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Loseva PA, Gladyshev VN. The beginning of becoming a human. Aging (Albany NY) 2024; 16:8378-8395. [PMID: 38713165 PMCID: PMC11131989 DOI: 10.18632/aging.205824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 02/27/2024] [Indexed: 05/08/2024]
Abstract
According to birth certificates, the life of a child begins once their body comes out of the mother's womb. But when does their organismal life begin? Science holds a palette of answers-depending on how one defines a human life. In 1984, a commission on the regulatory framework for human embryo experimentation opted not to answer this question, instead setting a boundary, 14 days post-fertilization, beyond which any experiments were forbidden. Recently, as the reproductive technologies developed and the demand for experimentation grew stronger, this boundary may be set aside leaving the ultimate decision to local oversight committees. While science has not come closer to setting a zero point for human life, there has been significant progress in our understanding of early mammalian embryogenesis. It has become clear that the 14-day stage does in fact possess features, which make it a foundational time point for a developing human. Importantly, this stage defines the separation of soma from the germline and marks the boundary between rejuvenation and aging. We explore how different levels of life organization emerge during human development and suggest a new meaning for the 14-day stage in organismal life that is grounded in recent mechanistic advances and insights from aging studies.
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Affiliation(s)
- Polina A. Loseva
- Division of Genetics, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Vadim N. Gladyshev
- Division of Genetics, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA
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2
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Gyngell C, Lynch F, Sawai T, Savulescu J. Stem cell-derived embryo models: moral advance or moral obfuscation? JOURNAL OF MEDICAL ETHICS 2024:jme-2023-109605. [PMID: 38429089 DOI: 10.1136/jme-2023-109605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 02/09/2024] [Indexed: 03/03/2024]
Abstract
Stem cell-derived embryo models (SCEMs) are model embryos used in scientific research to gain a better understanding of early embryonic development. The way humans develop from a single-cell zygote to a complex multicellular organism remains poorly understood. However, research looking at embryo development is difficult because of restrictions on the use of human embryos in research. Stem cell embryo models could reduce the need for human embryos, allowing us to both understand early development and improve assisted reproductive technologies. There have been several rapid advances in creating SCEMs in recent years. These advances potentially provide a new avenue to study early human development. The benefits of SCEMs are predicated on the claim that they are different from embryos and should, therefore, be exempt from existing regulations that apply to embryos (such as the 14-day rule). SCEMs are proposed as offering a model that can capture the inner workings of the embryo but lack its moral sensitivities. However, the ethical basis for making this distinction has not been clearly explained. In this current controversy, we focus on the ethical justification for treating SCEMs differently to embryos, based on considerations of moral status.
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Affiliation(s)
- Christopher Gyngell
- Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia
- Biomedical Ethics, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
- Melbourne Law School, The University of Melbourne Melbourne Law School, Carlton, Victoria, Australia
| | - Fiona Lynch
- Biomedical Ethics, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
- Melbourne Law School, The University of Melbourne Melbourne Law School, Carlton, Victoria, Australia
| | - Tsutomu Sawai
- Graduate School of Humanities and Social Sciences, Hiroshima University, Higashihiroshima, Hiroshima, Japan
- Institute for the Advanced Study of Human Biology (WPI-ASHBi), Kyoto University, Kyoto, Japan
- Centre for Biomedical Ethics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Julian Savulescu
- Biomedical Ethics, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
- Centre for Biomedical Ethics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Uehiro Centre for Practical Ethics, Faculty of Philosophy, University of Oxford, Oxford, UK
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3
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Reguera Cabezas M. [Some present and future ethical dilemmas surrounding advancements in in vitro fertilization.]. Salud Colect 2023; 19:e4462. [PMID: 38000000 DOI: 10.18294/sc.2023.4462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 10/26/2023] [Indexed: 11/26/2023] Open
Abstract
The growing field of assisted human reproduction has achieved unimaginable milestones. Its continuous development and the innovations it generates at times pose both ethical and legal dilemmas. This essay aims to elucidate the progressive changes occurring in the realm of the origin of life due to the development of new options and strategies in assisted human reproduction. First, it constructs an interdisciplinary reflection on human nature and the changes society faces from the perspectives of science, ethics, and law, particularly from the perspective of Spain. Second, it provides a brief overview of current or future biomedical techniques in the field of human reproduction. It concludes with a discussion of the need to reflect on the rapid advancement of science in assisted human reproduction.
