The bioethics of human fetal tissue research and therapy: moral decision making of professionals

Abstract

Objective: We investigated the decision making of professionals regarding the ethical acceptability of using human fetal tissue from elective abortion for research or therapy.

Study design: We surveyed 390 professionals from 20 European countries on their ethical beliefs regarding the scientific and medical use of human fetal tissue from elective abortion. We assessed the importance of basic medical ethics and beliefs regarding the morality of abortion and fetal rights to their decision making.

Results: Sixty-six percent of 198 responding professionals believed that use of fetal tissue from elective abortion was ethically acceptable. Beliefs regarding the morality of elective abortion and fetal exploitation overwhelmingly influenced individual ethics regarding fetal tissue research or therapy.

Conclusion: Ethical decision making is a dynamic process and individuals are not altogether consistent in their beliefs. The important public policy issues raised in this study concern the rights of the dead fetus, whether these rights are exploited through fetal tissue therapy, and whether women's right of authority over the disposition of aborted fetal tissue is abdicated.

PIP: In 1990, 390 professionals involved or interested in reproductive health issues from 20 European countries were randomly selected to participate in this study in collaboration with the Institute for Bioethics at Maastricht, the Netherlands. The group of scientists, physicians, public health officials, lawyers, philosophers, theologians, and ethicists were mailed an English-language, self-administered questionnaire. Surveys were completed by 198 professionals (51% response rate) from 20 European countries. 66% (n = 118) of the professionals believed that the therapeutic use of human fetal tissue from elective abortion was ethically acceptable, whereas 34% (n = 60) did not. Bivariate analysis showed that 87% (n = 47) of those who believed that life begins at or after viability and 90% (n = 60) of those who believed elective abortion was morally acceptable found the use of fetal tissue for research and therapy ethically acceptable. 137 did not believe that the potential medical benefits arising from fetal tissue therapy outweighed any moral problem associated with the abortion. Even so, 61% (n = 82) holding that position believed that the therapeutic use of fetal tissue from selective abortion was ethically acceptable. However, about half the sample stated that they were not knowledgeable about animal studies research on fetal tissue therapy in the treatment of Parkinson disease. Of the 68% (n = 113) who supported fetal tissue therapy generally, only 80 (70%) of these would continue to do so if research showed that fetal tissue therapy offered only temporary relief rather than actual cure. Consequently, 48% would support fetal tissue therapy in humans under these conditions. None of the multiple regression analysis variables measuring demographics or the concepts of beneficence, justice, abortion morality generally, or the use of scientific evidence remained significant. The only significant variables associated with an increased likelihood of approving the use of fetal tissues were ones representing the value and belief concepts of fetal rights, concerns over second-trimester abortion, respect for autonomy of the mother, and nonmaleficence.