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In 1997 I wrote a paper about fetal tissue use and delivered it at the PAN forum that year. It was presented with a title that was designed to cause people on both sides of the issue to think hard about their respective views. The title was Pro-Life and Pro-Udall. I have prepared this draft on the current stem cell debate and may forward it to the NIH. I would appreciate comments from the list members. It is about two pages long. For purposes of paper submission I would consider all comments to be anonomous unless I have specicific approval to encorporate your thoughts as a co-contributor. Response to NIH Stem Cell Guide lines Life is much to precious to terminate or abandon The basic tenet was and still is that human life is much to precious to terminate. The gift of life is something that should be treasured and protected at almost all cost. Decisions that involve living cells, that are completely dependent on other's cells to provide life of course get more complicated. When one set of cells threatens the other set of cells some tough decisions must be made. If both sets will be lost without intervention, life is lost. Intervention at this point seems to be morally and ethically acceptable and perhaps even mandated by the base premise that life is too precious to terminate or abandon. The decision to terminate one set versus the other set has evolved and will continue to evolve with life saving capabilities that exist at the time the decision is made. This I would define as a fluid life saving state. In the next situation the cells again are linked through a dependency and one set threatens the other set. The understanding of the threat has evolved and will continue to evolve with life saving capabilities that exist at the time. The understanding this time is that one life can be saved with intervention. Intervention at this point is more complicated than the first case where both would be lost with out intervention. The moral and ethical dimension here is expanded now because one set of cells is threatening the other and one will survive. In fully matured adult cells, when one set of cells threatens the other we remove the threat through incarceration, isolation and in some instance termination. The rights of the threatener are restricted and limited by our understanding of the seriousness of the threat. The ultimate penalty for this threat may be and today can be the elimination of the threatener. In a third situation the cells are frozen and can through some period of codependency become independent. Today the cells require codependent care to survive and potentially get subjected to cases one and two. Tomorrow they require only some form of incubation not yet available today. These cells can be born, cloned, reengineered in a mutually exclusive way or perhaps at some future point in a completely compatible way. Would the guidelines and laws be the same in either scenario? I.e. the mutually exclusive scenario versus the complete compatibility with synergistic benefits scenario. In the first two cases the life saving efforts could end when the decision is made to terminate one set of cells. The decisions about the two sets of cells that were directly involved in these cases could be viewed as final. No doubt this was the case at some point in our level of understanding. The third case takes a two dimensional playing field and makes it theoretical and multidimensional beyond this first drafts focus. But for now we have discovered and proven or are trying to prove that an opportunity for another life to be saved may exist by redeploying the cells that otherwise were considered terminated in the first to cases. There is belief that the cells have life giving potential. What potential, how many potentials how will we resolve the issues of these potentials. Some can be used to make a heart, some can be used for a lung, and some can be used to repair a sick sustantia nigra. And yes some might be used to clone and restore the very life that we thought was terminated thereby actually giving it life. Would ethics and morality forbid these life saving overtures? Well maybe yes and maybe no. If the choices are mutually exclusive, the complexity of deciding which path to follow will demand that a set of guidelines be deployed that takes into account the moral, ethical, and practical issues at the time the decision is made. Perhaps this can be called the fluid law. Today organ donations and transplants are a generally accepted practice. The source of the donation and the distribution of the donation are determined by a set of guidelines and laws that take into account our understanding of the issues at the time the decision must be made. In general the source can be legal an ethical or illegal and unethical. Ditto for the use. The guidelines and the law have evolved to protect us all from inappropriate behaviors in both the source and disposition issues. The heart transfer that is sourced from a naturally caused death is preferred over one that is sourced from a murder victim. The law makes that very clear. The disposition of the heart has a set of guidelines and laws that govern that transfer yet the laws are separate apart and distinct from the laws that deal with murder and death from natural causes. The same will be needed in the stem cell controversy. The cells can be obtained from aborted fetuses, umbilical cords, petri dish embryo's, genetically similar humans, porcine cells, and perhaps our own cells. The guidelines and laws that pertain to the various sources must necessarily address the very different issues that emerge from these very different sources. Likewise the disposition of these cells will require a set of guidelines and laws that address the different issues that could emerge based on the source on the cells. These could involve anything from cross species diseases to same species diseases to simple cell rejections. How the cells are obtained clearly makes a difference. Saving a life normally doesn't justify causing a death. Yet we saw in case one (the second paragraph) where one could argue that the decision was not to take a life but to save one even though cells were terminated. Since there may be instances where cell availability can be morally and ethically justified preparation for the proper use of these cells must proceed on the tenant that al life is precious and should be protected. There should be a separation of the sourcing and the dispositioning guidelines and laws and further within these two categories laws will have to evolve that recognize the circumstances that create the issues to begin with. The notion that one size fits all is clearly not appropriate here. To say that all methods of obtaining cells are legal is as inappropriate as saying no method of obtaining cells is legal. Respectfully, Bob Martone [log in to unmask] http://www.kingwoodcable.com/martone/