Letteratura scientifica selezionata sul tema "United States. Bureau of Insular Affairs. Library"

The World Trade Center Attack or 9/11 tragedy has awakened the international community, particularly the United States (US) to sharpen its foreign policy in facing security threats coming from ‘weak states’. One of the most prominent weak states examples that pose a grave threat to other countries are the Northern Triangle Countries of Central America that referred to Guatemala, Honduras, and El Salvador. Hence, this paper will discuss the rationale behind US initiatives in dealing with security threats in El Salvador as one of the Northern Triangle Countries. In analyzing the case, the writers will use the weak state concept and national interest concept. The result of this paper finds that El Salvador corresponds to the elements of a weak state and further poses security threats by giving rise to transnational criminal organizations, drug trafficking, and migrant problems in which overcoming those security threats has become US vital national interest. However, we also find that although decreasing security threats and strengthening El Salvador government capacity is highly correlated, strengthening El Salvador governance through the providence of aid and assistance is actually classified as US important national interest. Keywords: Security threats; Northern Triangle; weak state; El Salvador; national interest REFERENCES Ambrus, Steven. “Guatemala: The Crisis of Rule of Law and a Weak Party System.” Ideas Matter, January 28, 2019. https://blogs.iadb.org/ideas-matter/en/guatemala-the-crisis-of-rule-of-law-and-a-weak-party-system/. Andrade, Laura. Transparency In El Salvador. 1st ed. 1. El Salvador: University Institute for Public Opinion, Asmann, Parker. “El Salvador Citizens Say Gangs, Not Government 'Rule' the Country.” InSight Crime, August 19, 2020. https://insightcrime.org/news/brief/el-salvador-citizens-say-gangs-not- government-rules-country/. Accessed July 11, 2021. Art, Robert J. A. Grand Strategy for America. Ithaca: Century Foundation/Cornell UP, 2004. BBC News Indonesia "Kisah Di Balik MS-13, Salah Satu Geng Jalanan Paling Brutal Di Dunia." BBC News Indonesia. BBC, April 21, 2017.https://www.bbc.com/indonesia/majalah-39663817.Accessed July 11, 2021. Bureau of Western Hemisphere Affairs “U.S. Relations With El Salvador - United States Department of State.” U.S. Department of State. U.S. Department of State, April 14, 2021.https://www.state.gov/u-s-relations-with-el-salvador/. Accessed July 11, 2021. “Bureau of International Narcotics and Law ENFORCEMENT Affairs: El Salvador Summary -United States Department of State.” U.S. Department of State. U.S. Department of State, February3, 2021. https://www.state.gov/bureau-of-international-narcotics-and-law-enforcement-affairs-work-by-country/el-salvador-summary/. Central Intelligence Agency. Central Intelligence Agency, July 6, 2021. https://www.cia.gov/the-world-factbook/countries/el-salvador/. Accessed July 11, 2021. Dudley, Steven, and Avalos, Silva “MS13 In the Americas: How the World’s Most Notorious Gang Defies Logic, Resists Destruction. National Institute of Justice”, 2018. “El Salvador Homicides Jump 56 Percent as Gang Truce Unravels.” Reuters, December 30,2014.https://www.reuters.com/article/us-el-salvador-violence-idUSKBN0K81HR20141230. Eizenstat, Stuart E., John Edward Porter, and Jeremy M. Weinstein. “Rebuilding Weak States.”Foreign Affairs 84, no. 1 (2005): 134. https://doi.org/10.2307/20034213. FOXBusiness. “How MS-13, One of America's Most Dangerous Gangs, Is Funded.” Fox Business.Fox Business, April 19, 2017.https://www.foxbusiness.com/features/how-ms-13-one-of-americas-most-dangerous-gangs-is-funded. Accessed July 11, 2021. Fukuyama, Francis.Cornell University Press. Ithaca, USA: Cornell University Press, 2004. Galdamez, Eddie. “Water Pollution in El Salvador. Getting Worse Every Year.” El Salvador INFO,June 30, 2021. https://elsalvadorinfo.net/water-pollution-in-el-salvador/. Accessed July 11, 2021. Gies, Heather. “Once Lush, El Salvador Is Dangerously Close to Running out of Water.” Environment. National Geographic, May 4, 2021.https://www.nationalgeographic.com/environment/article/el-salvador-water-crisis-drought-climate-change. Accessed July 11, 2021. Giedraityte, Ieva. “Empire, Leadership OR Hegemony: US Strategies towards the Northern Triangle Countries in the 21st Century.” Latin American Yearbook – Political Science and International Relations 7 (2019): 175. https://doi.org/10.17951/al.2019.7.175-192. “Government Revenues.” Government Revenues - Countries - List. Accessed August 4, 2021.https://tradingeconomics.com/country-list/government-revenues. “Guatemala: An Assessment of Poverty.” Poverty Analysis - Guatemala: An Assessment of Poverty. Accessed August 4, 2021. https://web.archive.org/web/20161225194831/http://web.worldbank.org/WBSITE/EXTERNAL/ TOPICS/EXTPOVERTY/EXTPA/0,,contentMDK:20207581~menuPK:443285~pagePK:148956~piPK:216618~theSitePK:430367,00.html. Herningtyas, Ratih. "Weak State As A Security Threat: A Case Study Of Colombia." Journal of International Relations 2, no. 2 (2014): 146-156. “Honduras.” World Bank. Accessed August 4, 2021. https://www.worldbank.org/en/country/honduras#:~:text=Honduras%20is%20a%20low%20middle,than%20US%241.90%20per%20day. Iesue, Laura. “The Alliance for Prosperity Plan: A Failed Effort for Stemming Migration,” COHA, November 21, 2019, https://www.coha.org/the-alliance-for-prosperity-plan-a-failed-effort-for-stemming-migration/. Accessed July 11, 2021 Indexmundi. “Countries Ranked by Intentional Homicides (per 100,000 People)." Countries ranked by Intentional homicides (per 100,000 people), n.d.,https://www.indexmundi.com/facts/indicators/VC.IHR.PSRC.P5/rankings. Accessed July 11,2021. Insight Crime. “Central America Regional Security Initiative (CARSI)." InSight Crime, October 18,2011, https://insightcrime.org/uncategorized/central-america-regional-security-initiative/. Accessed July 11, 2021 “Income Held by Top 20 Percent in El Salvador.” Statista, July 5, 2021.https://www.statista.com/statistics/1075313/el-salvador-income-inequality/. International Monetary Fund. “El Salvador: Selected Issues.” IMF Staff Country Reports 16, no. 206 (2016): 1. https://doi.org/10.5089/9781498342346.002. Interpol "El Salvador." El Salvador, n.d.,https://www.interpol.int/en/Who-we-are/Member-countries/Americas/EL-SALVADOR. Accessed July 11, 2021. “Key Issues AFFECTING Youth in El Salvador - OCDE.” Key Issues affecting Youth in El Salvador - OCDE. Accessed August 8, 2021.https://www.oecd.org/fr/pays/elsalvador/youth-issues-in-el-salvador.htm. Lakhani, Nina. “Gang Violence in El Salvador Fuelling Country's Child Migration Crisis.” The Guardian. Guardian News and Media, November 18, 2014.https://www.theguardian.com/world/2014/nov/18/el-salvador-gang-violence-child-migration-crisis. Accessed July 11, 2021. “Life under Gang Rule in El Salvador.” Crisis Group, December 10, 2018. https://www.crisisgroup.org/latin-america-caribbean/central-america/el-salvador/life-under-gang-rule-el-salvador. Löwenheim, Oded. “Transnational Criminal Organizations and Security: The Case against Inflating the Threat.” International Journal 57, no. 4 (2002): 513–36. https://doi.org/10.2307/40203690. “Mano Dura: El Salvador Responds to Gangs.” Taylor & Francis. Accessed August 5, 2021.https://www.tandfonline.com/doi/abs/10.1080/09614520701628121?journalCode=cdip20.Menjivar, Cecilia, and Andrea Gomez Cervates. “El Salvador: Civil War, Natural Disasters, and Gang Violence Drive Migration.” migrationpolicy.org, May 11, 2021.https://www.migrationpolicy.org/article/el-salvador-civil-war-natural-disasters-and-gang-violence-drive-migration. Accessed July 11, 2021. Meyer, Peter J., and Ribando Clare Seelke. Central America Regional Security Initiative: Background and Policy Issues for Congress. Washington, D.C.: Library of Congress, Congressional Research Service, 2014. Michaels, Peter S. Lawless Intervention: United States Foreign Policy in El Salvador and Nicaragua, 6, 7, no. 2 (January 5, 1987). https://doi.org/https://core.ac.uk/download/pdf/71463263.pdf. OSAC. “El Salvador 2020 Crime & Safety Report,” https://www.osac.gov/Content/Report/b4884604- 977e-49c7-9e4a-1855725d032e. Days on July 9, 2021. “Overview.” World Bank. Accessed August 4, 2021. https://www.worldbank.org/en/country/elsalvador/overview. Patrick, Stewart. “Weak States and Global Threats: Assessing Evidence of Spillovers.” SSRN Electronic Journal, 2006, 1–31. https://doi.org/10.2139/ssrn.984057. Published by Teresa Romero, and Jul 5. “Gini Coefficient: Wealth Inequality in El Salvador.” Statista,July 5, 2021.https://www.statista.com/statistics/983230/income-distribution-gini-coefficient-el-salvador/. “Remarks by President Obama after Meeting with Central American Presidents.” National Archives and Records Administration. National Archives and Records Administration. Accessed August 8, 2021. https://obamawhitehouse.archives.gov/the-press-office/2014/07/25/remarks-president-obama-after-meeting-central-american-presidents. Riney, Lt Col Thomas J. “How Is MS-13 a Threat to US National Security? .” AIR WAR COLLEGE AIR UNIVERSITY , February 12, 2009. https://apps.dtic.mil/sti/pdfs/ADA540139.pdf. Rivera, Mauricio. “Drugs, Crime, and NONSTATE Actors in Latin America: Latin American Politics and Society.” Cambridge Core. Cambridge University Press, October 12, 2020. https://www.cambridge.org/core/journals/latin-american-politics-and-society/article/abs/drugs-crime-and-nonstate-actors-in-latin-america/67CF0B66AB8673D0C50F2F99AC93A1B7. Schneider, Mark. “Where Are the Northern Triangle Countries Headed? And What Is U.S. Policy?” Center for Strategic and International Studies (CSIS), July 9, 2021. https://www.csis.org/analysis/where-are-northern-triangle-countries-headed-and-what-us-policy. Seelke, Clare Ribando. “CRS Report for Congress.” El Salvador: Political, Economic, and Social Conditions and U.S. Relations, November 18, 2008. https://doi.org/https://www.refworld.org/pdfid/4951ec75e.pdf. Silva Avalos, Hector. “Corruption in El Salvador: Politicians, Police, and Transportistas.” SSRN, April 2, 2014. https://papers.ssrn.com/sol3/papers.cfm?abstract_id=2419174. Sleinan, Julett Pineda. “Salvadoran Court: Ex-President and Wife Guilty of Illicit Enrichment.” OCCRP. Accessed August 5, 2021. https://www.occrp.org/en/daily/13586-salvadoran-court-ex- president-and-wife-guilty-of-illicit-enrichment. The United States Department of Justice. “MS-13's Highest-Ranking Leaders Charged with Terrorism Offenses in the United States.”, January 19, 2021. https://www.justice.gov/opa/pr/ms-13-s-highest-ranking-leaders-charged-terrorism-offenses-united-states. Retrieved July 9, 2021. Transformation Index. “BTI 2020 El Salvador Country Report.” BTI Blog, 2020. https://www.bti-project.org/en/reports/country-report-SLV.html. Accessed July 11, 2021. “U.S. Strategy for Engagement in Central America Results Architecture – Overall Summary.”State.gov. Accessed August 8, 2021. https://www.state.gov/wp-content/uploads/2019/04/U.S.