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Affiliation(s)
- Marta Reguera Cabezas
- Bióloga, Magíster en Genética y Reproducción Humana Asistida, Unidad de Reproducción Asistida, miembro del Comité de Ética Asistencial, Hospital Universitario Marqués de Valdecilla, Cantabria, España
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4
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Abstract
Whole body gestational donation offers an alternative means of gestation for prospective parents who wish to have children but cannot, or prefer not to, gestate. It seems plausible that some people would be prepared to consider donating their whole bodies for gestational purposes just as some people donate parts of their bodies for organ donation. We already know that pregnancies can be successfully carried to term in brain-dead women. There is no obvious medical reason why initiating such pregnancies would not be possible. In this paper, I explore the ethics of whole-body gestational donation. I consider a number of potential counter-arguments, including the fact that such donations are not life-saving and that they may reify the female reproductive body. I suggest if we are happy to accept organ donation in general, the issues raised by whole-body gestational donation are differences of degree rather than substantive new concerns. In addition, I identify some intriguing possibilities, including the use of male bodies-perhaps thereby circumventing some potential feminist objections.
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Xue Y, Shang L. Are we ready for the revision of the 14-day rule? Implications from Chinese legislations guiding human embryo and embryoid research. Front Cell Dev Biol 2022; 10:1016988. [PMID: 36353513 PMCID: PMC9637635 DOI: 10.3389/fcell.2022.1016988] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 10/07/2022] [Indexed: 01/06/2024] Open
Abstract
The ISSCR recently released new guidelines that relaxed the 14-day rule taking away the tough barrier, and this has rekindled relevant ethical controversies and posed a fresh set of challenges to each nation's legislations and policies directly or indirectly. To understand its broad implications and the variation and impact of China's relevant national policies, we reviewed and evaluated Chinese laws, administrative regulations, departmental rules, and normative documents on fundamental and preclinical research involving human embryos from 1985 to 2022 in this paper. We have historically examined whether these regulations, including a 14-day rule, had restrictions on human embryo research, and whether and how these policies affected human embryo and embryoid research in China. We also discussed and assessed the backdrop in which China has endeavored to handle such as the need for expanding debates among justice practice, academia, and the public, and the shifting external environment influenced by fast-developing science and technology and people's culture and religions. In general, Chinese society commonly opposes giving embryos or fetuses the legal status of humans, presumably due to the Chinese public not seeming to have any strong religious beliefs regarding the embryo. On this basis, they do not strongly oppose the potential expansion of the 14-day rule. After the guidelines to strengthen governance over ethics in science, and technology were released by the Chinese government in 2022, Chinese policymakers have incorporated bioethics into the national strategic goals using a "People-Centered" approach to develop and promote an ecological civilization. Specifically, China follows the "precautionary principle" based on ethical priority as it believes that if scientific research carries any potential technological and moral risks on which no social ethical consensus has been attained, there would be a need to impose oversight for prevention and precaution. At the same time, China has adopted a hybrid legislative model of legislation and ethical regulations with criminal, civil and administrative sanctions and a 14-day limit specified within its national hESCs guidelines. This would certainly be a useful example for other countries to use when considering the possibility of developing a comprehensive, credible and sustainable regulatory framework.
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Affiliation(s)
- Yang Xue
- Law School, Tianjin University, Tianjin, China
- Center for Biosafety Research and Strategy, Tianjin University, Tianjin, China
| | - Lijun Shang
- School of Human Sciences, London Metropolitan University, London, United Kingdom
- Biological Security Center, London Metropolitan University, London, United Kingdom
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6
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Lendahl U. 100 plus years of stem cell research-20 years of ISSCR. Stem Cell Reports 2022; 17:1248-1267. [PMID: 35705014 PMCID: PMC9213821 DOI: 10.1016/j.stemcr.2022.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 03/25/2022] [Accepted: 04/05/2022] [Indexed: 11/25/2022] Open
Abstract
The International Society for Stem Cell Research (ISSCR) celebrates its 20th anniversary in 2022. This review looks back at some of the key developments in stem cell research as well as the evolution of the ISSCR as part of that field. Important discoveries from stem cell research are described, and how the improved understanding of basic stem cell biology translates into new clinical therapies and insights into disease mechanisms is discussed. Finally, the birth and growth of ISSCR into a leading stem cell society and a respected voice for ethics, advocacy, education and policy in stem cell research are described.
