them.
A further problem associated with the transplanting of embryonic stem cells is the risk of cancer. Glenn McGee, a bioethicist, has stated, 'The emerging truth in the lab is that [embryonic] stem cells are hard to rein in. The potential that they would explode into a cancerous mass after a stem cell transplant might turn out to be the Pandora's box of stem cell research.'

4. The prospect of imminent cures for serious diseases and disabilities using embryonic stem cells has been exaggerated
In the September, 2001, edition of the journal Stem Cells, the editor stated, 'We scientists have exaggerated the immediacy of the prospects of clinical therapies using stem cells, and ... this has led to public misunderstanding.
I continue to think that clinical application is a long way off ... Prior to clinical use of embryonic and foetal stem cells, it will be necessary to thoroughly investigate the malignant potential of embryonic stem cells.'
Dr Amin Abboud, assistant lecturer in medical ethics and health law at the University of New south Wales and a coordinator of Australasian Bioethics Information, a bioethical group for doctors and lawyers, has claimed, 'The diabetics and those who suffer Alzheimer's and Parkinson's disease have been promised hopes of cure that are non-existent ... Embryonic stem cells, by contrast [with adult stem cells] have not helped a single patient.'

5. Cure is not the only option for the treatment of disease and disability
Christopher Newell, a senior lecturer at the University of Tasmania's school of medicine, a consultant ethicist and a person with a disability, has stated that the overriding emphasis on curing disabilities detracts from efforts to make the lives of those who currently have disabilities as positive as possible.
Mr Newell has argued, 'We can find adequate money for stem-cell research, but what of the unmet need for people with disabilities and their carers which now exists?'
Mr Newell claims, 'Sadly our parliaments have failed to address the unmet need and the denial of the rights of those with disabilities ... The tragedy of the stem cell debate lies in the belief that the cure for disability lies just around the corner. Years after his horse-riding accident left him paralysed, it is doubtful that Reeve's scarred spinal cord can be repaired to enable him to walk ... Perhaps it is time for the vested interests promoting cloning in this country to move from using one American with a disability in an Australian policy debate to talking with Australians with a disability ... We have avoided asking how we as a society should embrace people with disabilities in the debates that ought to be about them,'

6. Adult stem cells may be superior to embryonic stem cells
Dr Gregory Pike, the deputy director of the Southern Cross Bioethics Institute in Adelaide, has noted, 'Work in many laboratories world-wide on stem cells derived from adult tissues is proving extremely promising, and may provide therapeutic application ahead of embryonic stem cell work.'
In addition to avoiding what Dr Pike refers to as the 'ethical quandary' of harvesting stem cells from embryos, using adult cells has the advantage of avoiding the cell rejection problems that occur when foreign cells are introduced into a patient's body. Using adult stem cells would allow patients to be treated with their own cells.
Marcia Riordan, executive officer of the Respect Life Office, Catholic Archdiocese, Melbourne, has claimed, 'Hundreds of thousands of cancer patients around the world have been successfully treated using adult stem cells. They have been used to treat patients with autoimmune disease, stroke, anaemia, cartilage and bone diseases.
They have repaired corneas and restored sight to the legally blind. Adult stem cells from a paraplegic woman's own body were injected into the site of her spinal-cord injury. This cured her incontinence and allowed her to move her fingers and toes.'

7. The use of embryonic stem cells may encourage human cloning
Dr Gregory Pike, the deputy director of the Southern Cross Bioethics Institute in Adelaide, has argued, 'To use these particular embryos is to set in concrete the principle that any human embryo can be destroyed. How long do we really think the line will hold before human beings are specifically created for destructive experimentation?'
Reality has already overtaken Dr Pike's speculation. In the middle of the debate over whether 'spare' IVF embryos should be used for stem cell research, Professor Alan Trounson, director of Monash University's Institute of Reproduction and Development, has declared his support for therapeutic cloning 'absolutely, unreservedly'.
Professor Trounson has stated, 'Therapeutic cloning is another horse in the race and you don't want to shoot the horse ... This is a very fast moving area and I think you need to be fairly flexible about the choices you make ... let us have the competitive edge and then let us take it right to the core of the issue of being able to deliver applications.'
Opponents of using 'spare' embryos to harvest stem cells argue that the commodification of the embryo leads directly to the cloning of embryos specifically for research and treatment purposes. It is claimed that this is a further and even more serious violation of the respect that should be attributed to human life.
This is the slippery slope or floodgate argument, which suggests that once the law allows one morally dubious practice it encourages the acceptance of even more dubious practices. Professor Trounson does not seem to care where the flood takes him in his pursuit of cures. 'I don't care if it's a floodgate,' he has stated. If it opens an opportunity to treat really serious diseases and disabilities it's alright with me.'
Critics of this position argue that we should not be willing to pursue cures at any cost.
At the far end of such concerns appears to be the apprehension that we will ultimately use for research and treatment purposes specifically produced embryos that have been allowed to develop to a far greater stage of maturity.
Dr Gregory Pike has argued, 'And when the day comes where human embryos can be maintained in artificial wombs for months, how long will it be before experiments on fully formed foetuses follow?'