-Central-America-Strategy-Objectives.pdf. United Nations High Commissioner for Refugees. “Death Threats and Gang Violence Forcing More Families to FLEE Northern Central America – UNHCR and Unicef Survey.” UNHCR. Accessed August 5, 2021. https://www.unhcr.org/news/press/2020/12/5fdb14ff4/death-threats-gang-violence-forcing-families-flee-northern-central-america.html. U.S. Department of Homeland Security, “Combating Gangs,” https://www.ice.gov/features/gangs.Diakses pada 9 Juli 2021. USAID, “GENERATING HOPE: USAID IN EL SALVADOR, GUATEMALA, AND HONDURAS,”https://www.usaid.gov/generating-hope-usaid-el-salvador-guatemala-and honduras. Diakses pada 8 Juli 2021. United States General Accounting Office, “EL SALVADOR Military Assistance Has Helped Counter but Not Overcome the Insurgency,” https://www.gao.gov/assets/nsiad-91-166.pdf. Retrieved July 8, 2021. U.S. Immigration and Customs Enforcement “Combating Gangs.”, January 27, 2021. https://www.ice.gov/features/gangs. Accessed July 9, 2021. Valencia, Robert. “MS-13 and Barrio 18 Gangs Allegedly Employ More People in El Salvador than the Country's Largest Employers.” Newsweek. Newsweek, November 2, 2018.https://www.newsweek.com/ms-13-barrio-18-gangs-employ-more-people-el-salvador-largest-employers-1200029. Accessed July 11, 2021 Wang, Shaoguang. "China's Changing of the Guard: The Problem of State Weakness." Journal of Democracy 14, no. 1 (2003): 36-42. doi:10.1353/jod.2003.0022. Weber, Max. “Economy and society: An outline of interpretive sociology. Vol. 1. Univ of California Press, 1978. Welsh, Teresa. “US to Resume Northern Triangle Aid, Pompeo Says.” devex, 2019.https://www.devex.com/news/us-to-resume-northern-triangle-aid-pompeo-says-95846. Whelan, Robbie. “Why Are People Fleeing Central America? A New Breed of Gangs Is Taking Over.” The Wall Street Journal. Dow Jones & Company, November 2, 2018. https://www.wsj.com/articles/pay-or-die-extortion-economy-drives-latin-americas-murder-crisis-1541167619. Retrieved July 8, 2021. Williams, Phil. "Transnational criminal enterprises, conflict, and instability." Turbulent Peace: The challenges of managing international conflict (2001): 97-112. World Bank. “Overview.” World Bank, October 9, 2020.https://www.worldbank.org/en/country/elsalvador/overview. Retrieved July 8, 2021.

Image 1: “Oklahoma State Highway Re-imagined.” CC BY-SA 4.0 2015 by author, using Wikimedia image by Ks0stm (CC BY-SA 3 2013). Introduction This article is divided in three major parts. First a scenario, second its context, and third, an analysis. The text draws on ethnographic research on security practices in the United States among police and parts of the intelligence community from 2006 through to the beginning of 2014. Real names are used when the material is drawn from archival sources, while individuals who were interviewed during fieldwork are referred to by their position rank or title. For matters of fact not otherwise referenced, see the sources compiled on “The Complete 911 Timeline” at History Commons. First, a scenario. Oklahoma, 2001 It is 1 April 2001, in far western Oklahoma, warm beneath the late afternoon sun. Highway Patrol Trooper C.L. Parkins is about 80 kilometres from the border of Texas, watching trucks and cars speed along Interstate 40. The speed limit is around 110 kilometres per hour, and just then, his radar clocks a blue Toyota Corolla going 135 kph. The driver is not wearing a seatbelt. Trooper Parkins swung in behind the vehicle, and after a while signalled that the car should pull over. The driver was dark-haired and short; in Parkins’s memory, he spoke English without any problem. He asked the man to come sit in the patrol car while he did a series of routine checks—to see if the vehicle was stolen, if there were warrants out for his arrest, if his license was valid. Parkins said, “I visited with him a little bit but I just barely remember even having him in my car. You stop so many people that if […] you don't arrest them or anything […] you don't remember too much after a couple months” (Clay and Ellis). Nawaf Al Hazmi had a valid California driver’s license, with an address in San Diego, and the car’s registration had been legally transferred to him by his former roommate. Parkins’s inquiries to the National Crime Information Center returned no warnings, nor did anything seem odd in their interaction. So the officer wrote Al Hazmi two tickets totalling $138, one for speeding and one for failure to use a seat belt, and told him to be on his way. Al Hazmi, for his part, was crossing the country to a new apartment in a Virginia suburb of Washington, DC, and upon arrival he mailed the payment for his tickets to the county court clerk in Oklahoma. Over the next five months, he lived several places on the East Coast: going to the gym, making routine purchases, and taking a few trips that included Las Vegas and Florida. He had a couple more encounters with local law enforcement and these too were unremarkable. On 1 May 2001 he was mugged, and promptly notified the police, who documented the incident with his name and local address (Federal Bureau of Investigation, 139). At the end of June, having moved to New Jersey, he was involved in a minor traffic accident on the George Washington Bridge, and officers again recorded his real name and details of the incident. In July, Khalid Al Mihdhar, the previous owner of the car, returned from abroad, and joined Al Hazmi in New Jersey. The two were boyhood friends, and they went together to a library several times to look up travel information, and then, with Al Hazmi’s younger brother Selem, to book their final flight. On 11 September, the three boarded American Airlines flight 77 as part of the Al Qaeda team that flew the mid-sized jet into the west façade of the Pentagon. They died along with the piloting hijacker, all the passengers, and 125 people on the ground. Theirs was one of four airplanes hijacked that day, one of which was crashed by passengers, the others into significant sites of American power, by men who had been living for varying lengths of time all but unnoticed in the United States. No one thought that Trooper Parkins, or the other officers with whom the 9/11 hijackers crossed paths, should have acted differently. The Commissioner of the Oklahoma Department of Public Safety himself commented that the trooper “did the right thing” at that April traffic stop. And yet, interviewed by a local newspaper in January of 2002, Parkins mused to the reporter “it's difficult sometimes to think back and go: 'What if you had known something else?'" (Clay and Ellis). Missed Opportunities Image 2: “Hijackers Timeline (Redacted).” CC BY-SA 4.0 2015 by author, using the Federal Bureau of Investigation (FBI)’s “Working Draft Chronology of Events for Hijackers and Associates”. In fact, several of the men who would become the 9/11 hijackers were stopped for minor traffic violations. Mohamed Atta, usually pointed to as the ringleader, was given a citation in Florida that spring of 2001 for driving without a license. When he missed his court date, a bench warrant was issued (Wall Street Journal). Perhaps the warrant was not flagged properly, however, since nothing happened when he was pulled over again, for speeding. In the government inquiries that followed attack, and in the press, these brushes with the law were “missed opportunities” to thwart the 9/11 plot (Kean and Hamilton, Report 353). Among a certain set of career law enforcement personnel, particularly those active in management and police associations, these missed opportunities were fraught with a sense of personal failure. Yet, in short order, they were to become a source of professional revelation. The scenarios—Trooper Parkins and Al Hazmi, other encounters in other states, the general fact that there had been chance meetings between police officers and the hijackers—were re-imagined in the aftermath of 9/11. Those moments were returned to and reversed, so that multiple potentialities could be seen, beyond or in addition to what had taken place. The deputy director of an intelligence fusion centre told me in an interview, “it is always a local cop who saw something” and he replayed how the incidents of contact had unfolded with the men. These scenarios offered a way to recapture the past. In the uncertainty of every encounter, whether a traffic stop or questioning someone taking photos of a landmark (and potential terrorist target), was also potential. Through a process of re-imagining, police encounters with the public became part of the government’s “national intelligence” strategy. Previously a division had been marked between foreign and domestic intelligence. While the phrase “national intelligence” had long been used, notably in National Intelligence Estimates, after 9/11 it became more significant. The overall director of the US intelligence community became the Director National Intelligence, for instance, and the cohesive term marked the way that increasingly diverse institutional components, types of data and forms of action were evolving to address the collection of data and intelligence production (McConnell). In a series of working groups mobilised by members of major police professional organisations, and funded by the US Department of Justice, career officers and representatives from federal agencies produced detailed recommendations and plans for involving police in the new Information Sharing Environment. Among the plans drawn up during this period was what would eventually come to be the Nationwide Suspicious Activity Reporting Initiative, built principally around the idea of encounters such as the one between Parkins and Al Hazmi. Map 1: Map of pilot sites in the Nationwide Suspicious Activity Reporting Evaluation Environment in 2010 (courtesy of the author; no longer available online). Map 2: Map of participating sites in the Nationwide Suspicious Activity Reporting Initiative, as of 2014. In an interview, a fusion centre director who participated in this planning as well as its implementation, told me that his thought had been, “if we train state and local cops to understand pre-terrorism indicators, if we train them to be more curious, and to question more what they see,” this could feed into “a system where they could actually get that information to somebody where it matters.” In devising the reporting initiative, the working groups counter-actualised the scenarios of those encounters, and the kinds of larger plots to which they were understood to belong, in order to extract a set of concepts: categories of suspicious “activities” or “patterns of behaviour” corresponding to the phases of a terrorism event in the process of becoming (Deleuze, Negotiations). This