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To the Editor: In advocating the creation of embryos for stem cell research by means of somatic cell nuclear transfer, Dr Lanza and colleagues1 fail to recognize at least 2 major issues. First, they overlook the fact that human embryos must be created from the eggs of women. Producing eggs engenders increased risks for women. Hyperstimulation can lead to liver damage, kidney failure, or stroke, and ovulation-stimulating drugs have been associated with ovarian cancer, according to some studies.2 Although women might be willing to undergo such risks for the sake of having a child, it seems clear that either payment for eggs or coercion would have to be used to persuade women to produce eggs for stem cell research.3 As with kidneys, hearts, and certain other body parts, society is reluctant to allow human eggs to enter into the stream of commerce, fearing that this would compromise extraeconomic values of deep importance.4 Coercion as a means of promoting medical research has been strongly criticized.3 Thus, before considering embryonic stem cell research, procedures need to be developed to protect women's health and freedom from overbearing financial or other pressure.5 Second, it is unlikely that a one-sided argument for embryo manufacture will change current US government research policies. Instead, it leaves stem cell research in the hands of private commercial enterprises, which are not bound by federal research regulations and tend to keep proprietary information secret. Lanza et al would continue this pattern of hidden research without accountable public oversight so that the creation of embryos through somatic cell nuclear transfer can move forward. Yet embryonic stem cell research enters a burgeoning field where inquiries into the uses of human procreative materials and procedures are being merged with those regarding genetic materials and procedures. Such research endeavors have major ethical and social implications for the value that is placed on procreation, the sorts of children that will be brought into the world tomorrow and in future generations, and, indeed, what it means to be human. Because of the public significance of such questions, there is, contrary to the opinion of Lanza et al, a pressing social need for a special oversight body to review and openly discuss all research—conducted in the public and private sectors—that involves both reproductive and genetic materials and procedures.5 References 1. Lanza RPCaplan ALSilver LMCibelli JBWest MDGreen RM The ethical validity of using nuclear transfer in human transplantation. JAMA. 2000;284:3175-3179.Google Scholar 2. National Advisory Board on Ethics in Reproduction, Report and recommendations on oocyte donation by the National Advisory Board on Ethics in Reproduction. In: Cohen CB, ed. New Ways of Making Babies: The Case of Egg Donation. Bloomington: Indiana University Press; 1996:233-302. 3. Baylis F Our cells/ourselves: creating human embryos for stem cell research. Womens Health Issues. 2000;10:140-145.Google Scholar 4. Cohen CB Selling bits and pieces of humans to make babies: the Gift of the Magi revisited. J Med Philos. 1999;24:288-306.Google Scholar 5. Cohen CB Leaps and boundaries: expanding oversight of human stem cell research. In: Holland S, Zoloth L, Lebacqz K, eds. The Stem Cell Debate. Cambridge, Mass: MIT Press. In press.
JAMA – American Medical Association
Published: Mar 21, 2001
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