Bursic 2:00
L11
THE DILEMMA OF EMBRYONIC STEM CELLS
Victoria Smith (vas66@pitt.edu)
WHERE WILL IT COME FROM?
In 2022 I will have my bioengineering degree from the
University of Pittsburgh, and I will be working in a lab to
grow new organs using various types of stem cells. It is my
job to ensure that each patient gets the exact type of stem cell
grown organ that they need. One day my boss comes to me
with a new assignment: A ten year old patient is in dire need
of a new liver, but his parents refuse to accept an organ that
was grown using embryonic stem cells. The problem is that
he needs this new organ within a day or he is likely to die, but
I lack the necessary resources to build his new organ from
non-embryonic stem cells in that time frame. The patient’s
doctor speaks to me personally and asks if I am willing to lie
about the type of stem cell used to grow the liver. He wants
me to say that it was grown using non-embryonic stem cells.
This will save the patient’s life; however, I will be lying to the
parents about the type of stem cell the organ was grown from.
Lying about something I know is false is ethically wrong, but
the child’s parents are risking their son’s life because they do
not believe in using embryonic stem cells. By lying to the
parents the son’s life will be saved, but I will be opposing the
ethical system set up for engineers.
If the parents learn that embryonic stem cells were used,
they could sue me and the company on the basis of being
deceitful and going against their wishes. If this happens it
would cost myself and my company a large sum of money,
and it would also give the company a bad reputation. No one
wants to work with a company that is publically known for
disregarding the wishes of its customers. The company I work
for could very well dismiss me with reasonable cause. This
would make it difficult to find another source of employment
since it would be on my permanent record that I lied to a
consumer. However, the young child would be alive and his
family would be together, which begs the question, should I
save his life? Or should I follow his parent’s wishes?
ETHICAL CODES
The National Society of Professional Engineers (NSPE)
has a code of ethics that all engineers must abide by. The first
fundamental canon in the code clearly states, “Engineers…
shall hold paramount the safety, health, and welfare of the
public” [1]. These are among the first words in the code. This
suggests that they are of the utmost importance. The health
and safety of the public comes before all other concerns. This
indicates that the life of the patient is more important than the
opinions of his parents. This is useful in the decision on
whether to follow through on the request of the doctor or not.
I would rather save his life and deal with the repercussions
University of Pittsburgh, Swanson School of Engineering 1
Submission Date 2015-11-03
later, than know I could have done something to help him
even if it may have been unethical. Also stated in the NSPE
code is that if an engineer makes a decision that is overruled
by someone else, which then endangers life or property, the
engineer should alert the appropriate authority [1]. As an
engineer in that situation I would make an embryonic stem
cell since it would save the child’s life. The parents are
overruling my decision and therefore endangering their son. I
would be obligated to tell those who could then take action on
this issue. Those authority figures may include the police,
more doctors, and my boss. Hopefully a combination of these
specialists would be able to convince the parents, or give me
permission to give the child the liver even without their
consent. These two sections of the NSPE code of ethics are
particularly helpful in the ethical problem. Both sections are
leaning towards the idea that the life of the patient is more
important than the ideals that his parents are trying to uphold.
Engineers are working to protect lives, and it seems
counterintuitive to have the ability to save a life, and not be
allowed to do so.
One part of the NSPE that was not helpful in the decision
was the canon, “Engineers shall perform series only in the
areas of their competence” [1]. The feat which I am
attempting to accomplish is clearly within the limits of my
job, since it is exactly what I am paid to do. I am trying to
grow a new organ in a laboratory for a specific patient
utilizing a specific set of materials. This canon is not useful
whatsoever and does not help advance the decision on my
issue any further.
The Biomedical Engineering Society (BMES) Code of
Ethics contains much of the same information as is in the
NSPE code. The primary canon in the NSPE code is the same
in the BMES code. The BMES code explains that engineers
shall, “Use their knowledge, skills, and abilities to enhance
the safety, health, and welfare of the public” [2]. Similarly to
the NSPE code this leads me to believe that the safety of the
patient is paramount to all else. The welfare of the public is
more important than arbitrary choices of others.
