Stem-cell science stirs debate in Muslim world, too
CAIRO AND TORONTO — Egypt is joining the ranks of nations where scientists conduct stem-cell research. The private Egyptian IVF (in vitro fertilization) Center in Cairo is preparing to start such work in October, using stem cells from umbilical cord blood with the permission of newborns' parents. It won't delve immediately into the controversial realm of embryonic stem cells or therapeutic cloning - a way of deriving stem cells from cloned embryos.
But as technology and cost barriers come down, clinical director Gamal Serour says he'd like to eventually use surplus "early embryos" from consenting couples who no longer need them for in vitro fertilization.
That could spark the same kind of ethical debate in Egypt that's now raging in the United States, and the prospect provides a window onto the Muslim world's divided views about the issue.
Unlike the Vatican in Catholicism, Islam does not have a centralized authority to state a position. Most Muslim countries - including Egypt - don't yet have laws concerning embryonic stem-cell research and cloning, says Thomas Eich, a researcher on Islamic bioethics at Bochum University in Germany.
Some Muslims in Egypt, a deeply conservative and religious country, are open to allowing embryonic stem-cell research, saying the embryo does not have a soul until later stages in its development. But others agree with Coptic Orthodox and Catholic clergy, who say it is immoral, even infanticide, to destroy embryos at any stage to harvest stem cells.
Cloning, even for therapeutic purposes, is currently forbidden in bylaws instituted by the Egyptian Medical Syndicate, an independent body overseeing all private and public medical practice in Egypt. The group also forbids the use of any embryos for experimentation.
"I don't know whether this position is going to stand for long ... [but destroying embryos for research] is not ethically right, it's not morally right, and it does not conform to our Islamic religion as it stands now," says Hamdy el-Sayed, the Muslim president of the Egyptian Medical Syndicate. "It's already a human life [at conception]." So far, he says, Egypt allows only nonembryonic stem-cell research, using sources such as umbilical cord blood.
But Dr. Serour argues that excess early embryos (less than 14 days old) are not yet human beings. "Instead of leaving them to perish, why not use them for research for the benefit of human beings?" he says during an interview at the International Islamic Center for Population Studies and Research in Cairo, which he directs.
Some Islamic scholars hold favorable views toward embryonic stem-cell research from the perspective of sharia (Islamic law). Most of these scholars believe ensoulment of the embryo occurs on the 120th day of the pregnancy, Mr. Eich says, and that is the point when it gains its moral status or rights as a legal person. Other Islamic scholars, however, say ensoulment occurs on the 40th day.
According to another view of sharia, there is a distinction between potential life and actual life, says Muzammil Siddiqi, chairman of the Islamic Law Council of North America in Orange County, Calif. Although life begins at conception in the womb, he says, an embryo formed by artificial fertilization "is not in its natural environment.... If it is not placed in the womb it will not survive and it will not become a human being."
"It is obligatory to pursue this research, [which] has great potential to relieve human disease and suffering," Dr. Siddiqi continues, but he believes stem cells should be derived only from therapeutic cloning or from excess frozen embryos that were created for in vitro fertilization.
Egypt will not be the first predominantly Muslim country to conduct stem-cell research. Iranian scientists developed human embryonic stem-cell lines in 2003 with the approval of Ayatollah Seyed Ali Khamenei, Iran's supreme religious leader, says LeRoy Walters, a professor at the Kennedy Institute of Ethics at Georgetown University in Washington. Singapore, where Muslims have a slight majority, has also produced embryonic stem-cell lines. And nonembryonic stem-cell research is conducted in Iran, Saudi Arabia, and Malaysia, says Una Chen, who is based in Giessen, Germany, as chairwoman of the International Committee for the International Society for Stem Cell Research.
In 2003, a scholar in Cairo issued a fatwa (Islamic religious ruling) stating that therapeutic cloning of embryos would be considered lawful and could be compared to the accepted practice of donating cells, tissues, or organs for transplants, Professor Walters says.
Some other Muslim groups and countries support both embryonic stem cell research and therapeutic cloning, such as Turkey, the Academy of Scientific Research and Technology in Egypt, and the National Fatwa Council in Malaysia.
But many officials in Muslim countries are concerned that these practices could lead to the cloning and killing of babies to supply organs or other "spare parts" for patients, says Zaghloul el-Naggar, an Egyptian expert on Islam and science. Other potential abuses: people selling embryos or using surplus embryos without consent of the parents.
Ragaa Mansour, scientific director and program manager of the Egyptian IVF Center, hopes these fears won't cause Egyptian officials to ban stem-cell research or severely restrict its funding. "How can we ban anything just because it can be misused?" Dr. Mansour says. "We should regulate and prevent misuse of technology [and] encourage research in the right direction."
So far, the Egyptian government doesn't appear to be taking any rash actions. "It's important for the government to support it, and I do encourage stem-cell research," says Salah Labib, director general of the Ministry of Health and Population's Specialized Medical Committee, a governmental arm responsible for funding well-established treatments.
Dr. Labib says he would be open to financing future stem-cell therapies, provided they are safer, easier, and cheaper than some of the treatments the government is financing now. "But I think every research should ... be ethically evaluated first," he says.
• The writer reported this story partly from Cairo and partly through phone interviews from Toronto.