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ARTICLES: D. J.H. Mathews, J. Sugarman, H. Bok, D. M. Blass, J. T. Coyle, P. Duggan, J. Finkel, H. T. Greely, A. Hillis, A. Hoke, R. Johnson, M. Johnston, J. Kahn, D. Kerr, J. Kurtzberg, S. M. Liao, J. W. McDonald, G. McKhann, K. B. Nelson, M. Rao, A. Regenberg, A. W. Siegel, K. Smith, D. Solter, H. Song, A. Vescovi, W. Young, J. D. Gearhart, and R. Faden Cell-based interventions for neurologic conditions. Ethical challenges for early human trials Neurology 2008; 0: 01.wnl.0000316436.13659.80v1 [Abstract]

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Cell-based interventions for neurologic conditions: Ethical challenges for early human trials

Patrick M. Pullicino, William J Burke, St Louis, Missouri, USA   (22 September 2008)

Reply from the authors

Debra J.H. Mathews, Jeremy Sugarman, and Ruth Faden, on behalf of the authors   (22 September 2008)

Cell-based interventions for neurologic conditions: Ethical challenges for early human trials 22 September 2008
Patrick M. Pullicino, University of Kent KIMHS, Canterbury CT2 7PD, United Kingdom, William J Burke, St Louis, Missouri, USA Send Correspondence to journal: Re: Cell-based interventions for neurologic conditions: Ethical challenges for early human trials pullic{at}umdnj.edu Patrick M. Pullicino, et al.	We read Mathews et al.’s review on ethical challenges for cell based clinical interventions. This article skirts the central ethical problem of using human embryonic stem cells. [1] No previous neurological treatment modality has involved the deliberate taking of a human life to obtain its therapeutic material. The approval of the use of stem cells obtained from the destruction of human embryos for neurological treatment trials is not a “standard challenge of human subjects research,” but represents an ethical Rubicon for the clinical neurological research community. It introduces a perversity to clinical research that justifies the taking of a life to attempt to improve another person’s quality of life and sets an ethical precedent not only for neurology clinical researchers but neurology Chairs as well. Scant reference is made in this review to the public, let alone neurologists, who are ethically opposed to human embryonic stem cell research. Stem cell research is not “a blip on the screen of non-specialists” but generates major public interest. Three ABC News/Washington Post polls showed that 28 to 33% of people oppose embryonic stem cell research, [2] and the current US President is opposed to this research. Neurologists have also opposed it. [3] Rather than addressing the ethical challenges of determining whether the use of human embryonic stem cells is moral, the authors euphemistically address “political challenges” to acceptance of this research, as though ethical acceptance is a foregone conclusion. The interdisciplinary working group included researchers that have publicly stated their support for human embryonic stem cell research. How many of the experts in this group were known to be against the use of human embryonic tissue in research? Surely a balance between these two groups is essential otherwise the deeply held concerns that many people have about human embryonic stem cell research will not be addressed. References 1. Mathews JH, Sugarman J, Bok H, et al. Cell-based interventions for neurologic conditions: Ethical challenges for early human trials. Neurology 2008;71:288-293. 2. http://www.pollingreport.com/science.htm (accessed on July 24, 2008). 3. Pullicino P, Burke WJ. Position on Stem Cell Research. Neurology 2005;65:1512-1513. Letter. Disclosure: The authors report no disclosures.
Reply from the authors 22 September 2008
Debra J.H. Mathews, Johns Hopkins University 100 North Charles Street, Suite 740, Baltimore, MD 21201, Jeremy Sugarman, and Ruth Faden, on behalf of the authors Send Correspondence to journal: Re: Reply from the authors dmathews{at}jhmi.edu Debra J.H. Mathews, et al.	While the destruction of human embryos in the conduct of embryonic stem cell research is morally and politically important, it is specific to one area of stem cell research. Our article states, "(Trials of cell- based interventions for neurological conditions) will raise many of the same questions about risk, benefit, and safety, regardless of the type of cell used (e.g., human embryonic stem cells [hESCs] vs adult stem cells); as such, our discussion applies to trials of cell-based interventions generally." [1] We do not engage in the issues raised by the destruction of human embryos. Rather, we address those issues that are relevant regardless of cell source. Disclosure: The authors report no disclosures.