King's University College at the University of Western Ontario, London, Canada.
Theor Med Bioeth. 2009;30(6):427-42. doi: 10.1007/s11017-009-9126-0.
In the wake of two recent developments in stem cell research, it is a fitting time to reassess the claim that stem cells will radically transform the concept and function of medicine. The first is the U.S. Food and Drug Administration's decision in January 2009 to approve Geron Corporation's Phase I clinical trial using human embryonic stem cells for patients with spinal cord injuries. The second is the National Institutes of Health's decision to permit federal funding of research using donated IVF human embryos in their July 2009 Guidelines on Human Stem Cell Research. We are now poised to see whether stem cell research can deliver on what it promises. However, what exactly does it promise and how? Moreover, who is doing the promising? Turning to the use of metaphor can help us to answer these questions and enable us to develop a better appreciation of the unique features of promised stem cell therapies. Indeed, metaphors have exerted profound influence in medicine, and it is fitting that we seek new metaphors for new therapies where appropriate. In this case, other metaphors such as magic bullets or the Holy Grail cannot capture what is unique about stem cells. Accordingly, I propose a new metaphor: the stem cell superhero. Stem cell superheroes are characterized by the following traits: they are seemingly capable of fighting the evil of virtually all disease (unlike "magic bullets") and they seem to be our only hope of doing so, although to summon them we must make difficult moral choices. In the course of assessing the merits of three recent yet covert references to the superhero metaphor, I conclude that this powerful new paradigm employs a problematic logic (i.e., we cannot know that something is "our only hope"), but that the aspiration as such is a good one.
在最近的两项干细胞研究进展之后，现在是重新评估干细胞将从根本上改变医学概念和功能这一说法的合适时机。第一个是美国食品和药物管理局在 2009 年 1 月决定批准 Geron 公司使用人类胚胎干细胞治疗脊髓损伤患者的 I 期临床试验。第二个是美国国立卫生研究院在 2009 年 7 月的人类干细胞研究指南中决定允许使用捐赠的体外受精人类胚胎进行联邦资助的研究。我们现在准备观察干细胞研究是否能兑现其承诺。然而，它到底能承诺什么，如何承诺？此外，谁在做出承诺？使用隐喻可以帮助我们回答这些问题，并使我们更好地了解承诺的干细胞疗法的独特特征。事实上，隐喻在医学中产生了深远的影响，因此，在适当的情况下，我们应该为新疗法寻找新的隐喻。在这种情况下，其他隐喻，如“魔弹”或“圣杯”，无法捕捉到干细胞的独特之处。因此，我提出了一个新的隐喻：干细胞超级英雄。干细胞超级英雄的特点是：他们似乎能够对抗几乎所有疾病的邪恶（不像“魔弹”），而且他们似乎是我们唯一的希望，尽管要召唤他们，我们必须做出艰难的道德选择。在评估最近三次隐蔽提到超级英雄隐喻的优点的过程中，我得出结论，这个强大的新范式采用了有问题的逻辑（即，我们不能知道某件事是“我们唯一的希望”），但这种愿望本身是好的。
