Islamic Perspective On Stem Cell

Islamic Perspective on Stem Cell
Prof.Dr.dr.H. Rusdi Lamsudin, SpS(K), M.Med.Sc

Dean
Faculty of Medicine
Indonesian Islamic University
Yogyakarta
Outline
Introduction
Definition stem cell
Types of stem cells
Sources of stem cells
Current treatments
Potential treatments
Controversy over ethical implication
Islamic perspective on stem cells

Introduction
A stem cell is a special kind of cell that
has a unique capacity to renew itself and
to give rise to specialized cell types

Researchers have for years looked for
ways to use stem cells to replace cells and
tissues that are damaged or diseased
Introduction
Research on stem cells is advancing
knowledge about how an organism
develops from a single cell and how
healthy cells replace damaged cells in
adult organisms

Promising area of science is also leading
scientists to investigate the possibility of
cell-based therapies to treat disease--
regenerative or reparative medicine

Introduction
Stem cells are one of the most
fascinating areas of biology today

Like many expanding fields of
scientific inquiry, research on stem
cells raises scientific questions as
rapidly as it degerates new
discoveries

Outline
Introduction
Types of stem cells
Current treatments

Stem cell
A cell from the embryo, fetus, or adult
that has, under conditions, the ability to
produce itself for a long period, or in the
case of adult stem cells, throughout the
life of the organism

Can give rise to specialized cells make up
the tissues and organs of the body
Outline
Introduction
Types of stem cells
Current treatments

Types
Totipotent
A single totipotent stem cell can grow into an entire
organism and even produce extra-embryonic tissues

Pluripotent
A single pluripotent stem cell has ability to give rise to
types of cells that develop from the three germ layers
(mesoderm, endoderm and ectoderm) from which all
cells of the body arise.
Multipotent
Multipotent stem cell can only become one particular
type of cells: e.g. blood cells, or bone cells

Outline
Introduction
Types of stem cells
Current treatments

Cord blood stem cells
Adult stem cells
Embryonic stem cells
Cord blood stem cells
Blood from the placenta and umbilical cord
that are left over after birth is source of
adult stem cells

Since 1988 these cord blood stem cells
have been used to treat;
Guthers disease
Hunter syndrome
Hurler syndrome
Acute lymphocytic leukaemia
And many more problems occuring mostly in children

Adult stem cells
Can be found in adult beings
Undiffrentiated cells that produce
daily provide certain specialized cells
Ex: bone marrow stem cells are
known to be able to transform into
liver, nerve, muscle and kidney cells
What are Human Embryonic
Stem Cells (HES cells)?
HES cells are stem cells derived from
the inner cell mass of the blastocyst
stage of a human embryo.

A stem cell is not specialized. That is, it
can give rise to different kinds of tissue.

A stem cell is self-renewing.

What are Human Embryonic
Stem Cells (HES cells)?

They can be kept alive indefinitely in
culture
Embryonic stem cells are pluripotent.
That is, they can differentiate into any
kind of tissue in the human body.

Unlike an embryo, they are not
totipotent. That is, they are not capable
of being implanted in a uterus and
giving rise to a human being.
Outline
Introduction
Types of stem cells
Current treatments

Current treatment
For more 30 years, bone morrow
stem cells have been used to treat
cancer patients which conditions as
leukemia and lymphoma

Current treatment
During chemotherapy
Most growing cells are killed by
cytotoxic agents
These agents not only kill the leukemia
or neoplastic cells, but also the stem
cells needed to replace the killed cells as
patient recovers
If the stem cells are removed before
chemotherapy, and then reinjected after
treatment is terminated

Current treatrment
The stem cells in the bone morrow
produce large amounts of red cells and
white blood cells, to keep the body healthy
and to help fight infections

Adult stem cells have been successfully
used to treat paralysis due to to spinal
injuries, Parkinsons disease and other
illness
Outline
Introduction
Types of stem cells
Current treatments

Potential treatment
Cancerous tumors

Apparently able to repair muscle damage
after heart attacks - bone morrow stem
cells

Follicle stem cells may lead to successes in
treating baldness through hair
multiplication within three or four years

Potential treatment

Type 1 Juvenile diabetes could be cure
with stem cells in the future.

