Stanford’s Fetal-Tissue Report
A cogent and balanced proposal for controlling the use of human fetal tissue in medical research and transplantation has been presented by the Committee on Ethics of the Stanford University Medical Center. It provides a framework as well as specific proposals for changes in federal regulations that deserve prompt implementation.
The Stanford study affirms the medical importance and ethical appropriateness of using fetal tissue. The unique properties of fetal tissue offer “the hope of new medical treatments for millions of people” and, while benefits cannot be guaranteed, “the opportunities to preserve life and alleviate suffering could be enormous,” the report concludes. In ethical terms, fetal tissue has the same status as a human cadaver, requiring appropriate permission for its use and careful respect.
What matters most, the committee concluded, is devising a policy that does not encourage induced abortions. Most of the specific proposals of the Stanford committee address that objective. Neither the women who undergo induced abortions nor the doctors assisting them should benefit. The woman should not be compensated in any way and the National Organ Transplantation Act should be amended specifically to exclude abortion-related expenses from the definition of permissible reimbursement. Furthermore, the Uniform Anatomical Gift Act should be amended to bar the donation of human fetal tissue to a specific person, thus deterring pregnancies planned to be terminated with an abortion to provide fetal tissue for a particular purpose. To avoid conflict of interest, “medical personnel who perform induced abortions should not be allowed any direct benefit from the subsequent use of the fetal tissue.”
The Stanford Medical Center proposals are published in the April 20 issue of the New England Journal of Medicine. An accompanying commentary is generally supportive, but demonstrates the complexity of the issue. For example, it argues that fetal tissue from spontaneous abortions, while escaping the controversy surrounding fetal tissue from induced abortions, poses serious problems because of the high percentage of chromosomal abnormalities and infections and “should not be used for transplantation into a human subject.” Thus, the supply of fetal tissue for human transplantation is dependent on induced abortions, either elective or therapeutic. That raises an issue with a political dimension for those seeking the prohibition of all abortions.
This is the third important contribution to medical ethics from the Stanford committee. In January of 1988 the committee dealt helpfully with the issue of death and the termination of life support systems. Last June the committee reported on appropriate uses of animals in medical research. We find this latest report convincing. The potential for good in the appropriate uses of fetal tissue is immense. The risks, enormous as they are, have been forthrightly addressed with controls that go beyond those currently in place.
