Controversy over Source of Fetal Tissue

The major policy issue surrounding neural grafting using fetal central nervous system (CNS) tissue centers on the use of fetal tissue in transplantation research. Four possible sources of fetal tissue are:

1. Spontaneous abortions

2. Induced abortions on unintended pregnancies

3. Induced abortions on fetuses conceived specifically for research or therapy

4. Embryos produced in vitro

A dependence on spontaneously aborted fetuses for research is impractical because of the limited number available, the inability to control the timing, and the fact that fetal tissue is fragile and deteriorates quickly after the death of the fetus. The major supply of fetal tissue, therefore, is likely to come from induced abortions on unwanted pregnancies. Instead of discarding or destroying the tissue, it is retrieved for research or transplantation. If even a small percentage of women elected to donate fetal tissue for research, the million and a half elective abortions performed in the United States each year would appear to be more than adequate to meet most research needs.

Unlike the use of fetuses spontaneously aborted, however, dependence on elective abortions as the primary source raises vehement objections on moral grounds by groups opposed to abortion. Other serious questions are raised when the research or therapy needs affect the timing and method of abortion, or if pressures are placed on the women undergoing the abortion to consent to donation. To ensure against the latter, most observers recommend that the decision to terminate a pregnancy be made separately from the consent for fetal research.

An even more troublesome source of fetal material might arise if a human fetus is conceived specifically for the purpose of aborting it for research or therapy. Although there is no documented evidence that this has happened, in at least two cases women have asked if they could become pregnant to produce tissues or organs for another person. In one case, the daughter of an Alzheimer's patient asked to be inseminated with the sperm of her father and, at the appropriate stage, to abort the fetus to provide her father with fetal neural tissue for transplantation. Although there is no evidence at present that this is technically possible, and the women's request was denied, this case demonstrates a possible demand for such applications. Similarly, another woman requested that her midterm fetus be aborted and the kidneys be transplanted to her husband who was dying of end-stage renal disease. There is also concern that increased pressures for fetal tissue could lead to a marketplace for this scarce resource which, in turn, could lead to exploitation of poor women (in the United States or elsewhere) paid to conceive solely to provide fetal materials, even if the practice were illegal.

The fourth source of human cells or tissue comes from embryos produced through IVF. Again, the situation is clouded by the need to distinguish between those embryos deliberately created for research purposes and those untransferred embryos remaining after IVF of multiple ova. Although persons who believe that life starts at conception are likely to oppose any use of human embryos for research purposes, many supporters of the use of spare embryos find the production of human embryos specifically for research unacceptable. Questions of consent, ownership, and payment are common to both categories.

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