1
|
Iltis AS, Koster G, Reeves E, Matthews KRW. Ethical, legal, regulatory, and policy issues concerning embryoids: a systematic review of the literature. Stem Cell Res Ther 2023; 14:209. [PMID: 37605210 PMCID: PMC10441753 DOI: 10.1186/s13287-023-03448-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 08/10/2023] [Indexed: 08/23/2023] Open
Abstract
Recent advances in methods to culture pluripotent stem cells to model human development have resulted in entities that increasingly have recapitulated advanced stages of early embryo development. These entities, referred to by numerous terms such as embryoids, are becoming more sophisticated and could resemble human embryos ever more closely as research progresses. This paper reports a systematic review of the ethical, legal, regulatory, and policy questions and concerns found in the literature concerning human embryoid research published from 2016 to 2022. We identified 56 papers that use 53 distinct names or terms to refer to embryoids and four broad categories of ethical, legal, regulatory, or policy considerations in the literature: research justifications/benefits, ethical significance or moral status, permissible use, and regulatory and oversight challenges. Analyzing the full range of issues is a critical step toward fostering more robust ethical, legal, and social implications research in this emerging area and toward developing appropriate oversight.
Collapse
Affiliation(s)
- Ana S Iltis
- Center for Bioethics, Health and Society and Department of Philosophy, Wake Forest University, Winston-Salem, NC, 27106, USA
| | - Grace Koster
- Center for Bioethics, Health and Society and Department of Philosophy, Wake Forest University, Winston-Salem, NC, 27106, USA
| | - Emily Reeves
- Center for Bioethics, Health and Society and Department of Philosophy, Wake Forest University, Winston-Salem, NC, 27106, USA
| | | |
Collapse
|
2
|
Barnhart AJ, Dierickx K. A Tale of Two Chimeras: Applying the Six Principles to Human Brain Organoid Xenotransplantation. Camb Q Healthc Ethics 2023; 32:1-17. [PMID: 36847198 DOI: 10.1017/s0963180123000051] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
Cerebral organoid models in-of-themselves are considered as an alternative to research animal models. But their developmental and biological limitations currently inhibit the probability that organoids can fully replace animal models. Furthermore, these organoid limitations have, somewhat ironically, brought researchers back to the animal model via xenotransplantation, thus creating hybrids and chimeras. In addition to attempting to study and overcome cerebral organoid limitations, transplanting cerebral organoids into animal models brings an opportunity to observe behavioral changes in the animal itself. Traditional animal ethics frameworks, such as the well-known three Rs (reduce, refine, and replace), have previously addressed chimeras and xenotransplantation of tissue. But these frameworks have yet to completely assess the neural-chimeric possibilities. And while the three Rs framework was a historical landmark in animal ethics, there are identifiable gaps in the framework that require attention. The authors propose to utilize an expanded three Rs framework initially developed by David DeGrazia and Tom L. Beauchamp, known as the Six Principles (6Ps). This framework aims to expand upon the three Rs, fill in the gaps, and be a practical means for assessing animal ethical issues like that of neural-chimeras and cerebral organoid xenotransplantation. The scope of this 6Ps application will focus on two separate but recent studies, which were published in 2019 and 2020. First, they consider a study wherein cerebral organoids were grown from donors with Down syndrome and from neurotypical donors. After these organoids were grown and studied, they were then surgically implanted into mouse models to observe the physiological effects and any behavioral change in the chimera. Second, they consider a separate study wherein neurotypical human embryonic stem cell-derived cerebral organoids were grown and transplanted into mouse and macaque models. The aim was to observe if such a transplantation method would contribute to therapies for brain injury or stroke. The authors place both studies under the lens of the 6Ps framework, assess the relevant contexts of each case, and provide relevant normative conclusions. In this way, they demonstrate how the 6Ps could be applied in future cases of neural-chimeras and cerebral organoid xenotransplantation.
Collapse
Affiliation(s)
- Andrew J Barnhart
- Centre for Biomedical Ethics and Law, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
| | - Kris Dierickx
- Centre for Biomedical Ethics and Law, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
| |
Collapse
|
3
|
Fabbri M, Ginoza M, Assen L, Jongsma K, Isasi R. Modeling policy development: examining national governance of stem cell-based embryo models. Regen Med 2023; 18:155-168. [PMID: 36601984 DOI: 10.2217/rme-2022-0136] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Researchers can now coax human pluripotent stem cells to imitate the structure and spontaneous self-organization of the developing human embryo. Although these stem cell-based embryo models present an advantageous alternative to embryo research, they also raise ethical and policy challenges. In 2021, the International Society for Stem Cell Research revised its Guidelines for Stem Cell Research and Clinical Translation, providing contemporaneous best practices for ethical conduct in the field. The Guidelines complement national governance frameworks; however, they also contain contentious and aspirational norms that might catalyze change in research practice and in the enactment of national policies. Using a sample of 11 research-intensive countries, the authors compare research policy frameworks against the International Society for Stem Cell Research Guidelines to showcase how developments in global and national policies might affect stem cell-based embryo model research governance and illustrate fertile areas for ethical reflection and policy development.
