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The ethical aspects of human stem cell research raise a wide variety of controversial and important issues. Many of these issues have to do with the different sources of stem cells. In principle stem cells can be obtained from adults, from umbilical cord blood, from fetal tissue and from embryonic tissue. Clearly there are widely differing views as to the ethics of sourcing stem cells in these four different ways. For the moment there is general consensus that embryos are the best source of stem cells for therapeutic purposes but this may of course change as the science develops. Then there is the question of whether or not embryos or fetuses may be deliberately produced in order to be sources of stem cells, whether or not they are also intended to survive stem cell harvesting and grow into healthy adults.

The ethical aspects of human stem cell research raise a wide variety of controversial and important issues. Many of these issues have to do with the different sources of stem cells. In principle stem cells can be obtained from adults, from umbilical cord blood, from fetal tissue and from embryonic tissue. Clearly there are widely differing views as to the ethics of sourcing stem cells in these four different ways. For the moment there is general consensus that embryos are the best source of stem cells for therapeutic purposes but this may of course change as the science develops. Then there is the question of whether or not embryos or fetuses may be deliberately produced in order to be sources of stem cells, whether or not they are also intended to survive stem cell harvesting and grow into healthy adults.

There are issues of free and informed consent, both of donors and recipients, the responsibility of accurate risk- benefit assessment, and particular attention needs to be paid to appropriate ethical standards in the conduct of research on human subjects. There are issues concerning the anonymity of the donors and security and safety of cell banks and of the confidentiality and privacy of the genetic information as well as the tissue they contain. Finally there are issues of commerce and remuneration for those taking part and of the transport and security of human tissue and genetic material and information across frontiers both within the EU and worldwide. All of these issues are important but most of them have received extensive discussion over the past few years.

Embryonic stem cells were first grown in culture as recently as February 1998 by James A. Thomson of the University of Wisconsin. In November of that year Thomson announced in Science that such human ES cells formed a wide variety of recognizable tissues when transplanted into mice, and these properties of stem cells, to form almost any tissue or bodily system coupled with their regenerative powers, are what makes stem cells such a promising therapeutic tool.

As we noted earlier, stem cells then might eventually enable us not only to grow tailor-made human organs which, using cloning technology of the type that produced Dolly the sheep, could be made individually compatible with their designated recipients. In addition to tailor-made organs or parts of organs, such as heart-valves, for example, it may be possible to use ES cells to colonize damaged parts of the body, including the brain, and to promote the repair and re-growth of damaged tissue. These therapeutic possibilities provide powerful moral reasons to pursue stem cell research.

Here we should remind ourselves of the possibility of therapies that would extend life, perhaps even to the point at which humans might become in some sense 'immortal'. This, albeit futuristic, dimension of stem cell research raises important issues that are worth serious consideration. Many scientists now believe that death is not inevitable and that the process whereby cells seem to be programmed to age and die is a contingent 'accident' of human development which can in principle and perhaps in fact be reversed and part of that reversal may flow from the regenerative power of stem cells.

International guidelines provide little clarity specifically on human embryo research. Apart from the wide international agreement on the prohibition of human reproductive cloning, agreements at European level have left the permissibility of particular research to the discretion of each member state. There are few guidelines, but if research is authorized by a member state then respect for human dignity requires an appropriate regulatory framework and the provision of guarantees 'against risks of arbitrary experimentation and the instrumentalization of embryos'. Both Italy and Greece rely upon the Council of Europe's Convention of Human Rights and Biomedicine, Article 18. This stipulates only two conditions: a prohibition on producing embryos for research purposes and the adoption of rules which are designed to ensure adequate protection of embryos. Not all countries have ratified this convention. . .

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