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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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Sawai T, Hatta T, Akatsuka K, Fujita M. Human genome editing in clinical applications: Japanese lay and expert attitudes. Front Genet 2023; 14:1205092. [PMID: 37662845 PMCID: PMC10469609 DOI: 10.3389/fgene.2023.1205092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 07/26/2023] [Indexed: 09/05/2023] Open
Abstract
Background: The world's first gene-edited babies, reported by the Chinese scientist He Jiankui, prompted an outcry of criticism and concerns worldwide over the use of genome editing for reproductive purposes. Many countries and academic associations opposed to heritable genome editing (HGE) called for public discussion involving various stakeholders. To hold a discussion of this nature and form a consensus concerning HGE, we must understand under what conditions stakeholders consider HGE acceptable and the reasons for which they deem it unacceptable. Methods: Laypeople and researchers were surveyed in May 2019. They were asked about the degree of their acceptance toward somatic genome editing (SGE) and HGE; those who answered "acceptable depending on the purpose" were queried further regarding their acceptance in the contexts of specific clinical purposes. Results: Responses were obtained from 4,424 laypeople and 98 researchers. The percentage of respondents choosing each option in attitudes to HGE was, from largest to smallest: "acceptable depending on purpose" (laypeople 49.3%; researchers 56.1%), "not acceptable for any purpose" (laypeople 45.8%; researchers 40.8%), and "acceptable for any purpose" (laypeople 5.0%; researchers 3.1%). In an additional question for those who answered "acceptable depending on the purpose," laypeople found the following purposes acceptable: infertility treatment (54.5%), treatment of life-threatening diseases (52.2%), and treatment of debilitating diseases (51.4%). Meanwhile, the degree of acceptance for enhancement purposes was 10.7, 7.9, 6.2, and 5.5% for physical, cognitive, health, and personality enhancements, respectively. In contrast, acceptance among the researchers was 94.5% and 92.7% for the treatment of life-threatening and debilitating diseases, respectively, compared with 69.1% for infertility treatment. Researchers' acceptance for enhancement purposes was similar to that of the lay participants, with 12.7, 9.1, 10.9, and 5.5% for physical, cognitive, health, and personality enhancement, respectively. Conclusion: In the past, debates regarding the acceptability of human genome editing in clinical applications tend to focus on HGE in many countries. Society will now need to debate the acceptability of both types of human genome editing, HGE and SGE.
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Affiliation(s)
- Tsutomu Sawai
- Graduate School of Humanities and Social Sciences, Hiroshima University, Higashi-Hiroshima, Japan
- Institute for the Advanced Study of Human Biology (ASHBi), Kyoto University, Kyoto, Japan
| | - Taichi Hatta
- Shizuoka Graduate University of Public Health, Shizuoka, Japan
| | - Kyoko Akatsuka
- Uehiro Research Division for iPS Cell Ethics, Center for iPS Cell Research and Application, Kyoto University, Kyoto, Japan
| | - Misao Fujita
- Institute for the Advanced Study of Human Biology (ASHBi), Kyoto University, Kyoto, Japan
- Uehiro Research Division for iPS Cell Ethics, Center for iPS Cell Research and Application, Kyoto University, Kyoto, Japan
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Akatsuka K, Hatta T, Sawai T, Fujita M. Genome editing of human embryos for research purposes: Japanese lay and expert attitudes. Front Genet 2023; 14:1205067. [PMID: 37424733 PMCID: PMC10324961 DOI: 10.3389/fgene.2023.1205067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 06/06/2023] [Indexed: 07/11/2023] Open
Abstract
Background: Multiple surveys of the general public and experts on human genome editing have been conducted. However, many focused only on editing in clinical applications, with few regarding its use for basic research. Given that genome editing for research purposes is indispensable for the realization of clinical genome editing, understanding lay attitudes toward genome editing in research, particularly using human embryos, which is likely to provoke ethical concerns, is helpful for future societal discussion. Methods: An online survey was conducted with Japanese laypeople and researchers to ascertain their views regarding human genome editing for research purposes. Participants were queried about their acceptance as a function of the target of genome editing (germ cells, surplus IVF embryos, research embryos, somatic cells); then, those who answered "acceptable depending on the purpose" were asked about their acceptance in the context of specific research purposes of genome editing. Participants were also asked about their expectations and concerns regarding human genome editing. Results: Replies were obtained from 4,424 laypeople and 98 researchers. Approximately 28.2-36.9% of the laypeople exhibited strong resistance to genome editing for research purposes regardless of their applications. In contrast, 25.5% of the researchers demonstrated resistance only to genome editing in research embryos; this percentage was substantially higher than those concerning the other three targets (5.1-9.2%). Approximately 50.4-63.4% of laypeople who answered "acceptable depending on the purpose" approved germline genome editing for disease research; however, only 39.3-42.8% approved genome editing in basic research to obtain biological knowledge. In contrast, the researchers displayed a lower degree of acceptance of germline genome editing for research purposes related to chronic diseases (60.9-66.7%) than for other research purposes (73.6-90.8%). Analysis of responses concerning expectations and concerns indicated that laypeople who would not accept genome editing of human embryos did not necessarily worry about "instrumentalization of the embryo." They also had substantially low expectations for recognized advantages of genome editing, including "advances in science" and "reduction of intractable diseases," compared with other groups of respondents. Conclusion: The assumptions shared among experts in conventional bioethical debates and policy discussions on human genome editing are not self-evident to laypeople.
