Fetal Tissue Research Without a Transplant Marketplace
Just look back on the past decade and you’ll see technological breakthroughs coming everywhere from software and silicon to DNA and superconductors. Virtually any material can now be a medium of innovation. But does society want its breakthrough innovations to come from the tissue of aborted fetuses?
We’re about to find out.
Roughly 1.6 million abortions are performed annually in this country. A tiny but increasing percentage of those discarded fetuses are being used as a research medium for scientists seeking new ways to treat diseases ranging from Parkinson’s to diabetes to Huntington’s chorea. Specifically, fetal tissue transplants represent a tremendous opportunity for helping the body repair itself. The initial results look promising, and there’s no concealing the excitement in the medical community.
But understandably, this research has become ensnared in the politics of abortion. Although two federal advisory panels concluded--after extraordinarily intense debates--that there is nothing inherently immoral or unethical about fetal tissue transplant research, the Bush Administration recently extended what has been a 20-month ban on federal financing of the work.
With the weary predictability of an exhausted cliche, anti-abortion forces proclaimed a victory for life and scientists condemned the move as a victory for ignorance.
“I don’t see that there’s a different order of things,” asserts Dr. Willard Gaylin, president of the Hastings Center, a bioethics think tank. “If there is a right to abortion and it is used and that tissue can be used to enhance the life of another child, then do it. The gift of life from across the border of death has been established for generations.”
In truth, this emerging controversy has been disgracefully handled by all parties involved. From the Bush Administration to the anti-abortionists to the medical community, each side has displayed a zealotry that pays little mind to the public good. The anti-abortion forces don’t want any good to come from aborted tissue, the scientists want their research unfettered, and the Bush Administration is desperate not to offend any constituency. All this posturing does nothing for anyone.
The scientists are not Galileos being asked to recant nor are they Victorian grave robbers exploiting other people’s misery for financial gain. They are politically obtuse professionals who sincerely believe that their research harms no one and will ultimately yield great benefit to the public’s health. By the same token, people who oppose abortion are equally adamant in their beliefs that it is a sin. (For the record, I am pro-choice.)
The real danger here is not in the idea of fetal tissue research (even anti-abortion forces have little quarrel about tissue obtained from spontaneous abortions) but that this research could lead to a market for fetal tissue. Do we really think it’s a good idea to inject free-market forces into the business of abortion the way we have into airlines and banks?
Picture the very real possibility that research now under way leads to tremendous breakthroughs in the treatment of diabetes and Alzheimer’s. Demand for fetal tissue would explode. Where would it all come from? The figure of 1.6 million abortions a year is meaningless in the context of tissue transplants. The suction method of abortion frequently destroys transplantable tissue. Estimates are that less than half the abortions that take place yield usable tissue.
Timing also matters. Should we tell a woman who wants an abortion that, if she only waits a week, her fetal tissue could help save someone’s life? Supporters of the transplants acknowledge that there should be a wall between the decision to abort and the decision to donate. But, in the real world, can there be? Indeed, one could make a case that the moral thing to do under the circumstances is to encourage the woman to donate her tissue. While you’re at it, why not offer to pay for the abortion if she is willing to donate? By creating a direct link between the act of abortion and clinical intervention, we are laying the groundwork for fetal commerce.
“There are no clear answers,” agrees Dr. Harvey Cohen, chief of the pediatric unit of hematology/oncology of the University of Rochester Medical Center and a fetal tissue transplant supporter. “There’s no question we are on a slippery slope.”
However, some slippery slopes are steeper than others. Unless society is prepared to harvest fetal tissue, demand would overwhelm supply.
Historically, there has been a very unhappy relationship between organic materials and markets. We have people lying in hospitals, waiting months for hearts or kidneys, secretly praying that someone without a helmet has a motorcycle accident. Would we condone an organ market in highway accident victims? Of course not. No one is happy with our system of organ transplants, and there are serious complaints about inequities in the system.
Similarly, we mismanaged our free-market approach to the blood supply to the point of paying junkies for their blood. Our blood banks have had to undergo a revolution in collection and testing to compensate for these errors. Many people are now scared to either give or receive blood. Private blood banks have now been set up to rival public services.
Yes, we can outlaw fetal tissue transactions. We also outlaw drugs and black markets for babies. Reality dictates that market forces are powerful things. Thus it makes sense to eliminate funding for fetal tissue transplant research. The hypocrisy of the recent Administration decision, however, is that it explicitly allows private fetal transplant research to continue. In other words, it’s OK to have a private market in fetal tissue. If it had as much courage as political expediency, the Administration would call for a halt of all fetal transplant research. The Administration’s policy sets the stage for the very market abuses it publicly fears.
My position is that it’s best to forbid transplants so there will be no fetal tissue market. Let me stress that fetal tissue research should continue. Insights from fetal tissue can help doctors save troubled fetuses in the womb. The molecular and cell biology of the fetus will offer insights into human growth factors and the onset of cancers, says the University of Rochester’s Cohen. Indeed, this research could even render tissue transplants irrelevant. The knowledge should always be more important than the availability of a fetus.
The challenge, however, is to do the research in a way that doesn’t inevitably lead to a fetal transplant marketplace. “If the population as a whole doesn’t want (fetal tissue transplants) then I’d drop it like a hot scone,” says Dr. Kevin Lafferty, who does privately funded fetal tissue transplants to treat diabetics at the University of Colorado.
Ultimately, fetal transplants are an innovation that will be determined more by politics than by technology. If people really want the benefits of fetal tissue transplants, a marketplace will be born. My belief is that this is not what society wants. Abortion is now a very difficult and very personal choice. It should not be the precursor to an auction.
