Dr Trevor Mudge, AMA Vice President, and Dr Greg Pike, Deputy Director, Southern Cross Bioethics Institute, with Leon Byner, Radio 5AA

So, what is the moral argument and what is the scientific argument? Well, let's separate the two and get a couple of viewpoints on this so that you'll be better informed. Let's, first of all, talk to the Deputy Director of the Southern Cross Bioethics Institute, Dr Greg Pike.

Greg, thanks for joining us this morning.

PIKE: Good morning, Leon.

BYNER: Can you explain what your opposition to stem cell research is based on?

PIKE: Leon, if I could just give a little science first, 'cause I think it's important that listeners are aware of what we're really talking about. But the issue of stem cells is not restricted to embryonic stem cells, but-- the moral debate is restricted to embryonic stem cells, but the science is not. And there are stem cells that can be isolated from the adult body and also from umbilical cords, the last which have been used in treatments and hold enormous promise.

But the moral dilemma about embryonic stem cells is that live human embryos would need to be destroyed to extract those stem cells, which then perhaps may be used in therapeutic treatments.

BYNER: Okay. Now, what is a live human embryo?

PIKE: A live human embryo is an embryo typically at the three to four day developmental stage. As most people would be aware, human life begins with sperm joining egg, and that one cell, termed a zygo, then begins development, and before long you've got about two hundred cells.

BYNER: Yeah.

PIKE: And the inner, what's called the inner cell mass, that collection of cells, is really what would go on to form the more developed embryo, then foetus, and eventually child, and up.

BYNER: Mmm.

PIKE: So, it's that inner cell mass which scientists have extracted and used to create what's called a stem cell line, embryonic stem cell line.

BYNER: Mmm.

PIKE: And so those stem cells, it is hoped, could be turned into any tissue and perhaps used in treatment.

BYNER: Okay. Now, people such as Christopher Reeve, who, as you know, was very high-profile, he had a terrible accident, used to be Superman, now he's virtually incapacitated, and he and many like him are saying, "Thank goodness for this breakthrough - maybe there's some hope". What do you say to that?

PIKE: Well, first of all, the continual reference to people who are suffering from conditions like that in this debate has actually got to the unhelpful stage.

BYNER: Why?

PIKE: The reason being that everybody is concerned about people who are suffering. No one is saying that we ought to allow people to continue suffering. And to frame the debate in such a way that somehow it is impossible to be against some form of research because this research will help these people: first of all, we just don't know if it will. That's number one. Second, there's a good alternative, which is the adult stem cell, which I described before, coming from umbilical cords, blood and every other tissue in the body.

BYNER: So, really, what you're saying is that you would have no problem in using an adult stem cell?

PIKE: Of course not.

BYNER: … but an embryonic stem cell, potentially, could be a child?

PIKE: Yeah. That's right. And, in fact, I would go further and say that there is no point along the developmental scale that we can suddenly say that the developing human being has moral status at this point. It's an arbitrary selection to actually say that suddenly at fourteen days or at three months or at birth, and some say after birth, perhaps even up to two years, if you listen to Peter Singer, is when moral worth comes.

And so somewhere along that spectrum you just have to make an arbitrary choice; or you do what the scientist says, which is human life begins and the moral significance starts with the development of that first fertilised egg.

BYNER: Okay. Let's bring in, now, the science from a different perspective with Dr Trevor Mudge from the AMA.

Trevor, good morning and thanks for joining us.

MUDGE: You're welcome. Thank you.

BYNER: Where does science and the doctors stand on stem cell research?

MUDGE: Well, I think that as professionals caring for people with chronic illness, we are, of course, very concerned that, I think as the Prime Minister said, no reasonable stone be left unturned in the search for cures for such diseases. Indeed, I mean, we would argue that there probably is an ethical imperative to use embryonic stem cells. Because, I mean, a secular view must respect human life wherever you, as an individual, decide that it begins, wherever on that continuum you make your decision about where it begins, be it at fertilisation or at fourteen days or whatever. Of course, the decision you make very much colours your view of appropriate behaviour. But respect for human life, even religious respect for human life, is not absolute that is, we already allow exceptions for respect of human life in cases of, say, self-defence, the prosecution of a just war and, for some people, capital punishment after due judicial process.

BYNER: Mm.

MUDGE: So that in any moral and ethical decision, one has to balance one's responsibility to one group versus one's responsibility to another group.

And I think for the medical profession, who see such patients on a daily basis, really, your ethical responsibility to Uncle Jim and his diabetes and Christopher Reeve and his paraplegia must outweigh your concerns for human life at the point where it's smaller than a full stop.

BYNER: Greg, what do you say to that?

