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Massachusetts Medical Society




Research involving human fetal tissue has been the subject of intense political debate in this country for almost two decades, and the use of fetal tissues in transplantation continues this controversy in another forum. Since Roe v. Wade ,1 the landmark decision on abortion by the U.S. Supreme Court in 1973, the federal government has focused public attention on fetal research by creating panels of experts. "3 This conclusion was accepted on a vote of 15 to 2, and included recommendations that the decision to abort be kept independent of the decision to retrieve and use fetal tissue, that recipients be informed of the tissue's fetal origins, and that fetal tissue be accorded the same respect given other cadaveric human tissue.3 In answer to the remaining questions, the panel adopted the following recommendations: the decision to abort must be made before the use of the tissue is discussed; anonymity should be maintained between donor and recipient; the timing and method of the abortion should not be influenced by the potential use of the fetal tissues; and the consent of the pregnant woman is necessary and sufficient for the use of tissue unless the father objects.3 The panel also concluded that "there is sufficient evidence from animal experimentation to justify proceeding with human clinical trials in Parkinson's disease and juvenile diabetes. [...]the Nazi analogy fails because those experiments were conducted on live, unconsenting patients, who suffered greatly from them, whereas research on fetal tissue involves only the dead remains of lawfully aborted fetuses, which cannot be harmed, and such research is done only with consent.2, 3 The dissenters' primary argument was that federal funding of fetal research would "institutionalize" governmental complicity with the "abortion industry"2, 3 -- a superficially appealing claim, perhaps, except that the federal government already profits directly from those who perform abortions, by taxing their earnings. The first transplantations in patients with Parkinson's disease, in which the patient's own adrenal tissue was used, attracted tremendous press coverage, and approximately 100 such procedures were performed in the United States on the basis of initial reports of success in Mexico.14 This experience indicates that local institutional review boards provide inadequate protection to the subjects of such research, just as they failed to protect the subjects of recent experiments with artificial hearts and xenografts.15 Adrenaltissue transplantations have had very disappointing results,16, 17 and serious questions have been voiced about the original Mexican cases.14 Fetal tissue is thought to have unique properties, and its use in patients with Parkinson's disease also subjects the patient to one less surgical procedure.


From The New England Journal of Medicine, George J. Annas, The Politics of Transplantation of Human Fetal Tissue, Volume 320, Page 1079 Copyright ©(1989) Massachusetts Medical Society. Reprinted with permission.



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