The following student opinion piece was written for the Columbia College course, "Frontiers in Bioethics" taught by Dr. John Loike, research scientist in the Department of Physiology and Cellular Biophysics at P&S. The course, which was given through the college's biology department for the first time this past spring, is designed to help students understand how scientific research can be used to manage potentially irresolvable bioethical issues.
The current controversy over funding the use of fetal cells and fetal tissue for medical treatment and research could surely benefit from a bit of public relations that is, disseminating information about what fetal tissue research has already achieved. Besides helping to evaluate the toxicity levels of drugs, allowing the development of cell lines, and providing a source of fetal cells for transplantation as an alternative to whole organ transplantation, fetal tissue research has been instrumental in the development of vaccines that have already saved millions of human lives. Recognizing the potential ethical objections to the origin of vaccines, we believe that the benefits of vaccines even those derived from fetal cells far surpass any ethical misgivings over the production of certain vaccines.
As early as the 1930s, the use of tissue from aborted fetuses has been instrumental in understanding cell biology and in developing vaccines. Fetal tissue research was responsible for helping develop the polio vaccine in the 1950s, and later the vaccine against rubella, and several other now-preventable diseases. Vaccines for rubella, chickenpox, and hepatitis-A are all grown in fetal cell lines and currently do not have an alternative source. A human cell line, WI-38, was obtained in the 1950s from the lung of an aborted fetus and used for the development of vaccines against chickenpox and rubella. The vaccine against rabies was developed using the same WI-38 human cell line.
The news that vaccines may be derived from fetal cells can be stunning to those who hear about it for the first time. Because of potential ethical objections to certain vaccine origins, there has been a push to remove fetal tissue from the field of vaccine development. While alternative sources do exist for certain viral vaccines derived from fetal cells, the use of vaccines derived from animal cell lines is not not free of ethical complications. Not only can the use of animal cell lines instead of fetal cell lines compromise the standards of vaccine development, it may also jeopardize the health and safety of society as a whole. One of the problems with using animals as a vaccine source is that undetected animal viruses may jump the species barrier, as demonstrated in the 1950s and 1960s, when millions were infected with polio vaccines contaminated with SV-40 (simian virus number 40) undetected in the monkey organs used to prepare the vaccines. Researchers consider SV-40 a powerful immunosuppressor and a cancer-causing virus. Fetal cell strains are considered more reliable and cause fewer adverse events than their respective animal-derived strains.
In addition to the danger of cross-species contamination, the use of animal-derived cells instead of fetal cells in certain vaccines, such as smallpox, has proved to have limited efficacy. Until the World Health Organization declared the disease eradicated in 1980, smallpox was considered one of the greatest scourges of humanity, killing about one-third of those infected. No longer considered optimal, the old smallpox vaccine was prepared from frozen calf lymph. Because of potential issues with controlling this earlier manufacturing process, its susceptibility to contamination with bacteria and other agents, the new smallpox vaccine is prepared using the fetal cell line MRC-5 as the substrate. MRC-5 is the same cell line currently used in vaccines for rubella, MMR (measles, mumps, rubella), rabies, and hepatitis-A.
As the national debate on the subject of fetal tissue and cell research continues, we should not forget what fetal tissue research has already achieved: protecting millions from preventable disease. According to the Centers for Disease Control and Prevention, in 1964 about 20,000 babies were born with congenital rubella syndrome (CRS), which may lead to blindness, deafness and retardation. By 1993, nine out of 10 people received an MMR vaccine and consequently, only seven cases of CRS were reported that year. Imagine if fetal cell research had been banned at the time the poliovirus was isolated how many more would have died or been debilitated from polio before a vaccine could be developed?
Regardless of one's stance on abortion, there is ample public support for those vaccines traceable to fetal cells. Although as a society we venerate the tolerance of a range of beliefs and opinions, we must also be held accountable for ensuring public health and safety. Ensuring a safe and effective vaccine is tied to stringent standards of vaccine manufacture. Giving the public a choice between an inferior or a superior vaccine places society in a more precarious position that is ethically impermissible. If it has been proven that a vaccine from animal cells is not as reliable and has the potential to cause cancer or other adverse effects, then it is unethical to provide this inferior vaccine when a superior one is available. A choice should be offered only if it can be shown that both vaccines are equally safe and effective. In future vaccine development, selecting the candidate for a cell substrate should be based on which candidate ensures to a greater degree the health and safety of society. Not only have some of these alternatives demonstrated limited effectiveness and direct harm to their recipients, but funding alternative vaccine research also diverts resources from diseases that have yet to benefit from a vaccine or a cure.
Fetal tissue research is more than a theoretical endeavor to extend the boundaries of human knowledge. Millions of people who are alive today because of this type of research are solid proof of its rewards. In balancing the risks and rewards for society and as the controversy continues over funding the use of fetal cells for medical treatment and research vaccines developed from fetal cells prove that the rewards to society from fetal research far outweigh the potential ethical objections raised about the origin of vaccines.
Mr. Barnwell and Ms. Joly were students in Dr. Loike's bioethics class.