PIKE: Well, I think that for a long, long time - and this goes back really, you know, centuries - respect for human life has been a fundamental and basic principle. And although, as Dr Mudge has described, that respect is not absolute in the sense that things like self-defence or just war have been put up as reasons when human life can be taken, in this instance we're not talking about an aggressor or self-defence, we're talking about human embryos, totally defenceless and totally stripped of any connection to parents or relationship of any sort, to be used as new laboratory animals.

This will be the first time certainly in Australia that, if this goes ahead, there will be enshrined in law the justification for experimenting destructively on our own offspring. Now, there's something deep in the psyche that's affected by that.

And as the Deputy Prime Minister said on air I think yesterday, what this really means is that this is perhaps a good example of slippery slopes in action. And what will almost certainly occur next, perhaps within five, ten, fifteen years, will be the deliberate creation of human embryos for research because we have allowed so-called spare IVF ones to be used. And then following that, as has happened in Britain, the deliberate creation of cloned human embryos - or certainly allowed in Britain - it hasn't happened yet - allowed in British law. And then the next steps will follow. So, I think it's clear that this is the suspension of a major principle and the consequences will yet be seen.

BYNER: Trevor Mudge, what do you say to that?

MUDGE: It's not a suspension of a major principle. I agree entirely that in any ethical system, religious or secular, respect for human life is essential. But, as I said, that respect can never be - is not, never has been and never will be absolute, and must be weighed against your ethical responsibility to leave no reasonable stone unturned.

BYNER: Trevor, can you explain why - Dr Greg Pike argues why can't you use adult stem cells. Why do you have to use embryonic stem cells? Is there a scientific reason?

MUDGE: Well, at the moment, we don't know which horse running in this race is most likely to cross the finishing line first if you like, whether it's the adult stem cell or whether it's the umbilical stem cell or the embryonic one.

BYNER: Yeah.

MUDGE: It's just that on first principles, and we, the science of this has not just been worked out. But, on first principles, stem cells from embryos are, theoretically, much more capable of developing into a bigger variety of tissue than stem cells from an adult. But, look, he's right in the sense that we don't know it's just that in a race where the prize is so great, we just can't afford to pull one of the major horses.

BYNER: What's the prize?

MUDGE: The prize is cure of diabetes and Alzheimer's disease and Parkinson's disease and muscular dystrophy. And, look, the potential is truly enormous. And I know that the media is full of, you know, big research potential and this, that and the other, but really stem cell research is amongst the most exciting things ever to happen to medicine. Yes, it's a long time in the future, yes, we don't know that it will work or to what degree it will work, but the potential is so enormous.

BYNER: Greg?

PIKE: I would conclude, perhaps, by saying that there is no shortage of good potential - oh, sorry, good possible outcomes to be obtained by all sorts of, perhaps, unethical means. And it wouldn't be hard to suggest means, other means, by which you could get a good end from a dodgy means, so that's not really the key part of the argument here.

And if we're talking about principles of, or basic scientific principles if you like, about the types of stem cells whether embryonic or adult. Certainly, with embryonic stem cells, there is no way that stem cells derived from embryos can immediately be used in any therapeutic application, because they'll simply be rejected. We already have adult stem cell treatments coming from someone's own body which have actually treated that individual, and that was most clearly seen in the Boy in the Bubble case in Britain, reported just yesterday, and so there's certainly some advantages in adult stem cells before we even get off the mark.

And the other risk, which would have to be acknowledged, is that embryonic stem cells already have the potential to form teratomas and cancerous masses. That is known in mouse embryonic stem cell studies and something which, on first principles, we ought to be very wary of. So there are some very good reasons why, at the very least perhaps, we should just put a moratorium on embryonic stem cell research and let the horse, the ethical horse, go ahead.

BYNER: Are we really, Greg, saying that embryonic stem cells have rights?

PIKE: Not embryonic stem cells, no. I would argue that the embryo has rights.

BYNER: The embryo has rights?

PIKE: The embryo has rights. And, of course, the embryonic stem cells extracted from that destroy that embryo.

BYNER: Yeah.

PIKE: And the rights that that embryo has are something that's been widely recognised. The Council of Europe has spoken clearly in defence of the rights of human embryos to exist free of destructive experimentation.

BYNER: Trevor, your final comments?

MUDGE: Oh, well, I think that it's very easy to selectively quote the science to suit your ends. What we really need to do is look at the science and let that guide the terrible balance. I don't, for one minute, not understand the terrible dilemma that those who believe that human life is equal and begins at the moment of fertilisation. This is a big ethical problem.

But I would ask them to think about the millions of Australians who will die of diabetes, who will die of chronic neurological conditions, and to deny them the potential, however small, for a cure I think would be ethically wrong.

BYNER: Gentlemen, thank you for giving us both sides of the view.

That's, first of all, Dr Greg Pike, Deputy Director of the Southern Cross Bioethics Institute, and from the Australian Medical Association, their Vice President, Dr Trevor Mudge.

Ends