Two Israeli institutions, Haifa’s Technion Israel Institute of Technology and Rambam Medical Center in Haifa, began exporting stem cells culled from human embryos to Germany this year, arousing a storm of controversy within both countries’ scientific and medical communities.
Because stem cells have enormous medical potential, many scientists, doctors and ethicists favor the move, saying the research project for which the cells will be used has the potential not only to advance scientific knowledge, but also to develop new medical treatments that could save many lives.
But many jurists and sociologists say that the exports, although legal, are problematic. In Israel, they argue, the exports were decided upon without any public discussion or even any discussion by national committees on medical ethics; while in Germany, the move has elicited considerable public criticism, including from the country’s National Ethics Council.
Like many other countries, Germany forbids stem cells to be culled from human embryos for research purposes within its own borders. A year ago, however, the Bundestag passed a law permitting human stem cells to be imported in exceptional cases.
“At the time, the German press pointed out the ethical double standard of this law and the absurdity of permitting an act that is forbidden on German embryos to be carried out on embryos that come from other population groups,” noted Yael Hashiloni-Dolev, a lecturer in sociology at Tel Aviv University who is writing a doctoral thesis on the application of genetic knowledge in Israel and Germany.
The stem cells are being culled by professor Yosef Itzkowitz-Eldor, head of Rambam’s gynecology department, using the Technion’s facilities. The Technion, said Itzkowitz-Eldor, is not being paid; this is a joint scientific venture in which the Technion will receive part ownership of any fruits resulting from the research.
The German researcher who is receiving the cells, Dr. Oliver Brustle of Bonn University, is trying to determine how a stem cell can be “convinced” to develop into an adult nerve cell. Brustle, who has been studying nerve cells and stem cells in rats for many years, hopes that it will eventually be possible to use transplants of nerve cells grown from stem cells to cure diseases such as Alzheimer’s and Parkinson’s.
Brustle has wanted to move on to studying human stem cells for some time, but until last year, German law made this impossible.
When the new law permitting imports of stem cells was passed in 2002, he immediately applied for an import license from an interdisciplinary ethics council. According to the law, this council may grant such licenses only for research of “outstanding scientific quality” that cannot be performed either on animal cells or on adult stem cells (which are found in bone marrow).
Late that year, Brustle became the first German to receive a permit from the council — a decision that aroused much opposition in Germany.
Professor Jens Reich of the Max Delbruck Center for Molecular Medicine in Berlin said the German reluctance to permit research on embryonic stem cells has two main sources: The first is the memory of the Nazis’ experiments on human beings. The second is Immanuel Kant’s philosophy of ends and means, which has gained wide currency in Germany. This philosophy holds that each individual is an end in itself and must, therefore, not be used as a tool for achieving aims that do not directly benefit him or her. Thus, human experimentation is justified only if the subject would benefit personally from the research.
Professor Asa Kasher of Tel Aviv University’s philosophy department, an expert in bioethics, responds that an embryo is not a “person,” so the Kantian prohibition does not apply. “The embryos from which the stem cells are produced are five days old,” he said.
“They look like a microscopic ball of cells and have not yet developed the special characteristics that we perceive as ‘human.’”
Furthermore, he argued, the Germans’ position deprives many sick people of the possible medical benefits of stem cell research.
“Perhaps we, the Jews of Israel, are the only ones who can tell them that on this matter, they are exaggerating,” he concluded.
But professor Amos Shapira of Tel Aviv University’s law faculty, also an expert in medical ethics, disagreed. The German law, he said, is “a problematic ethical compromise, along the lines of ‘we won’t do the dirty work, but we will do research if [the dirty work] is done by someone else.’”
Dr. Carmel Shalev, head of the ethics and patients’ rights department at the Gartner Institute in Tel Hashomer, added that whether or not stem cells should be exported, the decision should be made at the national level rather than by individual institutions.