What specific ethical decision criterion can you use to explain the issues that surround Stem Cell

therapy? Include the references (in an APA format) you used as basis for your answer.

In recent years, modern medicine's utilization of stem cells has gained prominence. It's easier to perform
now, and there are more stem cell clinics. This rise in popularity has brought ethical difficulties. Although
stem cell research has helped academics and healthcare professionals better understand the human
body and develop new treatments for diseases, the use of stem cells, particularly those derived from
embryos, is still a controversial topic. This brings us to the ethical decision criterion based on “rights”.
Zakrzewski et al. (2019) discussed that this issue started in 1998, when scientists discovered the ability of
extracting embryonic stem cells (ESCs) from human embryos. Stem cell therapy proved to be effective in
treating many diseases, even many that were previously incurable. When scientists isolated embryonic
stem cells in the lab, the embryo, which had the potential to become a human, was destroyed. Seeing the
large potential from human embryonic stem cells (hESCs), their efforts were centered on making it
possible to isolate stem cells without endangering their source which is the embryo. On the other hand,
the controversy was generated among religious organizations such as the Catholic Church as well as the
“pro-life” movement. The central dilemma is whether it is morally permissible to investigate breakthrough
treatments for diseases at the risk of harming an early human embryo. It is said that life starts in the
womb, in fertilization, or in conception, hence, arguing that the hESCs may disrespect the right of a
human embryo to live. Individual viewpoints in this argument are so deeply founded in basic moral values
that constructing a definitive policy that everyone can agree on sounds unlikely. Aside from its ethical
concerns, it should also be noted that hESCs has also safety concerns. Different cell types from hESCs
are difficult to control after in vivo transplantation and when undifferentiated hESCs are transplanted,
teratomas, tumors that contain all three germ layers, could develop (Volarevic, 2018). Zakrzewski et al.
(2019) stated that while human ESCs are still an ethically questionable source of cells, they are
potentially powerful instruments for therapeutic applications of tissue regeneration. Because of the
complexity of stem cell regulatory mechanisms, there is still a lot to learn from in vitro observations

References:

- Volarevic, V., Markovic, B. S., Gazdic, M., Volarevic, A., Jovicic, N., Arsenijevic, N., Armstrong,
L., Djonov, V., Lako, M., & Stojkovic, M. (2018). Ethical and safety issues of stem cell-based
therapy. International Journal of Medical Sciences, 15(1), 36–45.
https://doi.org/10.7150/ijms.21666
- Zakrzewski, W., Dobrzyński, M., Szymonowicz, M., & Rybak, Z. (2019). Stem cells: Past, present,
and future. Stem Cell Research & Therapy, 10(1). https://doi.org/10.1186/s13287-019-1165-5
Give a specific medical procedure or treatment protocol that is used in the Philippines that's given
an approval for compassionate use. Include the references (in an APA format) you used as basis
for your answer.

In 2021, an advisory No. 2021-0759 which is a clarification and approval on the use of Remdesivir was
eleased by the Food and Drug Administration Philippines. According to FDA, the institution did not
approve Remdesivir for treatment of COVID-19. It is also stated that Remdesivir is used in adults and
pediatric patients of age 12 years or older and weighing at least 40kg for COVID-19 treatment requiring
hospitalization. In order to have this medicine a physician must apply for ‘Compassionate Special
Permits” or CSP. According to FDA, a CSP is defined as a special permit provided to physicians or
hospitals to use investigational pharmaceuticals or drugs that have not yet been licensed or are in the
process of being registered in the Philippines for the treatment of critically sick patients. A CSP can only
be requested by the physician in charge or the institution where patients are being treated, who will be
fully responsible for the use and dispensing of the requested drug product. The CSP holder must
adequately notify the patient of the product's experimental status and produce an FDA report on the
outcomes for each patient who is given the product. This permit is only granted to competent medical
specialists/institutions who are authorized to use the product on a limited number of patients with a low
volume, and it is valid for one year. FDA added that this is in no way intended to replace the registration
process of drugs which involves systematic evaluation of evidence-based data. Lastly, No product
granted with CSP can be marketed commercially.
Express your guided opinion backed up by reference about CRISPR-cas9 and its future
applications and ethical challenges.

CRISPR-cas9 has been widely utilized in gene editing since its discovery. Cas9, the accompanying
protein, allows this linked system to make very specific DNA modifications. Some previously found gene
editing approaches had little efficiency in particular targeting. I do commend this technology because of its
simplicity and efficiency. I can see that this technology can create even more breakthroughs. However,
some ethical concerns and challenges are also associated with this technology. One application of
CRISPR-cas9 is in the field of agriculture. According to Zhu et al. (2020) unlike traditional breeding
methods, CRISPR-Cas9 technology allows for the quick generation of optimal germplasms by removing
negative genetic factors that cause undesirable qualities or introducing gain-of-function mutations by
precise genome editing. On this study of the same author, advantages such as increasing yield,
improving quality, and disease and herbicide resistance are among its applications in crop improvement.
The CRISPR/Cas9 gene-editing technology has been applied to approximately 20 plant species such as
rice, wheat, maize, soybean, potato, tomato, citrus, and grapes (Paroma, 2020). With the CRISPR
technology’s contribution to the development of hundreds of crop varieties with enhanced agronomic
performance and have transformed breeding techniques, some future applications may be the
domestication of crops that are not usually grown or planted in a certain country due to climate conditions.
More food crop fortifications may come through like the golden rice innovation. In addition, more shelf-
stable food varieties may arise. This technique is also a big help in achieving food security and solving
malnutrition issues specifically iron and zinc deficiency (Borrill et al., 2014). With the expansion of this
technology’s application in the world of agriculture and food comes also its expanded market. Hence,
raises more concerns and questions on its regulation. Another is off-target mutations, transmission of
features to unrelated animals in the environment, and ecological imbalance because to the loss of a
population targeted by gene drive (Shinwari et al., 2017). More ethical concerns are raised in CRISPR-
cas9’s application to human specifically to human embryo.

Despite regulatory and societal challenges, CRISPR genome engineering has promising uses. Although,
it may seem to be intimidating to learn about this technology, it can significantly advance our
understanding on our agriculture, food, as well as in other scientific fields. CRISPR technology must be
adopted on multiple platforms with input from ethical, social, religious, legislative, and technological
experts to build a long-term policy on its benefits and concerns.

References:
Borrill, P., Connorton, J.M., Balk, J., Miller, A.J., Sanders, D. and Uauy, C. (2014). Biofortification of wheat
grain with iron and zinc: integrating novel genomic resources and knowledge from model crops. Frontiers
in Plant Science  5: doi:  10.3389/fpls.2014.00053

Paroma, A. (2020). Application of CRISPR-CAS 9 in Food and Agriculture Science: A Narrative Review.
Open Access Journal of Biogeneric Science and Research, 2(2).
https://doi.org/10.46718/jbgsr.2020.02.000041

Shinwari, Z. K., Tanveer, F., & Khalil, A. T. (2017). Ethical issues regarding CRISPR mediated genome
editing. The CRISPR/Cas System: Emerging Technology and Application.
https://doi.org/10.21775/9781910190630.09

Zhu, H., Li, C., & Gao, C. (2020). Applications of CRISPR–Cas in agriculture and Plant Biotechnology.
Nature Reviews Molecular Cell Biology, 21(11), 661–677. https://doi.org/10.1038/s41580-020-
00288-9