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Affiliation(s)
- Urban Lendahl
- Department of Cell and Molecular Biology, Karolinska Institutet, 17177 Stockholm, Sweden.
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7
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Ai Z, Yin Y, Niu B, Li T. Deconstructing human peri-implantation embryogenesis based on embryos and embryoids. Biol Reprod 2022; 107:212-225. [PMID: 35552636 DOI: 10.1093/biolre/ioac096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 04/11/2022] [Accepted: 05/03/2022] [Indexed: 11/14/2022] Open
Abstract
The peri-implantation period from blastula to gastrula is one of the crucial stages of human embryo and stem cell development. During development, human embryos undergo many crucial events, such as embryonic lineage differentiation and development, structural self-assembly, pluripotency state transition, cell communication between lineages, and crosstalk between the embryo and uterus. Abnormalities in these developmental events will result in implantation failure or pregnancy loss. However, because of ethical and technical limits, the developmental dynamics of human peri-implantation embryos and the underlying mechanisms of abnormal development remain in a "black box". In this review, we summarize recent progress made towards our understanding of human peri-implantation embryogenesis based on extended in vitro cultured embryos and stem cell-based embryoids. These findings lay an important foundation for understanding early life, promoting research into human stem cells and their application, and preventing and treating infertility. We also propose key scientific issues regarding peri-implantation embryogenesis and provide an outlook on future study directions. Finally, we sum up China's contribution to the field and future opportunities.
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Affiliation(s)
- Zongyong Ai
- State Key Laboratory of Primate Biomedical Research; Institute of Primate Translational Medicine, Kunming University of Science and Technology, Kunming, Yunnan, 650500, China.,Yunnan Key Laboratory of Primate Biomedical Research, Kunming, Yunnan, 650500, China
| | - Yu Yin
- State Key Laboratory of Primate Biomedical Research; Institute of Primate Translational Medicine, Kunming University of Science and Technology, Kunming, Yunnan, 650500, China.,Yunnan Key Laboratory of Primate Biomedical Research, Kunming, Yunnan, 650500, China
| | - Baohua Niu
- State Key Laboratory of Primate Biomedical Research; Institute of Primate Translational Medicine, Kunming University of Science and Technology, Kunming, Yunnan, 650500, China.,Yunnan Key Laboratory of Primate Biomedical Research, Kunming, Yunnan, 650500, China
| | - Tianqing Li
- State Key Laboratory of Primate Biomedical Research; Institute of Primate Translational Medicine, Kunming University of Science and Technology, Kunming, Yunnan, 650500, China.,Yunnan Key Laboratory of Primate Biomedical Research, Kunming, Yunnan, 650500, China
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8
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Anifandis G, Sutovsky P, Turek PJ, Chavez SL, Kunej T, Messini CI, Schon SB, Mavroforou A, Adashi EY, Krawetz SA. Bioethics in human embryology: the double-edged sword of embryo research. Syst Biol Reprod Med 2022; 68:169-179. [PMID: 35380489 DOI: 10.1080/19396368.2022.2052771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
There has been a significant increase in the use of assisted reproductive therapies (ARTs) over the past several decades, allowing many couples with infertility to conceive. Despite the achievements in this field, a mounting body of evidence concerning the epigenetic risks associated with ART interventions such as ovarian hormonal stimulation, intracytoplasmic sperm injection (ICSI), and in vitro culture (IVC) of oocytes and embryos has also emerged. Induced development of multiple follicles, the IVC media itself, and extended culture may alter the epigenome of both gametes and embryos, resulting in yet to be fully understood developmental, postnatal, and adult life health consequences. Investigators have attempted to decipher the molecular mechanisms mediating ART-induced epigenetic changes using either human samples or animal models with some success. As research in this field continues to expand, the ethical responsibilities of embryologists and researchers have become critically important. Here, we briefly discuss the ethical aspects of ART research, concentrating on the constraints arising from the perceived 'unnaturalness' of many of these procedures. Secondly, we focus on the bioethics and morality of human embryo research in general and how ethically acceptable model systems may be used to mimic early human embryogenesis. Lastly, we review the 14-day culture limit of human embryos and the notion that this rule could be considered of taken into account using new technologies and cues from animal models. The 'black box' of early post-implantation embryogenesis might be revealed using embryo models. As long as this distinct moral line has been drawn and closely followed, we should not fear scientific growth in embryo research. Although in vitro fertilization (IVF) is ethically acceptable, research with human embryos to improve its success raises serious ethical concerns that are in need of constant revisiting.Glossary index: Moral status: the ascription of obligations and rights to embryos on the basis of sentience; Sentience: the capacity of the developing embryo to experience feelings and sensations, such as the awareness of pain; Ectogenesis: the growth of the embryo in an artificial environment outside the mother's body.
