Introduction

Human embryonic stem cell (HESC) research remains a topic of considerable debate among policymakers both within the United States and abroad. The announcement in February 2004 that stem cell investigators in South Korea had created the first documented cloned human embryos and had derived a colony of stem cells from one of the embryos demonstrates that scientific research is proceeding even as the policy debates continue and new policies are enacted. This issue of the Kennedy Institute of Ethics Journal focuses on the current state of national and international policy in the area of HESC research.

LeRoy Walters provides a comprehensive survey of the policies for HESC research in four regions of the world. He reports on the recent debate at the United Nations concerning one type of such research, the cloning of human embryos, and reviews the positions that various religious traditions have adopted regarding HESC research. He concludes that in several instances the religious traditions seem to have influenced the public-policy debates in this area.

Ole Döring offers a closer look at the recent efforts in China to regulate activities in biomedical research and practice. He provides background on some of the key developments in Chinese bioethics, especially in relation to genetics, stem cells, cloning, and reproductive medicine. With respect to China, at least, he observes that the regulatory efforts, for all their merits, do not represent China, Chinese people, or China's culture, in any significant sense. Rather they reflect the visions and interests of researchers and bioethics, who constitute a limited but influential group of people in China.

The background provided by Dr. Döring sets the stage for a recent set of "Ethical Guidelines for Human Embryonic Stem Cell Research," produced at the Ethical, Legal, and Social Implications Department of the Chinese National Human Genome Center at Shanghai, the official English translation of which is published here. The document is one of two proposals for scientifically and ethically satisfactory regulations on HESC research that have been submitted to China's legislators. The other document was generated by an interdisciplinary advisory group of leading scientists and ethicists from Beijing.

Nikolaus Knoepffler outlines eight possible policy options concerning HESC research and evaluates them in light of the assumptions, arguments, and decisions underlying them. He concludes that, on review, the main arguments presented offer no clear guidance regarding which policy options are ethically permissible. Dr. Knoepffler then asks whether this uncertainty provides sufficient reason for every country to develop legislation in whatever way it wants. He submits that legislation developed in this way cannot be called rational or in accordance with ethical standards. Rather, rational legislation following ethical standards, which may differ from country to country, must take consistency into consideration—i.e., if one uses a certain set of ethical standards in one area, one should use the same standards in another, comparable area.

In response to Dr. Knoepffler's paper, Alfonso Gómez-Lobo challenges his rejection of the two most conservative policy options—(1) the prohibition of all HESC research or (2) the permissibility of such research only on those cell lines created before a certain date, provided that further wrongdoing is avoided. Dr. Gómez-Lobo argues that three of the arguments in support of these conservative options, taken together, constitute good reasons to hold that human embryos are endowed with dignity from fertilization onward. Consequently, countries that want their public policies to match the moral imperative of respect for human beings should refrain from allowing destructive human embryo research and instead should devote considerable energy and public funds to research and clinical trials using non-embryonic stem cells.

Jeffrey Kahn and Anna Mastroianni discuss a recent case in which preimplantation genetic diagnosis was used by a couple not only to test IVF-created embryos for genetic disease, but also to test for immune compatibility with a child in the family in need of an hematopoetic stem cell transplant. The authors raise some of the ethical and policy issues brought out by the case, which they...