STEM CELLS RESEARCH

STEM CELLS RESEARCH

Stem cells are defined as the cells extracted from the umbilical cord after birth. These cells that are taken from it play a role in rebuilding blood cells and strengthening the immune system of patients with blood diseases such as leukaemia  and anaemia. They may also be used to treat neurological diseases such as brain paralysis, Alzheimer’s and so on. These cells are not attacked by the immune system, because they quickly develop into a neutral state. The umbilical cord looks somewhat like a rope; it connects the foetus in the uterus to the placenta. It contains two arteries and one vein. The arteries take blood carrying waste material from the foetus to the placenta, and the vein takes blood carrying oxygen and nutrients from the mother’s blood to the foetus.  

There are 3 possible sources of stem cells to use for transplants: bone marrow, the bloodstream (peripheral blood), and umbilical cord blood from newborns. Although bone marrow was the first source used in stem cell transplant, peripheral blood is used most often today. Bone marrow is the spongy tissue in the center of bones. Its main job is to make blood cells that circulate in your body and immune cells that fight infection. Bone marrow was the first source used for stem cell transplants because it has a rich supply of stem cells. The bones of the pelvis (hip) contain the most marrow and have large numbers of stem cells in them. For this reason, cells from the pelvic bone are used most often for a bone marrow transplant. Enough marrow must be removed to collect a large number of healthy stem cells. For a bone marrow transplant, the donor gets general anesthesia (drugs are used to put the patient into a deep sleep). For a peripheral blood stem cell transplant, the stem cells are taken from the blood. A very thin flexible tube (called a catheter) is put into one of the donor’s veins and attached to tubing that goes to a special machine. The machine separates the blood, and keeps only the stem cells. The rest of the blood goes back to the donor. This takes several hours, and may need to be repeated for a few days to get enough stem cells. The stem cells are filtered, stored in bags, and frozen until the patient is ready for them. Not everyone who needs an allogeneic stem cell transplant can find a well-matched donor among the people who have signed up to donate. For these patients, umbilical cord blood may be a potential source of stem cells. Around 30% of unrelated hematopoietic stem cell transplants now come from cord blood. A large number of stem cells are normally found in the blood of newborn babies. After birth, the blood that is left behind in the placenta and umbilical cord (known as cord blood) can be taken and stored for later use in a stem cell transplant. The cord blood is frozen until needed. A possible drawback of cord blood is the smaller number of stem cells present. But this is partly balanced by the fact that each cord blood stem cell can form more blood cells than a stem cell from adult bone marrow. Still, it can take cord blood transplants longer to engraft and start working. To be safe, most cord blood transplants done so far have been in children and smaller adults.  

Hence the idea developed of keeping these cells in “banks”. In Dubai there are public and private stem cell banks, and in Jeddah there is a private company that stores cells for those who want that, in return for a fee. These banks implement measures to guarantee that the cells will not be tampered with; the owner can also follow up and check on them just as he can check on the money in his bank account. Some doctors have stated that it is possible to preserve these cells for up to 25 years, and some doctors say that it is possible to store them for life. These cells are useful not only for their owner who may be affected by diseases in which he can benefit from them; rather he can also donate them to others. Stem cells have indeed been used to treat cases of sickness and they have been a successful alternative to the risky procedure of transplanting bone marrow. From a medical point of view, stem cells are regarded as an alternative to organ donation, as it is possible to regenerate the patient’s damaged cells. For their owner, they are a perfect match for his cells, and he is the only one who has a perfect match. Among members of the same family, the likelihood of a match varies between 25% to 40%. All of this, of course, applies so long as the mother does not have any communicable diseases such as hepatitis or AIDS. Hence it is essential to carry out tests on the mother’s blood before collecting the stem cells.   

Because of these benefits in the cells that are taken from the umbilical cord, some of those who do not fear Allah hastened to obtain umbilical cords by means of deliberate abortion. We are sorry to say that some of those whom people trusted with their lives did that. Hence there was a clear statement by the Islamic Fiqh Council that it is haraam to carry out deliberate abortions for the purpose of using the embryo’s organs – including stem cells, of course. In cooperation between this Council and the Islamic Medical Sciences Organization, the status was determined. Firstly, it is not permissible to use foetuses as a source for organs that are needed for transplant into another individual except in some cases that are subject to conditions that must be met which are; it is not permissible to deliberately induce abortion for the purpose of using the foetus in order to transplant organs into another individual. Rather abortion should be limited to that which is natural and spontaneous (i.e., miscarriage) and not deliberate, or abortion that is carried out for a legitimate shar‘i reason. Surgery should not be resorted to in order to extract the foetus except where that is necessary in order to save the mother’s life ; Then, if the foetus is viable (i.e., could survive), then medical treatment should focus on saving and preserving its life, and it should not be used for organ transplants. If the foetus is not viable, it is not permissible to use it except after its death, subject to conditions mentioned in statement no. 1 of the fourth conference of this Council, which discusses one human benefiting from the organs of another human, living or dead. Secondly, it is not permissible to use the process of organ transplant for commercial gain under any circumstances. And last but not least, it is essential to delegate responsibility for supervision of organ transplants to a committee of specialist and trustworthy individuals.  

