February 22, 2024

Ethical quicksand surrounds therapies for spinal cord injury

Although stem cells show great promise for repairing spinal cord injuries, there are so many practical obstacles to be overcome that clinical experiments with humans are probably unethical, argues a Melbourne neurosurgeon. Writing in the Medical Journal of Australia, Professor Jeffrey Rosenfeld and a bioethics colleague, Dr Grant Gillett, of the University of Otago Medical School, outline a number of troublesome ethical issues which will arise in a clinical setting.

In the first place, experimenting with humans is problematic because “the less neurologically impaired the patient is, the greater the likelihood that manipulation of the spine will produce a worsening of effect”. There is also immense pressure “from patients, biotechnology companies and universities… Scientific objectivity may be further diminished by the egos and commercial imperatives of the proponents.” A stem cell graft could be rejected if it were not from the patient’s own cells and tumours could form. “The potential almost silences the sternest critics of such technology, but the fact remains that the ethical challenges are daunting,” the authors conclude.

The MJA article was the basis for an ABC feature in which Christopher Reeve, the paralysed actor, pleaded for political support for human embryonic stem cell research. Bioethicist Christopher Newell, of the University of Tasmania, however, pointed out that agitation for huge investment in blue sky stem cell research ignored the day-to-day plight of people with disabilities.

“When the stem cell debate was on you may recall that parliamentarians wept as they spoke about the situation of people with disabilities in their constituencies,” he said ironically. “And then the legislation was passed and… within weeks the same parliamentarians were talking about cutting back on welfare and pensions for people with disabilities…”