Autoimmune diseases and promise of
stem cell-based therapies

Rebuilding the nervous system with stem
cells
Patient's DNA from
skin cell injected into
nucleus of Donor egg
cell
Add growth stimulating
compounds
Egg becomes a
blastocyst with about
150 stem cells
Stem cells cultured with
nutrient providing
feeder cells
Polar body
Donor egg's DNA
Nucleus
Donor DNA Extracted
from egg cell
Patient's DNA
Patient's
Cell
Stem cells
Feeder
cells
Injected Stem Cells
Radiolabeled Designer Stem Cells
Organ specific stem cells
are separated from cell
culture and transfected with
a reporter gene (*).
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KT B
Stem cells are then injected
into the recipeint.
Radiolabeled probe
targeting the reporter gene
will be used to track these
stem cells in the body
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Outline
Introduction
Types of stem cells
Current treatments

One of the most heated ethical issues
surrounding embryonic stem (ES) cell
research is independent of reseach goal or
outcome possibilities

This ethical issue involves the status of
human embryo
(the status of the human embryo)
Position #1
Embryos are human individuals and should not be
used or destroyed for research purposes

Position #2
Embryos do not have the same status as fetus or a
baby and can be uesd for research

(the status of the human embryo)

Position #3
Embryos should not be created for research, but can
be used if they left over from in vitro fertilization
(IVF) procedures

Position #4
Embryos are clusters of cells no different from other
cells and can be created specifically for use in
research
US President George W Bush announced
his executive decision on August 9, 2001,
after consulting with scientists, scholars,
bioethicists, religious leaders, doctors,
researchers, members of Congress, [his]
Cabinet, and [his] friends and reading
heartfelt letters from many Americans,
to prohibit the use of federal funding to
work with embryonic cell lines created
after that date.
In April 2004, 206 members of Congress,
including many moderate republicans, and
some other prominent public figures
signed a letter urging President Bush to
relax the policy

The 2004 Democratic presidential
candidate, John Kerry, had promised to
support all types of stem cells research if
elected President
Organ Tissue replacement
Fetal stem
cells taken
after
child-birth
death
Stem cells
from your
blood
Stem cells
from your
organ
Animal
Organs
e.g., pig organ
Cadaver
Organs
e.g., cornea
Stem Cell
Umbilical
stem cells
at your
birth
Umbilical
stem cells
from
others'
birth
Stem cells
grown
from a
discarded
aborted
fetus
Stem cells
from pre-
implanted
embryo
which is
to be
discarded
Artificial
Organs
Mechanical
artificial
organ
Biological
artificial
organ
Stem cells
from a
zygote
modified
in vitro
and
implanted
for one
month
Liver
bioreactor
with your
stem cells
Liver
bioreactor
with stem
cells not
from you
Artificial
heart
Living
Donor
e.g., kidney
Religious perspectives
It is interesting to note that religions that
have strong traditions of legal and
religious law
Judaism and Islam, support most forms of
stem cell research
Catholic Christian group have come out
strongly against embryonic stem cell
research as they view it as a form of
abortion, which they see as murder

An Islamic Perspective on Stem
Cells Research
References
1. A Muslim Perspective on Embryonic Stem-Cell
research. IIIssues, Vol II, Number 3, August 29,
2001, Publish by the Islamic Institute,
Washington DC
2. Muzzammii Siddiqi. An Islamic Perspective on
Stem Cells Research. Article Ref:ICO202-404,
february 27, 2002
3. Michele Weckerly. The Islamic View on Stem Cell
Research
4. IMANAs Position on Organ Donation and
Transplantation. Our Position The Position of
Islamic Medical Association of North America
on Issues of Medical Ethics. March, 26, 2005
Cells Research
IIIssues, 2001
In an effort to formulate a policy position on
embryonic stem cells research, and to ensure
Muslim American participation in the debate of the
ethical and scientific issue, the Islamic Institue
convened a panel of expert, in cooperation with;
The Figh Council of North America (FCNA, North
American council of Islamic jurisprudence)
The Graduate School of Islamic and Social Science
(GSISS)
The International Institute of Islamic Thought
(IIIT)
The panel, consisting of medical doctors, scientist,
and Islamic scholars
Cells Research
IIIssues, 2001
Muslims have strongly rejected human
cloning experimentation that contradicts
Islamic legislation and prohibited in all its
forms because it contradicts with Islam

Nevertheless, virtually all Muslim scholars
see in-vitro fertilization (IVF) as a
compassionate and humane scientific
procedure to help infertile couples bear
children. IVF, Islamic scholars emphasize,
has to be performed under strict guidelines
Cells Research
IIIssues, 2001
The Islamic Institute supports stem-cell
research on these spare embryos from in-
vitro fertilization (IVF)

Under the Islamic principle of the
purposes and higher causes of the shariah
(Islamic law), we believe it is a societal
obligation to perform research on the extra
embryos instead of discarding them
Cells Research
IIIssues, 2001

None of the Islamic scholars on the panel,
or those scholars that were subsequently
consulted, felt the opinion was anyway
contradictory to Islamic principles
Cells Research
IIIssues, 2001

