Note: Stem cell therapy, due to its novelty, holds many unknown dimensions even for physicians and specialists in this treatment method. Regarding this treatment method, there are both many unsaid points and incorrect exaggerations, the veracity or falsity of which must be judged. We discussed the difference between using this treatment method and other methods, such as gene therapy, with Dr. Sadeq Qadimi. Having obtained his doctorate in Jurisprudence and Fundamentals of Islamic Law, he has been seriously studying in the medical field for years. He believes that stem cell therapy, despite its numerous benefits, entails various therapeutic, social, economic, and ethical harms that must be guarded against. The detailed exclusive interview of Contemporary Jurisprudence with this professor and researcher of the Seminary follows below:
Contemporary Jurisprudence: Generally speaking, what applications are conceivable for stem cells in terms of medical treatment?
Qadimi: Regarding the applications of stem cells in terms of therapy and medicine, it can be said that they have extensive applications in the therapeutic and medical fields, some of which we will mention:
The treatment of blood diseases is one of the oldest applications of stem cells, which has a long history in advanced countries and a shorter history in our country. In this method, bone marrow transplantation is used, which is very famous and is employed to treat seasonal diseases and other blood disorders. Also, stem cell transplantation is used for the treatment of leukemia.
The second case is the treatment of chronic diseases, such as diseases where a person suffers from autoimmunity; meaning the immune system spontaneously destroys and attacks the body’s cells, which is technically called autoimmune. Among its types, one can mention lupus and rheumatic arthritis. Stem cells are very applicable in treating these diseases and can repair damaged tissues.
The third case is tissue regeneration; meaning it can regenerate damaged tissues resulting from burns and surgery.
The fourth case is heart diseases. Sometimes, as a result of a heart attack, the heart muscle undergoes change or atrophy and is severely damaged in a way that requires replacement. Stem cells can easily repair this muscle, though this treatment method has not been finalized yet, but very special use can be made of it.
The fifth case is the treatment of neurological disorders. For example, to treat Alzheimer’s and Parkinson’s, new neurons are substituted for damaged neurons, returning the person to a state of balance to some extent. This method is underway in our country as well, and I am aware that its project is ongoing at the Razi and Avicenna Research Centers and has been successful in the laboratory stage.
The sixth case is the treatment of metabolic diseases, such as the production of beta cells in the pancreas for the purpose of treating Type 1 diabetes, or targeted therapies for cancer.
The seventh case is beautification and rejuvenation, where stem cells are also employed to repair damaged tissues.
Generally, due to the high ability stem cells have in repairing and regenerating tissues and organs, they have many applications in repairs.
Contemporary Jurisprudence: Is the treatment method via stem cells different from the treatment method via gene therapy?
Qadimi: These two methods differ from several aspects. We said that stem cells have the capability of differentiation and proliferation and are used for tissue repair and disease treatment; but gene therapy is used to correct genes within cells for the purpose of treating or even preventing diseases, and its goal is repairing or replacing defective genes.
Their second difference is that stem cells can be transplanted directly to the damaged site and are used for hematopoiesis or mesenchymal purposes; but in gene therapy, vectors and carriers are used to transfer therapeutic genes to the patient’s cells.
The third difference is that genes can be injected directly into the target cells in the body, or cells can be modified outside the body and then returned to the body.
These two methods also differ in terms of application: Stem cells are mostly used in treating blood diseases, tissue repair, and chronic diseases; whereas gene therapy, due to its specificity and transferability, is mostly used in genetic diseases, various types of cancer, and viral diseases.
Regarding the risks and challenges of these two methods, it must be said: If stem cells go out of control, they can create tumors, which can be considered among the disadvantages of this method. In gene therapy, healthy genes might also be damaged, which is among the potential dangers of this method; although both methods are generally promising.
Contemporary Jurisprudence: What are the benefits of treatment via stem cells compared to other methods?
Qadimi: Among the benefits of stem cell therapy is the ability to repair and regenerate tissues. In other methods, there isn’t much emphasis on being able to repair or regenerate a tissue, and the discussion is mostly about transplantation and replacement rather than repair; but in the stem cell therapy method, tissues can be returned to their initial state through repair.
Another benefit is the treatment of chronic diseases; meaning diseases that an individual has struggled with for many years can be treated with this method.
Another benefit of this treatment method is the reduction of the need for painkillers or surgery; because in this method, repair takes place and no tissue is transplanted, so it is not rejected by the body to necessitate painkillers for suppressing the person’s immunity. Also, since there is no transplant involved, there is no need for surgical operation either.
The fourth benefit is the high therapeutic potential mentioned in previous discussions.
The fifth benefit is that this treatment method stimulates the immune system, meaning it strengthens the immune system; because we stated that in this method, no tissue is transplanted to necessitate painkillers for suppressing the body’s immune system; therefore, this method leads to the strengthening of the body’s immune system.
The sixth benefit is that this treatment method has no side effects. In this method, since there is no transplant, there are no side effects involved; rather, a body tissue is merely repaired. In this method, we encounter personalized medicine (shakhsi-sazi darman). In the science of law, the personalization of punishment is discussed, or even in educational discussions, they say to give an educational program according to the person’s aptitude, which means the personalization of education. Now here too, the most important point of this treatment method is this very personalization of treatment, why? Because the person’s own stem cells are transplanted to the person themselves and the person’s own initial tissue is returned; meaning personalization takes place exactly. Perhaps one can boldly say that this is one of the best treatments.
The seventh benefit is that research on this treatment method is not stagnant and is up-to-date, developing, and progressing; in other words, it is both dynamic and generative.
Contemporary Jurisprudence: Does the use of stem cells entail harms for the body?
Qadimi: It can be said yes, this treatment method, like any other treatment method, is not free of flaws. Medically, one of these dangers is the issue of transplant rejection. In cases where the stem cell is taken from a foreign person, the probability of its rejection by the body or its infection exists. On the other hand, since these cells have extraordinary proliferation capability, the probability of tumor emergence also exists in this method.
From an ethical perspective, collecting stem cells from a human embryo sometimes takes place secretly and without the patient’s knowledge, and this matter entails ethical and even legal challenges.
From a social aspect, this treatment method has a high cost, and it might be said that the majority of society cannot have the power, ability, and access to it, and this very matter entails a feeling of discrimination and injustice in them.
Economically, numerous illegal and high-profit businesses form around this method, which is considered a type of harm and must be guarded against.