Regenerative medicine, the process of creating living tissue to repair or replace tissue or organ function lost due to age, disease, damage or congenital defects, holds great medical potential, even as a Roman Catholic perspective requires close study of related ethical considerations, said Fr. Kevin FitzGerald, a Jesuit and research associate professor in the Georgetown University oncology department's division of biochemistry and pharmacology.
Fr. FitzGerald has doctorates in molecular biology and bioethics from Georgetown University, where he holds the Dr. David P. Lauler Chair for Catholic Health Care Ethics. He taught a CHA webinar on regenerative medicine in November. Drawing on information from the National Institutes of Health, he told the audience that biomedical therapies hold the potential to stimulate healing in damaged tissues or organs in the body. Scientists also are working to grow tissues and organs in the laboratory with a goal of implanting the products in a body when it cannot heal itself.
And, in a nation where the waiting list of candidates for organ transplants vastly outstrips the number of organs available for donation, the field of regenerative medicine potentially could help solve the problem of the shortage of organs, he said. In the first eight months of 2013, more than 120,000 candidates were on a waiting list for organ transplant (about 77,000 of them considered active waiting list candidates) with about 19,000 transplants conducted during that time, he said. Fr. FitzGerald noted that regenerative medicine, while offering the potential for health care treatments, is not an area being explored just for its medical promise, but because businesses see the potential for making money, as well.
A controversial component of regenerative medicine — one that has been an area of grave ethical concern for the Catholic Church — involves the use of pluripotent embryonic stem cells, which come from human embryos, as a basis for building new tissue. The process of obtaining these cells destroys a human embryo. However, the Catholic Church does support using stem cells obtained from adult tissue and umbilical cord blood. "Catholic institutions at times have taken the lead in promoting such constructive research, which is already providing cures and treatments for suffering patients," according to the United States Conference of Catholic Bishops website.
Fr. FitzGerald said researchers have made great progress in recent years in learning how to manipulate adult stem cells, or those that exist in small numbers in several types of adult tissue, including stem cells found in the brain, the spinal column and even in fat. Many tissues in the body have a relatively small percentage of stem cells, which can generate specialized cells, providing a source of replacement cells for those lost during injury or due to natural wear and tear. Some tissues, in particular bone marrow, have stem cells that can leave their original site and roam the body to assist in repair of some other tissues, he explained.
For instance, adult stem cells found in fat can be removed from the body and reprogrammed to become other types of cells, whether nerve, bone or muscle cells, he said. "I haven't met anybody yet who is too desirous to hang onto all of the fat cells they have," Fr. FitzGerald joked.
He also explained that organ printing, or the computer-aided assembly of biological tissues and organs layer by layer, is a rapidly evolving field, and scientists expect the technology will allow for advances in tissue engineering. Such printing of tissue and organs could provide a way for scientists to conduct biomedical research, to make new discoveries about drugs before use in the body and to provide organs for transplantation.
Fr. FitzGerald also touched upon several research projects related to regenerative medicine that have developed methods of growing cells from other animal species for use in humans. He said more work must be done to reach consensus about the morality of such projects.
He also said ethical debates about regenerative medicine need to relate to a wider public health context. While regenerative medicine holds great promise, focus must remain on the huge numbers of people worldwide whose basic health safety and health care needs remain unmet. Fr. FitzGerald cited the United Nation's Millennium Development Goals Report from 2011, which states that more than 2.6 billion people in the world lack access to flush toilets or adequate sanitation. Sanitation systems reduce the spread of diarrheal diseases that kill 4,000 children a day.
As debates continue about the ethical implications of regenerative medicine, central to the discussion must be questions about what it means to be human and what steps and choices protect human dignity. A Roman Catholic response to regenerative medicine calls for care for each and to all, from the beginning to the end of life, he noted.
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