conceptualisation of terrorism was standardised, so that it could be taught, and applied, in discerning and documenting the incidents comprising an event’s phases. In police officer training, the various suspicious behaviours were called “terrorism precursor activities” and were divided between criminal and non-criminal. “Functional Standards,” developed by the Los Angeles Police Department and then tested by the Department of Homeland Security (DHS), served to code the observed behaviours for sharing (via compatible communication protocols) up the federal hierarchy and also horizontally between states and regions. In the popular parlance of videos made for the public by local police departments and DHS, which would come to populate the internet within a few years, these categories were “signs of terrorism,” more specifically: surveillance, eliciting information, testing security, and so on. Image 3: “The Seven Signs of Terrorism (sometimes eight).” CC BY-SA 4.0 2015 by author, using materials in the public domain. If the problem of 9/11 had been that the men who would become hijackers had gone unnoticed, the basic idea of the Suspicious Activity Reporting Initiative was to create a mechanism through which the eyes and ears of everyone could contribute to their detection. In this vein, “If You See Something, Say Something™” was a campaign that originated with the New York City Metropolitan Transportation Authority, and was then licensed for use to DHS. The tips and leads such campaigns generated, together with the reports from officers on suspicious incidents that might have to do with terrorism, were coordinated in the Information Sharing Environment. Drawing on reports thus generated, the Federal Government would, in theory, communicate timely information on security threats to law enforcement so that they would be better able to discern the incidents to be reported. The cycle aimed to catch events in emergence, in a distinctively anticipatory strategy of counterterrorism (Stalcup). Re-imagination A curious fact emerges from this history, and it is key to understanding how this initiative developed. That is, there was nothing suspicious in the encounters. The soon-to-be terrorists’ licenses were up-to-date, the cars were legal, they were not nervous. Even Mohamed Atta’s warrant would have resulted in nothing more than a fine. It is not self-evident, given these facts, how a governmental technology came to be designed from these scenarios. How––if nothing seemed of immediate concern, if there had been nothing suspicious to discern––did an intelligence strategy come to be assembled around such encounters? Evidently, strident demands were made after the events of 9/11 to know, “what went wrong?” Policies were crafted and implemented according to the answers given: it was too easy to obtain identification, or to enter and stay in the country, or to buy airplane tickets and fly. But the trooper’s question, the reader will recall, was somewhat different. He had said, “It’s difficult sometimes to think back and go: ‘What if you had known something else?’” To ask “what if you had known something else?” is also to ask what else might have been. Janet Roitman shows that identifying a crisis tends to implicate precisely the question of what went wrong. Crisis, and its critique, take up history as a series of right and wrong turns, bad choices made between existing dichotomies (90): liberty-security, security-privacy, ordinary-suspicious. It is to say, what were the possibilities and how could we have selected the correct one? Such questions seek to retrospectively uncover latencies—systemic or structural, human error or a moral lapse (71)—but they ask of those latencies what false understanding of the enemy, of threat, of priorities, allowed a terrible thing to happen. “What if…?” instead turns to the virtuality hidden in history, through which missed opportunities can be re-imagined. Image 4: “The Cholmondeley Sisters and Their Swaddled Babies.” Anonymous, c. 1600-1610 (British School, 17th century); Deleuze and Parnet (150). CC BY-SA 4.0 2015 by author, using materials in the public domain. Gilles Deleuze, speaking with Claire Parnet, says, “memory is not an actual image which forms after the object has been perceived, but a virtual image coexisting with the actual perception of the object” (150). Re-imagined scenarios take up the potential of memory, so that as the trooper’s traffic stop was revisited, it also became a way of imagining what else might have been. As Immanuel Kant, among others, points out, “the productive power of imagination is […] not exactly creative, for it is not capable of producing a sense representation that was never given to our faculty of sense; one can always furnish evidence of the material of its ideas” (61). The “memory” of these encounters provided the material for re-imagining them, and thereby re-virtualising history. This was different than other governmental responses, such as examining past events in order to assess the probable risk of their repetition, or drawing on past events to imagine future scenarios, for use in exercises that identify vulnerabilities and remedy deficiencies (Anderson). Re-imagining scenarios of police-hijacker encounters through the question of “what if?” evoked what Erin Manning calls “a certain array of recognizable elastic points” (39), through which options for other movements were invented. The Suspicious Activity Reporting Initiative’s architects instrumentalised such moments as they designed new governmental entities and programs to anticipate terrorism. For each element of the encounter, an aspect of the initiative was developed: training, functional standards, a way to (hypothetically) get real-time information about threats. Suspicion was identified as a key affect, one which, if cultivated, could offer a way to effectively deal not with binary right or wrong possibilities, but with the potential which lies nestled in uncertainty. The “signs of terrorism” (that is, categories of “terrorism precursor activities”) served to maximise receptivity to encounters. Indeed, it can apparently create an oversensitivity, manifested, for example, in police surveillance of innocent people exercising their right to assemble (Madigan), or the confiscation of photographers’s equipment (Simon). “What went wrong?” and “what if?” were different interrogations of the same pre-9/11 incidents. The questions are of course intimately related. Moments where something went wrong are when one is likely to ask, what else might have been known? Moreover, what else might have been? The answers to each question informed and shaped the other, as re-imagined scenarios became the means of extracting categories of suspicious activities and patterns of behaviour that comprise the phases of an event in becoming. Conclusion The 9/11 Commission, after two years of investigation into the causes of the disastrous day, reported that “the most important failure was one of imagination” (Kean and Hamilton, Summary). The iconic images of 9/11––such as airplanes being flown into symbols of American power––already existed, in guises ranging from fictive thrillers to the infamous FBI field memo sent to headquarters on Arab men learning to fly, but not land. In 1974 there had already been an actual (failed) attempt to steal a plane and kill the president by crashing it into the White House (Kean and Hamilton, Report Ch11 n21). The threats had been imagined, as Pat O’Malley and Philip Bougen put it, but not how to govern them, and because the ways to address those threats had been not imagined, they were discounted as matters for intervention (29). O’Malley and Bougen argue that one effect of 9/11, and the general rise of incalculable insecurities, was to make it necessary for the “merely imaginable” to become governable. Images of threats from the mundane to the extreme had to be conjured, and then imagination applied again, to devise ways to render them amenable to calculation, minimisation or elimination. In the words of the 9/11 Commission, the Government must bureaucratise imagination. There is a sense in which this led to more of the same. Re-imagining the early encounters reinforced expectations for officers to do what they already do, that is, to be on the lookout for suspicious behaviours. Yet, the images of threat brought forth, in their mixing of memory and an elastic “almost,” generated their own momentum and distinctive demands. Existing capacities, such as suspicion, were re-shaped and elaborated into specific forms of security governance. The question of “what if?” and the scenarios of police-hijacker encounter were particularly potent equipment for this re-imagining of history and its re-virtualisation. References Anderson, Ben. “Preemption, Precaution, Preparedness: Anticipatory Action and Future Geographies.” Progress in Human Geography 34.6 (2010): 777-98. Clay, Nolan, and Randy Ellis. “Terrorist Ticketed Last Year on I-40.” NewsOK, 20 Jan. 2002. 25 Nov. 2014 ‹http://newsok.com/article/2779124›. Deleuze, Gilles. Negotiations. New York: Columbia UP, 1995. Deleuze, Gilles, and Claire Parnet. Dialogues II. New York: Columbia UP 2007 [1977]. Federal Bureau of Investigation. “Hijackers Timeline (Redacted) Part 01 of 02.” Working Draft Chronology of Events for Hijackers and Associates. 2003. 18 Apr. 2014 ‹https://vault.fbi.gov/9-11%20Commission%20Report/9-11-chronology-part-01-of-02›. Kant, Immanuel. Anthropology from a Pragmatic Point of View. Trans. Robert B. Louden. Cambridge: Cambridge UP, 2006. Kean, Thomas H., and Lee Hamilton. Executive Summary of the 9/11 Commission Report: Final Report of the National Commission on Terrorist Attacks upon the United States. 25 Oct. 2015 ‹http://www.9-11commission.gov/report/911Report_Exec.htm›. Kean, Thomas H., and Lee Hamilton. The 9/11 Commission Report: Final Report of the National Commission on Terrorist Attacks upon the United States. New York: W.W. Norton, 2004. McConnell, Mike. “Overhauling Intelligence.” Foreign Affairs, July/Aug. 2007. Madigan, Nick. “Spying Uncovered.” Baltimore Sun 18 Jul. 2008. 25 Oct. 2015 ‹http://www.baltimoresun.com/news/maryland/bal-te.md.spy18jul18-story.html›. Manning, Erin. Relationscapes: Movement, Art, Philosophy. Cambridge, MA: MIT P, 2009. O’Malley, P., and P. Bougen. “Imaginable Insecurities: Imagination, Routinisation and the Government of Uncertainty post 9/11.” Imaginary Penalities. Ed. Pat Carlen. Cullompton, UK: Willan, 2008.Roitman, Janet. Anti-Crisis. Durham, NC: Duke UP, 2013. Simon, Stephanie. “Suspicious Encounters: Ordinary Preemption and the Securitization of Photography.” Security Dialogue 43.2 (2012): 157-73. Stalcup, Meg. “Policing Uncertainty: On Suspicious Activity Reporting.” Modes of Uncertainty: Anthropological Cases. Eds. Limor Saminian-Darash and Paul Rabinow. Chicago: U of Chicago P, 2015. 69-87. Wall Street Journal. “A Careful Sequence of Mundane Dealings Sows a Day of Bloody Terror for Hijackers.” 16 Oct. 2001.