 

It seems – and Allah knows best – that it is permissible to make use of the cells found in the umbilical cord, especially when the cord is usually discarded. The Fiqh Council of the Organization of the Islamic Conference issued a statement concerning this matter during its session that was held on 18 Jumada al-Aakhirah 1408 AH (6 February 1988 CE). The text of this statement follows: Firstly: it is permissible to transplant an organ from its place in a person’s body to elsewhere in his body, whilst making sure that the expected benefit from this procedure outweighs any potential harm, and on condition that this is done for the purpose of replacing a missing organ or reshaping it, or changing its function, or correcting a defect or removing a deformity that is causing psychological or physical pain.  We should point out that it is not permissible for anyone to donate sperm or eggs for the purpose of producing zygotes (fertilised eggs) which will then develop into the foetus with the aim of obtaining the stem cells from it. It is also not permissible to use cloning in order to obtain foetal stem cells. Rather permission is limited to obtaining stem cells from umbilical cords. 

We should point out that it is not permissible for anyone to donate sperm or eggs for the purpose of producing zygotes (fertilised eggs) which will then develop into the foetus with the aim of obtaining the stem cells from it. It is also not permissible to use cloning in order to obtain foetal stem cells. Rather permission is limited to obtaining stem cells from umbilical cords. A statement was issued by the Islamic Fiqh Council – in cooperation between this Council and the Islamic Medical Sciences Organization, and in light of the conclusions reached by the conference referred to, and knowing that this does not mean transplanting the brain of one person to another person; rather the aim of this transplant is to treat a defect in specific cells in the brain that are not able to excrete sufficient chemical or hormone substances, so they are supplemented with similar cells from another source; or it is done to treat gaps in the nervous system that result from some injuries, the Council determined that, firstly, if the source of the tissue is the adrenal gland of the patient himself, and there is an advantage in that because it will not be rejected by his immune system as the cells are from the same body, there is nothing wrong with that from a shar‘i point of view. Secondly, if the source is an animal foetus, there is nothing wrong with this method if it can be successful and there are no shar‘i reservations. Doctors have stated that this method has been successful in different kinds of animals and it is hoped that it will be successful whilst taking the necessary medical precautions to avoid rejection by the immune system. Thirdly, if the source of tissues is living cells from the brain of an early embryo – as old as ten to eleven weeks – the ruling varies according to two methods. The first method: taking the tissue directly from a human foetus in the mother’s uterus by opening the uterus surgically; this method results in death of the embryo as soon as the brain cells are taken, and it is haraam unless it happens after spontaneous abortion (miscarriage) or an abortion that is permitted in sharee‘ah in order to save the mother’s life, and after ascertaining that the foetus has died, whilst paying attention to the conditions.The second method is the method which may be brought about in the near future, which involves growing brain cells in “farms” in order to make use of them. There is nothing wrong with this from a shar‘i point view, if the source of the cells is legitimate and they were obtained in a manner that is Islamically permissible. 

In my opinion, stem cells, which are the original cells from which the embryo is created, have the ability – by Allah’s leave – to develop into different types of cells in the human body. Scientists have recently been able to find out about these cells and to isolate them and grow them with the aim of using them for medical treatment and various scientific experiments. Hence they can be used to treat disease and they are expected to have a great impact in the future in treating many diseases and physical deformities, including some types of cancer, diabetes, kidney and liver failure, and so on. From the reading, I found out that these cells can be obtained from numerous sources, which are firstly, the embryo at the blastula stage, where it forms a sphere of cells from which the various cells of the body will grow. Zygotes (fertilized eggs) produced in attempts at in-vitro fertilisation are regarded as the main source. It is also possible to deliberately fertilise an egg from a donor with sperm from a donor in order to obtain zygotes, and grow them until they reach the blastula stage, then extract the stem cells from them. Secondly, from aborted foetuses at any stage of pregnancy. Thirdly, from the placenta or umbilical cord. The fourth source is from children and adults and lastly by cloning which is done by taking a cell from an adult human, then extracting its nucleus and inserting it into an egg from which the nucleus has been removed, with the aim of reaching the blastula stage, then obtaining stem cells from it.  

