November 20, 2012
As local experts begin the process of creating regulations for stem cell therapy, dissenting voices are weighing in on what may become more of a moral than scientific debate. The government has appointed a task force to produce recommendations for the regulation of stem cell therapy in the country. Former Minister of Health Dr. Marcus Bethel has publicly warned of the potential for abuse in this new field of medical science if it is not properly regulated. He called on the newly-appointed task force to do its homework before any recommendations are put forward. Bethel, who was a part of the first Christie administration, was part of the effort to shut down unauthorized stem cell therapy in The Bahamas in 2004 after it was discovered that such procedures were being performed at a Freeport clinic without any regulations being in place.
Stem cells are undifferentiated cells that have the capacity to renew themselves and to differentiate into various cell types, such as blood, muscle and nerve cells. Embryonic stem cells are derived from donors, whether it be aborted fetuses or placentas, and cord blood that is found in umbilical cords and other sources. Adult stem cells can be found in most tissue and organ systems, such as bone marrow, the skin and the gut. Some health experts and researches think embryonic stem cell therapy has the potential to be even more effective that adult stem cell therapy. Earlier this month a local pastor said that while he supports adult stem cell therapy and has benefitted from it, embryonic stem cell therapy is "immoral".
"I am completely against abortion," said Pastor Lyall Bethel of Grace Community Church. "And to think that someone is compounding one wrong with further wrong, with harvesting our cells, I would strongly come against it in that regard. "On top of that abortion is illegal in this country." Advancements in the field Since 2006 researchers in the United States and other parts of the world have been able to reprogram adult cells to an embryonic state, using proteins called transcription factors, according to "Stem-cell research is now bearing fruit" in the January 28 edition of The Economist. "Though these reprogrammed cells, known as induced pluri-potent stem (IPS) cells, might one day be used for treatment, their immediate value is that they are also an excellent way to understand illness," the excerpt reads.
"Using them, it is possible to make pure cultures of types of cells that have gone wrong in a body. Crucially, the cultured cells are genetically identical to the diseased ones in the patient." This development should be considered with those who oppose research on stem cells derived from aborted fetuses. One of the country's leading cardiologists has already said The Bahamas could be performing "hundreds" of stem cell procedures by this time next year. Dr. Conville Brown, lead surgeon behind the country's first stem cell operation last month, praised the recent formation of the task force and said the controversial procedure offers much promise.
"We have to be careful in The Bahamas, to make sure we have an environment that protects individuals and the reputation of the country," he explained. "Many things are happening in this arena. There is a lot of good, but it's not all good." Dr. Charles Diggiss, chief medical officer at Doctors Hospital, said yesterday that the dual benefits of autologous stem cell transplantation are that cells can be processed in such a way that the cell line can become and regenerate the mature tissue or organs where they are placed, and there are also substances associated with those cells that can stimulate the development of new blood vessels that help to sustain new tissue.
The National Cancer Institute in the United States defines autologous stem cell transplantation as a medical procedure in which stem cells are removed, stored, and later given back to the same person. Diggiss said with this type of procedure, the traditional ethical issues associated with the therapy are "off the table". Diggiss said embryonic stem cells therapy is not something Doctors Hospital is currently looking at. "I think you need to accept that adult stem cells, and given all the advances in the science right now in adult stem cells that, that is the initial step; testing the waters, doing it safely and high quality," he said.
"Eventually there are applications that embryonic [stem] cells have, which may prove to be far superior than the current processes of trying to trick the adult cells, and eventually we need to ensure that we are a part of the current science. "... The science is developing, it's dynamic and as that science develops we simply need to apply principles of safety, ethical practices, integrity and quality, and obviously protect the patients and the reputation of Doctors Hospital, and protect the reputation of The Bahamas - make sure that we are not running naively into new technology." Patient safety However, Diggiss said the Ethics Committee at Doctors Hospital is looking very closely at patient safety issues associated with adult stem cell treatment.
He said patients who have conditions that may not be helped by current treatments or that are complex and carry a high risk of death or failure with current treatments view stem cell therapy as a last resort. "They are motivated to seek whatever appears to be a way to either restore or even cure a condition and that really is the ethical burden institutions like ours carry - making sure that we are not taking advantage of individuals who are desperate for a cure," Diggiss said.
"We have to look at the science. We have to accept what has been done as far as the established protocols in the U.S. We have to question whether the protocols have been accepted in other jurisdictions like in Europe and Canada or other parts of the world where stem cell research is a little more aggressive than it is currently in the [western part of the world]." He insisted it is important that patients are exposed to no greater harm with this new therapy than they would be exposed to if they were offered the current conventional treatments.
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