Photo ID 158378414 © Eduard Muzhevskyi | Dreamstime.com ABSTRACT There is a debate about the ethical implications of using human embryos in stem cell research, which can be influenced by cultural, moral, and social values. This paper argues for an adaptable framework to accommodate diverse cultural and religious perspectives. By using an adaptive ethics model, research protections can reflect various populations and foster growth in stem cell research possibilities. INTRODUCTION Stem cell research combines biology, medicine, and technology, promising to alter health care and the understanding of human development. Yet, ethical contention exists because of individuals’ perceptions of using human embryos based on their various cultural, moral, and social values. While these disagreements concerning policy, use, and general acceptance have prompted the development of an international ethics policy, such a uniform approach can overlook the nuanced ethical landscapes between cultures. With diverse viewpoints in public health, a single global policy, especially one reflecting Western ethics or the ethics prevalent in high-income countries, is impractical. This paper argues for a culturally sensitive, adaptable framework for the use of embryonic stem cells. Stem cell policy should accommodate varying ethical viewpoints and promote an effective global dialogue. With an extension of an ethics model that can adapt to various cultures, we recommend localized guidelines that reflect the moral views of the people those guidelines serve. BACKGROUND Stem cells, characterized by their unique ability to differentiate into various cell types, enable the repair or replacement of damaged tissues. Two primary types of stem cells are somatic stem cells (adult stem cells) and embryonic stem cells. Adult stem cells exist in developed tissues and maintain the body’s repair processes.[1] Embryonic stem cells (ESC) are remarkably pluripotent or versatile, making them valuable in research.[2] However, the use of ESCs has sparked ethics debates. Considering the potential of embryonic stem cells, research guidelines are essential. The International Society for Stem Cell Research (ISSCR) provides international stem cell research guidelines. They call for “public conversations touching on the scientific significance as well as the societal and ethical issues raised by ESC research.”[3] The ISSCR also publishes updates about culturing human embryos 14 days post fertilization, suggesting local policies and regulations should continue to evolve as ESC research develops.[4] Like the ISSCR, which calls for local law and policy to adapt to developing stem cell research given cultural acceptance, this paper highlights the importance of local social factors such as religion and culture. I. Global Cultural Perspective of Embryonic Stem Cells Views on ESCs vary throughout the world. Some countries readily embrace stem cell research and therapies, while others have stricter regulations due to ethical concerns surrounding embryonic stem cells and when an embryo becomes entitled to moral consideration. The philosophical issue of when the “someone” begins to be a human after fertilization, in the morally relevant sense,[5] impacts when an embryo becomes not just worthy of protection but morally entitled to it. The process of creating embryonic stem cell lines involves the destruction of the embryos for research.[6] Consequently, global engagement in ESC research depends on social-cultural acceptability. a. US and Rights-Based Cultures In the United States, attitudes toward stem cell therapies are diverse. The ethics and social approaches, which value individualism,[7] trigger debates regarding the destruction of human embryos, creating a complex regulatory environment. For example, the 1996 Dickey-Wicker Amendment prohibited federal funding for the creation of embryos for research and the destruction of embryos for “more than allowed for research on fetuses in utero.”[8] Following suit, in 2001, the Bush Administration heavily restricted stem cell lines for research. However, the Stem Cell Research Enhancement Act of 2005 was proposed to help develop ESC research but was ultimately vetoed.[9] Under the Obama administration, in 2009, an executive order lifted restrictions allowing for more development in this field.[10] The flux of research capacity and funding parallels the different cultural perceptions of human dignity of the embryo and how it is socially presented within the country’s research culture.[11] b. Ubuntu and Collective Cultures African bioethics differs from Western individualism because of the different traditions and values. African traditions, as described by individuals from South Africa and supported by some studies in other African countries, including Ghana and Kenya, follow the African moral philosophies of Ubuntu or Botho and Ukama, which “advocates for a form of wholeness that comes through one’s relationship and connectedness with other people in the society,”[12] making autonomy a socially collective concept. In this context, for the community to act autonomously, individuals would come together to decide what is best for the collective. Thus, stem cell research would require examining the value of the research to society as a whole and the use of the embryos as a collective societal resource. If society views the source as part of the collective whole, and opposes using stem cells, compromising the cultural values to pursue research may cause social detachment and stunt research growth.[13] Based on local culture and moral philosophy, the permissibility of stem cell research depends on how embryo, stem cell, and cell line therapies relate to the community as a whole. Ubuntu is the expression of humanness, with the person’s identity drawn from the “’I am because we are’” value.[14] The decision in a collectivistic culture becomes one born of cultural context, and individual decisions give deference to others in the society. Consent differs in cultures where thought and moral philosophy are based on a collective paradigm. So, applying Western bioethical concepts is unrealistic. For one, Africa is a diverse continent with many countries with different belief systems, access to health care, and reliance on traditional or Western medicines. Where traditional medicine is the primary treatment, the “’restrictive focus on biomedically-related bioethics’” [is] problematic in African contexts because it neglects bioethical issues raised by traditional systems.”[15] No single approach applies in all areas or contexts. Rather than evaluating the permissibility of ESC research according to Western concepts such as the four principles approach, different ethics approaches should prevail. Another consideration is the socio-economic standing of countries. In parts of South Africa, researchers have not focused heavily on contributing to the stem cell discourse, either because it is not considered health care or a health science priority or because resources are unavailable.[16] Each country’s priorities differ given different social, political, and economic factors. In South Africa, for instance, areas such as maternal mortality, non-communicable diseases, telemedicine, and the strength of health systems need improvement and require more focus[17] Stem cell research could benefit the population, but it also could divert resources from basic medical care. Researchers in South Africa adhere to the National Health Act and Medicines Control Act in South Africa and international guidelines; however, the Act is not strictly enforced, and there is no clear legislation for research conduct or ethical guidelines.[18] Some parts of Africa condemn stem cell research. For example, 98.2 percent of the Tunisian population is Muslim.[19] Tunisia does not permit stem cell research because of moral conflict with a Fatwa. Religion heavily saturates the regulation and direction of research.[20] Stem cell use became permissible for reproductive purposes only recently, with tight restrictions preventing cells from being used in any research other than procedures concerning ART/IVF. Their use is conditioned on consent, and available only to married couples.[21] The community's receptiveness to stem cell research depends on including communitarian African ethics. c. Asia Some Asian countries also have a collective model of ethics and decision making.[22] In China, the ethics model promotes a sincere respect for life or human dignity,[23] based on protective medicine. This model, influenced by Traditional Chinese Medicine (TCM), [24] recognizes Qi as the vital energy delivered via the meridians of the body; it connects illness to body systems, the body’s entire constitution, and the universe for a holistic bond of nature, health, and quality of life.[25] Following a protective ethics model, and traditional customs of wholeness, investment in stem cell research is heavily desired for its applications in regenerative therapies, disease modeling, and protective medicines. In a survey of medical students and healthcare practitioners, 30.8 percent considered stem cell research morally unacceptable while 63.5 percent accepted medical research using human embryonic stem cells. Of these individuals, 89.9 percent supported increased funding for stem cell research.[26] The scientific community might not reflect the overall population. From 1997 to 2019, China spent a total of $576 million (USD) on stem cell research at 8,050 stem cell programs, increased published presence from 0.6 percent to 14.01 percent of total global stem cell publications as of 2014, and made significant strides in cell-based therapies for various medical conditions.[27] However, while China has made substantial investments in stem cell research and achieved notable progress in clinical applications, concerns linger regarding ethical oversight and transparency.[28] For example, the China Biosecurity Law, promoted by the National Health Commission and China Hospital Association, attempted to mitigate risks by introducing an institutional review board (IRB) in the regulatory bodies. 5800 IRBs registered with the Chinese Clinical Trial Registry since 2021.[29] However, issues still need to be addressed in implementing effective IRB review and approval procedures. The substantial government funding and focus on scientific advancement have sometimes overshadowed considerations of regional cultures, ethnic minorities, and individual perspectives, particularly evident during the one-child policy era. As government policy adapts to promote public stability, such as the change from the one-child to the two-child policy,[30] research ethics should also adapt to ensure respect for the values of its represented peoples. Japan is also relatively supportive of stem cell research and therapies. Japan has a more transparent regulatory framework, allowing for faster approval of regenerative medicine products, which has led to several advanced clinical trials and therapies.