Collapse
Affiliation(s)
- Morris Fabbri
- Dr John T Macdonald Foundation Department of Human Genetics, John P Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | | | - Lars Assen
- University Medical Center Utrecht, Utrecht, 3584, The Netherlands
| | - Karin Jongsma
- University Medical Center Utrecht, Utrecht, 3584, The Netherlands
| | - Rosario Isasi
- Dr John T Macdonald Foundation Department of Human Genetics, John P Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, FL 33136, USA.,Dr John T Macdonald Foundation Department of Human Genetics, John P Hussman Institute for Human Genomics, Interdisciplinary Stem Cell Institute, Miami, FL 33136, USA
| |
Collapse
|
4
|
Barnhart AJ, Dierickx K. The Many Moral Matters of Organoid Models: A systematic review of reasons. MEDICINE, HEALTH CARE, AND PHILOSOPHY 2022; 25:545-560. [PMID: 35532849 DOI: 10.1007/s11019-022-10082-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 01/15/2022] [Accepted: 03/31/2022] [Indexed: 06/14/2023]
Abstract
OBJECTIVE To present the ethical issues, moral arguments, and reasons found in the ethical literature on organoid models. DESIGN In this systematic review of reasons in ethical literature, we selected sources based on predefined criteria: (1) The publication mentions moral reasons or arguments directly relating to the creation and/or use of organoid models in biomedical research; (2) These moral reasons and arguments are significantly addressed, not as mere passing mentions, or comprise a large portion of the body of work; (3) The publication is peer-reviewed and published in an academic article, book, national-level report, working paper, or Ph.D. thesis; (4) The publications collected are in English. ANALYSIS Each article was read in-depth for identifiable moral reasons, arguments, and concerns. These were then inductively classified and synthesized to create broader categories of reasons, and eventually an overarching conceptual scheme was created. RESULTS A total of twenty-three sources were included and analyzed out of an initial 266 collected sources. Five themes of ethical issues and arguments were found: Animal Experimentation; Clinical Applications and Experiments; Commercialization and Consent; Organoid Ontology and Moral Status; and Research Ethics and Research Integrity. These themes are then further broken down into sub-themes and topics. Given the extensive nature of the topics found, we will focus on describing the topics that comprised of more in-depth reasons and arguments rather than few, passing mentions or concerns. CONCLUSIONS The ethics of organoids requires further deliberation in multiple areas, as much of the discussions are not presented as in-depth arguments. Such sentiments are also echoed throughout the organoid ethics literature.
Collapse
Affiliation(s)
- Andrew J Barnhart
- Centre for Biomedical Ethics and Law, Department of Public Health and Primary Care, KU Leuven, 3000, Leuven, Belgium.
| | - Kris Dierickx
- Centre for Biomedical Ethics and Law, Department of Public Health and Primary Care, KU Leuven, 3000, Leuven, Belgium
| |
Collapse
|
5
|
Ankeny RA, Munsie MJ, Leach J. Response to Open Peer Commentaries on "Developing a Reflexive, Anticipatory, and Deliberative Approach to Unanticipated Discoveries: Ethical Lessons from iBlastoids". THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2022; 22:W1-W3. [PMID: 38410959 DOI: 10.1080/15265161.2021.2013987] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/28/2024]
|
6
|
Monasterio Astobiza A, Molina Pérez A. Why iBlastoids (Embryo-like Structures) Do Not Rise Significant Ethical Issues. THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2022; 22:59-61. [PMID: 34962199 DOI: 10.1080/15265161.2021.2001103] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
|
7
|
Barnhart AJ, Dierickx K. A RAD Approach to iBlastoids with a Moral Principle of Complexity. THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2022; 22:54-56. [PMID: 34962201 DOI: 10.1080/15265161.2021.2001101] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
|
8
|
Zhang H, Zhang C, Wang J, Yang Y, Wei Y, Zhang Z, Wang Y. Governance of Emerging Biotechnologies: Lessons from Two Chinese Cases. THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2022; 22:56-58. [PMID: 34962206 DOI: 10.1080/15265161.2021.2001110] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Affiliation(s)
- Hui Zhang
- Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, People's Hospital of Henan University
- School of Nursing and Health, Zhengzhou University
| | - Cuilian Zhang
- Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, People's Hospital of Henan University
| | - Jing Wang
- Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, People's Hospital of Henan University
| | - Yongguang Yang
- Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, People's Hospital of Henan University
| | - Yubao Wei
- Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, People's Hospital of Henan University
| | | | - Yuming Wang
- Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, People's Hospital of Henan University
| |
Collapse
|
9
|
Lysaght T. Anticipatory Governance and Foresight in Regulating for Uncertainty. THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2022; 22:51-53. [PMID: 34962204 DOI: 10.1080/15265161.2021.2001111] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
|
10
|
Scott CT, Barlevy D. How Ethics Can Better Anticipate the Consequences of Emerging Biotechnologies. THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2021; 22:46-48. [PMID: 36569466 PMCID: PMC9788647 DOI: 10.1080/15265161.2021.2001112] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Affiliation(s)
- Christopher Thomas Scott
- Baylor College of Medicine, Center for Medical Ethics and Health Policy, One Baylor Plaza, Houston, 77030-3411 United States
| | - Dorit Barlevy
- Baylor College of Medicine, Center for Medical Ethics and Health Policy, One Baylor Plaza, Houston, Houston, 77030-3411 United States
| |
Collapse
|
11
|
Nelson JP, Selin C, Lambert L, Guston DH. Amplifying the call for anticipatory governance. THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2021; 22:48-50. [PMID: 36733779 PMCID: PMC9891711 DOI: 10.1080/15265161.2021.2001109] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Affiliation(s)
- John P Nelson
- School for the Future of Innovation in Society, Arizona State University, 1120 South Cady Mall, Tempe, Arizona 85281
| | - Cynthia Selin
- School for the Future of Innovation in Society, Arizona State University, 1120 South Cady Mall, Tempe, Arizona 85281
| | - Lauren Lambert
- School of Sustainability, Arizona State University, 800 S. Cady Mall, Tempe, Arizona 85281
| | - David H Guston
- School for the Future of Innovation in Society, Arizona State University, 1120 South Cady Mall, Tempe, Arizona 85281
| |
Collapse
|