8. Most embryonic stem cells will be used for less significant purposes than the treatment of disease or injury
Dr Nicholas Tonti-Filippini, a consultant bioethicist and prominent Catholic intellectual, has argued that cell rejection problems mean that embryonic cells will not be widely or successfully used for treating patients with diseases or injuries.
Dr Tonti-Filippini maintains that the pressure for access to embryonic stem cells, other than for research purposes, is because they can be used as part of drug testing. 'So what you are talking about is using human embryos to test drugs and ... when people look at it that way, all this business about getting [quadriplegic actor] Christopher Reeve to walk again, or curing Alzheimer's or diabetes is not where the research is actually going.
It's a myth - nobody is seriously putting forward any solutions or therapies involving [embryonic] stem cells.'
The point of Dr Tonti-Filippini's observations appears to be that much of the talk about using embryonic stem cells directly to cure spinal cord injuries or Alzheimer's disease is just a blind to justify taking embryonic cells that will be used either for drug testing or less targeted research.

Further implications
Given that both sides of Parliament have allowed a conscience vote on the issue, it is not certain that federal laws allowing the harvesting of stem cells from 'spare' embryos will win the support of both houses of Parliament. The proposed legislation has, however, been generally praised as moderate and there appears to be a wide measure of media support for it. The Prime Minister, Mr Howard's, position on the question has been commended for its caution. Under the proposed guidelines there will be no guaranteed access to 'spare' embryos as yet not in existence, cloning has been banned, and stem-cell research guidelines are to be reviewed in three years.
Despite the caution embodied in the current federal position on using 'spare' embryos to harvest stem cells, it seems highly unlikely that some of the restrictions currently being imposed will continue.
Logically, if a government is going to allow researchers access to 'spare' embryos currently in existence, there is no reason why they should not have access to embryos that will come into existence at a later date as a by-product of IVF techniques. What is interesting here is why researchers would want further embryos. There are now between 70,000 and 80,000 frozen embryos that they could potentially have access to.
It is hard not to believe that there is a subtext being acted out on both sides of this debate.
Many medical researchers clearly want access to embryonic stem cells for a range of purposes, some of which are outlined in the background to this issue outline. However, the primary purpose of such cells will not be the imminent treatment and cure of certain high profile injuries and diseases. Doubtless research effort will go into these areas, but application would appear to be a long way off. The dual problems of malignancy and rejection will have to be overcome before treatments are a real possibility.
Adult stem cells do not present rejection problems, however, they are generally difficult to harvest and slow to grow. Further, though there are grounds to suspect that it may be possible to encourage them to develop into a wider range of cells than was first thought, as multipotent rather than pluripotent cells, their application for disease treatment is more limited than that of embryonic stem cells.
The rejection problem associated with using embryonic stem cells would be overcome if it were possible to clone an embryo so that it would have the same genotype as the patient to be treated. This would be possible if the embryo had been cloned from the patient. Thus, the use of embryonic stem cells for treatment purposes appears to be in part dependent on a general acceptance of 'therapeutic cloning'. The only place in the world where therapeutic cloning is currently legal is in Great Britain.
At least some of Australia's medical research community appears to want therapeutic cloning. The Prime Minister had no sooner indicated that he was prepared to allow researchers access to 'spare' embryos than Professor Alan Trounson, director of Monash University's Institute of Reproduction and Development, declared his support for therapeutic cloning 'absolutely, unreservedly'. Professor Trounson urged, 'Let us have the competitive edge and then let us take it right to the core of the issue of being able to deliver applications.'
Clearly, if applications, rather than pure research, were at issue than therapeutic cloning would make this far more possible, though the apparent problems of malignancy associated with embryonic stem cells would still have to be overcome.
On an ethical level therapeutic cloning would appear to leave our politicians and perhaps our population in a dilemma. The promise of wonderful cures has brought many within the community and many of our political leaders to the point of accepting the harvesting of embryonic stem cells from 'spare' embryos. Now it appears that these cures or 'applications' may be dependent on 'therapeutic cloning.'
Many people are apparently prepared to accept harvesting from embryos that are already destined for destruction. However, would the Australian community be prepared to accept that a life be created solely so that it could be used to cure another person and in the process be killed? It is a question both the Australian people and their leaders will soon have to answer. Our stem cell research guidelines are to be reviewed three years after they come into effect. The therapeutic cloning debate will have begun well before this.
Mr Howard's reluctance to guarantee researchers access to 'spare' embryos not yet in existence may stem from an unwillingness to accept that any life should be brought into existence earmarked for use and then destruction. The Prime Minister's decision may not simply be perverse and illogical. It may be an attempt to prevent the medical research lobby arguing, 'Excess IVF embryos are already being created that are destined to be used for research, why not clone embryos that would be more useful to treat diseases?'
Whether we answer yes or no to embryos being cloned as raw material for research and treatment will depend in part on how much significance we attribute to human life in the early stages of its development. Popular acceptance of abortion and of the creation of huge numbers of surplus embryos as part of the IVF process suggest that the community's regard for early human life is dependent on the value it attaches to the opposing benefit - for example reproductive freedom of choice for women and children for infertile couples. Indeed the popular sticking point with regard to therapeutic cloning seems to be not that a human life is being sacrificed so much as that the embryo has been cloned.
Why people object to cloning per se is not clear. There appears to be some nightmare scenario in the popular mind of troops of identical replicas goose-stepping into the future. Such apprehensions are clearly exaggerated. Once these fears are seen to be extreme, and this may take no more than the assurance that therapeutic clones would never be allowed to reach maturity, then the public may be prepared to accept such cloning. As with its stance on the legalisation of euthanasia, the federal Parliament may have a more conservative position on therapeutic cloning than the Australian people.
Where respect for early human life fits in this picture remains to be seen.

