Ethical challenges for using human cells in clinical cell therapy

In this chapter, different challenges for using human cells in clinical cell therapy are identified and discussed. Several types of challenges are defined and described, with particular attention to the relation between ethical and scientific challenges. Some challenges are cell and disease specific: they are raised by research on special types of cells with certain methods in order to pave the way for cell therapies of particular diseases. But since scientific work is carried out in a societal and value-loaded context, the relations between scientific, ethical, and regulatory challenges are complex. Three theses are first discussed: there is not one fixed list of ethical challenges, some challenges are disease and cell type specific; there are challenges at all stages of the translation from bench to bedside, and the challenges are related to the various stages of translation. Moreover, experimental and ethical research needs to be integrated. Finally, a fourth thesis is suggested: if a constructive and well-argued position is desired, it is necessary to be specific not only about the scientific details but also about the value premises. Everybody is for justice, integrity, and respect for persons. But what precisely does this mean when it is applied to the choices scientists and regulators have to face in their daily work?