Fetal Tissue Use Raises Questions
Transplants of tissue from human fetuses offer hope in treating AIDS and other diseases, but doctors acknowledge the need to resolve ethical questions surrounding the practice.
Anti-abortionists have denounced procedures involving the use of tissue from fetuses obtained through spontaneous or induced abortions.
The transplants, mostly of brain and glandular tissue, are supported by the American Medical Assn.’s Council on Scientific Affairs and its Council on Ethical and Judicial Affairs.
The councils urged continued federal funding for the transplants in a joint report discussed last week during the AMA’s annual policy-making convention in Chicago.
The report notes that fetal tissue transplants have “led to the development of a number of important research and medical advances.”
But Dr. George M. Bohigian, chairman of the science council, and Dr. Russell H. Patterson Jr., chairman of the judicial group, acknowledged the ethical dilemmas posed by such research.
At issue is the possibility that a decision to have an abortion will be coupled with a decision to donate fetal tissue for transplantation, they wrote.
“The use of fetal tissue for transplantation purposes is ethically permissible” when a number of conditions are met, they wrote. These conditions include:
The recipient of the tissue is not designated by the donor.
A final decision regarding abortion is made before initiating discussion of the transplantation use of fetal tissue.
Fetal tissue is not provided in exchange for financial remuneration above that necessary to cover reasonable expenses.
The authors note that the acquisition and use of tissue obtained from dead fetuses is governed by the Uniform Anatomical Gift Act, which has been adopted by all states and the District of Columbia.
The act permits donation of fetal tissue for research purposes with the consent of either parent if there is no objection from the other.
However, several states have restrictive statutes governing the donation of fetal tissue for research.
Massachusetts and Michigan prohibit abortion if it is conditional on the use of the fetal tissue for research.
Arizona law bars post-mortem use of fetal remains for “any medical experimentation” if the tissue is derived from an induced abortion.
In one recent study involving human fetal tissue, liver cells and bits of thymus and lymph glands transplanted into mice with impaired immune systems helped make those systems function properly. The doctors wrote that the effort “may become a valuable model in studying” AIDS.
Fetal brain tissue transplants could also offer promising advances in the treatment of diabetes and Parkinson’s disease, they said.
Transplants using tissue from a fetus after spontaneous or induced abortion would appear to be analogous to the use of cadaver tissue and organs, the report said.
“The principal ethical concern in the use of human fetal tissue transplants is the degree to which the decision to have an abortion is separated from the decision to donate the post-mortem tissue,” the doctors wrote.
“Safeguards to reduce any motivation, reason or incentive by the woman to have an abortion can be developed to allow the benefits of this procedure to be made available to those who are in need of improved therapies.”