EMBRYONIC STEM CELLS
The following information contains the majority of my
research on embryonic stem cells. It encompasses information
on the donation of stem cells and what medical professionals
think is appropriate in terms of the use of these cells.
Donation
There are many situations where biological materials can
be donated, such as the donation of blood or bone marrow.
Victoria Smith
There is no ethical question as to whether or not these
materials should be used because they were donated. The
same thought process should be used for stem cells.
According to Bioethical Inquiry, when embryos are created
for reproductive assistance, there is sometimes a surplus that
are not used for the intended purposes. They are then
discarded, and if the country’s laws allow, they can be
donated. Some countries allow the use of the embryos for
stem cell research, and it is in fact their greatest source of stem
cells, while other countries strictly forbid any use of these
embryos [3]. If embryos are donated according to the nation’s
laws, then there is no reason that they should not be used to
their fullest extent. The embryos and stem cells would
otherwise be wasted. Instead they should be used to save
other’s lives. Especially if the fate of the stem cells was to be
destroyed. In either case the stem cells would go to waste
when they could be helping to extend the lives of others. The
article also claimed, “The commonest rationale for opting to
donate was a willingness to contribute to potentially curative
medical research” [3]. If the donors are in complete
agreement for the use of their donated embryos then there
should be no restrictions on what the cells can be used for.
In this scenario the company I work for only uses
embryonic stem cells that have been donated. Therefore, it is
completely within the legal and ethical bounds for my
company to use those stem cells. The parents of the patient
should be able to recognize that the stem cells were donated
for a situation similar to their son’s. They may be morally
objected to the use of stem cells, but these stem cells have
been willingly donated for the sole purpose of helping others
recover and live better lives. This article is helpful to my
scenario because it proves that not all embryonic stem cell use
is immoral. If they are donated with the intent to aid others, it
would be wasteful to not utilize them to their full extent.
lack of a moral side of the new method. It is not helpful in my
decision on whether or not to use the available embryonic
stem cells to save the boy’s life.
Other Opinions
The debate on stem cells has been going on since
approximately 1998, when the first human embryonic stem
cells were harvested [5]. Since this first derivation of
embryonic stem cells, research has continued with a growing
fervor. The uses of these stem cells seem endless. According
to Scientific Engineering Ethics, one of the largest debates
against these stem cells is that, “The process of isolation of
ESC from a pre-implantation embryo called the blastocyst,
results in the death of the embryo” [6]. The reason most
dissenters are morally against the use of stem cells in because
the embryo dies. The idea of killing another human is against
many peoples’ values. However, the debate on whether or not
embryos are actual, living humans is another topic. In my
situation, this article was quite helpful. It was a study on
medical students and doctors. The study consisted of
approximately half male and half female volunteers. Of those
who responded to the survey question, 85% of the males were
in favor of stem cell research, while 86% of the females held
the same opinion [6]. It represents that a large majority of the
medical professionals believe that stem cell research is
morally sound and that its benefits outweigh its downfalls. Dr.
Cheryl Lee, an emergency room doctor in Cincinnati, Ohio,
has the opinion that it is “totally justifiable” to use stem cells
to save a patient’s life. Using fetal tissue that would otherwise
not be used is completely warranted [7]. If the majority of
medical professionals agree that stem cell research is
justifiable, then the fact that the non-medically trained parents
dissent has little to no sway on my opinion. The doctor of the
patient and many medical professionals all agree that the use
of stem cells to save a patient’s life is completely legitimate.
Embryonic Stem Cell Replacements
Embryonic stem cells have no replacement that is known
of yet, but scientists are working to find an alternative method
that works just as well. The most recent advancement seems
promising. The new method that Mark Brown, a professor at
the University of Wisconsin, discusses is called induced
pluripotent stem cell research. These stem cells can do the
same things that embryonic stem cells do, without raising a
moral impediment. It has become possible to create these cells
without using embryonic stem cells, which erases the moral
question of whether or not embryos are living and should be
looked at using the same laws as all living humans [4]. In the
words of the journal, the “technology seems to render this
ethical debate quite moot” [4]. If this is the case then
situations such as mine will no longer be a possible future.
