-Caveat Lector-

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Export of human stem cells from Israel to Germany sparks ethical storm
Two Israeli institutions, Haifa's Technion Israel Institute of Technology
and Rambam Medical Center in Haifa, began exporting stem cells culled from
human embryos to Germany this month, arousing a storm of controversy within
both countries' scientific and medical communities.

Because stem cells have enormous medical potential, many scientists, doctors
and ethicists favor the move, saying the research project for which the
cells will be used has the potential not only to advance scientific
knowledge, but also to develop new medical treatments that could save many
lives.

But many jurists and sociologists say that the exports, though completely
legal, are very problematic. In Israel, they argue, the exports were decided
upon without any public discussion or even any discussion by national
committees on medical ethics; while in Germany, the move has elicited
considerable public criticism, including from that country's National Ethics
Council.

Like many other countries, Germany forbids stem cells to be culled from
human embryos for research purposes within its own borders. A year ago,
however, the Bundestag passed a law permitting human stem cells to be
imported in exceptional cases.

"At the time, the German press pointed out the ethical double standard of
this law and the absurdity of permitting an act that is forbidden on German
embryos to be carried out on embryos that come from other population
groups," notes Yael Hashiloni-Dolev, a lecturer in sociology at Tel Aviv
University who is currently writing a doctoral thesis on the application of
genetic knowledge in Israel and Germany.

The stem cells are being culled by Professor Yosef Itzkowitz-Eldor, the head
of Rambam's gynecology department, using the Technion's facilities. The
Technion, says Itzkowitz-Eldor, is not being paid; this is a joint
scientific venture in which the Technion will receive part ownership of any
fruits resulting from the research.

The German researcher who is receiving the cells, Dr. Oliver Brustle of Bonn
University, is trying to determine how a stem cell can be "convinced" to
develop into an adult nerve cell. Brustle, who has been studying nerve cells
and stem cells in rats for many years, hopes that it will eventually be
possible to use transplants of nerve cells grown from stem cells to cure
diseases such as Alzheimer's and Parkinson's.

Brustle has wanted to move on to studying human stem cells for some time,
but until last year, German law made this impossible. When the new law
permitting imports of stem cells was passed last January, he immediately
applied for an import license from an interdisciplinary ethics council.
According to the law, this council may grant such licenses only for research
of "outstanding scientific quality" that can not be performed either on
animal cells or on adult stem cells (which are found in bone marrow). Last
month, Brustle became the first German to receive a permit from the
council - a decision that aroused much opposition in Germany.

Professor Jens Reich of the Max Delbruck Center for Molecular Medicine in
Berlin says the German reluctance to permit research on embryonic stem cells
has two main sources. The first is the memory of the Nazis' experiments on
human beings. The second is Immanuel Kant's philosophy of ends and means,
which has gained wide currency in Germany. This philosophy holds that man is
an end in himself and must, therefore, not be used as a tool for achieving
aims that do not directly benefit him. Thus, human experimentation is
justified only if the subject would benefit personally from the research.

Professor Asa Kasher of Tel Aviv University's philosophy department, an
expert in bio-ethics, responds that an embryo is not a "person," so the
Kantian prohibition does not apply. "The embryos from which the stem cells
are produced are five days old," he says. "They look like a microscopic ball
of cells and have not yet developed the special characteristics that we
perceive as `human.'"

Furthermore, he argues, the Germans' position deprives many sick people of
the possible medical benefits of stem cell research. "Perhaps we, the Jews
of Israel, are the only ones who can tell them that on this matter, they are
exaggerating," he concludes.

But Professor Amos Shapira of Tel Aviv University's law faculty, also an
expert in medical ethics, disagrees. The German law, he says, is "a
problematic ethical compromise, along the lines of `we won't do the dirty
work, but we will do research if [the dirty work] is done by someone else.'"

Dr. Carmel Shalev, head of the Gartner Institute's ethics and patients'
rights department, adds that whether or not stem cells should be exported,
the decision should be made at the national level rather than by individual
institutions.

By Tamara Traubmann

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