Stem Cell Ethics

Kernel

Lately there have been a few breakthroughs with embryonic stem cell research (most recently the production of lung cells), and it looks like a very positive avenue for future medical treatments. But it's had me thinking about the moral implications of the process.

I'm one of those people who believe life occurs at conception when the sperm fertilises the egg, so I'm not comfortable with making this process happen atrificially so we can harvest cells. Just wondering what other people's thoughts are on this, and also asking if I am correct in assuming that once stem cell research is refined, it will then be possible (though not as easy) to switch to bone marrow stem cells?

Doper Than U

Do you agree with fertility treatment for couples who cannot have children?

ArthurDent

You might want to look at this site - pretty good FAQ re current state of stem cell research

http://stemcells.nih.gov/StemCells/Templates/StemCellContentPage.aspx?NRMODE=Published&NRORIGINALURL=%2finfo%2ffaqs%2easp&NRNODEGUID=%7bA604DCCE-2E5F-4395-8954-FCE1C05BECED%7d&NRCACHEHINT=NoModifyGuest#useadult

This is also a useful article on current research in adult stem cells
Finding a way around the stem-cell controversy
http://www.theglobeandmail.com/servlet/ArticleNews/TPStory/LAC/20050823/HSTEM23/TPScience/

The main problem with research on non-embryonic stem cells is that they are differentiated and do not have the potential that embryonic cells have to become any type of cell.

Embryonic stem cell research is many years ahead of non-embryonic stem cell research because of this - and even with embryoinc stem cell research we are still a long way off being able to make therapies that work for a large patient population - lots of issues with delivering the treated cells into the body.

It comes down to whether you are willing to wait possible another 15 or 20 years to develop non-embryonic stem cell treatments or 5 -10 years for embryonic stem cell treatments and most people are willing to accept that it is ok to work on embryonic stem cells if it means such treatments are available sooner rather than later.

Kernel

Doper Than U wrote:

Do you agree with fertility treatment for couples who cannot have children?

Yes, of course. But that's a different issue entirely.

ArthurDent wrote:

The main problem with research on non-embryonic stem cells is that they are differentiated and do not have the potential that embryonic cells have to become any type of cell.

Yes, I have heard this alright, but I also heard that non-embryonic stem cells were capable of doing the same job, just with much greater difficulty?

Doper Than U wrote:

It comes down to whether you are willing to wait possible another 15 or 20 years to develop non-embryonic stem cell treatments or 5 -10 years for embryonic stem cell treatments and most people are willing to accept that it is ok to work on embryonic stem cells if it means such treatments are available sooner rather than later.

Well, I'm not so sure about that conclusion. I think a lot of people would have ethical difficulties with embryonic stem cell research (as has been shown in the United States for example), even if it means having to wait longer for the treatments. Isn't it selfish and unethical for us to basically create human embryos for harvesting so that we can live longer or in better health? To me, that's the kernel of the issue and the one that causes the unease....

Doper Than U

Kernel wrote:

Yes, of course. But that's a different issue entirely.

It's not if your main gripe with Stem Cell research lies in the fact that they destroy embryos. At the end of the day, embryo's must be destroyed in fertility treatment. At least 20 embryos will be implanted, only one of which is designed to survive. On top of those 20, many more are often created for the one "service". All but one of hundred's of embryos will survive. That is the death of hundreds of "lives" if you believe that life starts with the embryo, which you have stated you do believe. Stem Cell research would use those embryos which would otherwise be completely wasted (i.e. they will be destroyed by being thrown down a sink most likely). Not only that, but stem cells from those embryo's would help people who are already living.

So it's not a different issue at all. Your perception of it being different doesn't actually make it so. The fact is, hundreds of viable embryos (read : "lives") are destroyed in fertility treatment. Hundreds of lives could be saved with Stem Cell research from embryo's that are destined at creation to die. There is no question that stem cell research from fertility embryo's is a must for those with otherwise incurable diseases.

Even if your perception forces you to see fertility treatment as a positive thing due to the fact that a life is created, and stem cell research as a negative thing because it destroys embryo's, it cannot be denied that far more "lives" are lost in fertility treatment due to the death (by design!) of the embryos in the fertility treatment process. Do I think that the lives of the living are "worth more" than the lives of the "never to be born"? Yes, I probably do. It all comes down to the fact that these embryos will never fulfill their potential to be babies (by design). So to waste them entirely is truly the disgusting part. You can't have it both ways.

