Hostname: page-component-586b7cd67f-2brh9 Total loading time: 0 Render date: 2024-11-28T10:01:03.877Z Has data issue: false hasContentIssue false
  • English
  • Français

Regulating Transfer and Use of Fetal Tissue in Transplantation Procedures: The Ethical Dimensions

Published online by Cambridge University Press:  24 February 2021

Nikki Melina Constantine Bell
Nikki Melina Constantine Bell*
Affiliation:
Hofstra University; Boston University
Get access Rights & Permissions [Opens in a new window]

Extract

For twenty years scientists have worked to find an effective treatment to ease the quivering, the stiffness, and the difficulty in controlling bodily movements which are the primary symptoms of Parkinson's disease. The disease can be treated with L-dopa, a drug that mimics the dopamine that coordinates neural transmission in the human brain, which Parkinson's sufferers have ceased to produce in sufficient quantities. The L-dopa, however, produces damaging side-effects and sometimes proves ineffectual. Researchers discovered in animal experiments that the effects of a laboratory-developed disease simulating Parkinson's disease could be mitigated using fetal brain tissue transplants, which produced the natural dopamine the animals’ cells failed to produce adequately.

These experiments were replicated with human subjects, and fetal tissue transplants have shown great potential as a treatment for Parkinson's disease. Fetal tissue is ideal for transplantation because it is in a stage of primitive development in which it adjusts easily to a new environment.

Type
Articles
Information
American Journal of Law & Medicine , Volume 20 , Issue 3 , 1994 , pp. 277 - 294
Copyright
Copyright © American Society of Law, Medicine and Ethics and Boston University 1994

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1 Ryan, Kenneth J., Tissue Transplantation from Aborted Fetuses, Organ Transplantation from Anencephalic Infants and Keeping Brain-Dead Pregnant Women Alive Until Fetal Viability, 65 S. CAL. L. REV. 683, 686 (1991)Google Scholar.

2 Id. at 685.

3 Id. at 686.

4 Freed, Curt R. et al., Transplantation of Human Fetal Dopamine Cells for Parkinson's Disease: Results at One Year, 47 Arch. Neurol. 505 (1990)Google Scholar.

5 Ryan, supra note 1, at 684.

6 Id.

7 Id.

8 Liskowsky, David R., From the Congressional Office of Technology Assessment, 265 JAMA 3225, 3225 (1991)Google Scholar.

9 Id.

10 Sally Squires, Spinal Cord Repair Research Yields Results, Wash. Post, Sept. 22, 1992, at Health, 6.

11 Human Fetal Tissue Transplantation Treatment for Diabetes (DM), Parkinson's, Alzheimer's Disease Available to U.S. Patients in Moscow, PR Newswire, Sept. 24, 1992 [hereinafter Available in Moscow].

12 id.

13 id.

14 Clark, Matt et al., Should Medicine Use the Unborn?, Newsweek, Sept. 14, 1987, at 62, 63Google Scholar.

15 Id.

16 Id. at 62.

17 Id.

18 Mahowald, Mary B. et al., The Ethical Options in Transplanting Fetal Tissue, 18 Hastings Center Rep., Feb. 1987, at 9, 10Google Scholar.

19 Ryan, supra note 1, at 687.

20 Id

21 Childress, James F., Deliberations of the Human Fetal Tissue Transplantation Research Panel, in Biomedical Politics 215, 218 (Kathi E. Hanna ed., 1991)Google Scholar.

22 Ryan, supra note 1, at 688.

23 Id.

24 Hilts, Philip J., Fetal-Tissue Bank Cannot Meet Goal, Agency Memo Says, N.Y. Times, July 27, 1992, At Al.Google Scholar

25 Id.

26 Id.

27 Id.

28 See id.

29 Id.

30 Annas, George J. & Elias, Sherman, The Politics of Transplantation of Human Fetal Tissue, 320 New Eng. J. Med. 1079, 1081 (1989)Google Scholar.

31 H.R. 2057, 102d Cong., 2d Sess. (1992).

32 Id.

33 House Fails to Override Veto of Fetal Tissue Bill, Chi. Trib., June 25, 1992, at 12.

34 Fetal Tissue: Bush Vetoes NIH Reauthorization Bill, Am. Pol. Network, Health Line, June 24, 1992.

35 Hilts, supra note 24.

36 Suit Challenges Ban on Federal Financing of Fetal Tissue Research, N.Y. Times, Oct. 25, 1992, at 31 [hereinafter Suit Challenges Ban].