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Affiliation(s)
- George Anifandis
- Department of Obstetrics and Gynecology, ART Unit, School of Health Sciences, Faculty of Medicine, University of Thessaly, Larisa, Greece
| | - Peter Sutovsky
- Division of Animal Sciences and the Department of Obstetrics, Gynecology and Women's Health, University of Missouri, Columbia, MO, USA
| | | | - Shawn L Chavez
- Division of Reproductive & Developmental Sciences, Oregon National Primate Research Center, Departments of Obstetrics & Gynecology, Molecular & Medical Genetics, and Biomedical Engineering, Oregon Health & Science University, Portland, OR, USA
| | - Tanja Kunej
- Biotechnical Faculty, Department of Animal Science, University of Ljubljana, Domzale, Slovenia
| | - Christina I Messini
- Department of Obstetrics and Gynecology, ART Unit, School of Health Sciences, Faculty of Medicine, University of Thessaly, Larisa, Greece
| | - Samantha B Schon
- Division of Reproductive Endocrinology & Infertility, Department of Obstetrics & Gynecology, University of Michigan, Ann Arbor, MI, USA
| | - Anna Mavroforou
- School of Health Sciences, Faculty of Nursing, University of Thessaly, Larisa, Greece
| | - Eli Y Adashi
- Center for Prisoner Health and Human Rights, The Warren Alpert Medical School, Division of Biology and Medicine, Brown University, Providence, RI, USA
| | - Stephen A Krawetz
- Department of Obstetrics and Gynecology, Molecular Medicine & Genetics, C.S. Mott Center for Human Growth and Development, Wayne State University School of Medicine, Detroit, MI, USA
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9
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Revisiting selected ethical aspects of current clinical in vitro fertilization (IVF) practice. J Assist Reprod Genet 2022; 39:591-604. [PMID: 35190959 PMCID: PMC8995227 DOI: 10.1007/s10815-022-02439-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 02/16/2022] [Indexed: 12/19/2022] Open
Abstract
Ethical considerations are central to all medicine though, likely, nowhere more essential than in the practice of reproductive endocrinology and infertility. Through in vitro fertilization (IVF), this is the only field in medicine involved in creating human life. IVF has, indeed, so far led to close to 10 million births worldwide. Yet, relating to substantial changes in clinical practice of IVF, the medical literature has remained surprisingly quiet over the last two decades. Major changes especially since 2010, however, call for an updated commentary. Three key changes deserve special notice: Starting out as a strictly medical service, IVF in recent years, in efforts to expand female reproductive lifespans in a process given the term “planned” oocyte cryopreservation, increasingly became more socially motivated. The IVF field also increasingly underwent industrialization and commoditization by outside financial interests. Finally, at least partially driven by industrialization and commoditization, so-called add-ons, the term describing mostly unvalidated tests and procedures added to IVF since 2010, have been held responsible for worldwide declines in fresh, non-donor live birthrates after IVF, to levels not seen since the mid-1990s. We here, therefore, do not offer a review of bioethical considerations regarding IVF as a fertility treatment, but attempt to point out ethical issues that arose because of major recent changes in clinical IVF practice.
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10
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A framework for the responsible reform of the 14-day rule in human embryo research. Protein Cell 2022; 13:552-558. [PMID: 35165849 PMCID: PMC9232680 DOI: 10.1007/s13238-022-00907-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/04/2022] [Indexed: 11/05/2022] Open
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11
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Blackshaw BP, Rodger D. Why we should not extend the 14-day rule. JOURNAL OF MEDICAL ETHICS 2021; 47:712-714. [PMID: 34112713 PMCID: PMC8479730 DOI: 10.1136/medethics-2021-107317] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 04/21/2021] [Accepted: 04/25/2021] [Indexed: 05/08/2023]
Abstract
The 14-day rule restricts the culturing of human embryos in vitro for the purposes of scientific research for no longer than 14 days. Since researchers recently developed the capability to exceed the 14-day limit, pressure to modify the rule has started to build. Sophia McCully argues that the limit should be extended to 28 days, listing numerous potential benefits of doing so. We contend that McCully has not engaged with the main reasons why the Warnock Committee set such a limit, and these still remain valid. As a result, her case for an extension of the 14-day rule is not persuasive.