Kernel

Doper Than U wrote:

It's not if your main gripe with Stem Cell research lies in the fact that they destroy embryos. At the end of the day, embryo's must be destroyed in fertility treatment.

Not at all, there are many different types of fertility treatment. You seem to be speaking of IVF (In Vitro Fertilisation), which also raises ethical questions to me. But I take your point in regard to that.

Doper Than U wrote:

Stem Cell research would use those embryos which would otherwise be completely wasted (i.e. they will be destroyed by being thrown down a sink most likely). Not only that, but stem cells from those embryo's would help people who are already living.

Eh? I don't follow you, in what way would they be flushed down the sink? If sacrificing a new born baby could help people who are living, do you still think people would do it? I wouldn't do it myself, whether I'm dying or not.

Doper Than U wrote:

So it's not a different issue at all. Your perception of it being different doesn't actually make it so. The fact is, hundreds of viable embryos (read : "lives") are destroyed in fertility treatment. Hundreds of lives could be saved with Stem Cell research from embryo's that are destined at creation to die. There is no question that stem cell research from fertility embryo's is a must for those with otherwise incurable diseases.

Well, you asked do I agree with fertility treatment, not specifying IVF, which is only one option (and not the most used or successful).

http://www.babycenter.com/refcap/preconception/fertilityproblems/1228997.html

Regarding it being a must for people with incurable diseases, that doesn't mean it is right or acceptable. We must weigh up the ethics first.

And you're right, I do think it is different when the procedure is used to create a life (which is the rightful purpose of fertilisation - it's purpose is not to create spare parts for us).

Doper Than U wrote:

Even if your perception forces you to see fertility treatment as a positive thing due to the fact that a life is created, and stem cell research as a negative thing because it destroys embryo's, it cannot be denied that far more "lives" are lost in fertility treatment due to the death (by design!) of the embryos in the fertility treatment process.

Yes, but as I already mentioned, the purpose of fertilisation and creation of an embryo is to bring about a new life. The porpose of using embryos for stem cell research is much different, and is aimed at prolonging life. If stem cell research takes off and becomes a normal medical procedure, how many 'lives' as you call them, will be sacrificed every day all around the world, and for what? To cure an incurable disease? If the baby was fully developed, would you agree with harvesting it then for spare parts or cures?

Doper Than U wrote:

Do I think that the lives of the living are "worth more" than the lives of the "never to be born"? Yes, I probably do. It all comes down to the fact that these embryos will never fulfill their potential to be babies (by design). So to waste them entirely is truly the disgusting part. You can't have it both ways.

Yes, but the reason these embryos will never fulfill their natural potential is because we create an artificial situation to prevent that. Which is perhaps a crime against nature?

Doper Than U

Kernel wrote:

Eh? I don't follow you, in what way would they be flushed down the sink? If sacrificing a new born baby could help people who are living, do you still think people would do it? I wouldn't do it myself, whether I'm dying or not.

I mean that the embryos created for IVF (and yes, I was referring to this, apologies for not being clearer) are completely wasted (bar the one that "makes" it). You may as well throw them down a sink. They will never, ever be a "baby". So all those embryos that could be used for saving people already "alive", are instead being essentially thrown away. Yet it's a necessary part of IVF.

And you're right, I do think it is different when the procedure is used to create a life (which is the rightful purpose of fertilisation - it's purpose is not to create spare parts for us).

The porpose of using embryos for stem cell research is much different, and is aimed at prolonging life. If stem cell research takes off and becomes a normal medical procedure, how many 'lives' as you call them, will be sacrificed every day all around the world, and for what? To cure an incurable disease? If the baby was fully developed, would you agree with harvesting it then for spare parts or cures?

Nope I don't think it's right that a "fully" developed baby be harvested for spare parts. I also don't think it's right to waste perfectly viable embryos, especially as people could be cured by their use. You (from what I can gather) aren't exactly enthusiastic about IVF, so I can see why you would view both procedures as abhorrent in some way. However, you then go on to say that you think it is ok to waste embryos in an effort to create life, and yet not ok to us those embryos to sustain a life that already exists. Thus putting one life (indeed a life that doesn't yet "exist") above another life. There is no difference in throwing it down the proverbial sink, and manipulating it to help others. The end result is still an embryo that didn't become a baby.