37 Harris v. McRae, 448 U.S. 297 (1980).

38 Suit Challenges Ban, supra note 36, at 31.

39 Id. Specifically, plaintiffs claimed that the HHS could not effect a permanent ban without a § 553 rule making, and therefore violated the Administrative Procedure Act. McRae, 448 U.S. at 297.

40 All Things Considered (National Public Radio, Host Lynn Neary, Nov. 6, 1992)Google Scholar.

41 See Gordon, Slovut, Doctors Debate Bush's Ban on Using Fetal Tissue, Star Trib., Oct. 28, 1992, at 8AGoogle Scholar.

42 Remarks of President Bill Clinton at White House Ceremony Repealing the Abortion Gag Rule, Fetal Tissue Research and Other Health Policy Decisions, Fed. News Serv., Jan. 22, 1993, available in Lexis, Legis library, Fednew File.

43 Unif. Anatomical Gift Act § 1(2), 8A U.L.A. 9 (1987).

44 Unif. Anatomical Gift Act § 3.

45 Unif. Anatomical Gift Act § 8(b).

46 “ ‘Dead fetus’ means a fetus ex utero which exhibits neither heartbeat, spontaneous respiratory activity, spontaneous movement of voluntary muscles, nor pulsation of the umbilical cord (if still attached).” 45 C.F.R. § 46.203(f) (1991).

47 45 C.F.R. § 46.206(a) (3).

48 45 C.F.R. § 46.206(b).

49 45 C.F.R. § 46.210.

50 “On the Report and Recommendations of the National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research,” reprinted in A Symposium on Fetal Research, 22 VILL. L. REV. 297, 301 (1977) [hereinafter DHEW Guidelines].

51 Id. at 301.

52 E.g., Ryan, supra note 1, at 687; Danis, Mark W., Fetal Tissue Transplants: Restricting Recipient Designation, 39 Hastings L.J. 1079 (1988)Google Scholar.

53 Annas & Elias, supra note 30, at 1080.

54 Childress, supra note 21, at 221.

55 See id. at 228.

56 Id.

57 Id.

58 Unif. Anatomical Gift Act §§ 2-3, 8A U.L.A. 17.

59 Nolan, Kathleen, Genug ist Genug: A Fetus Is Not a Kidney, 18 Hastings Center Rep., Dec. 1988, at 13, 14–15.CrossRefGoogle Scholar

60 Id. at 14.

61 Childress, supra note 21, at 231.

62 DHEW Guidelines, supra note 50, at 313.

63 See Unif. Anatomical Gift Act §§ 3, 8A U.L.A. 17.

64 Roe v. Wade, 410 U.S. 113, 156-59 (1973).

65 Superintendent of Belchertown State Sch. v. Saikewicz, 370 N.E.2d 417, 429-31 (Mass. 1977).

66 Id. at 430.

67 Jehovah's Witnesses are a religious group whose doctrine forbids the receipt of blood transfusions. See, e.g., Shorter v. Drury, 695 P.2d 116 (Wash. 1985).

68 Cruzan v. Director, Missouri Dep't of Health, 497 U.S. 261 (1990).

69 Determinism [is] [t]he philosophical view that maintains that all events in the universe, including all human events, are absolutely determined or conditioned by necessary and sufficient antecedent causes. The determinist denies, therefore, the reality of randomness or chance in nature and rejects human free will. Every action is the result of a necessary chain of causes. Ethics and the Search for Values 513 (Luis E. Navia & Eugene Kelly eds., 1980).

70 Nolan, supra note 59, at 15.

71 Id. at 14.

72 Id. at 15.

73 Robertson, John A., Rights, Symbolism, and Public Policy in Fetal Tissue Transplantation, 18 Hastings Center Rep., Dec. 1988, at 5, 9 (1988)Google Scholar.

