October 28, 2015 — Summary of "Fetal Tissue Research: An Ongoing Story of Professionally Responsible Success," Gelber et al., American Journal of Gynecology, Sept. 29, 2015.
The recent controversy over fetal tissue research has "obscure[d] professional responsibility in this matter, which has been a disservice to the medical community and the patients who can and do benefit from resulting medical advances," write Shari Gelber of the Weill Medical College at Cornell University and colleagues.
In this commentary, the authors "explain why the use of fetal tissue for research and treatment should not be controversial but, instead, viewed as a professionally responsible success story."
History of Fetal Tissue Research
Touching on the history of fetal tissue research, the authors write that while studies that rely on animal tissue "are informative for many diseases, viruses are often species specific, so nonhuman studies were often not informative." Since "viruses were difficult to cultivate ... [p]reventive or therapeutic agents were ... mostly unattainable," they add.
For example, the authors note, "Only the human brain tissue from embryos that were the product of induced abortion was successful as a host" to grow poliovirus in a 1930s study that attempted to cultivate the virus "in the cultures of chicks, mice, monkeys and human embryo cells." According to the authors, that "line of research was continued" by other researchers "who found that the virus could be grown in cells from numerous embryonic tissue types in addition to neurons." The authors write that "these advances in human embryo-derived viral culture advanced the field and led to the ability to cultivate varicella, measles, and numerous other viruses."
The authors also write about how fetal tissue research helped eliminate rubella, noting, "Research using cadaveric fetal tissue led to the development of the rubella vaccine and the subsequent elimination of congenital rubella in the Americas." The authors continue, "More recently, fetal tissue became a cornerstone of some of the most promising therapies for Parkinson['s] disease and other difficult-to-treat adult conditions."
Further, the authors contend that "fetal tissue benefits scientific research across many fields, including physicians and scientists who may not even realize its contribution to their work." For example, the authors highlight that the HEK293 cell line, which "originated from the kidney cells of an aborted embryo," has "become ubiquitous in research" and has "been used in the development and production of therapeutics."
After tracing the effect of fetal tissue research, the authors discuss the informed consent process as it relates to abortion and fetal tissue research. The researchers explain that "[d]eidentified tissue from surgical procedures is used routinely in research without consent." As a result, the practice of seeking informed consent from women who have abortions about whether they would like to donate the fetal tissue is an "additional protectio[n]" and shows "a level of respect for women that is not required in other spheres of medicine."
The authors write, "Once a patient has independently made her informed decision to authorize induced abortion, it is reasonable to present her with the opportunity to consider authorizing procurement of tissues and organs from the fetal cadaver for purposes of research and treatment." According to the researchers, women who opt to donate fetal tissue might be driven by altruistic motivations. However, they note, "There is no evidence that the potential for societal benefit causes patients to choose [abortion] or that research on fetal tissue causes abortion," adding, "Any claims to the contrary are pure speculation." They add that "neither the woman nor her physician derives financial benefit from authorizing procurement of fetal tissues."
Fetal tissue procurement "is legally permitted and regulated and is supported by professional responsibility in obstetrics and gynecology," and the practice is "supported by the ethical principle of justice." They conclude, "The success story of cadaveric fetal tissue research and treatment should continue unhindered, to fulfill professional responsibility to current and future patients."