Yes, but the reason these embryos will never fulfill their natural potential is because we create an artificial situation to prevent that. Which is perhaps a crime against nature?

Yup. I agree. But then, we also created these embryos where they wouldn't have existed (i.e. if an egg is fertilised naturally, you get one embryo). Now we have hundreds, just so we can make one child. Our own efforts to create life has by necessity required the destruction of hundreds of possible lives. These "possible lives", these excess embryos, were never destined to exist (nor, one could argue, is the child created by the IVF procedure). My point at the end of all of this is that killing many for the sake of one is no more abhorrent than harvesting many for the sake of millions. You can't say one is ok without the other being ok too.

Personally, I think there're too many people on the planet anyway. But that's a whole other topic.

NeilJ

Can any one tell me, is there much difference between the potential of umbilical stem cells vs. embryonic stem cells? Embryonic stem cells are far better than adult stem cells at doing what you want them to. What about umbilical stem cells found in the afterbirth?

Neil

Kernel

Doper Than U wrote:

I mean that the embryos created for IVF (and yes, I was referring to this, apologies for not being clearer) are completely wasted (bar the one that "makes" it). You may as well throw them down a sink. They will never, ever be a "baby". So all those embryos that could be used for saving people already "alive", are instead being essentially thrown away. Yet it's a necessary part of IVF.

Oh right, I get you. But the important part of this, is that while using IVF to try to create a child, and having excess embryos that don't make it, is different to creating the embryos to carry out stem cell research. And as mentioned, if stem cell therapy takes off, there will be a wholesale and industrialised amount of embryos created for non-natural purposes.

Doper Than U wrote:

Nope I don't think it's right that a "fully" developed baby be harvested for spare parts. I also don't think it's right to waste perfectly viable embryos, especially as people could be cured by their use.

Well, the ethical difficulty arises when you try to distinguish between at what stage it is acceptable to harvest a developing baby (as I believe, when conception occurs and an embryo is formed, this is a life, so harvesting this embryonic life is not much different imo to harvesting a fully developed baby). And how do you mean embryos would be wasted? It's not like stem cell research is going to wait for an IVF mother to conceive, then remove other embryos from her.

Doper Than U wrote:

You (from what I can gather) aren't exactly enthusiastic about IVF, so I can see why you would view both procedures as abhorrent in some way.

No, I'm not mad keen on the idea, but I would have a more relaxed view on IVF than stem cell research, since under IVF at least the embryos are being used (and have a chance to develop) the way nature and God intended.

Doper Than U wrote:

Thus putting one life (indeed a life that doesn't yet "exist") above another life. There is no difference in throwing it down the proverbial sink, and manipulating it to help others. The end result is still an embryo that didn't become a baby.

At what point do you think a life begins to exist, if not at conception? And as mentioned, I think there is a difference, since creating embryos to give them a chance at developing naturally to a child, is different to creating them for spare parts. I'm not entrenched on this view, it's just something I wanted to discuss, but the more I do, and the more I learn, the more I think stem cell research is slightly dodgy ethically speaking.

Doper Than U wrote:

Yup. I agree. But then, we also created these embryos where they wouldn't have existed (i.e. if an egg is fertilised naturally, you get one embryo). Now we have hundreds, just so we can make one child. Our own efforts to create life has by necessity required the destruction of hundreds of possible lives. These "possible lives", these excess embryos, were never destined to exist (nor, one could argue, is the child created by the IVF procedure). My point at the end of all of this is that killing many for the sake of one is no more abhorrent than harvesting many for the sake of millions. You can't say one is ok without the other being ok too.

Hmmm I don't know about that. The fact that these embryos were not destined to exist just means that we shouldn't have made them exist in the first place. But then, destiny is a funny thing, since even if we created them, wouldn't that mean that that was their destiny. But I do see your point at the end, and it makes sense. In fact it's probably the best argument I have heard in the 'for' box so far... But then, that's only accepting IVF as ethically sound also, which I don't really feel comfortable with - but more comfortable than stem cell as mentioned. And also, I'm thinking that the number of embryos that 'don't make it' under IVF would be a lot less than the number of embryos harvested for stem cell research, which was why I was wondering if, once the embryonic stem cell therapy was discovered, would that result in it then being possible to use non-embryonic or adult stem cells. If so, then yes, it could be worthwhile, but I would still not be at ease with the ethics of the project, even though ultimately it would save lives. I guess it's a bit like nazi medical research on jewish prisoners. That may have came up with some small medical benefits, but even the benefits were (of course) in no way worth the price to human life.