[31] South Korea is also actively engaged in stem cell research and has a history of breakthroughs in cloning and embryonic stem cells.[32] However, the field is controversial, and there are issues of scientific integrity. For example, the Korean FDA fast-tracked products for approval,[33] and in another instance, the oocyte source was unclear and possibly violated ethical standards.[34] Trust is important in research, as it builds collaborative foundations between colleagues, trial participant comfort, open-mindedness for complicated and sensitive discussions, and supports regulatory procedures for stakeholders. There is a need to respect the culture’s interest, engagement, and for research and clinical trials to be transparent and have ethical oversight to promote global research discourse and trust. d. Middle East Countries in the Middle East have varying degrees of acceptance of or restrictions to policies related to using embryonic stem cells due to cultural and religious influences. Saudi Arabia has made significant contributions to stem cell research, and conducts research based on international guidelines for ethical conduct and under strict adherence to guidelines in accordance with Islamic principles. Specifically, the Saudi government and people require ESC research to adhere to Sharia law. In addition to umbilical and placental stem cells,[35] Saudi Arabia permits the use of embryonic stem cells as long as they come from miscarriages, therapeutic abortions permissible by Sharia law, or are left over from in vitro fertilization and donated to research.[36] Laws and ethical guidelines for stem cell research allow the development of research institutions such as the King Abdullah International Medical Research Center, which has a cord blood bank and a stem cell registry with nearly 10,000 donors.[37] Such volume and acceptance are due to the ethical ‘permissibility’ of the donor sources, which do not conflict with religious pillars. However, some researchers err on the side of caution, choosing not to use embryos or fetal tissue as they feel it is unethical to do so.[38] Jordan has a positive research ethics culture.[39] However, there is a significant issue of lack of trust in researchers, with 45.23 percent (38.66 percent agreeing and 6.57 percent strongly agreeing) of Jordanians holding a low level of trust in researchers, compared to 81.34 percent of Jordanians agreeing that they feel safe to participate in a research trial.[40] Safety testifies to the feeling of confidence that adequate measures are in place to protect participants from harm, whereas trust in researchers could represent the confidence in researchers to act in the participants’ best interests, adhere to ethical guidelines, provide accurate information, and respect participants’ rights and dignity. One method to improve trust would be to address communication issues relevant to ESC. Legislation surrounding stem cell research has adopted specific language, especially concerning clarification “between ‘stem cells’ and ‘embryonic stem cells’” in translation.[41] Furthermore, legislation “mandates the creation of a national committee… laying out specific regulations for stem-cell banking in accordance with international standards.”[42] This broad regulation opens the door for future global engagement and maintains transparency. However, these regulations may also constrain the influence of research direction, pace, and accessibility of research outcomes. e. Europe In the European Union (EU), ethics is also principle-based, but the principles of autonomy, dignity, integrity, and vulnerability are interconnected.[43] As such, the opportunity for cohesion and concessions between individuals’ thoughts and ideals allows for a more adaptable ethics model due to the flexible principles that relate to the human experience The EU has put forth a framework in its Convention for the Protection of Human Rights and Dignity of the Human Being allowing member states to take different approaches. Each European state applies these principles to its specific conventions, leading to or reflecting different acceptance levels of stem cell research. [44] For example, in Germany, Lebenzusammenhang, or the coherence of life, references integrity in the unity of human culture. Namely, the personal sphere “should not be subject to external intervention.”[45] Stem cell interventions could affect this concept of bodily completeness, leading to heavy restrictions. Under the Grundgesetz, human dignity and the right to life with physical integrity are paramount.[46] The Embryo Protection Act of 1991 made producing cell lines illegal. Cell lines can be imported if approved by the Central Ethics Commission for Stem Cell Research only if they were derived before May 2007.[47] Stem cell research respects the integrity of life for the embryo with heavy specifications and intense oversight. This is vastly different in Finland, where the regulatory bodies find research more permissible in IVF excess, but only up to 14 days after fertilization.[48] Spain’s approach differs still, with a comprehensive regulatory framework.[49] Thus, research regulation can be culture-specific due to variations in applied principles. Diverse cultures call for various approaches to ethical permissibility.[50] Only an adaptive-deliberative model can address the cultural constructions of self and achieve positive, culturally sensitive stem cell research practices.[51] II. Religious Perspectives on ESC Embryonic stem cell sources are the main consideration within religious contexts. While individuals may not regard their own religious texts as authoritative or factual, religion can shape their foundations or perspectives. The Qur'an states: “And indeed We created man from a quintessence of clay. Then We placed within him a small quantity of nutfa (sperm to fertilize) in a safe place. Then We have fashioned the nutfa into an ‘alaqa (clinging clot or cell cluster), then We developed the ‘alaqa into mudgha (a lump of flesh), and We made mudgha into bones, and clothed the bones with flesh, then We brought it into being as a new creation. So Blessed is Allah, the Best of Creators.”[52] Many scholars of Islam estimate the time of soul installment, marked by the angel breathing in the soul to bring the individual into creation, as 120 days from conception.[53] Personhood begins at this point, and the value of life would prohibit research or experimentation that could harm the individual. If the fetus is more than 120 days old, the time ensoulment is interpreted to occur according to Islamic law, abortion is no longer permissible.[54] There are a few opposing opinions about early embryos in Islamic traditions. According to some Islamic theologians, there is no ensoulment of the early embryo, which is the source of stem cells for ESC research.[55] In Buddhism, the stance on stem cell research is not settled. The main tenets, the prohibition against harming or destroying others (ahimsa) and the pursuit of knowledge (prajña) and compassion (karuna), leave Buddhist scholars and communities divided.[56] Some scholars argue stem cell research is in accordance with the Buddhist tenet of seeking knowledge and ending human suffering. Others feel it violates the principle of not harming others. Finding the balance between these two points relies on the karmic burden of Buddhist morality. In trying to prevent ahimsa towards the embryo, Buddhist scholars suggest that to comply with Buddhist tenets, research cannot be done as the embryo has personhood at the moment of conception and would reincarnate immediately, harming the individual's ability to build their karmic burden.[57] On the other hand, the Bodhisattvas, those considered to be on the path to enlightenment or Nirvana, have given organs and flesh to others to help alleviate grieving and to benefit all.[58] Acceptance varies on applied beliefs and interpretations. Catholicism does not support embryonic stem cell research, as it entails creation or destruction of human embryos. This destruction conflicts with the belief in the sanctity of life. For example, in the Old Testament, Genesis describes humanity as being created in God’s image and multiplying on the Earth, referencing the sacred rights to human conception and the purpose of development and life. In the Ten Commandments, the tenet that one should not kill has numerous interpretations where killing could mean murder or shedding of the sanctity of life, demonstrating the high value of human personhood. In other books, the theological conception of when life begins is interpreted as in utero,[59] highlighting the inviolability of life and its formation in vivo to make a religious point for accepting such research as relatively limited, if at all.[60] The Vatican has released ethical directives to help apply a theological basis to modern-day conflicts. The Magisterium of the Church states that “unless there is a moral certainty of not causing harm,” experimentation on fetuses, fertilized cells, stem cells, or embryos constitutes a crime.[61] Such procedures would not respect the human person who exists at these stages, according to Catholicism. Damages to the embryo are considered gravely immoral and illicit.[62] Although the Catholic Church officially opposes abortion, surveys demonstrate that many Catholic people hold pro-choice views, whether due to the context of conception, stage of pregnancy, threat to the mother’s life, or for other reasons, demonstrating that practicing members can also accept some but not all tenets.[63] Some major Jewish denominations, such as the Reform, Conservative, and Reconstructionist movements, are open to supporting ESC use or research as long as it is for saving a life.[64] Within Judaism, the Talmud, or study, gives personhood to the child at birth and emphasizes that life does not begin at conception:[65] “If she is found pregnant, until the fortieth day it is mere fluid,”[66] Whereas most religions prioritize the status of human embryos, the Halakah (Jewish religious law) states that to save one life, most other religious laws can be ignored because it is in pursuit of preservation.[67] Stem cell research is accepted due to application of these religious laws. We recognize that all religions contain subsets and sects. The variety of environmental and cultural differences within religious groups requires further analysis to respect the flexibility of religious thoughts and practices. We make no presumptions that all cultures require notions of autonomy or morality as under the common morality theory, which asserts a set of universal moral norms that all individuals share provides moral reasoning and guides ethical decisions.