ITEM: Last Monday, at Atlanta’s Shepherd Center, a patient suffering paralysis from a spinal cord injury became the first person known to be treated with human embryonic stem cells. Other patients will soon be admitted into the landmark clinical trial, whose narrow purpose is to determine whether human embryonic stem cells are safe to use.
Keeping the faith: One religious perspective on issues of the day ITEM: On Monday in Jerusalem, approval was given for a clinical trial to determine whether stem cells can be helpful in treating amyotrophic lateral sclerosis (ALS), the neurological ailment known as Lou Gehrig’s disease. In the Israeli trial, the stem cells are being taken from the bone marrow of adults and do not involve embryonic stem cells in any way. The trial will be conducted at Hadassah Medical Center.
ITEM: A week ago Friday, the journal Cell Stem Cell reported that a group of University of Colorado Cancer Center researchers have found a way to erase the content of adult stem cells so that they mimic embryonic stem cells. Embryonic stem cells are blank slates; properly coded, they can become any type of tissue.
ITEM: Another breakthrough involving adult stem cells was announced recently in Boston. Researchers at Children’s Hospital and the Harvard Stem Cell Institute said they found a way to “directly reprogram” adult cells without having to erase them first. As the campus weekday newspaper the Harvard Crimson put it, “direct reprogramming simply flips an adult cell directly into the desired form.” The development is being hailed as a “significant advance.”
For the purposes of this column, the most significant items are the last two, because they could lead to a change in how Jewish law views the harvesting of embryonic stem cells (ESC) for research and their cloning.
ESC research is intensely controversial on moral and ethical grounds. Various Christian groups oppose it. So does a Reform responsum issued by the Central Conference of American Rabbis in 2001 (5761.7). “The embryo,” the responsum said, “may not have attained the status of a nefesh, a legal person …, [but it is] a human being, and by that token it partakes of the sanctity of all human life. Rather than attempt to calculate the value of one human being against that of another, let us instead ask ourselves what this sanctity means.”
Most Jewish legal authorities, on the other hand, support ESC research. The only real debate for them is whether cloning embryos specifically for ESC research is permissible.
Two halachic principles specifically come into play here. The first is that of choleh l’faneinu (literally, the ill person is before us). Jewish law prohibits deriving any benefit from a corpse short of the immediate saving of another life. Obviously, this does not apply to ESC research. No one can seriously suggest that an ill individual will derive any immediate life-saving benefit from research that reportedly remains in its earliest stages.
On the other hand, choleh l’faneinu has undergone considerable expansion since it was first conceived over two centuries ago. Rather than an actual beneficiary, authorities today seek to create a statistical choleh l’faneinu in ruling on such matters as, say, organ transplantation. Thus, in an ESC context, the issue is whether any of the current victims of Parkinson’s Disease or diabetes, say, will be alive when the research, it is hoped, bears fruit. Since that is a virtual certainty, choleh l’faneinu, the ill person indeed is before us.
The other issue is how we define pikuach nefesh, regard for human life, the principle of Jewish law that overrides nearly all the other laws. The sages of blessed memory made clear that the mere potential for danger to life is sufficient for pikuach nefesh to kick in (see the Babylonian Talmud tractate Yoma 84b-85b).
The lives of victims of Parkinson’s disease or diabetes are at actual risk. If they are truly the choleh l’faneinu, as many current interpretations of halachah would have it, then anything it takes to save their lives is halachically sound.
The Reform responsum, it must be noted, rejects a “mathematical approach … [that] ignores some vital moral issues,” not the least of which is that “even there, in the microscopic fertilized egg, lies the supreme potential for humanity.”
To Rabbi Moses Tendler, however, the mathematical approach is on point. Tendler, who is very much to the right of the Orthodox center, is also one of the nation’s most respected biologists and bioethicists. “In stem cell research and therapy, the moral obligation [is] to save human life, the paramount ethical principle in biblical law,” he told a federal commission in 1999. In fact, he said, it was an obligation derived from the Torah itself (Genesis 1:28).
Tendler would extend this to cloning, as well. Sephardic authorities in Israel agree regarding cloning. Many, but not all, Ashkenazic Israeli authorities do not, even though many do support ESC research generally. In the United States, on the other hand, there appears to be majority support for cloning among the Ashkenazic Orthodox rabbinate.
What would happen, though, if the circumstances changed?
Rabbi Elliot Dorff raised the issue of changed circumstance in a 2002 paper that was approved by the Conservative movement’s Committee on Jewish Law and Standards (see CJLS response, YD 336.2002, Stem Cell Research). In that paper, he argues for ESC research on the grounds that we are dealing with “an embryo situated outside a woman’s womb, where it cannot with current technology ever become a human being.”
What would happen, though, he asks, if we could gestate a human being entirely outside a woman’s womb? “Would that change our perception?”
The same can be asked of the advances in adult stem cell research. This is especially true of the Boston-based research, which already has seen cells taken from a mouse’s pancreas turned into the kind of insulin-producing cells needed by Type 1 diabetes patients. If this can be replicated using human cells, the potential exists to create any type of cell, including new nerve cells, which would have tremendous life-giving implications for Parkinson’s and ALS patients especially.
If the potential is met, the need to clone embryonic stem cells – or to harvest them in the first place – may cause Jewish legal authorities to revisit their support for ESC research. It would not be surprising to see the Reform position, currently a minority view, become the dominant one.
On the other hand, if the clinical trial just begun in Atlanta eventually proves a boon to patients with spinal cord injuries, it is just as possible that the Reform position will move closer to the current majority view.