THE STEM CELL DEBATE
The Bangkok Post
Monday November 26, 2007
It's being touted as the latest
| |
this new therapy
really safe?
Story by APIRADEE TREERUTKUARKUL
It's the year 2030. Satta Silarat is lying in his hospital bed, breathing slowly against a background of rapid beeps from the heart monitor. The old man has been suffering from heart disease for a long time and needs an urgent operation.
After surgery, Satta recovers and is discharged.
The day he is discharged a man in a dark suit is waiting for him out in front of the hospital.
''It's not good if anybody sees us meeting,'' Satta tells the man, who works for Amata, an organ cloning company.
The firm provided the cloned heart he received during the transplant operation that saved his life.
''I'm just curious,'' the man in the dark suit says. ''If you're so much against our company, why did you opt to use our cloning service?''
Satta comes to a halt. ''If I'm dead, who's going to lead the protests against your company?'' the old activist says wryly.
This is a scene from an entry in the cartoon and animation competition about bioethics run by the National Health Foundation and the National Centre for Genetics Engineering and Biotechnology.
The bioethics of cloning and the use of stem cells is currently the subject of heated debate.
And although the scene depicted is only an animation, it really could happen in the next 20 years.
Stem cells are immature cells which have the capacity to turn into many different types of cells that make up tissues and organs. Experts have heralded stem cell transplants as the future for treatment of various genetic disorders.
Cells can be obtained from many sources _ embryos, adult tissue, bone marrow, blood and umbilical cord.
Stem cell injections are increasingly being used worldwide to treat ailments as diverse as Parkinson's disease and diabetes.
Some medical researchers claim stem cell treatment can prolong a patient's life and tout the process as the new hope for sufferers of chronic diseases.
However, there are also concerns that commercial banking of stem cells, or injecting them into a patient, is more hype than hope.
''Do we pin much hope on medical advances? Stem cell treatment for most chronic diseases is still very much in the research stage and any advertising [about their efficacy] should be a subject of concern,'' said Prasert Palittapongarnpim, a stem cell expert at Chiang Rai Prachanukroh hospital.
Dr Prasert warned that while stem cell treatment had been proven successful for leukaemia and thelassemia, as a cure for other chronic diseases it was still in the experimental stage.
Without thorough safety measures, stem cell therapy could endanger patients. There was a higher risk of infection and resistance to the new cells.
Critics also question if it is ethical, because no laws governing the use of stem cells have been laid down.
Vichai Chokewiwat, who chairs the Southeast Asian Medical Ethics Foundation, conceded there was a grey line between stem cell experiments and medical treatment in Thailand because there was no clear legal line between stem cell research and treatment.
It was essential that doctors heed the Helsinki Declaration on medical ethics and human experimentation, which says patients as consumers must be aware of all health risks, said Dr Vichai.
Although the Medical Services Department has set up a committee to draft regulations on the use of stem cells for research, the task is still far from complete. Nothing has been done since the first hearing earlier this year, he said.
Moreover, the draft regulation does not cover stem cell therapy in hospitals because the issue should be considered by each hospital's ethics committee.
Dr Vichai said the Medical Council and the Medical Registration Division should be more responsible in taking care of patients' interests when there is no law to regulate stem cell use.
''The Public Health Ministry has all the essential bodies to take care of the business. For example, the Medical Council is responsible for doctors' actions and medical ethics, while the Medical Registration Division is tasked with dealing with hospital malpractice.
''It all depends how much effort they are willing to put into it,'' he said.
Dr Teerawat Hemachuta, of Chulalongkorn University's faculty of medicine, said health bodies need to draw up measures to guard against abuse of stem cell research. He claimed some patients treated with stem cells felt better during the first phase of treatment, but their condition later deteriorated and in some cases they even died.
''Some medical researchers worry that any controls on stem cell research and study will hinder advancement in the technology,' ''In fact, there are some research projects that practically abuse patients. Such unethical stem cell research could backfire on national medical science in the long run. ''That's why laws and regulations on stem cell use are urgently needed in this country.'' Sawaeng Boonchalermvipas, an expert on medical law at Thammasat University, said in the absence of specific regulations on stem cell therapy, health agencies should apply the Medical Council's regulation regarding human organ transplants to stem cell research and treatment. Patients and their relatives should realise that any cell treatment is still in a preliminary stage here, he said. Commercial stem cell therapy was considered ''fraudulent business'' under Article 341 of the Criminal Act. ''Both the law and medical ethics are equally important to doctors when it comes to the stem cell issue,'' said Mr Sawaeng. ''Patients' lives should not be put at risk by unethical medical practices.'' Tassanee Nanudorn, editor of Smart Buy magazine run by the non-governmental organisation Consumer Thai, said a lack of expertise in the field further adds to the problems inherent to stem cell exploitation. Apart from the need to speed up passage of laws and regulations, the public should also be equipped with facts and information about stem cell technology. Only through knowledge could they protect their own interests and not be easily misled by mushrooming advertising about the benefits of stem cell treatment. ''Thai consumers are at risk of becoming the victims of medical hype because of the increase in stem cell therapy and stem cell banks at private and state hospitals without proper controls and experts to explain the pros and cons,'' she said.
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