[68] We only wish to show that the interaction with morality varies between cultures and countries. III. A Flexible Ethical Approach The plurality of different moral approaches described above demonstrates that there can be no universally acceptable uniform law for ESC on a global scale. Instead of developing one standard, flexible ethical applications must be continued. We recommend local guidelines that incorporate important cultural and ethical priorities. While the Declaration of Helsinki is more relevant to people in clinical trials receiving ESC products, in keeping with the tradition of protections for research subjects, consent of the donor is an ethical requirement for ESC donation in many jurisdictions including the US, Canada, and Europe.[69] The Declaration of Helsinki provides a reference point for regulatory standards and could potentially be used as a universal baseline for obtaining consent prior to gamete or embryo donation. For instance, in Columbia University’s egg donor program for stem cell research, donors followed standard screening protocols and “underwent counseling sessions that included information as to the purpose of oocyte donation for research, what the oocytes would be used for, the risks and benefits of donation, and process of oocyte stimulation” to ensure transparency for consent.[70] The program helped advance stem cell research and provided clear and safe research methods with paid participants. Though paid participation or covering costs of incidental expenses may not be socially acceptable in every culture or context,[71] and creating embryos for ESC research is illegal in many jurisdictions, Columbia’s program was effective because of the clear and honest communications with donors, IRBs, and related stakeholders. This example demonstrates that cultural acceptance of scientific research and of the idea that an egg or embryo does not have personhood is likely behind societal acceptance of donating eggs for ESC research. As noted, many countries do not permit the creation of embryos for research. Proper communication and education regarding the process and purpose of stem cell research may bolster comprehension and garner more acceptance. “Given the sensitive subject material, a complete consent process can support voluntary participation through trust, understanding, and ethical norms from the cultures and morals participants value. This can be hard for researchers entering countries of different socioeconomic stability, with different languages and different societal values.[72] An adequate moral foundation in medical ethics is derived from the cultural and religious basis that informs knowledge and actions.[73] Understanding local cultural and religious values and their impact on research could help researchers develop humility and promote inclusion. IV. Concerns Some may argue that if researchers all adhere to one ethics standard, protection will be satisfied across all borders, and the global public will trust researchers. However, defining what needs to be protected and how to define such research standards is very specific to the people to which standards are applied. We suggest that applying one uniform guide cannot accurately protect each individual because we all possess our own perceptions and interpretations of social values.[74] Therefore, the issue of not adjusting to the moral pluralism between peoples in applying one standard of ethics can be resolved by building out ethics models that can be adapted to different cultures and religions. Other concerns include medical tourism, which may promote health inequities.[75] Some countries may develop and approve products derived from ESC research before others, compromising research ethics or drug approval processes. There are also concerns about the sale of unauthorized stem cell treatments, for example, those without FDA approval in the United States. Countries with robust research infrastructures may be tempted to attract medical tourists, and some customers will have false hopes based on aggressive publicity of unproven treatments.[76] For example, in China, stem cell clinics can market to foreign clients who are not protected under the regulatory regimes. Companies employ a marketing strategy of “ethically friendly” therapies. Specifically, in the case of Beike, China’s leading stem cell tourism company and sprouting network, ethical oversight of administrators or health bureaus at one site has “the unintended consequence of shifting questionable activities to another node in Beike's diffuse network.”[77] In contrast, Jordan is aware of stem cell research’s potential abuse and its own status as a “health-care hub.” Jordan’s expanded regulations include preserving the interests of individuals in clinical trials and banning private companies from ESC research to preserve transparency and the integrity of research practices.[78] The social priorities of the community are also a concern. The ISSCR explicitly states that guidelines “should be periodically revised to accommodate scientific advances, new challenges, and evolving social priorities.”[79] The adaptable ethics model extends this consideration further by addressing whether research is warranted given the varying degrees of socioeconomic conditions, political stability, and healthcare accessibilities and limitations. An ethical approach would require discussion about resource allocation and appropriate distribution of funds.[80] CONCLUSION While some religions emphasize the sanctity of life from conception, which may lead to public opposition to ESC research, others encourage ESC research due to its potential for healing and alleviating human pain. Many countries have special regulations that balance local views on embryonic personhood, the benefits of research as individual or societal goods, and the protection of human research subjects. To foster understanding and constructive dialogue, global policy frameworks should prioritize the protection of universal human rights, transparency, and informed consent. In addition to these foundational global policies, we recommend tailoring local guidelines to reflect the diverse cultural and religious perspectives of the populations they govern. Ethics models should be adapted to local populations to effectively establish research protections, growth, and possibilities of stem cell research. For example, in countries with strong beliefs in the moral sanctity of embryos or heavy religious restrictions, an adaptive model can allow for discussion instead of immediate rejection. In countries with limited individual rights and voice in science policy, an adaptive model ensures cultural, moral, and religious views are taken into consideration, thereby building social inclusion. While this ethical consideration by the government may not give a complete voice to every individual, it will help balance policies and maintain the diverse perspectives of those it affects. Embracing an adaptive ethics model of ESC research promotes open-minded dialogue and respect for the importance of human belief and tradition. By actively engaging with cultural and religious values, researchers can better handle disagreements and promote ethical research practices that benefit each society. This brief exploration of the religious and cultural differences that impact ESC research reveals the nuances of relative ethics and highlights a need for local policymakers to apply a more intense adaptive model. - [1] Poliwoda, S., Noor, N., Downs, E., Schaaf, A., Cantwell, A., Ganti, L., Kaye, A. D., Mosel, L. I., Carroll, C. B., Viswanath, O., & Urits, I. (2022). Stem cells: a comprehensive review of origins and emerging clinical roles in medical practice. Orthopedic reviews, 14(3), 37498. https://doi.org/10.52965/001c.37498 [2] Poliwoda, S., Noor, N., Downs, E., Schaaf, A., Cantwell, A., Ganti, L., Kaye, A. D., Mosel, L. I., Carroll, C. B., Viswanath, O., & Urits, I. (2022). Stem cells: a comprehensive review of origins and emerging clinical roles in medical practice. Orthopedic reviews, 14(3), 37498. https://doi.org/10.52965/001c.37498 [3] International Society for Stem Cell Research. (2023). Laboratory-based human embryonic stem cell research, embryo research, and related research activities. International Society for Stem Cell Research. https://www.isscr.org/guidelines/blog-post-title-one-ed2td-6fcdk; Kimmelman, J., Hyun, I., Benvenisty, N. et al. Policy: Global standards for stem-cell research. Nature 533, 311–313 (2016). https://doi.org/10.1038/533311a [4] International Society for Stem Cell Research. (2023). Laboratory-based human embryonic stem cell research, embryo research, and related research activities. International Society for Stem Cell Research. https://www.isscr.org/guidelines/blog-post-title-one-ed2td-6fcdk [5] Concerning the moral philosophies of stem cell research, our paper does not posit a personal moral stance nor delve into the “when” of human life begins. To read further about the philosophical debate, consider the following sources: Sandel M. J. (2004). Embryo ethics--the moral logic of stem-cell research. The New England journal of medicine, 351(3), 207–209. https://doi.org/10.1056/NEJMp048145; George, R. P., & Lee, P. (2020, September 26). Acorns and Embryos. The New Atlantis. https://www.thenewatlantis.com/publications/acorns-and-embryos; Sagan, A., & Singer, P. (2007). The moral status of stem cells. Metaphilosophy, 38(2/3), 264–284. http://www.jstor.org/stable/24439776; McHugh P. R. (2004). Zygote and "clonote"--the ethical use of embryonic stem cells. The New England journal of medicine, 351(3), 209–211. https://doi.org/10.1056/NEJMp048147; Kurjak, A., & Tripalo, A. (2004). The facts and doubts about beginning of the human life and personality. Bosnian journal of basic medical sciences, 4(1), 5–14. https://doi.org/10.17305/bjbms.2004.3453 [6] Vazin, T., & Freed, W. J. (2010). Human embryonic stem cells: derivation, culture, and differentiation: a review. Restorative neurology and neuroscience, 28(4), 589–603. https://doi.org/10.3233/RNN-2010-0543 [7] Socially, at its core, the Western approach to ethics is widely principle-based, autonomy being one of the key factors to ensure a fundamental respect for persons within research. For information regarding autonomy in research, see: Department of Health, Education, and Welfare, & National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research (1978). The Belmont Report. Ethical principles and guidelines for the protection of human subjects of research.; For a more in-depth review of autonomy within the US, see: Beauchamp, T. L., & Childress, J. F. (1994). Principles of Biomedical Ethics. Oxford University Press. [8] Sherley v. Sebelius, 644 F.3d 388 (D.C. Cir. 2011), citing 45 C.F.R. 46.204(b) and [42 U.S.C. § 289g(b)]. https://www.cadc.uscourts.gov/internet/opinions.nsf/6c690438a9b43dd685257a64004ebf99/$file/11-5241-1391178.pdf [9] Stem Cell Research Enhancement Act of 2005, H. R. 810, 109th Cong. (2001). https://www.govtrack.us/congress/bills/109/hr810/text; Bush, G. W. (2006, July 19). Message to the House of Representatives. National Archives and Records Administration. https://georgewbush-whitehouse.archives.gov/news/releases/2006/07/20060719-5.html [10] National Archives and Records Administration. (2009, March 9). Executive order 13505 -- removing barriers to responsible scientific research involving human stem cells. National Archives and Records Administration. https://obamawhitehouse.archives.gov/the-press-office/removing-barriers-responsible-scientific-research-involving-human-stem-cells [11] Hurlbut, W. B. (2006). Science, Religion, and the Politics of Stem Cells. Social Research, 73(3), 819–834. http://www.jstor.org/stable/40971854 [12] Akpa-Inyang, Francis & Chima, Sylvester. (2021). South African traditional values and beliefs regarding informed consent and limitations of the principle of respect for autonomy in African communities: a cross-cultural qualitative study. BMC Medical Ethics. 