Letters to the Editor
LETTERS TO THE EDITOR Stem Cells and Religion As stem cells edge toward clinical translation, much focus has been placed on bioethics, but what seems less often contemplated is the intertwined role of religion. It is well recognized that religious beliefs can influence the acceptance and delivery of health care, particularly in controversial issues. However, in current medicine we are not trained to be sensitive in discussing religion, nor do we often factor this in when facilitating patient choices. Putting theoretical conjectures and moral disputes aside, we now need to anticipate the near future when stem cells become part of a routine conversation between physician and patient. It is important for everyday physicians to understand what religious issues they may face in the practice of stem cell medicine and to identify potential scenarios and practical approaches to deal with them. There will come a day when the patient forbidden to have organ transplants or blood transfusions will need to consider whether this precludes them from receiving stem cells and their derivatives, such as bioengineered organs. There will be questions regarding how strict these boundaries are—if donated cells themselves are not retransplanted and only used in vitro, then can the cancer patient or the patient with a rare disease access personalized medicine by donating their cells for disease modeling and drug testing? Are only adult stem cells permitted? Even if cell and tissue transplants are tolerated, how much manipulation is allowed until it is considered “playing God” and morally unacceptable? For patients that refuse treatment, do we apply our current protocols of informed consent and refusal of medical treatment? What about the physician who refuses to provide stem cell therapies? Can religion pervade a physician’s duty to their patients if there is proven evidence of stem cells being the best standard of care? Above all, what are genuine religious beliefs and what are
misconceptions? These questions are complex, difficult to predict, and will evolve further with the situation itself. Some religious authorities such as the Vatican have begun to organize dialogue regarding stem cells. Curiously, while bioethicists and theologians strive to understand the theoretical aspects of stem cells so they can make an educated contribution, scientists and physicians regularly seem to disregard the overlap between religion and medicine. This disparity needs to be addressed. To equip physicians in engaging patients in matters of faith, we may also have to rethink physician education. Religious organizations and leaders need to be acknowledged as important stakeholders and included in the conversation to define and navigate these issues just as much as bioethicists and policy makers. This uncharted territory is too gray an area to limit the discussion to a select group, and religion can both facilitate and threaten the progress and delivery of stem cell medicine. Recommendations, policies, and consensus guidelines should specifically address religious issues in ways that go beyond our conventional framework in implementing new medical advances and training clinicians. This can only be achieved by serious and transparent dialogue, which needs to begin early. It needs to begin now.
KIRYU K. YAP Department of Surgery, St. Vincent’s Hospital, Melbourne, Victoria, Australia; Discipline of Medicine & Department of Surgery, University of Adelaide, Royal Adelaide Hospital, Adelaide, South Australia, Australia
Disclosures The author indicates no potential conflicts of interest. http://dx.doi.org/10.5966/sctm.2014-0092
STEM CELLS TRANSLATIONAL MEDICINE 2014;3:977 www.StemCellsTM.com
©AlphaMed Press 2014
LETTERS TO THE EDITOR Stem Cells and Religion As stem cells edge toward clinical translation, much focus has been placed on bioethics, but what seems less often contemplated is the intertwined role of religion. It is well recognized that religious beliefs can influence the acceptance and delivery of health care, particularly in controversial issues. However, in current medicine we are not trained to be sensitive in discussing religion, nor do we often factor this in when facilitating patient choices. Putting theoretical conjectures and moral disputes aside, we now need to anticipate the near future when stem cells become part of a routine conversation between physician and patient. It is important for everyday physicians to understand what religious issues they may face in the practice of stem cell medicine and to identify potential scenarios and practical approaches to deal with them. There will come a day when the patient forbidden to have organ transplants or blood transfusions will need to consider whether this precludes them from receiving stem cells and their derivatives, such as bioengineered organs. There will be questions regarding how strict these boundaries are—if donated cells themselves are not retransplanted and only used in vitro, then can the cancer patient or the patient with a rare disease access personalized medicine by donating their cells for disease modeling and drug testing? Are only adult stem cells permitted? Even if cell and tissue transplants are tolerated, how much manipulation is allowed until it is considered “playing God” and morally unacceptable? For patients that refuse treatment, do we apply our current protocols of informed consent and refusal of medical treatment? What about the physician who refuses to provide stem cell therapies? Can religion pervade a physician’s duty to their patients if there is proven evidence of stem cells being the best standard of care? Above all, what are genuine religious beliefs and what are
misconceptions? These questions are complex, difficult to predict, and will evolve further with the situation itself. Some religious authorities such as the Vatican have begun to organize dialogue regarding stem cells. Curiously, while bioethicists and theologians strive to understand the theoretical aspects of stem cells so they can make an educated contribution, scientists and physicians regularly seem to disregard the overlap between religion and medicine. This disparity needs to be addressed. To equip physicians in engaging patients in matters of faith, we may also have to rethink physician education. Religious organizations and leaders need to be acknowledged as important stakeholders and included in the conversation to define and navigate these issues just as much as bioethicists and policy makers. This uncharted territory is too gray an area to limit the discussion to a select group, and religion can both facilitate and threaten the progress and delivery of stem cell medicine. Recommendations, policies, and consensus guidelines should specifically address religious issues in ways that go beyond our conventional framework in implementing new medical advances and training clinicians. This can only be achieved by serious and transparent dialogue, which needs to begin early. It needs to begin now.
KIRYU K. YAP Department of Surgery, St. Vincent’s Hospital, Melbourne, Victoria, Australia; Discipline of Medicine & Department of Surgery, University of Adelaide, Royal Adelaide Hospital, Adelaide, South Australia, Australia
Disclosures The author indicates no potential conflicts of interest. http://dx.doi.org/10.5966/sctm.2014-0092
STEM CELLS TRANSLATIONAL MEDICINE 2014;3:977 www.StemCellsTM.com
©AlphaMed Press 2014