Doper Than U wrote:

Personally, I think there're too many people on the planet anyway. But that's a whole other topic.

Well, that's the truth, but that doesn't give us carte blanche over creating, or terminating other lives I guess.

Doper Than U

I agree, or at least , I understand and can identify where you're coming from on this argument. The fact is I'm not a specialist in this or in IVF, so I don't have all the answers I want to make a better argument...

I would disagree with this though :

Kernel wrote:

I guess it's a bit like nazi medical research on jewish prisoners. That may have came up with some small medical benefits, but even the benefits were (of course) in no way worth the price to human life.

Yes, I agree.. there is no way on earth that one could justify what the nazi's did, but I can't possibly compare this with Stem Cell research. An embryo is far less developed than the flies you swot, the chicken you eat and the grass you cut. It is a small collection of cells, with the "potential" to be a baby. It is not a baby. (It may be "life", but no more so than the multi-celled organisms that float in your toilet).

Also, if you say that "by creating them, we have given them a destiny" (or that has become a destiny for them) then one can also argue that they were destined to be harvested... who is to say that wasn't the divine intention all along? To give humanity the means and knowledge to completely heal itself... (Not something I personally believe, but then, I don't believe in God either, it just seems to be rather spurious reasoning to say that God would be against it, given that he created us and we got to this point... are we suggesting that God may have got it wrong? Oh right, I keep forgetting the convenient excuse of "free will"...).

*I think that in IVF hundreds of embryos are created, but not all are implanted, in case there is a need to implant a second or third time around. If it works the first time around, the leftover embryos are disposed of. It is these ones I'm referring to when I say "excess embryos"*

Kernel wrote:

Well, that's the truth, but that doesn't give us carte blanche over creating, or terminating other lives I guess.

It certainly does not! That's not where I was going at all! I was kind of suggesting that maybe creating more and more babies, and keeping sick people alive longer is merely adding to our over-population problems. (Or is that the same thing? Creating and terminating lives.. after all, by not helping, you are allowing someone to die.. allowing the termination of life).

But then, there's no way you'll see me suggesting that this is in any way the right viewpoint.. in fact, quite the opposite given that I support stem cell research (within reason), and the fact that I will most likely have to avail of fertility treatment at some point if I want to have children (whether it's IVF or not I don't know.. I'm not even thinking about it atm).

Kernel

Doper Than U wrote:

Yes, I agree.. there is no way on earth that one could justify what the nazi's did, but I can't possibly compare this with Stem Cell research. An embryo is far less developed than the flies you swot, the chicken you eat and the grass you cut. It is a small collection of cells, with the "potential" to be a baby. It is not a baby. (It may be "life", but no more so than the multi-celled organisms that float in your toilet).

Well, the Nazi analogy was just to point out that they believed they were advancing medical science, without regard to the ethics in question, and isn't there a danger we are leaping into the same chasm with stem cell research? And even though an embryo begins as only a single dividing cell, I believe in the divinity of human life, and as such, even though the cells are doing their work, I believe at the moment of conception a life is formed. Think about it, at what point do you draw the line, when a foetus is developing, it's still comparable to an embryo, in that it is a developing organism. When a baby is born, it can do nothing for itself, and so is also developing. The embryo is developing just the same, only difference is that many people have vague notions that it's not as important as a baby, or it's not as important as a person etc.

I would certainly put a human embryo above a simple strain of bacteria found in a toilet, as most people should. The science may be comparable between the two, but the ethics and theology are quite different. When we start going down the road of clinical science without ethics, morals or theology (all of which have gotten society this far) then we end up becoming like those nazi scientists. Do we start looking at handicapped people, or people in vegetative states and deciding they are no more complex than animals or other organisms?

Doper Than U wrote:

Also, if you say that "by creating them, we have given them a destiny" (or that has become a destiny for them) then one can also argue that they were destined to be harvested... who is to say that wasn't the divine intention all along? To give humanity the means and knowledge to completely heal itself... (Not something I personally believe, but then, I don't believe in God either, it just seems to be rather spurious reasoning to say that God would be against it, given that he created us and we got to this point... are we suggesting that God may have got it wrong? Oh right, I keep forgetting the convenient excuse of "free will"...).

