The intense research on stem cells has led to considerable potential advantages and we have actually shown that intense ethical debate leads to even more innovation. In fact that necessity is the mother of invention has never been so true

Were it not for an intensive activity on the part of scientists to try to bypass the use of embryonic stem cells, the induced stem cell would probably not have been discovered. What this means is that we are now using adult cells and inducing them to become stem cells without passing them through a growth stage where they form embryos.

But this has led to a different kind of thinking as well. Rather than seeking cure for diseases as was commonly spoken of when discussing this technology – for example injecting stem cells into the nervous system to create new tissue which replaces pathological ones and thus curing conditions like Parkinson’s Disease and other – Scientific American (March 2011) now summarises what the drug community has been waiting for a long time.

Instead of trying to cure diseases by stem cells, we can take cells of sick people themselves, providing they give their consent – and use these cells to experiment on drugs. Traditionally researchers look for drugs and these have to go through intensive drug trials before they can be made available. There are several phases of trials, including testing them on a small number of healthy volunteers, then testing them on a larger group of patients with the condition the drug is supposed to target and later, when researchers are ready to test it against a placebo or against the available treatment we go to the double-blind control study where the drug is given to patients and neither they nor the treating physician would know which drug they are receiving/administering – the drug being researched or the traditional drug.

Of course this whole process involves a considerable amount of patients and money. To recruit patients for research on drugs one has to go through thorough processes of informed consent and recruit people who are proficient in doing this process, especially for vulnerable groups such as children, elderly or those with special conditions. If this kind of research can be done in the laboratory instead of on patients it would save researchers and people a lot of time and sacrifice.

What is done is that patients suffering from a condition donate small biopsies of their skin. A group of patients with ALS – a motor neuron disease which causes considerable distress and paralysis – was studied. These cells have foreign genes injected into them to induce them to become stem cells which grow as a clump – much like an embryo does. It is not an embryo however. Signalling molecules are then used to induce these cells to develop into the type of tissue the research wants. In this case, since ALS is a nervous system disorder, they are induced to develop into nerve cells. The crux is here – since these cells were obtained from patients with ALS, the cultured cells will have the characteristics of the disease. From this culture, several are then developed.

New drugs are therefore tested on these cultures. Robots can be used for expediency and several drugs can be tested on different cultures – all obtained from the same tissue samples. Those with promising results are taken and several tests can then be directed to them alone. One can imagine the time and money, not to mention the use of animals and then humans, which one bypasses in this way.

It is not to say that at the end of the day a trial on humans will not be carried out before the drug is marketed. But one saves an immense amount of energy and danger of initial phases – especially when one has to go through this phase hundreds of times for different drugs being tested.

For patients this is, as always, a race against time. But if successful, it will make everyone a winner. It proves once again that science is not the enemy, as in the face of controversy, not only does it look for new less problematic methods, but can generate new ides in the process. For ethicists it is a win-win situation as well as it has shown that ethical input does produce good result. Ethics is not there to stop research but to direct it in ways which are morally acceptable. The efforts of working together have begun to pay off.

Pierre Mallia is Associate Professor in Family Medicine, Patients’ Rights and Bioethics at the University of Malta; he is also Ethics Advisor to the Medical Council of Malta. He is also former president of the Malta College of

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