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To: Parkinson Information Exchange Subject: Fetal tissue transplantation research Following is an excerpt from an article entitled "The Short, Exceedingly Strange Debate Over Fetal Tissue Transplant Research" which appeared in the American Journal of Ethics and Medicine, Fall 1994, written by Dr. Arthur Caplan, Director of the Center of Bioethics, University of Pennsylvania School of Medicine. "One of the first acts President Bill Clinton performed upon assuming office was to rescind the ban the Bush administration had imposed in 1988 on the use of Federal funds to pay for research on transplants using tissues obtained from aborted fetuses. Congress subsequently enacted legislation governing the use of such tissue. The NIH has now reopened its grant application process to those who wish to pursue research on this form of transplantation. "The argument over the use of tissues from aborted fetuses for transplantation reearch was one of the strangest in the annals of human experimentation ethics. The debate focused almost exclusively on the proposals of a tiny handful of American scientists to use fetal tissue transplants to see whether they might be of benefit to persons suffering from Parkinsonism or diabetes. Yet, few people appear to have understood how truly bizarre it was to debate the morality of this research given the prior history of fetal tissue transplant research and the ongoing commitment of the Federal government to funding other forms of research using tissues obtained from aborted fetuses. "Transplants using tissue from aborted fetuses were hardly unknown in medicine at the time the debate over the morality of fetal tissue transplants erupted. The first experiment involving a fetal tissue transplant using tissue from an aborted fetus took place in Italy with a patient suffering from diabetes. The experiment, which did not succeed, was reported in the medical literature in 1928. The first American experiment using fetal pancreas to try to treat a person with diabetes took place in 1939. It too failed. At least one form of fetal tissue transplantation had, however, been established as therapeutic long before the debate broke out about the morality of such research. (Vawter, et. al., 1990) "By the early 1970s many transplant experiments using fetal cells in newborn babies had been undertaken. The subjects were children afflicted with a congenital condition known as DiGeorge's syndrome. Babies with this condition are born severely immunocompromised because they do not have a functioning thymus. The results reported throughout the 1970s and 1980s of transplant research for this condition were very positive. One report on the successful use of fetal tissue transplants appeared in the peer reviewed literature just a year before the Bush administration imposed its ban. (Vawter et. al., 1990). "Not only did transplants using tissue from electively aborted fetuses have a long history in medicine prior to the debate which eventuated in the Bush administration's ban, but fetal tissue from aborted fetuses had nong been used in medican research for such purposes as toxicity studies, research on fetal development. and the culturing of tissue lines for all manner of genetic and biological research. These types of experiments continued with Federal support throughout the time period when the government imposed ban on fetal tissue research for transplantation prevailed. In 1988, the year the ban was imposed, the NIH spent 8.3 million dollars on non- transplant related research involving human fetal tissue. "Not only did the government support research using fetal tissue, the government had historically been involved in procuring such tissues. The Federal government in 1961 helped create a tissue bank, the Laboratory for the Study of Human Embryos and Fetuses at the University of Washington, for distributing fetal tissues to researchers in the United States. A similar bank had been in existence in the United Kingdom under the auspices of the British Medical Research Council since 1957. Oddly, arguments about the merits of allowing fetal tissue transplant research to proceed were treated as independent from, and unconnected to, the use of fetal tissue from aborted fetuses for other forms of scientific research which continued with government support throughout the five years the ban existed. (Vawter, et. al., 1991) The only way of understanding how it could be that the nation's leaders, interest groups, members of the media and scientific societies could find themselves embroiled in a debate about the permissibility of research that had a half century history in medicine, which had already proven successful in the treatment of at least one disease, and which used precisely the same source of tissue as many other forms of publicly funded research, is politics. Specifically, abortion politics fueled the debate. The debate about the use of fetal tissue for transplants was nothing more than a chapter in the nation's long-running debate about the morality of elective abortion (Vawter and Caplan, 1992). "The strangest thing about the many strange things which characterized the debate about the use of fetal tissue from elective abortions for transplants was that hardly anyone challenged the underlying notion that allowing research on fetal tissue transplants would increase the incidence of abortion. (Vawter, et. al., 1990); Garry, Caplan, et. al., 1992). There was no evidence at all that the expenditure of Federal funds on other forms of research using fetal tissue from elective abortion had any impact on rates of abortion. Nor was there any evidenced presented that women thinking about or seeking abortions would assign very much if any weight to considerations about the disposition of fetal remains post-abortion. And no one seemed interested in asking whether the supply of tissue required to conduct a small number of experiments would require more abortions than the one and a half million taking place each year in the United States." Dolores Gross