U.S. Policy on Fetal Research Hypocritical

Pioneering medical research frequently provokes ethical controversies. But no research initiative in American medicine has evoked more genuine dishonesty or more hypocrisy than the use of fetal tissue transplants to help treat victims of Parkinson’s disease, diabetes and other crippling illnesses. This controversy offers a shameful example of medical innovation mismanagement.

At the center of this controversy are the products of abortion: dead fetuses. Because of its unique biological properties, fetal tissue provides researchers tremendous insights into the workings of the human body. Quite possibly, fetal tissue could prove as vital to healing certain diseases as any blockbuster drug, surgical procedure or transplantable organ.

Transplant research supporters argue that it is sinful to waste the tissue when it could be used to heal the living. Transplant opponents insist that explicitly linking abortion to healing would effectively excuse or encourage the procedure. So although the government funds generic research on fetal tissue, it explicitly refuses to fund transplant research. Arguing that such research is essential, Congress recently voted to lift the funding ban--a move the Bush Administration vows to veto.

That debate is political gamesmanship tarted up as public policy. The real issue here isn’t fetal tissue transplant research; it’s what happens if this research leads to widely practical therapies. Dr. Kenneth Riley, chairman of obstetrics, gynecology and reproductive biology at Harvard Medical School and a champion of fetal tissue transplant research, believes that work under way in treating Parkinson’s disease will generate demand for transplant treatment within three to five years. What happens if fetal tissue proves just as useful in treating diabetes and Alzheimer’s? What are the probable consequences of success?

With more than half a million Parkinson’s sufferers, nearly three quarters of a million severely effected diabetics and several million potential Alzheimer’s victims, the consequences are potentially massive. Theoretically, fetal transplant surgery could become more prevalent than heart surgery.

Shifts in public perception might prove equally dramatic. With transplant technology, an abortion can be transformed from a personal tragedy to a gift of life. Supporters of fetal tissue transplants affirm that there should be a wall between the decision to abort and the decision to donate. But, practically, can there be? Indeed, should there be? Would it be wrong for a doctor to tell a woman who wants an abortion that, if she waits only two weeks, her fetal tissue could help save someone’s life? Perhaps that knowledge will ease her trauma. While you’re at it, why not offer to pay for the abortion if she is willing to donate? Society does it for blood; why not for fetal tissue?

Let’s complicate the question. “What happens when (abortion pill) RU-482 comes to America and there’s no tissue?” poses Harvard’s Ryan. The economics of fetal tissue availability is quite unlike the economics of kidneys, livers and hearts.

What mother of a crippled Type 1 diabetic girl wouldn’t seriously consider the possibility of an induced abortion to save her suffering child? What loving daughter wouldn’t explore that possibility to save her father from the cruel decay of Parkinson’s? Indeed, what kind of subtle and overt pressures might women be subjected to if close friends and relatives are similarly stricken? What does “choice” mean under these circumstances?

“If these techniques turn out to be successful, would anyone try to deny that this shifts the process of decision making towards choosing to have an abortion?” asks Dr. James Mason, the assistant secretary for health at the Department of Health and Human Services who champions the Bush Administration’s fetal tissue transplant funding ban.

For scientists to divorce fetal tissue transplant research from its therapeutic implications is appallingly dishonest. Simply saying that the difficult ethical choices are up to society is an abdication of responsibility that should disqualify them from public funds. If scientists believe that harvesting aborted fetal tissue or direct family donations are appropriate public policy, then they should defend it and not hide behind the academic veil of “research.”

Unfortunately, the Bush Administration’s stand on fetal tissue transplants isn’t only dishonest, it’s also breathtakingly hypocritical. While forbidding public funds for fetal transplant research that might lead to induced abortions, the government explicitly allows privately funded fetal tissue transplant research to continue. In other words, it’s OK to have a private marketplace in fetal tissue. Mason acknowledges the conflict but says that his department’s reach doesn’t extend beyond government research funding. At best, that’s disingenuous--at worst, it leads to what Harvard’s Ryan calls an “anything goes” medical marketplace, much as we have with in vitro fertilization.

That our government and medical establishment duck the life-and-death ethical issues posed by an emerging technique is nothing short of disgraceful. If they treated patients the way they’ve treated this policy, they would be sued for malpractice.