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Affiliation(s)
- Kyoko Akatsuka
- Uehiro Research Division for iPS Cell Ethics, Center for iPS Cell Research and Application, Kyoto University, Kyoto, Japan
| | - Taichi Hatta
- Shizuoka Graduate University of Public Health, Shizuoka, Japan
| | - Tsutomu Sawai
- Graduate School of Humanities and Social Sciences, Hiroshima University, Higashi-Hiroshima, Japan
- Institute for the Advanced Study of Human Biology (ASHBi), Kyoto University, Kyoto, Japan
| | - Misao Fujita
- Uehiro Research Division for iPS Cell Ethics, Center for iPS Cell Research and Application, Kyoto University, Kyoto, Japan
- Institute for the Advanced Study of Human Biology (ASHBi), Kyoto University, Kyoto, Japan
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Yui H, Muto K, Yashiro Y, Watanabe S, Kiya Y, Fujisawa K, Harada K, Inoue Y, Yamagata Z. Survey of Japanese researchers and the public regarding the culture of human embryos in vitro beyond 14 days. Stem Cell Reports 2023; 18:799-806. [PMID: 36963386 PMCID: PMC10147549 DOI: 10.1016/j.stemcr.2023.02.005] [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: 08/15/2022] [Revised: 02/17/2023] [Accepted: 02/18/2023] [Indexed: 03/26/2023] Open
Abstract
The International Society for Stem Cell Research (ISSCR) has eliminated its prohibition on research involving the culturing of human embryos beyond 14 days within the updated 2021 guidelines. We conducted a survey of Japanese researchers working in stem cell- or embryo-related research (n = 535) and the public (n = 3,000) about their attitudes toward the 14-day rule. Among the researchers, 46.2% agreed that embryos could be cultured beyond 14 days, a result that was slightly lower among the public (37.9%). Among those that disagreed with embryo culturing beyond 14 days, 9.5% of researchers and 5.1% of the public agreed with culturing embryos within 14 days. Among the public, higher comprehension levels correlated with both agreement and disagreement with the culture of embryos beyond 14 days compared with "cannot judge." Further research and pubic discourse are necessary in order to better understand the factors informing participant decisions regarding the 14-day rule.
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Affiliation(s)
- Hideki Yui
- University of Yamanashi Faculty of Medicine Graduate School of Medicine, Chuo City, Japan.
| | - Kaori Muto
- The University of Tokyo Institute of Medical Science, Minato-ku, Japan
| | - Yoshimi Yashiro
- Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Itabashi-ku, Japan; Kanagawa University of Human Services School of Health Innovation, Kawasaki City, Japan
| | - Saori Watanabe
- The University of Tokyo Institute of Medical Science, Minato-ku, Japan
| | - Yukitaka Kiya
- The University of Tokyo Institute of Medical Science, Minato-ku, Japan
| | - Kumiko Fujisawa
- The University of Tokyo Institute of Medical Science, Minato-ku, Japan
| | - Kana Harada
- The University of Tokyo Institute of Medical Science, Minato-ku, Japan
| | - Yusuke Inoue
- The University of Tokyo Institute of Medical Science, Minato-ku, Japan
| | - Zentaro Yamagata
- University of Yamanashi Faculty of Medicine Graduate School of Medicine, Chuo City, Japan
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Akatsuka K, Hatta T, Sawai T, Fujita M. Public attitudes in Japan toward the reproductive use of gametes derived from human-induced pluripotent stem cells. Future Sci OA 2021; 7:FSO754. [PMID: 34840811 PMCID: PMC8609981 DOI: 10.2144/fsoa-2021-0065] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 09/30/2021] [Indexed: 11/23/2022] Open
Abstract
PURPOSE To investigate the interests of the Japanese general public in the reproductive use of in vitro derived (IVD)-gametes. METHODS We conducted an online survey and obtained answers from 3096 respondents. RESULTS More than half of the respondents agreed with the reproductive use of IVD-gametes by infertile heterosexual married couples but disagreed with the same use by unmarried or homosexual individuals. Nearly 70.0% disagreed with the use for designing a baby. DISCUSSION In Japan at present, the use of IVD-gametes that deviate from societal values regarding reproduction and family prescribed by the conventional marriage system is unlikely to be accepted. It is also unlikely to be accepted for non-treatment purposes in reproduction.
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Affiliation(s)
- Kyoko Akatsuka
- Uehiro Research Division for iPS Cell Ethics, Center for iPS Cell Research & Application, Kyoto University, Japan, 53 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan
| | - Taichi Hatta
- Shizuoka Graduate University of Public Health, Japan, 4-27-2 Kita Ando, Aoi-ku, Shizuoka 420-0881, Japan
| | - Tsutomu Sawai
- Institute for the Advanced Study of Human Biology (WPI-ASHBi), KUIAS Kyoto University, Japan, Yoshida-Konoe-cho, Sakyo-ku, Kyoto 606-8501, Japan
| | - Misao Fujita
- Uehiro Research Division for iPS Cell Ethics, Center for iPS Cell Research & Application, Kyoto University, Japan, 53 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan
- Institute for the Advanced Study of Human Biology (WPI-ASHBi), KUIAS Kyoto University, Japan, Yoshida-Konoe-cho, Sakyo-ku, Kyoto 606-8501, Japan
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