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Monday 15 July 2013

Informed consent stem cell

Many scientists believe that people are misinformed about stem cells, their  sources, their potential  benefits,  and  harms. It  also seems  that  medical  companies and  industries are optimistic about stem cell future. So, a demand for stem cell research and therapy has been created in many societies. Some centres  for the treatment are in countries with a lesser ethical oversight, such as China and some Eastern European countries. An increase in stem cell tourism has received attention in many countries (Zarzeczny, 2010). For these reasons, disclosure of information to patients and their families is essential. Murdoch et  al (2010, page 21) have emphasized that such disclosure should have at least three elements:
"1. Disclose and discuss the potential for real physical, psychological, and economic harm from the interventions and travel, including costs of the procedure relative to patient’s means.
2. Disclose and relay independent scientific evidence of risk or benefit for a defined intervention.
3. Disclose any evidence of ethical misconduct or questionable practices. This includes:
-      Failure to supply local and national evidence of oversight.
-      Engaging in questionable patient recruiting practices.
-      Clear misrepresentation, fraud, or patient abuse."

As mentioned before, the extra embryos of IVF clinics which are no longer wanted by the
parents  are  sources  for  stem  cell  research.  Obtaining  consent  for  such   embryos  is problematic. There are questions of whether consent of biological  parents is enough and how the consent should be obtained and recorded. Also, as Balint (2001) states, there may be emotional pressure on parents to consent. The parents' feelings and beliefs may also cause additional anxiety and a sense of guilt about embryo donation for use in research.
Consent of gamete donors in cases of IVF should also be obtained and  recorded. Many ethicists are worried about risks to women who participate in the egg production process. In the Korean cloning fraud, one ethical problem was  related to the egg collection from the subordinate women staff, which raised  the  issue of coercion and violation of their rights (Longstaff et al., 2009, as cited in Saunders & Savulescu, 2008). From a feminist perspective, the instrumental use of women in the process of the creation of embryos for research is an important concern, since the creation of human embryos for research purposes requires the harvesting of eggs from women (United Nations Educational, Scientific and  Cultural Organization, 2004). In animal cloning, there is a need for hundreds of unfertilized eggs to produce one cloned embryo. In women, there has to be a  period of hormone treatment followed by invasive surgery to obtain oocytes for research purposes. In addition to the risk of   exploitation   of   women   and   commercialization   of   human   eggs   (United   Nations Educational, Scientific and Cultural Organization, 2004), there may be life-threatening risks such as Ovarian Hyper-stimulation Syndrome (OHSS).

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