Indeed, but that was a deeper question as regards predestined fates, if something happens, whatever it is, then one can argue that it was destined to happen. I would say God would have little to do with much of it, it is human free-will which has determined the destiny of these embryos which we would harvest. And human-free will often leads to us doing bad things in the name of all kinds of political beliefs or sciences. As for God being against stem cell research, I would have no idea, I don't even know if I'm against it yet, but I do know that my conscience is telling me it's a little bit shady - ethically - to say that least.

Doper Than U wrote:

*I think that in IVF hundreds of embryos are created, but not all are implanted, in case there is a need to implant a second or third time around. If it works the first time around, the leftover embryos are disposed of. It is these ones I'm referring to when I say "excess embryos"*

I'm not too keyed up on IVF myself, but I would ask the question: why are excess embryos created, and why so many, if each one needs to be implanted seperately?

Doper Than U wrote:

It certainly does not! That's not where I was going at all! I was kind of suggesting that maybe creating more and more babies, and keeping sick people alive longer is merely adding to our over-population problems. (Or is that the same thing? Creating and terminating lives.. after all, by not helping, you are allowing someone to die.. allowing the termination of life).

Well, that's where the grey area is, by not helping, you are allowing someone to die, but you are going against nature to help. The grey area I refer to is that the same can be said for all forms of medicine as contravening natural selection. My own opinion of overpopulation in the world is that we need to become more responsible as our technology (for preventing natural selection) develops. But there are other factors involved such as the development of the third world, which historically has been shown to stabilise population growth rates.

Doper Than U wrote:

But then, there's no way you'll see me suggesting that this is in any way the right viewpoint.. in fact, quite the opposite given that I support stem cell research (within reason), and the fact that I will most likely have to avail of fertility treatment at some point if I want to have children (whether it's IVF or not I don't know.. I'm not even thinking about it atm).

I understand your position on stem cell research, it may be one of those issues that I can never reconcile or come to a definite conclusion within myself, it would ease the burden if I thought that once stem cell research advanced through embryonic research that we would then be in a position to use adult stem cells as the same treatment. I don't know if this is possible, but certainly after the lung cells were created, there was speculation that they could now adapt the method to use adult stem cells, which I would be much more comfortable with.

Good luck with any fertility treatment if you recieve it in the future, btw. I hope any children we bring into the world will live in an ethical society!

Doper Than U

Kernel wrote:

Do we start looking at handicapped people, or people in vegetative states and deciding they are no more complex than animals or other organisms?

No, that's not what I'm saying. I was referring to the fact that an embryo is merely a collection of cells (a small collection at that.. it is not a "finished" being, if you like... far from it). A handicapped person or a person in a vegetative state is a fully formed organism, as is the chicken. As for complexity.. humans are no more or less complex than our mammalian counterparts (with the exception of a few things, most notably the brain.. but then other animals are far more advanced than we are in other areas...). An embryo, on the other hand, is far less complex an entity than a fully formed mammal.. it's merely a collection of cells. I agree though, this doesn't mean that they should be created and destroyed on a whim.

I'm not too keyed up on IVF myself, but I would ask the question: why are excess embryos created, and why so many, if each one needs to be implanted seperately?

Each one is not implanted separately, many are implanted in order to give a better chance of pregnancy :

The chances of a successful pregnancy is approximately 20-30 percent for each IVF cycle. There are many factors that determine success rates including the age of the patient, the quality of the eggs and sperm, the duration of the infertility, the health of the uterus, and the medical expertise. It is a common practice for IVF programs to boost the pregnancy rate by placing multiple embryos during embryo transfer. A flip side of this practise is a higher risk of multiple pregnancy, itself associated with obstetric complications.

If you've only got a 20/30% chance of pregnancy with each IVF cycle, and you have to implant many embryos for each go.. you can see why so many are created.

Good luck with any fertility treatment if you recieve it in the future, btw. I hope any children we bring into the world will live in an ethical society!

Thanks ... and as for the ethical society? I'll just be happy if the planet hasn't imploded thanks to Global Warming... talk about your ethics.. I'm sure whoever created this planet ain't happy that we made such a mess.

