There can be no doubt that one of the major burning issues in our nation is the matter of stem cell research and therapy. Discussion on what direction our nation should take in dealing with stem cell research has led to much heated debate often highly polarized in nature. Indeed, the dust has not settled around the controversy generated by this debate and is discussed everywhere from the halls of Parliament to the barber shops.
As a result, there appears to be a widespread confusion as to the nature of this medical procedure and other matters related to it. Someone has suggested that the average Bahamian does not know much about stem cell research and does not care. This statement, however, is only half the truth. While it is true that the vast majority of Bahamians do not know exactly what stem cell research and therapy is, they certainly do care, realizing that it has to do with health. Also, anything to do with health generates tremendous interest in every corner of the globe in the world today. My purpose then in this contribution is threefold -- to attempt to define this novel medical phenomenon, to examine the ethical aspects or to discuss the matter from the perspective of Christian ethics, and to evaluate the potential benefits and pitfalls involved in the establishment of stem cell research and therapy in The Bahamas.
What are stem cells?
This is the question that must be answered for adequate appreciation of the magnitude of the challenge of the operation of stem cell research and therapy in the Commonwealth of The Bahamas today. The definition provided by Dr. Kevin Bethel, director of The Family Wellness Center in Freeport, is: "Stem cells are precursor cells that can transform into other cells. Stem cells are part of the normal healing process."
Cells may be described as the building blocks of the body. Well, stem cells are the simplest or most basic type of cells which, as Dr. Bethel points out can transform (or transform themselves) into whatever type of cell is required for the functioning of a particular organ of that most complex of created things -- the human body.
Now, despite the major advances made in medicine in recent decades, there remains much more knowledge to be acquired when it comes to the cells that compromise the human body, especially stem cells. Stem cell research, then, is the on-going process of learning and discovering more about the basic cells, capable of transforming themselves into literally thousands of different types of cells. It is a highly specialized and expensive process.
Medical research is not an end in itself. Rather, its purpose is to provide healthcare for those who are ill. Stem cell therapy then is the next step to stem cell research -- the application of knowledge gained in the lab to the treatment of patients whether in the doctor's office or the operating theater. Concisely, whereas stem cell research is the theoretical aspect, stem cell therapy is the practical aspect of stem cell medical care.
Now, broadly speaking, stem cell research and therapy is a blanket term covering three closely related but clearly distinguishable categories of this exciting and expanding field of modern medicine.
o Embryonic cell research and therapy: The earliest approach to this aspect of medicine, it consists of extraction of stem cells from the human embryo for therapeutic procedures.
o Autologous or adult stem cell research and therapy: Stem cells as part of the normal healing process are to be found in the human body in abundance, though the quantity decreases as they age. Here, then stem cells harvested from the one part of the body are used to heal a diseased part of the body. In other words, your own stem cells are used to treat your own ailment.
o Cloning: This is the process of reproduction in which the female cell is fertilized in the lab. It may be described as "asexual reproduction" (reproduction without sexual intercourse) and as such is similar to reproduction in the most primitive form of life where reproduction takes place by constant division and separation of the amoeba.
Evaluation from the perspective of Christian ethics
Having defined and classified the various types of treatments applied in stem cell research and therapy, it is appropriate to discuss the main purpose of this contribution - evaluation of stem cell research and therapy from the perspective of Christian ethics.
This is by no means an easy task. This is precisely because theologians and ecclesiastical leaders of the major denominations have not given the consideration required to the complex moral and ethical challenges raised by stem cell research and therapy. Part of the reason for this may be the plain fact that matters of sexual morality have so dominated the agenda during recent years, especially the matter of gay marriage, that the powers that be have had little time or energy to expend in dealing with this matter.
The Lutheran Church for instance, came out with a 15,000-word document on human sexuality in 2010; but has produced little or nothing on stem cell research and therapy. The same can be said of most Christian bodies. There is precious little moral guidance for the layperson when it comes to this modern medical development.