Sources
The Age
27/2/02 page 14 editorial, 'Tying the hands of researchers'
27/2/02 page 15 comment by John McBain, 'Rome must not rule research'
28/2/02 page 17 comment by Warwick Neville, 'Stem cells and the stemming of debate'
2/3/02 page 7 (Insight section) comment by Gregory K Pike, 'Embryo debate is moral, not sectarian'
3/3/02 page 17 comment by Margaret Wertheim, 'Let us debate, not demonise'
26/3/02 page 2 news item by Tom Noble, 'How a humble mouse made the politicians jump'
27/3/02 comment by Dr Amin Abboud, 'Embryonic stem cells: the debate we shouldn't have'
27/3/02 page 16 four letters to the editor on embryo stem cells
28/3/02 page 14 five letters to the editor on embryo stem cells
1/4/02 page 15 comment by Christopher Pearson, 'Stem-cell research and the forces of darkness'
3/4/02 page 15 comment by Reverend Anthony Fisher, 'Only humans have "something special"'
4/4/02 page 15 comment by Paul Komesaroff, 'Dealing with medical ethics the humane way'
5/4/02 page 1 news item by Louise Dodson, Darren Gray and Tom Noble, 'Go-ahead on stem cells, but premiers want more'
5/4/02 page 6 analysis by Phillip Hudson, 'PM faces a private challenge on a personal issue'
5/4/02 page 6 news item by David Wroe, 'Human cloning will be next: churches'
5/4/02 page 6 news item by Tom Noble, 'IVF pioneer Trounson happy with Prime Minister's stance, as far as it goes'5/4/02 page 13 comment by Louise Dodson, 'The day morality and conscience took centre stage in Canberra'
6/4/02 page 6 (Insight section) editorial, 'Sensible compromise on stem-cell research'
8/4/02 page 15 comment by Christopher Pearson, 'Trying to please the gods and the people'
9/4/02 page 15 comment by Alasdair Palmer, 'Beware: human cloning risks creating monsters'
10/4/02 page 15 comment by Guy Barnett, 'Why Howard's stem-cell research plan must fail'

The Australian
2/3/02 page 8 editorial, 'Society supports stem-cell research'
5/3/02 page 13 comment by Angela Shanahan, 'Lobbyists' bogeyman a moral hero'
28/3/02 page 11 comment by Christopher Newell, 'Superman's mission no miracle cure'
1/4/02 page 1 news item by John Kerin and Ian Henderson, 'Premiers approve stem-cell research'
1/4/02 page 12 news item by Deborah Hope, 'Pushing the boundary of cell research'
1/4/02 page 12 news item by Jamie Walker, 'Ethical gulf widens'
1/4/02 page 12 comment by Paul Brock, 'Whose life - and suffering - is it anyway?'
1/4/02 page 12 comment by Steve Bracks, Bob Carr, Peter Beattie, Jim Bacon, Geoff Gallop and Mike Rann, 'The premiers'
1/4/02 page 12 news item by Belinda Hickman, 'The churches'
1/4/02 page 13 analysis by Deborah Hope, 'The technology'
1/4/02 page 13 analysis by Deborah Hope, 'The main players'
6/4/02 page 4 news item by John Kerin, 'States agree to PM's stem-cell limits'
6/4/02 page 4 comment by Deborah Hope, 'Howard's decision politically correct'
9/4/02 page 11 analysis by Jamie Walker, 'Primitive state of being'
9/4/02 page 13 comment by Michael Cook, 'Taken by our leaders'

The Herald Sun
28/2/02 page 22 comment by Robyn Riley, 'Don't stem cell research'
11/3/02 page 18 comment by Marcia Riordan, 'No need to kill to cure'
3/4/02 page 19 comment by Professor Julian Savulescu, 'Dare to say yes'
5/4/02 page 20 editorial, 'A victory for humanity'