Lo Bernard, Parham Lindsay
University of California San Francisco Program in Medical Ethics, San Francisco, California 94143, USA.
Endocr Rev. 2009 May;30(3):204-13. doi: 10.1210/er.2008-0031. Epub 2009 Apr 14.
Stem cell research offers great promise for understanding basic mechanisms of human development and differentiation, as well as the hope for new treatments for diseases such as diabetes, spinal cord injury, Parkinson's disease, and myocardial infarction. However, human stem cell (hSC) research also raises sharp ethical and political controversies. The derivation of pluripotent stem cell lines from oocytes and embryos is fraught with disputes about the onset of human personhood. The reprogramming of somatic cells to produce induced pluripotent stem cells avoids the ethical problems specific to embryonic stem cell research. In any hSC research, however, difficult dilemmas arise regarding sensitive downstream research, consent to donate materials for hSC research, early clinical trials of hSC therapies, and oversight of hSC research. These ethical and policy issues need to be discussed along with scientific challenges to ensure that stem cell research is carried out in an ethically appropriate manner. This article provides a critical analysis of these issues and how they are addressed in current policies.
干细胞研究为理解人类发育和分化的基本机制带来了巨大希望,同时也为糖尿病、脊髓损伤、帕金森病和心肌梗死等疾病的新治疗方法带来了希望。然而,人类干细胞(hSC)研究也引发了激烈的伦理和政治争议。从卵母细胞和胚胎中获取多能干细胞系充满了关于人的起始的争议。体细胞重编程以产生诱导多能干细胞避免了胚胎干细胞研究特有的伦理问题。然而,在任何hSC研究中,在敏感的下游研究、同意为hSC研究捐赠材料、hSC疗法的早期临床试验以及hSC研究的监督方面都会出现棘手的困境。这些伦理和政策问题需要与科学挑战一起讨论,以确保干细胞研究以符合伦理的适当方式进行。本文对这些问题以及当前政策如何解决这些问题进行了批判性分析。