Abdulaziz Sachedina, a Muslim Professor of Religious Studies at the University of Virginia, stated “Research on stem cells made possible by biotechnical intervention is regarded as an act of faith in the ultimate will of God as the Giver of all life as long as such an intervention is undertaken with the purpose of improving human health.” There has been several published reports on the Islamic perspective of stem cell research by both non-Muslims and Muslims. These authors conclude that Islam permits stem cell research in principle. The Muslim World League’s Islamic Jurisprudence Council conference in December 2003 held in Mecca, Saudi Arabia issued this fatwā (religious opinion) that it is permissible to use stem cells for either legitimate scientific research or for therapy as long as its sources are legitimate. For example, adults if they give permission as long as it does not inflict harm on them; children with their guardian’s permission for a legal benefit without inflicting harm on them; placenta or umbilical cord blood with the permission of the parents; spontaneously aborted embryos or those aborted for a legally acceptable cause and with the permission of the parents; excess fertilized eggs produced during the course of IVF and donated by the parents with assurance that they are not to be used to produce an illegal pregnancy. It is forbidden to obtain or use stem cells if its source is illegitimate as, for example, intentionally aborted foetuses (abortion without a legal medical reason); intentional fertilization between a donated ovum and sperm; and therapeutic cloning. Besides that, Yusuf al-Qaradawi, a well-known contemporary Islamic scholar, stated that if it becomes possible through research to clone organs e.g. heart, liver and kidney, it will be permissible and it may become mandatory to pursue such endeavors. All Shia scholars agree that therapeutic cloning is permissible. Somatic cell nuclear transfer using a somatic cell from a person and fusing it with an enucleated human ovum thus producing a human embryonic clone is a promising form of “therapeutic cloning.  

From another view, the Catholic Church opposes the Embryonic Stem Cell Research which lead to the released of a document entitled “Declaration on the Production and the Scientific and Therapeutic Use Of Human Embryonic Stem Cells”. On August 25, 2000, by the Pontifical Academy for Life which summarizes the reasons why the Catholic Church opposes ESCR which are firstly, the preparation of embryonic stem cells from a living embryo requires the destruction of the embryo, which the Church teaches is a gravely immoral act. Secondly, some scientists have used cloning to produce embryos in order to harvest stem cells. While these embryos are not created in the normal manner, the Church recognizes that they, too, are alive, and their destruction is gravely immoral. Lastly, the Church opposes the use of embryonic stem-cell lines that already exist for the same reason that they oppose the creation of new lines: Those lines began with the destruction of innocent human life. 

To conclude, we should point out that it is not permissible for anyone to donate sperm or eggs for the purpose of producing zygotes (fertilised eggs) which will then develop into the foetus with the aim of obtaining the stem cells from it. It is also not permissible to use cloning in order to obtain foetal stem cells. Rather permission is limited to obtaining stem cells from umbilical cords. In cooperation between the Islamic Fiqh Council Council and the Islamic Medical Sciences Organization, and in light of the conclusions reached by the conference referred to, and knowing that this does not mean transplanting the brain of one person to another person; rather the aim of this transplant is to treat a defect in specific cells in the brain that are not able to excrete sufficient chemical or hormone substances, so they are supplemented with similar cells from another source; or it is done to treat gaps in the nervous system that result from some injuries, the Council determined three things. First is if the source of the tissue is the adrenal gland of the patient himself, and there is an advantage in that because it will not be rejected by his immune system as the cells are from the same body, there is nothing wrong with that from a shar‘i point of view.  Second is if the source is an animal foetus, there is nothing wrong with this method if it can be successful and there are no shar‘i reservations. Doctors have stated that this method has been successful in different kinds of animals and it is hoped that it will be successful whilst taking the necessary medical precautions to avoid rejection by the immune system.  Third is if the source of tissues is living cells from the brain of an early embryo – as old as ten to eleven weeks – the ruling varies according to two methods. The first method is by taking the tissue directly from a human foetus in the mother’s uterus by opening the uterus surgically; this method results in death of the embryo as soon as the brain cells are taken, and it is haraam unless it happens after spontaneous abortion (miscarriage) or an abortion that is permitted in sharee‘ah in order to save the mother’s life, and after ascertaining that the foetus has died. The second method is the method which may be brought about in the near future, which involves growing brain cells in “farms” in order to make use of them. There is nothing wrong with this from a shar’i point of view, if the source of the cells is legitimate and they were obtained in a manner that is islamically possible.