Dr. Insoo Hyun, a professor at the Center for Bioethics at the Harvard Medical School, gave a lecture titled “Ethical Issues in Stem Cell Research: Past, Present, and Future” at the inaugural event of the Bioethics Society of Boston College on Wednesday.
While teaching at Harvard, Hyun also works in the department of bioethics at Case Western Reserve University in their medical school. He also serves on the International Society of Stem Cell Research, a group that publishes guidelines for stem cell research.
Hyun began the lecture recounting how he could never have dreamed that he would be working in the field of bioethics with stem cell research, because the field had not been invented yet. He started as a biology pre-med major, but switched to philosophy.
Expanding on this point, he advised students to “gather a really strong skill set in writing, argumentation, discussion, varied expression, analytical thought.”
The lecture weaved together the past, present, and future of stem cell research and ethics by presenting the ongoing challenge of obtaining funding through all three time periods.
“There’s a rule that’s renewed every year where you can’t use federal funds for research,” Hyun said. By restricting federal funding, stem cell research has had to find alternative methods of funding for research. States and colleges, as well as the private sector, have all become involved in providing money for stem cell researchers.
In the mid-2000s, with alternative sources of funding, the quantity of stem cell research increased, as did the pace of the research. However, there were no guidelines for how to continue researching ethically.
“Usually when you control the money, you control the research,” Hyun explained. Since the federal government was not providing funding during this period, the government then had no way to control the research that researchers were doing. There were no federal guidelines or oversight committees.
Another difficulty with stem cell research and ethics is that it is extremely difficult to send research and proposals to clinical trials.
“Cells are very unstable—they change and mutate over time,” said Hyun. “Once you put them into a patient, they could possibly graft for the rest of their lives.” He noted that this creates difficulties with phase one of clinical trials because no healthy patient wants to alter their body in a way that could be permanent, and sick patients do not want to risk a procedure that could make them sicker.
According to Hyun, the challenge is to create a system that allows for responsible medical innovation without a clinical trial format. There is a precedent for this: most cancer treatments were medical innovation performed without a trial.
The future of bioengineering and stem cell research is organoids, embryo models, and multicellular-engineered living systems. All three of these involve stem cells that, when placed in hydrogel, form 3-D models of human organs or embryos.
The ethical challenges of producing these models has been met by bringing in engineering ethics to the science lab.
“It’s always the same format: anticipating what the new technology might do to society before it’s released, or once it’s out there, if something bad happens, assigning blame,” said Hyun. This is the tradeoff that stem cell research will be looking at in the future: Researchers will have to balance the potential good with the potential bad and handle the consequences.
After the lecture, Hyun took questions from the audience.
One student asked, “At what point is it really considered playing God? And at that point does the good really outweigh the negative potentials?”
Hyun responded, “People might say that medicine is playing God.”
The argument has always been that one has to look at the positives and negatives. Issues arise when only one side is studied at the expense of the other, which Hyun said he sees in both the scientists who are overly positive about stem cell research and the people who are completely against such research.
However, according to Hyun, “It almost seems, after a while, to be disrespectful of nature.”