There are, however, moral principles in the Bible that may be applied in thinking about the ethical aspect of stem cell research and therapy. These include the principle of sanctity and the uniqueness of human life (based on the doctrine of creation: Genesis 1-2) and the supreme worth and uniqueness of every human being, created in the image and likeness of the deity. Also relevant is the law of love as taught by Jesus (Mark 12: 28-32; John 15:17) and the apostle Paul (I Corinthians 13). Bearing these principles in mind, I can examine the three main categories of stem cell research and therapy.
First, there can be no doubt that embryonic stem cell research and therapy raises serious ethical concerns. Pastor Anthony Grant, in an interview recently broadcast over television stated that the use of stem cells from the embryo was morally wrong because human life begins at conception -- the fertilization of the female egg by sperm in the womb.
It is most interesting to note that this position by an Evangelical Protestant charismatic theologian is virtually the same as that of the Catholic theologians who regard the extraction of stem cells from the embryo as tantamount to abortion. And as is very well known, the Roman Catholic Church is strongly and uncompromisingly opposed to abortion, and indeed, all forms of birth control, except the rhythm method.
Christian theologians, then, both Catholic and Protestant, do not favor embryonic stem cell research and therapy. Interestingly enough, Dr. Bethel noted that embryonic stem cell therapy is dated and is no longer practiced in most countries in the world today.
If embryonic stem cell research and therapy raise major ethical concerns, then cloning brings up ethical and moral considerations that are much deeper and highly controversial. While cloning has proved successful in the case of animals (Molly, the Scottish lamb was the first animal reproduced by cloning), it does raise very serious ethical and theological concerns when applied to human beings.
According to the teaching of the Bible, as pointed out above, each human being representing the pinnacle of creation is unique (Genesis 1:26-27; 2:7-23). This concept is at the heart of the teaching of Jesus in the parable of the talents, in which persons are endowed with different gifts and talents by God (Matt. 25: 14-30). It is reinforced by St. Paul who emphasized that in the church, members are given various talents to fulfill their ministry (I Cor. 12; Eph. 4). The idea of cloning, therefore, of trying to create duplicates of a person runs against the grain of the teaching of the Bible, which holds tenaciously to the concept of the uniqueness of every individual.
Theologically speaking, it was well expressed by the late Reverend Percival Gibson, Lord Bishop of Jamaica, on a visit to The Bahamas many years ago soon after being appointed to Episcopal office. An educator and recognized as the most brilliant Caribbean ethical thinker of the 20th century, he addressed a group of bright students including this writer (then a schoolboy in short pants).
Acting as a typical teacher, he called out one of the students. The bishop said to the boy, "There never was and there never will be another boy like you." Then the bishop went on to speak to the eager students about the uniqueness of their own gifts and talents urging them to "be the best that they can be". On the basis then of the teaching of scripture and what may be called "The Gibson Principle", it can be stated unequivocally that cloning from a moral and theological perspective is an absolute "no-no".
The fear of cloning by some mad scientist seeking to create life or clone human is one major reason why stem cell research and therapy has run into an obstacle in the United States of America. President George Bush, for instance, was adamant in emphasizing that no attempt should be made "to clone human beings". It is not surprising then, that during the Bush Administration that legislative brakes were applied to the then rapidly advancing American stem cell research and therapy.
This brings us directly to the third matter for our consideration - the pros and cons of the operation of stem cell research and therapy in The Bahamas today.
According to eminent Bahamian cardiologist, Dr. Conville Brown, who has been involved in proposals to bring stem cell research and therapy to The Bahamas as far back as 2005, the slowdown in the United States as a result of the opportunity actions of the Bush Administration presents a window of opportunity for The Bahamas to move ahead in this new frontier in medicine. With proper legislation in place, it would be possible to carry out advanced research of stem cell therapy here in The Bahamas at a stage more advanced than in the United States of America.