74 Nolan, supra note 59, at 13.

75 Terry, Nicolas P., “Alas! Poor Yorick,” I Knew Him Ex Utero: The Regulation of Embryo and Fetal Experimentation and Disposal in England and the United States, 39 Vand. L. Rev. 419, 432 (1986)Google Scholar.

76 Robertson, supra note 73, at 9.

77 Nolan, supra note 59, at 16.

78 Mary Anne, Warren et al., Can the Fetus Be an Organ Farm?, 8 Hastings Center Rep., Oct. 1978, at 23Google Scholar.

79 635 F. Supp. 469, 471 (S.D. Ohio 1986), aff‘d 822 F.2d 1390 (6th Cir. 1987).

80 597 F. Supp. 636, 670 (E.D. La. 1984), aff'd sub nom. Margaret S. v. Edwards, 794 F.2d 994 (5th Cir. 1986).

81 Planned Parenthood Ass'n v. Cincinnati, 822 F.2d at 1398.

82 497 F. Supp. 1340, 1351 (D.N.D. 1980).

83 Id. at 1351-52.

84 Id. at 1351.

85 112 S. Ct. 2791 (1992).

86 Id. at 2799.

87 See supra note 50 and accompanying text.

88 Nolan, supra note 59, at 16-17.

89 See Moore v. Regents of the Univ. of Calif., 793 P.2d 479 (1990). In the Moore case, the California Supreme Court decided that the plaintiff did not state a cause of action for conversion when his doctor, without informing him, developed a commercially valuable cell line using his therapeutically removed spleen. The court commented that “the laws governing such things as human tissues, transplantable organs, blood, fetuses, pituitary glands, corneal tissue, and dead bodies deal with human biological materials as sui generis, regulating their disposition to achieve policy goals rather than abandoning them to the general law of personal property.” Id. at 489. A person's control of his body tissue is limited “in the sense that [the law] prohibits him from taking the removed part to his home and keeping it on his mantel.” Id. at 503. However, the court declared that “ ‘scientific use’ contrary to the patient's expressed wish” should be prohibited. Id. at 492.

90 “Every human being of adult years and sound mind has a right to determine what shall be done with his own body….” Schloendorff v. Society of New York Hosp., 105 N.E. 92, 93 (N.Y. 1914).

91 Available in Moscow, supra note 11.

92 Nolan, supra note 59, at 17.

93 Id.

94 Id.

95 Greely, Henry T. et al., Special Report: The Ethical Use of Human Fetal Tissue in Medicine, 320 New Eng. J. Med. 1093, 1095 (1989)Google Scholar.

96 Robertson, supra note 73, at 6.

97 Greely, supra note 95, at 1095.

98 Childress, supra note 21, at 222-23.

99 Id.

100 Robertson, supra note 73, at 6.

101 Childress, supra note 21, at 223.

102 Robertson, supra note 73, at 6.

103 Id.

104 Id.

105 Id.

106 Nolan, supra note 59, at 14. See Paul Ramsey, the Ethics of Fetal Research 98-99 (1975).

107 Nolan, supra note 59, at 14. See Ramsey, supra note 106, at 99.

108 Nolan, supra note 59, at 14-15.

109 Robertson, supra note 73, at 7. In the context of a woman conceiving a fetus merely to abort it as if it were a “renewable” tissue like blood or sperm, Kathleen Nolan writes:

[P]art of the horror associated with the thought of a woman using a fetus purely to benefit herself or another springs from an ineluctable subconscious association of this act with a primordial or archetypal image—that of a mother turning and eating her child. The intended beneficence of the act is impotent to wash away the defilement implicit in such imagery.

Nolan, supra note 59, at 16-17.

110 Warren et al., supra note 78, at 23-24.

111 Roe v. Wade, 410 U.S. 113 (1973).

112 Id. at 163-64.

113 Robertson, supra note 73, at 8.

114 Benjamin Ginzburg, the Adventure of Science 78, 87-89 (1930).

115 Aristotle believed that both the earth and the body were composed of four humors: black bile (earth), blood (air), yellow bile (fire), and phlegm (water). Anatomy was conceptualized by analogy to the earth rather than by observation.

116 See Stephen W. Hawking, a Brief History of Time: From the Big Bang to Black Holes (1988).

117 Ginzburg, supra note 114, at 322-24. us id. at 52-55, 87-89, 322-24.