This article was not helpful in coming to a decision about my
scenario. This new method may render my scenario to be
completely obsolete. There would no longer be any
embryonic stem cells in the future. It does not address the
moral question of embryonic stem cells. It only discusses the
THE DECISION
In the end, it is of my opinion that the life of the boy is
more important than his parent’s decision to not use
embryonic stem cells. It is clear that the majority of medical
professionals agree that it is worthwhile to use the embryonic
stem cells, that may or may not grow to have a full life, to
save the life of a patient who is guaranteed a complete life if
the stem cells are used. Embryonic stem cells that are
willingly donated should be unrestricted in their use. The
donors understand what they are sacrificing, and they are in
complete agreement that it is worth it to donate in order to
save another human’s life. The ethical codes clearly state that
an engineer’s first duty is to the safety of the public [1, 2]. In
this case, the boy is the public, and his life is in danger from
his parents. The decision to use the embryonic stem cells to
save the boy’s life is an easy decision. In other similar
circumstances I would make the same choice to save patient’s
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Victoria Smith
lives. The only way I would change this decision is if I knew
that the stem cells would in some way cause him to come to
future harm.
ADDITIONAL SOURCES
“Air Bags, Safety, and Social Experiments”. Online
Ethics Center. (Online Article).
“Prioritizing Needs”. Stanford Biodesign. (Online
Article).
“The Leaning Tower: A Timely Dilemma”. Texas Tech
University. (Online Article).
ADVICE FOR ENGINEERS
To any engineer in a similar dilemma, I advise looking at
case studies with comparable circumstances. It was difficult
to find a situation that was applicable to my topic due to the
futuristic notion of my topic. If there had been similar
situations I would have thoroughly researched them to
understand what actions had been taken, and what the
outcome was. I would then have decided whether or not those
outcomes were favorable for the public. If they had been
beneficial to the public, I would have taken similar measures.
If they had not been beneficial, I would attempt to understand
what those situations failed to do. By looking at the downfalls
and successes of others, we can see what does the most good
for the greatest number of people. I also advise to engineers
in similar predicaments to do what they believe is right.
Generally those who are practicing in the field have a higher
knowledge than those who are emotionally involved in the
situation. The engineer knows that the stem cells were
donated to help the public in any way they can. It would be
unwise to not utilize the stem cells to save a life. Typically the
engineer will know best. When an engineer is confronted by
another professional and that professional asks them to do a
task to save a life, it seems logical to follow that professional’s
advice. When the options are to save a life and lie, or to tell
the truth knowing you are responsible for someone’s death,
the decision is not difficult. I would make the same decision
to save their life every time, knowing what the possible
repercussions are.
ACKNOWLEDGMENTS
I would like to thank the librarians for their extremely
useful website. It provided almost all of the information we
needed. I would also like to thank Matthew McCutchen f
or keeping me on task when I was getting distracted from
this paper. I would also like to thank my mom for letting me
interview her, and for being a medical professional whose
opinion on medical topics has a legitimate standing in the
professional world.
REFERENCES
[1] (2007). “Code of Ethics for Engineers”. National
Society of Professional Engineers. (Online article).
[2] (2004). “Biomedical Engineering Society Code of
Ethics”. Biomedical Engineering Society. (Online Article).
[3] J. L. Scully, E. Haimes, A. Mitzkat, R. Porz, C.
Rehmann-Sutter . (2012). “Donating Embryos to Stem Cell
Research”. Bioethical Inquiry. (Online article).
[4] M. Brown. (2013). “No Ethical Bypass of Moral
Status in Stem Cell Research”. Bioethics. (Online Article). pp.
12-13
[5] (2015). “Stem Cell Basics”. National Institute of
Health. (Online article).
http://stemcells.nih.gov/info/basics/pages/basics1.aspx
[6] N. Manzar, B. Manzar, N. Hussain, M. F. A. Hussain,
S. Raza. (2013). “The Ethical Dilemma of Embryonic Stem
Cell Research”. Scientific Engineering Ethics. (Online
article). p. 97-98, 102
[7] C. Lee. (2015, November 1). Interview
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