22. 10.1186/s12910-021-00678-4. [13] Source for further reading: Tangwa G. B. (2007). Moral status of embryonic stem cells: perspective of an African villager. Bioethics, 21(8), 449–457. https://doi.org/10.1111/j.1467-8519.2007.00582.x , see also Mnisi, F. M. (2020). An African analysis based on ethics of Ubuntu - are human embryonic stem cell patents morally justifiable? African Insight, 49(4). [14] Jecker, N. S., & Atuire, C. (2021). Bioethics in Africa: A contextually enlightened analysis of three cases. Developing World Bioethics, 22(2), 112–122. https://doi.org/10.1111/dewb.12324 [15] Jecker, N. S., & Atuire, C. (2021). Bioethics in Africa: A contextually enlightened analysis of three cases. Developing World Bioethics, 22(2), 112–122. https://doi.org/10.1111/dewb.12324 [16] Jackson, C.S., Pepper, M.S. Opportunities and barriers to establishing a cell therapy programme in South Africa. Stem Cell Res Ther 4, 54 (2013). https://doi.org/10.1186/scrt204; Pew Research Center. (2014, May 1). Public health a major priority in African nations. Pew Research Center’s Global Attitudes Project. https://www.pewresearch.org/global/2014/05/01/public-health-a-major-priority-in-african-nations/ [17] Department of Health Republic of South Africa. (2021). Health Research Priorities (revised) for South Africa 2021-2024. National Health Research Strategy. https://www.health.gov.za/wp-content/uploads/2022/05/National-Health-Research-Priorities-2021-2024.pdf [18] Oosthuizen, H. (2013). Legal and Ethical Issues in Stem Cell Research in South Africa. In: Beran, R. (eds) Legal and Forensic Medicine. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-32338-6_80, see also: Gaobotse G (2018) Stem Cell Research in Africa: Legislation and Challenges. J Regen Med 7:1. doi: 10.4172/2325-9620.1000142 [19] United States Bureau of Citizenship and Immigration Services. (1998). Tunisia: Information on the status of Christian conversions in Tunisia. UNHCR Web Archive. https://webarchive.archive.unhcr.org/20230522142618/https://www.refworld.org/docid/3df0be9a2.html [20] Gaobotse, G. (2018) Stem Cell Research in Africa: Legislation and Challenges. J Regen Med 7:1. doi: 10.4172/2325-9620.1000142 [21] Kooli, C. Review of assisted reproduction techniques, laws, and regulations in Muslim countries. Middle East Fertil Soc J 24, 8 (2020). https://doi.org/10.1186/s43043-019-0011-0; Gaobotse, G. (2018) Stem Cell Research in Africa: Legislation and Challenges. J Regen Med 7:1. doi: 10.4172/2325-9620.1000142 [22] Pang M. C. (1999). Protective truthfulness: the Chinese way of safeguarding patients in informed treatment decisions. Journal of medical ethics, 25(3), 247–253. https://doi.org/10.1136/jme.25.3.247 [23] Wang, L., Wang, F., & Zhang, W. (2021). Bioethics in China’s biosecurity law: Forms, effects, and unsettled issues. Journal of law and the biosciences, 8(1). https://doi.org/10.1093/jlb/lsab019 https://academic.oup.com/jlb/article/8/1/lsab019/6299199 [24] Wang, Y., Xue, Y., & Guo, H. D. (2022). Intervention effects of traditional Chinese medicine on stem cell therapy of myocardial infarction. Frontiers in pharmacology, 13, 1013740. https://doi.org/10.3389/fphar.2022.1013740 [25] Li, X.-T., & Zhao, J. (2012). Chapter 4: An Approach to the Nature of Qi in TCM- Qi and Bioenergy. In Recent Advances in Theories and Practice of Chinese Medicine (p. 79). InTech. [26] Luo, D., Xu, Z., Wang, Z., & Ran, W. (2021). China's Stem Cell Research and Knowledge Levels of Medical Practitioners and Students. Stem cells international, 2021, 6667743. https://doi.org/10.1155/2021/6667743 [27] Luo, D., Xu, Z., Wang, Z., & Ran, W. (2021). China's Stem Cell Research and Knowledge Levels of Medical Practitioners and Students. Stem cells international, 2021, 6667743. https://doi.org/10.1155/2021/6667743 [28] Zhang, J. Y. (2017). Lost in translation? accountability and governance of Clinical Stem Cell Research in China. Regenerative Medicine, 12(6), 647–656. https://doi.org/10.2217/rme-2017-0035 [29] Wang, L., Wang, F., & Zhang, W. (2021). Bioethics in China’s biosecurity law: Forms, effects, and unsettled issues. Journal of law and the biosciences, 8(1). https://doi.org/10.1093/jlb/lsab019 https://academic.oup.com/jlb/article/8/1/lsab019/6299199 [30] Chen, H., Wei, T., Wang, H. et al. Association of China’s two-child policy with changes in number of births and birth defects rate, 2008–2017. BMC Public Health 22, 434 (2022). https://doi.org/10.1186/s12889-022-12839-0 [31] Azuma, K. Regulatory Landscape of Regenerative Medicine in Japan. Curr Stem Cell Rep 1, 118–128 (2015). https://doi.org/10.1007/s40778-015-0012-6 [32] Harris, R. (2005, May 19). Researchers Report Advance in Stem Cell Production. NPR. https://www.npr.org/2005/05/19/4658967/researchers-report-advance-in-stem-cell-production [33] Park, S. (2012). South Korea steps up stem-cell work. Nature. https://doi.org/10.1038/nature.2012.10565 [34] Resnik, D. B., Shamoo, A. E., & Krimsky, S. (2006). Fraudulent human embryonic stem cell research in South Korea: lessons learned. Accountability in research, 13(1), 101–109. https://doi.org/10.1080/08989620600634193. [35] Alahmad, G., Aljohani, S., & Najjar, M. F. (2020). Ethical challenges regarding the use of stem cells: interviews with researchers from Saudi Arabia. BMC medical ethics, 21(1), 35. https://doi.org/10.1186/s12910-020-00482-6 [36]Association for the Advancement of Blood and Biotherapies. https://www.aabb.org/regulatory-and-advocacy/regulatory-affairs/regulatory-for-cellular-therapies/international-competent-authorities/saudi-arabia [37] Alahmad, G., Aljohani, S., & Najjar, M. F. (2020). Ethical challenges regarding the use of stem cells: Interviews with researchers from Saudi Arabia. BMC medical ethics, 21(1), 35. https://doi.org/10.1186/s12910-020-00482-6 [38] Alahmad, G., Aljohani, S., & Najjar, M. F. (2020). Ethical challenges regarding the use of stem cells: Interviews with researchers from Saudi Arabia. BMC medical ethics, 21(1), 35. https://doi.org/10.1186/s12910-020-00482-6 Culturally, autonomy practices follow a relational autonomy approach based on a paternalistic deontological health care model. The adherence to strict international research policies and religious pillars within the regulatory environment is a great foundation for research ethics. However, there is a need to develop locally targeted ethics approaches for research (as called for in Alahmad, G., Aljohani, S., & Najjar, M. F. (2020). Ethical challenges regarding the use of stem cells: interviews with researchers from Saudi Arabia. BMC medical ethics, 21(1), 35. https://doi.org/10.1186/s12910-020-00482-6), this decision-making approach may help advise a research decision model. For more on the clinical cultural autonomy approaches, see: Alabdullah, Y. Y., Alzaid, E., Alsaad, S., Alamri, T., Alolayan, S. W., Bah, S., & Aljoudi, A. S. (2022). Autonomy and paternalism in Shared decision‐making in a Saudi Arabian tertiary hospital: A cross‐sectional study. Developing World Bioethics, 23(3), 260–268. https://doi.org/10.1111/dewb.12355; Bukhari, A. A. (2017). Universal Principles of Bioethics and Patient Rights in Saudi Arabia (Doctoral dissertation, Duquesne University). https://dsc.duq.edu/etd/124; Ladha, S., Nakshawani, S. A., Alzaidy, A., & Tarab, B. (2023, October 26). Islam and Bioethics: What We All Need to Know. Columbia University School of Professional Studies. https://sps.columbia.edu/events/islam-and-bioethics-what-we-all-need-know [39] Ababneh, M. A., Al-Azzam, S. I., Alzoubi, K., Rababa’h, A., & Al Demour, S. (2021). Understanding and attitudes of the Jordanian public about clinical research ethics. Research Ethics, 17(2), 228-241. https://doi.org/10.1177/1747016120966779 [40] Ababneh, M. A., Al-Azzam, S. I., Alzoubi, K., Rababa’h, A., & Al Demour, S. (2021). Understanding and attitudes of the Jordanian public about clinical research ethics. Research Ethics, 17(2), 228-241. https://doi.org/10.1177/1747016120966779 [41] Dajani, R. (2014). Jordan’s stem-cell law can guide the Middle East. Nature 510, 189. https://doi.org/10.1038/510189a [42] Dajani, R. (2014). Jordan’s stem-cell law can guide the Middle East. Nature 510, 189. https://doi.org/10.1038/510189a [43] The EU’s definition of autonomy relates to the capacity for creating ideas, moral insight, decisions, and actions without constraint, personal responsibility, and informed consent. However, the EU views autonomy as not completely able to protect individuals and depends on other principles, such as dignity, which “expresses the intrinsic worth and fundamental equality of all human beings.” Rendtorff, J.D., Kemp, P. (2019). Four Ethical Principles in European Bioethics and Biolaw: Autonomy, Dignity, Integrity and Vulnerability. In: Valdés, E., Lecaros, J. (eds) Biolaw and Policy in the Twenty-First Century. International Library of Ethics, Law, and the New Medicine, vol 78. Springer, Cham. https://doi.org/10.1007/978-3-030-05903-3_3 [44] Council of Europe. Convention for the protection of Human Rights and Dignity of the Human Being with regard to the Application of Biology and Medicine: Convention on Human Rights and Biomedicine (ETS No. 164) https://www.coe.int/en/web/conventions/full-list?module=treaty-detail&treatynum=164 (forbidding the creation of embryos for research purposes only, and suggests embryos in vitro have protections.); Also see Drabiak-Syed B. K. (2013). New President, New Human Embryonic Stem Cell Research Policy: Comparative International Perspectives and Embryonic Stem Cell Research Laws in France. Biotechnology Law Report, 32(6), 349–356. https://doi.org/10.1089/blr.2013.9865 [45] Rendtorff, J.D., Kemp, P. (2019). Four Ethical Principles in European Bioethics and Biolaw: Autonomy, Dignity, Integrity and Vulnerability. In: Valdés, E., Lecaros, J. (eds) Biolaw and Policy in the Twenty-First Century. International Library of Ethics, Law, and the New Medicine, vol 78. Springer, Cham. https://doi.org/10.1007/978-3-030-05903-3_3 [46] Tomuschat, C., Currie, D. P., Kommers, D. P., & Kerr, R. (Trans.). (1949, May 23). Basic law for the Federal Republic of Germany. https://www.btg-bestellservice.de/pdf/80201000.pdf [47] Regulation of Stem Cell Research in Germany. Eurostemcell. (2017, April 26). https://www.eurostemcell.org/regulation-stem-cell-research-germany [48] Regulation of Stem Cell Research in Finland. Eurostemcell. (2017, April 26). https://www.eurostemcell.org/regulation-stem-cell-research-finland [49] Regulation of Stem Cell Research in Spain. Eurostemcell. (2017, April 26). https://www.eurostemcell.org/regulation-stem-cell-research-spain [50] Some sources to consider regarding ethics models or regulatory oversights of other cultures not covered: Kara MA. Applicability of the principle of respect for autonomy: the perspective of Turkey. J Med Ethics. 