Legislation in The Bahamas now under consideration strictly prohibits the two forms of stem cell research and therapy, which raises major concerns from the perspective of Christian ethics - embryonic stem cell research and cloning. The only type of stem cell research and therapy that will be legal in The Bahamas is autologous or adult stem cell research and therapy. Properly and strictly administered, the proposed legislation can provide the legal framework for a healthy Bahamian stem cell research and therapy industry.
Benefits
Because of The Bahamas' proximity to the USA, The Bahamas can become a major center for stem cell research and therapy. This means that major facilities for research and treatment can be established, resulting in greatly increased employment at all levels and the rapid expansion of medical tourism.
At the level of research, highly trained medical professionals would be attracted to The Bahamas. There are a number of highly qualified Bahamians serving top posts in medical institutions in the USA (including my brother, who has served at Howard University, Washington D.C. for many years). Some of these professionals may be attracted to return to serve at home as opportunities for their employment, at salaries commensurate with that they are receiving abroad, would become available in the field of medical research. Moreover, there would be openings for people at all levels in the medical field including administrators, physicians, nurses and assistant nurses. In the construction phase, hundreds of jobs would become available.
There would also be an increase in medical tourism. Because treatment at an advanced level would be available here before the USA, many people would come to The Bahamas for medical attention.
William Whatley, administrator of Nurse Nancy Aide of Colorado, USA, has opinioned that The Bahamas could be the next area for the expansion of medical tourism, replacing other destinations in Latin America.
The development of medical tourism can prove especially beneficial to Freeport. It can, indeed, help to jumpstart the sluggish economy.
Concisely, a properly administered stem cell research and therapy industry can prove to be a win-win situation.
With regard to the benefits of stem cell research and therapy, there are certain particular aspects of medical care that are particularly promising including:
o Treatment of diabetes: Stem cell therapy may stimulate the body's pancreas to produce more insulin.
o Heart disease: Stem cell therapy may be used for the repair of the delicate muscles of the heart after a heart attack. The need for heart transplants may be reduced. Very significantly, leading Bahamian heart specialists, Dr. Conville Brown and Dr. Dwyane Sands, both support this procedure.
o Diseases of the blood: A ministerial colleague suffers from a rare form of leukemia (cancer of the blood). Stem cell therapy may be of great assistance to such persons.
o Kidney disease: We can survive with only one kidney as demonstrated by persons who have donated their kidney to another person suffering from kidney disease. I know a young lady who suffers from kidney disease and has to be on dialysis. Again, stem cell research may prove useful here, greatly reducing the number of persons who must go on dialysis or seek a kidney transplant.
o Cancer: Cancer cells develop independently of others in the body. It may be possible, by means of stem cell research and therapy to develop cells that may block or inhibit the growth of other cells.
There are, therefore enormous, nearly mind-boggling benefits to be derived from properly administered and monitored stem cell research therapy operations in The Bahamas today.
It is not without significance that two of our leading physicians representing both sides of the political divide, Dr. Marcus Bethel and Dr. Hubert Minnis have warned that it is essential that stem cell research and therapy should be strictly policed to prevent abuse.
This is precisely why we should not countenance building more complexes then we can manage and supervise - perhaps one in Nassau and two in Grand Bahama for the time being.
The benefits of having a stem cell and therapy industry are great indeed - many jobs, fame as a medical research and therapy center, growth in medical tourism and amazing new medical techniques for the benefit of visitors and Bahamians. But this opportunity can only be of long term benefit if such stem cell research and therapy is most strictly monitored.
It is submitted, therefore, that we should move forward to take advantage of this window of opportunity available to us by being ahead of the USA in stem cell research and therapy. We need not be deterred by possible barriers and need to bear in mind that the Japanese word for challenge or crisis is dangerous opportunity.
o Rev. J. Emmette Weir is a Methodist minister in Grand Bahama. He serves as a voluntary chaplain at the Rand Memorial Hospital.
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