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Export of human stem cells from Israel to Germany sparks ethical storm



Two Israeli institutions, Haifa's Technion Israel Institute of Technology and Rambam
Medical Center in Haifa, began exporting stem cells culled from human embryos to
Germany this month, arousing a storm of controversy within both countries' scientific
and medical communities.

Because stem cells have enormous medical potential, many scientists, doctors and
ethicists favor the move, saying the research project for which the cells will be used 
has
the potential not only to advance scientific knowledge, but also to develop new medical
treatments that could save many lives.

But many jurists and sociologists say that the exports, though completely legal, are 
very
problematic. In Israel, they argue, the exports were decided upon without any public
discussion or even any discussion by national committees on medical ethics; while in
Germany, the move has elicited considerable public criticism, including from that
country's National Ethics Council.

Like many other countries, Germany forbids stem cells to be culled from human
embryos for research purposes within its own borders. A year ago, however, the
Bundestag passed a law permitting human stem cells to be imported in exceptional
cases.

"At the time, the German press pointed out the ethical double standard of this law and
the absurdity of permitting an act that is forbidden on German embryos to be carried 
out
on embryos that come from other population groups," notes Yael Hashiloni-Dolev, a
lecturer in sociology at Tel Aviv University who is currently writing a doctoral 
thesis on
the application of genetic knowledge in Israel and Germany.

The stem cells are being culled by Professor Yosef Itzkowitz- Eldor, the head of
Rambam's gynecology department, using the Technion's facilities. The Technion, says
Itzkowitz-Eldor, is not being paid; this is a joint scientific venture in which the 
Technion
will receive part ownership of any fruits resulting from the research.

The German researcher who is receiving the cells, Dr. Oliver Brustle of Bonn 
University,
is trying to determine how a stem cell can be "convinced" to develop into an adult 
nerve
cell. Brustle, who has been studying nerve cells and stem cells in rats for many years,
hopes that it will eventually be possible to use transplants of nerve cells grown from
stem cells to cure diseases such as Alzheimer's and Parkinson's.

Brustle has wanted to move on to studying human stem cells for some time, but until
last year, German law made this impossible. When the new law permitting imports of
stem cells was passed last January, he immediately applied for an import license from
an interdisciplinary ethics council. According to the law, this council may grant such
licenses only for research of "outstanding scientific quality" that can not be 
performed
either on animal cells or on adult stem cells (which are found in bone marrow). Last
month, Brustle became the first German to receive a permit from the council - a
decision that aroused much opposition in Germany.

Professor Jens Reich of the Max Delbruck Center for Molecular Medicine in Berlin says
the German reluctance to permit research on embryonic stem cells has two main
sources. The first is the memory of the Nazis' experiments on human beings. The
second is Immanuel Kant's philosophy of ends and means, which has gained wide
currency in Germany. This philosophy holds that man is an end in himself and must,
therefore, not be used as a tool for achieving aims that do not directly benefit him. 
Thus,
human experimentation is justified only if the subject would benefit personally from 
the
research.

Professor Asa Kasher of Tel Aviv University's philosophy department, an expert in bio-
ethics, responds that an embryo is not a "person," so the Kantian prohibition does not
apply. "The embryos from which the stem cells are produced are five days old," he says.
"They look like a microscopic ball of cells and have not yet developed the special
characteristics that we perceive as `human.'"

Furthermore, he argues, the Germans' position deprives many sick people of the
possible medical benefits of stem cell research. "Perhaps we, the Jews of Israel, are 
the
only ones who can tell them that on this matter, they are exaggerating," he concludes.

But Professor Amos Shapira of Tel Aviv University's law faculty, also an expert in
medical ethics, disagrees. The German law, he says, is "a problematic ethical
compromise, along the lines of `we won't do the dirty work, but we will do research if 
[the
dirty work] is done by someone else.'"

Dr. Carmel Shalev, head of the Gartner Institute's ethics and patients' rights
department, adds that whether or not stem cells should be exported, the decision
should be made at the national level rather than by individual institutions.
By Tamara Traubmann


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