2007 Nov;33(11):627-30. doi: 10.1136/jme.2006.017400. PMID: 17971462; PMCID: PMC2598110. Ugarte, O. N., & Acioly, M. A. (2014). The principle of autonomy in Brazil: one needs to discuss it ... Revista do Colegio Brasileiro de Cirurgioes, 41(5), 374–377. https://doi.org/10.1590/0100-69912014005013 Bharadwaj, A., & Glasner, P. E. (2012). Local cells, global science: The rise of embryonic stem cell research in India. Routledge. For further research on specific European countries regarding ethical and regulatory framework, we recommend this database: Regulation of Stem Cell Research in Europe. Eurostemcell. (2017, April 26). https://www.eurostemcell.org/regulation-stem-cell-research-europe [51] Klitzman, R. (2006). Complications of culture in obtaining informed consent. The American Journal of Bioethics, 6(1), 20–21. https://doi.org/10.1080/15265160500394671 see also: Ekmekci, P. E., & Arda, B. (2017). Interculturalism and Informed Consent: Respecting Cultural Differences without Breaching Human Rights. Cultura (Iasi, Romania), 14(2), 159–172.; For why trust is important in research, see also: Gray, B., Hilder, J., Macdonald, L., Tester, R., Dowell, A., & Stubbe, M. (2017). Are research ethics guidelines culturally competent? Research Ethics, 13(1), 23-41. https://doi.org/10.1177/1747016116650235 [52] The Qur'an (M. Khattab, Trans.). (1965). Al-Mu’minun, 23: 12-14. https://quran.com/23 [53] Lenfest, Y. (2017, December 8). Islam and the beginning of human life. Bill of Health. https://blog.petrieflom.law.harvard.edu/2017/12/08/islam-and-the-beginning-of-human-life/ [54] Aksoy, S. (2005). Making regulations and drawing up legislation in Islamic countries under conditions of uncertainty, with special reference to embryonic stem cell research. Journal of Medical Ethics, 31:399-403.; see also: Mahmoud, Azza. "Islamic Bioethics: National Regulations and Guidelines of Human Stem Cell Research in the Muslim World." Master's thesis, Chapman University, 2022. https://doi.org/10.36837/ chapman.000386 [55] Rashid, R. (2022). When does Ensoulment occur in the Human Foetus. Journal of the British Islamic Medical Association, 12(4). ISSN 2634 8071. https://www.jbima.com/wp-content/uploads/2023/01/2-Ethics-3_-Ensoulment_Rafaqat.pdf. [56] Sivaraman, M. & Noor, S. (2017). Ethics of embryonic stem cell research according to Buddhist, Hindu, Catholic, and Islamic religions: perspective from Malaysia. Asian Biomedicine,8(1) 43-52. https://doi.org/10.5372/1905-7415.0801.260 [57] Jafari, M., Elahi, F., Ozyurt, S. & Wrigley, T. (2007). 4. Religious Perspectives on Embryonic Stem Cell Research. In K. Monroe, R. Miller & J. Tobis (Ed.), Fundamentals of the Stem Cell Debate: The Scientific, Religious, Ethical, and Political Issues (pp. 79-94). Berkeley: University of California Press. https://escholarship.org/content/qt9rj0k7s3/qt9rj0k7s3_noSplash_f9aca2e02c3777c7fb76ea768ba458f0.pdf https://doi.org/10.1525/9780520940994-005 [58] Lecso, P. A. (1991). The Bodhisattva Ideal and Organ Transplantation. Journal of Religion and Health, 30(1), 35–41. http://www.jstor.org/stable/27510629; Bodhisattva, S. (n.d.). The Key of Becoming a Bodhisattva. A Guide to the Bodhisattva Way of Life. http://www.buddhism.org/Sutras/2/BodhisattvaWay.htm [59] There is no explicit religious reference to when life begins or how to conduct research that interacts with the concept of life. However, these are relevant verses pertaining to how the fetus is viewed. ((King James Bible. (1999). Oxford University Press. (original work published 1769)) Jerimiah 1: 5 “Before I formed thee in the belly I knew thee; and before thou camest forth out of the womb I sanctified thee…” In prophet Jerimiah’s insight, God set him apart as a person known before childbirth, a theme carried within the Psalm of David. Psalm 139: 13-14 “…Thou hast covered me in my mother's womb. I will praise thee; for I am fearfully and wonderfully made…” These verses demonstrate David’s respect for God as an entity that would know of all man’s thoughts and doings even before birth. [60] It should be noted that abortion is not supported as well. [61] The Vatican. (1987, February 22). Instruction on Respect for Human Life in Its Origin and on the Dignity of Procreation Replies to Certain Questions of the Day. Congregation For the Doctrine of the Faith. https://www.vatican.va/roman_curia/congregations/cfaith/documents/rc_con_cfaith_doc_19870222_respect-for-human-life_en.html [62] The Vatican. (2000, August 25). Declaration On the Production and the Scientific and Therapeutic Use of Human Embryonic Stem Cells. Pontifical Academy for Life. https://www.vatican.va/roman_curia/pontifical_academies/acdlife/documents/rc_pa_acdlife_doc_20000824_cellule-staminali_en.html; Ohara, N. (2003). Ethical Consideration of Experimentation Using Living Human Embryos: The Catholic Church’s Position on Human Embryonic Stem Cell Research and Human Cloning. Department of Obstetrics and Gynecology. Retrieved from https://article.imrpress.com/journal/CEOG/30/2-3/pii/2003018/77-81.pdf. [63] Smith, G. A. (2022, May 23). Like Americans overall, Catholics vary in their abortion views, with regular mass attenders most opposed. Pew Research Center. https://www.pewresearch.org/short-reads/2022/05/23/like-americans-overall-catholics-vary-in-their-abortion-views-with-regular-mass-attenders-most-opposed/ [64] Rosner, F., & Reichman, E. (2002). Embryonic stem cell research in Jewish law. Journal of halacha and contemporary society, (43), 49–68.; Jafari, M., Elahi, F., Ozyurt, S. & Wrigley, T. (2007). 4. Religious Perspectives on Embryonic Stem Cell Research. In K. Monroe, R. Miller & J. Tobis (Ed.), Fundamentals of the Stem Cell Debate: The Scientific, Religious, Ethical, and Political Issues (pp. 79-94). Berkeley: University of California Press. https://escholarship.org/content/qt9rj0k7s3/qt9rj0k7s3_noSplash_f9aca2e02c3777c7fb76ea768ba458f0.pdf https://doi.org/10.1525/9780520940994-005 [65] Schenker J. G. (2008). The beginning of human life: status of embryo. Perspectives in Halakha (Jewish Religious Law). Journal of assisted reproduction and genetics, 25(6), 271–276. https://doi.org/10.1007/s10815-008-9221-6 [66] Ruttenberg, D. (2020, May 5). The Torah of Abortion Justice (annotated source sheet). Sefaria. https://www.sefaria.org/sheets/234926.7?lang=bi&with=all&lang2=en [67] Jafari, M., Elahi, F., Ozyurt, S. & Wrigley, T. (2007). 4. Religious Perspectives on Embryonic Stem Cell Research. In K. Monroe, R. Miller & J. Tobis (Ed.), Fundamentals of the Stem Cell Debate: The Scientific, Religious, Ethical, and Political Issues (pp. 79-94). Berkeley: University of California Press. https://escholarship.org/content/qt9rj0k7s3/qt9rj0k7s3_noSplash_f9aca2e02c3777c7fb76ea768ba458f0.pdf https://doi.org/10.1525/9780520940994-005 [68] Gert, B. (2007). Common morality: Deciding what to do. Oxford Univ. Press. [69] World Medical Association (2013). World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA, 310(20), 2191–2194. https://doi.org/10.1001/jama.2013.281053 Declaration of Helsinki – WMA – The World Medical Association.; see also: National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research. (1979). The Belmont report: Ethical principles and guidelines for the protection of human subjects of research. U.S. Department of Health and Human Services. https://www.hhs.gov/ohrp/regulations-and-policy/belmont-report/read-the-belmont-report/index.html [70] Zakarin Safier, L., Gumer, A., Kline, M., Egli, D., & Sauer, M. V. (2018). Compensating human subjects providing oocytes for stem cell research: 9-year experience and outcomes. Journal of assisted reproduction and genetics, 35(7), 1219–1225. https://doi.org/10.1007/s10815-018-1171-z https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6063839/ see also: Riordan, N. H., & Paz Rodríguez, J. (2021). Addressing concerns regarding associated costs, transparency, and integrity of research in recent stem cell trial. Stem Cells Translational Medicine, 10(12), 1715–1716. https://doi.org/10.1002/sctm.21-0234 [71] Klitzman, R., & Sauer, M. V. (2009). Payment of egg donors in stem cell research in the USA. Reproductive biomedicine online, 18(5), 603–608. https://doi.org/10.1016/s1472-6483(10)60002-8 [72] Krosin, M. T., Klitzman, R., Levin, B., Cheng, J., & Ranney, M. L. (2006). Problems in comprehension of informed consent in rural and peri-urban Mali, West Africa. Clinical trials (London, England), 3(3), 306–313. https://doi.org/10.1191/1740774506cn150oa [73] Veatch, Robert M. Hippocratic, Religious, and Secular Medical Ethics: The Points of Conflict. Georgetown University Press, 2012. [74] Msoroka, M. S., & Amundsen, D. (2018). One size fits not quite all: Universal research ethics with diversity. Research Ethics, 14(3), 1-17. https://doi.org/10.1177/1747016117739939 [75] Pirzada, N. (2022). The Expansion of Turkey’s Medical Tourism Industry. Voices in Bioethics, 8. https://doi.org/10.52214/vib.v8i.9894 [76] Stem Cell Tourism: False Hope for Real Money. Harvard Stem Cell Institute (HSCI). (2023). https://hsci.harvard.edu/stem-cell-tourism, See also: Bissassar, M. (2017). Transnational Stem Cell Tourism: An ethical analysis. Voices in Bioethics, 3. https://doi.org/10.7916/vib.v3i.6027 [77]Song, P. (2011) The proliferation of stem cell therapies in post-Mao China: problematizing ethical regulation, New Genetics and Society, 30:2, 141-153, DOI: 10.1080/14636778.2011.574375 [78] Dajani, R. (2014). Jordan’s stem-cell law can guide the Middle East. Nature 510, 189. https://doi.org/10.1038/510189a [79] International Society for Stem Cell Research. (2024). Standards in stem cell research. International Society for Stem Cell Research. https://www.isscr.org/guidelines/5-standards-in-stem-cell-research [80] Benjamin, R. (2013). People’s science bodies and rights on the Stem Cell Frontier. Stanford University Press.