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Affiliation(s)
| | - Daniel Rodger
- Allied Health Sciences, London South Bank University School of Health and Social Care, London, UK
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12
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Lovell-Badge R, Anthony E, Barker RA, Bubela T, Brivanlou AH, Carpenter M, Charo RA, Clark A, Clayton E, Cong Y, Daley GQ, Fu J, Fujita M, Greenfield A, Goldman SA, Hill L, Hyun I, Isasi R, Kahn J, Kato K, Kim JS, Kimmelman J, Knoblich JA, Mathews D, Montserrat N, Mosher J, Munsie M, Nakauchi H, Naldini L, Naughton G, Niakan K, Ogbogu U, Pedersen R, Rivron N, Rooke H, Rossant J, Round J, Saitou M, Sipp D, Steffann J, Sugarman J, Surani A, Takahashi J, Tang F, Turner L, Zettler PJ, Zhai X. ISSCR Guidelines for Stem Cell Research and Clinical Translation: The 2021 update. Stem Cell Reports 2021; 16:1398-1408. [PMID: 34048692 PMCID: PMC8190668 DOI: 10.1016/j.stemcr.2021.05.012] [Citation(s) in RCA: 118] [Impact Index Per Article: 39.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 05/16/2021] [Accepted: 05/17/2021] [Indexed: 12/11/2022] Open
Abstract
The International Society for Stem Cell Research has updated its Guidelines for Stem Cell Research and Clinical Translation in order to address advances in stem cell science and other relevant fields, together with the associated ethical, social, and policy issues that have arisen since the last update in 2016. While growing to encompass the evolving science, clinical applications of stem cells, and the increasingly complex implications of stem cell research for society, the basic principles underlying the Guidelines remain unchanged, and they will continue to serve as the standard for the field and as a resource for scientists, regulators, funders, physicians, and members of the public, including patients. A summary of the key updates and issues is presented here.
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Affiliation(s)
| | - Eric Anthony
- International Society for Stem Cell Research, Skokie, IL, USA
| | - Roger A Barker
- Cambridge Center for Brain Repair and WT-MRC Stem Cell Institute, Cambridge, UK
| | | | | | | | - R Alta Charo
- University of Wisconsin-Madison, Madison, WI, USA
| | - Amander Clark
- University of California, Los Angeles, Los Angeles, CA, USA
| | | | | | | | | | | | | | - Steve A Goldman
- University of Rochester Medical Center, Rochester, NY, USA; University of Copenhagen, Copenhagen, Denmark
| | | | - Insoo Hyun
- Harvard Medical School, Boston, MA, USA; Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | | | - Jeffrey Kahn
- Berman Institute of Bioethics, Johns Hopkins University, Baltimore, MD, USA
| | | | | | | | | | - Debra Mathews
- Berman Institute of Bioethics, Johns Hopkins University, Baltimore, MD, USA
| | - Nuria Montserrat
- Institute for Bioengineering of Catalonia (IBEC), Barcelona, Spain
| | - Jack Mosher
- International Society for Stem Cell Research, Skokie, IL, USA
| | - Megan Munsie
- University of Melbourne, Melbourne, VIC, Australia
| | - Hiromitsu Nakauchi
- Stanford University, Stanford, CA, USA; University of Tokyo, Tokyo, Japan
| | | | | | - Kathy Niakan
- Francis Crick Institute, London, UK; Centre for Trophoblast Research, University of Cambridge, Cambridge, UK
| | | | | | - Nicolas Rivron
- IMBA-Institute of Molecular Biotechnology, Vienna, Austria
| | | | | | - Jeff Round
- Institute of Health Economics, Edmonton, AB, Canada
| | | | - Douglas Sipp
- RIKEN Center for Developmental Biology, Wako, Japan; Keio University School of Medicine, Tokyo, Japan
| | | | - Jeremy Sugarman
- Berman Institute of Bioethics, Johns Hopkins University, Baltimore, MD, USA
| | - Azim Surani
- Gurdon Institute, University of Cambridge, Cambridge, UK
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