A majority of Muslim Americans support
embryonic stem cell research according to
a new poll conducted by the Islamic
Institute.
The Washington-based Islamic advocacy
group also announced its support for
research based on the recommendations of
panel Islamic scholars, scientists, and
medical doctors
Cells Research
Dr. Muzammii Siddiqi, 2002
IVF is permissible in Islam
First question
Second question
Cells Research
First question
Should an embryo, which is formed within
a few days after an artificial fertilization
and is not yet in the womb of its mother,
be considered a human being, with all
rights of human being?
Cells Research
Answer First question

Muslim jurists have made a clear distinction
between the early stages of pregnancy (first 40
days) and its later stages

It is mentioned that if someone attacks a pregnant
woman and aborts her baby in the early stages of
her pregnancy, that persons punishment will be
less than that of the person who does that during
full pregnancy . And if he kills the child after the
birth, then he is liable to be punish for homicide
Cells Research
Second Question
Whether according to the Shariah it is
acceptable to destroy an embryo for shake
of research, even if this research can
potentially cure many otherwise fatal
disease?

Cells Research
Answer Second Question
That the embryo in this stage is not human.
It is not in its natural environment, the
womb
If it is not placed in the womb it will not
survive and it will not become a human being
So there is nothing wrong in doing this
research, especially this research has
potential to cure disease

Cells Research
Recommnedation #1
Recommendation #2
Recommendation #3

Cells Research
Recommnedation #1
It is claimed by experts in the field that
the research on stem cell has potential to
relieve human disease and suffering
If this the case then it is not only allowed
but it is obligatory (fard kifayah) to pursue
this research

Cells Research
Recommendation #2
The use of embryonic stem cell should be very
heavily limited.
Only allow isolation of stem cells from frozen
embryos that were created for the purpose of in
vitro fertilization and would otherwise have
destroyed
Obtain full consent from the donors
Provide safequards against monetary compensation
to embryo donors and against the creation of
embryos in excess of what is required for in vitro
fertilization

Cells Research
Recommendation #3
Perhaps research using stem cells derived
from adults will eventually prove to be
most promising
We should encourage further research on
the use of adult stem cells, to the point
where ir will be unnecessary to use
embryos for this purpose
Specifically, we should find better ways to
isolate existing stem cells in the human
body
Cells Research
Michele Weckerly
To analyze Islams stance towards stem cell
research, the status of embryo must be
determined
In Chapter 23 (Al Muminuun), verse 12-14,
the Quran teaches:
We created (khalaqna) man of an extraction of
clay, then we sent him, a drop in a safe lodging,
then We created of the drop a clot, then We created
of the clot a tissue, then We created of the tissue
bones, the We covered the bones in flesh;
thereafter We produced it as another creatur. So
blessed be God, then the best of creators
(khaliqin)!
Cells Research
Michele Weckerly
Allah passage has been interpreted to
indicate that a fetus is is perceived as
human life, only later on the biological
development because of the Qurans
use of the words thereafter We
produced his as another creature.
Addtionally, many scholars indicate
that ensoulment of the fetus does not
occur until the end of the fourth month
of pregnancy (120 days),
Cells Research
Michele Weckerly
However, tradition states:
Each of you possesses his own formation
within his mothers womb, first as a drop
of matter for forty days, then as a blood
clot for forty days, and then the angel is
sent to breathe life into him

Cells Research
Michele Weckerly
Additionally, the Shariah makes a distinction between
actual life and potential life, determining that actual
life should be afforded more protection than potential
life.

Under most interpretations of Islamic law, the embryo
is not considered a person and the use of it for stem
cell research does not violate Islamic law.

Also, under this same line of analysis, stem cells from
aborted fetuses would also be permitted if the abortion
was performed before the fourth month of pregnancy

Cells Research
IMANAs Position on Organ Donation and
Transplantation. Our Position The
Position of Islamic Medical Association of
North America on Issues of Medical Ethics.
March, 26, 2005
Transplantation in general, both giving and
receiving organs, is allowed for this the purpose
of saving life
This has be done under the following guidelines:

Cells Research
The guidelines
1. The medical need has to be defined
2. The possible benefit to the patient has
to be defined
3. Consent from the donor as well as
recipient must be obtained
4. No finacial incentive to the donor or
his relatives for giving his organs (a
voluntary gift may be permitted)

Cells Research
The guidelines
5. Any permanent harm to the donor must be
avoided
6. May not transplant sex organs (testicles,
ovaries or) which violate the sanctity of
marriage
7. There should be no sale of organs by any
party
8. There should be cost to family of the donor
for removing the organ
9. Cadaver donation is permitted but only if
specifically mention in that persons will or in
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Islamic Perspective on Stem Cell

Prof.Dr.dr.H. Rusdi Lamsudin, SpS(K), M.Med.Sc

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