Vokes

NeilJ wrote:

Can any one tell me, is there much difference between the potential of umbilical stem cells vs. embryonic stem cells? Embryonic stem cells are far better than adult stem cells at doing what you want them to. What about umbilical stem cells found in the afterbirth?

Neil

Yes. I've seen stem cells of the umbilical cord in the news recently. There was an arcticle about it in the Independent.

Can someone fill me in? Are they any better/more useful than embryonic stem cells?

Lisapeep

Kernel wrote:

I'm asking if I am correct in assuming that once stem cell research is refined, it will then be possible (though not as easy) to switch to bone marrow stem cells?

There is in fact a company who will harvest stem cells from the blood in the umbilical cord when the baby is born. These stem cells may then be used, years down the line, in cases where the baby may get leukemia or some other disease, to treat diseases. Technology may even allow for an entire pancreas to be grown for the person to treat diabetes. And because it is grown from their own stem cells, it will be compatible with their body.

Umbilical stem cells are not able to become lungs or livers etc as embryonic stem cells are. This is because umbilical stem cells have had longer to mature than embryonic stem cells. Adult stem cells are even more matured and are therefore even less flexible than umbilical stem cells.

So as you can see, alternative methods do exist!

edanto

Sofaking wrote:

Can someone fill me in? Are they any better/more useful than embryonic stem cells?

Just to add to lisapeeps, the big advantage that umbilical stem cells have is that rejection may not happen. It seems like a good bet that some useful treatments will come from this technology in the future. And it's ethically neutral, right?

Of course embryonic stem cells are a different story ethically, but it could be argued that donating unused embryos from IVF is in some ways analogous to organ donation.

Now this is stretching it quite a bit, but I think it's worth considering.

IVF treatment involves making a lot of fertilised eggs and implanting a few in each cycle. Enough eggs are collected and fertilised for several IVF cycles before being frozen.

Months ago, I was researching this for college and one lady I spoke to from a Dublin IVF clinic told me that at the moment, they store all these frozen fertilised eggs for years as there isn't any legislation on what to do with them. In the UK, I think they are disposed of after a time and in any case it may not be safe to implant a fertilised egg that has been frozen for many years.

So, what to do with these eggs? 'Dispose' of them? Or use them in research? It might be distasteful to consider using them in research, but why is that? Is there that much difference between thawing them out or using them for research?
The choice that people made years ago to accept the idea that parts of dead people would be put into others to save their lives must have been quite difficult as well. So, that's the analogy.

On balance, I feel it's ethically sound to allow some of these eggs to be used for embryonic stem cell research that might find cures for some really debilitating diseases. Some people may choose never to avail of any potential treatments, for religious reasons - but who are we to deny others a treatment they ethically agree with?

Kernel

Looks like some people think stem cell research is not the Holy Grail of modern medicine anyway:

http://news.bbc.co.uk/1/hi/sci/tech/4213566.stm

edanto

He's taking a commendable, realistic position and I hope his message gets carried quite far.

But he's speaking from a country where embryonic stem cell research is legal.

Here, I don't know what the law says about working with human embryonic stem cells, but the recent Department of Health Commission on Assisted Human Reproduction recommended on page xii of this that research should be allowed on embryos that are surplus after IVF treatment. So, I guess if they're only making a recommendation, maybe the law doesn't cover this area yet?

Panserborn

Kernel wrote:

and also asking if I am correct in assuming that once stem cell research is refined, it will then be possible (though not as easy) to switch to bone marrow stem cells?

A girl in the lab I work in uses marrow cells to generate bone-matrix froming osteoblast cells. She uses compounds derived from seaweed that were known to have benificial effects on bone growth to spark the change in the cells. All this is done in tissue culture and not yet in patients but the aim of the overall project is to make a matrix infused with marrow stem cells and the compounds to make replacement bone and joints for patients.

The work is carried out in the biochemistry dept and the National Center for Biomedical Engineering and Science (NCBES) at NUI Galway.

forest gump

Doper Than U wrote:

Do you agree with fertility treatment for couples who cannot have children?

i absolutely agree with this and to be honest i cant see how anyone can disagree. one of the most natural things in life is the creation of new life and a sperm and egg cell still fuse. the only thing is this occurs outside the body. its more natural to create a child this way than to not have a child at all. i'm just afraid that we get to the point where we think its ok to create children for the purpose of stem cell research or as an organ donor. unfortunately we are quickly progressing this way