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Science / Medicine : Fetal Tissue Research Stirs Debate : Procedure Shows Promise in Treatments Although Abortion Foes Oppose It

<i> Times Staff Writer</i>

She is a 49-year-old rural Ohioan whose 57-year-old husband has been suffering from Parkinson’s disease for nearly a decade. Lately, they have been riveted by ongoing news reports describing promising experimental surgery on Parkinson’s patients using transplanted cells taken from aborted fetuses.

“I know it sounds terrible, but if I could become pregnant and have an abortion to help him, I would do it,” she said recently. “It’s not something I would want to do. But if he couldn’t be helped any other way, I would do it. You’ve got to understand. This is somebody you love so badly. I’d do anything to help him.”

The conversation was academic since she was surgically sterilized several years ago and can no longer become pregnant. But her conviction was sincere, and it was unyielding. If there were no alternative, and she had the power to provide a lifesaving treatment for her husband, she said she would not hesitate for a moment.

It is just this kind of scenario that troubles those who are struggling over the conflicting and often disturbing issues raised by research using fetal tissue. It is a field that scientists believe holds extraordinary promise in the treatment of an array of serious illnesses, including Parkinson’s, Alzheimer’s disease, diabetes, Huntington’s disease, leukemia, spinal cord injuries and a growing list of other conditions.

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Earlier this month, researchers reported the successful transplantation of human fetal immune system cells into mice, an accomplishment that is expected to have a major impact on the study of many diseases, especially AIDS, a fatal affliction of the immune system.

But it also raises a specter that has existed in the history of all medical advances: the longstanding tug-of-war between science and other forces in society--in this case the vocal and highly political anti-abortion movement.

Medical technology throughout the years has always been guided by the principle that experiments--however controversial--can often be justified if their potential benefits to humanity can outweigh either the possible risks or moral objections. Indeed, in this debate, scientists have argued loud and clear that the subject of elective abortion, which is legal in this country, must be considered apart from the pros and cons of fetal research.

But opponents of abortion disagree, insisting that a distinction cannot be made between the two and that fetal tissue, since it is obtained from an “immoral” procedure, is tainted and should not be used--no matter how lifesaving it may prove. Further, they insist, to sanction research using fetal tissue is to condone an act that, as one anti-abortionist put it, “dehumanizes every one of us as members of the human race.”

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Two weeks ago, an independent panel made up of health officials, ethicists, legal experts, academics and others, convened by the federal government to examine the issues raised by the use of fetal tissue, declared that it was “acceptable” for researchers to use human fetal tissue obtained from legal abortions and urged that the work continue. The committee, after hearing two days of testimony that occasionally disintegrated into a dialogue on abortion, declined to take a position on the morality of abortion but stressed that safeguards should be developed “respecting the principled viewpoints of all affected parties.”

The group is scheduled to present its recommendations in early December to the National Institutes of Health, which is deliberating the fate of a moratorium imposed in April on the federal funding of such research. Even if the agency decides to support a resumption of the research, scientists still face a stiff opponent in President Reagan, who is seeking an executive order or some other measure to block the research use of fetal tissue.

Although the controversy is new, fetal tissue research is not. As early as the 1930s, fetal tissue was used extensively to develop cell lines, which are samples of cells that can continue to grow in the laboratory and are self-sustaining.

Fetal cell lines have special advantages because of their rapid growth and adaptability. Cell lines prepared from human tissues are critical for the reproduction of human viruses, both for the diagnosis of disease and in the production and safety testing of human vaccines. In fact, the discovery of the polio vaccine in the 1950s was based on cultures of human fetal kidney cells.

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Fetal tissue research has taken a new turn in recent years, however. The most recent focus has been on experimental surgery involving the transplantation of fetal cells directly into humans--healthy cells that it is hoped will assume the functions of diseased or defective cells in the human body.

One scientist speaking before the panel estimated that the potential beneficiaries in this country of transplantation using fetal cells included 600,000 persons with diabetes, 500,000 with Parkinson’s disease; 20,000 hemophiliacs; 300,000 with spinal cord injuries; 2 million with Alzheimer’s disease; 10,000 with Huntington’s disease, and 12,000 with muscular dystrophy.

There are an estimated 1.5 million induced abortions in the United States every year. Most of the aborted fetuses are cremated. This, scientists argue, is valuable research material that is wasted and potentially could be put to good use to help others.

“If this type of use of fetal tissue doesn’t go forward and there is a withholding of vital therapy--is this not an ethically indefensible position?” asked William Lyman, assistant professor of pathology and neuroscience at the Albert Einstein College of Medicine in the Bronx.

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Medical ethicist Arthur L. Caplan, director of the center for biomedical ethics at the University of Minnesota, agreed. “Those who want to adhere to the principle of never using fetal tissue have to be prepared to say: ‘What are we foregoing?’ ” he said. “At what price to those who will be benefited will we adhere to principle?”

But others raise troubling questions, perhaps the most disturbing illustrated by the emotions of the woman in Ohio. Will the use of fetal tissue encourage women to have abortions that they would otherwise not have? Will the proliferation of fetal research change the way the public feels about abortions? Should fetal parts be treated like other organ donations, even though the circumstances of death clearly differ? Will fetal tissue be treated like a “commodity” to be sold or trafficked?

Most of the panel concluded that safeguards can--and should--be developed that would prevent most of the above situations from occurring. They could be easily solved by laws or regulations prohibiting the pregnant woman from designating the recipient of her fetal tissue and forbid her--or anyone--from selling fetal tissue or receiving any financial reward or other incentives for providing it.

Further, the panel said, any discussion of consent for the use of such tissue must be deferred until after the decision to abort has been made.

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None of this, however, will satisfy the anti-abortion movement--some of whose members have compared fetal tissue research to the experiments conducted by Nazis on Jews confined in concentration camps during the Holocaust.

“We should not give scientists a blank check,” said Kay C. James, president of Black Americans for Life. “It’s wrong to kill those who commited no crime. We must not compound this moral and ethical lapse by weaving it into the warp . . . of modern medicine.”

But Robin Chandler Duke, national co-chairman of the Population Crisis Committee/Draper Fund, declared: “It’s just not going to go away. It’s been with us since the written word. And now it is legal, and it is safe.

“Nobody likes abortion. But most people recognize it should be legal and safe. We should use fetal research for all the right and good reasons, within the parameters of law and ethics. To hold medical research hostage . . . would be a very grave mistake.”

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