Table 2 Qualitative analysis of ethical concerns related to three sources of neural stem cells
Category/subcategories | Description | Example response/s |
|---|---|---|
Abortion | Anti-abortion, concerns about abortion | “(I am) anti-abortion” |
Generation of an abortion industry | Generation of an abortion industry and commercialisation | “If it's paid and generates a market for abortions.” |
Monetary incentivisation of abortion | Donors being swayed or incentivised to undergo an abortion by compensation or payments | “Financial remuneration could end up being a part of the process and therefore sway decision making for those considering elective abortion.” |
Abortion conflicts with personal/moral beliefs | Personal, ethical and moral views about abortion shaping the acceptability of stem cell source | “Although I think abortion should be legal and safe, I'm not sure that it's an ethical choice…” “Is it morally right to use cells from an aborted fetus?” |
Protection and upholding of life | The need to protect and uphold life of the fetus/embryo, including participants that stated they were pro-life | “I believe it is a human deserving of life.” |
Developmental status of the embryo or fetus | Fetuses or embryos used at late developmental stages and personal beliefs around what constitutes “life.” | “Need to have upper limit of age of fetus that can be used—blastocyst is fine in my view.” “At what point is a fetus brain a baby brain?” |
Fetus or embryo has equivalent value to any human life | Fetuses have the same status as a human being. Additionally, NSCs are living and should be treated as such | “Would not want to take away from someone’s life.” |
Biological/laboratory mistakes and manipulation | Medical/laboratory manipulation of fetuses, embryos and NSCs including mistakes, errors and health of the therapeutic product | “Any laboratory manipulation must not result in errors in coding or mutation.” “Must be obtained from a healthy IVF embryo.” |
Exploitation of donors | Unfair treatment of people donating NSCs | “Really exploitation is my main concern of vulnerable populations.” |
Exploitation of mothers/parents | Exploitation, coercion and persuasion of donors as well as concerns around vulnerability of people donating NSCs | “Some concerns around persuasion of mothers…” “Exploitation of women in a time of uncertainty.” |
Exploitation of adults to obtain donor tissue* | Exploitation, coercion and risk of harm for vulnerable adults including illegal organ harvesting, e.g., medical patients and prisoners | “There is a lot of 'medical research' (often involves harvesting of organs) being done on prisoners in China; & I don't like that idea at all.” |
Inadequate informed consent | Adequacy/clarity of consent processes and extent of voluntary donation | “That they are willingly donated and not taken unethically or without knowledge.” “Ensuring consent for donation is clear.” |
Monetary incentivisation to donate a potential therapeutic product | Risk of incentivising donation with renumeration of donors | “If women are paid to undergo IVF to generate available embryos.” |
Regulation of NSC procurement | How NSCs are sourced and obtained, including the need for regulation around NSCs to ensure they are ethically sourced and the potential for commercialisation is mitigated | “That they (cells) are ethically…collected.” “Needs reasonably strict regulation.” |
Solely generating NSCs for therapeutic use | Women may become pregnant or that embryos would be created with the sole intention of creating NSCs for therapeutic use | “The risk of parents falling pregnant specifically to gain the cells of their fetus doesn't sit well with me.” “Would not want fetuses to be produced for the purpose of research.” |
Religious beliefs^ | Religious beliefs informing ethical concerns and acceptability of NSC sources | “(This) conflicts with my religious beliefs.” |