Spare Embryos and Stem Cell Research: Consent Issues
Notice bibliographique
Résumé
Introduction Embryonic stem cells are touted as a source of promising treatment for debilitating diseases such as Parkinsons, Alzheimers, diabetes, cardiovascular disease, and many others. (1) In order to exploit therapeutic potential of stem cells, extensive research is required on risks and benefits of their use. (2) Respect for ethical boundaries should be included in this risk-benefit evaluation. Different sources of stem cells have different therapeutic potential. The four sources of stem cells are: embryonic stem cells (hESC), adult stem cells (ASC), stem cells of aborted foetuses, and finally, umbilical cord stem cells. hESC are either totipotent or pluripotent. Totipotent cells are found when embryo is composed of eight cells or less. Each totipotent cell is capable of developing into a complete organism. (3) Pluripotent cells can differentiate into many cellular types but they cannot create an entire organism (i.e. an embryo), hESC that come from blastocyst, an embryonic structure found six days post-fertilization, are pluripotent. (4) Spare embryos at blastocyst stage can provide pluripotent hESC. For their part, ASC are multipotent, that is, they can differentiate into certain specialized cellular types. (5) but most often are committed to a single function. (6) Their principal function is to replace differentiated cells in a particular tissue when it is damaged or old. (7) Cells from aborted foetuses are multipotent. These cells can come, for example, from neural foetal tissue and be derived into neural stem ceils. Cells from umbilical cord also form part of this multipotent cell type category. Haematopoietic stem cells can be extracted from umbilical cord and represent an interesting alternative to bone marrow graft. (8) The therapeutic potential of each of these stem cell types remains to be established. Each seems full of promise but only research will tell. The most controversial is that which requires creation of embryos for research. Indeed, current restrictions on deliberate creation of embryos for research (9) have led researchers to go to another existing source of embryos: surplus embryos left over from in vitro fertilization (IVF). Access depends on donation by couple of embryos for research purposes. It is spare embryos of pluripotent potential that are subject of this paper. To date, donor consent to research on surplus embryos has been general in nature. Since March 4, 2002, however, Human Pluripotent Stem Cell Research: Guidelines for CIHR-Eunded Research (hereinafter referred to as Guidelines) require a specific consent for stem cell research. The major reasons provided are as follows: immortalized cell lines will be created that will continue to divide indefinitely and could be used in different research projects for many years; these cell lines could have an important commercial value (10) (without profiting embryo donors themselves) and such research necessarily requires destruction of embryos. In Canada, in absence of adoption of An Act Respecting Assisted Human Reproductive Technologies and Related Research (Bill C-13), (11) it is CIHR Guidelines that govern ethical review of stem cell research protocols. Since 1998, Tri-Council Policy Statement: Ethical Conduct for Research Involving Human, (hereinafter referred to as the Tri-Council Policy Statement) governs process of ethical review of research. Obviously, general common law and civil law principles and procedures governing consent also apply. We will begin our study of issue of consent to stem cell research with a brief analysis of Bill C-13, followed by Tri-Council, Policy Statement and CIHR Guidelines. We will then examine conformity of consent forms used in eight Canadian fertility centres prior to 2003 against these norms. Finally, we will argue that stem cell research on spare embryos is not really that unique. …
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Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,002 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
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