Friday, March 4, 2016

The controversy of fetal tissue research

Project #3: The controversy of fetal tissue research
by Sasha Afanasyeva
After sting videos were released this summer by anti-abortion activists about Planned Parenthood fetal tissue donations, a political storm has erupted with some calling for a ban of fetal tissue research and donations. Fetal tissue is used to develop vaccines and research conditions such as Parkinson’s disease and Down syndrome. Should fetal tissue research and donations be banned or restricted, that effect will be felt amongst all the stakeholder groups. These stakeholder groups include anti-abortion activists and Republicans, researchers and the Association of American Medical Colleges, Planned Parenthood, and more broadly any beneficiaries of vaccinations and research for degenerative diseases. Such analysis of stakeholder groups is critical to better understand the complexity of the fetal tissue research controversy.



Anti-Abortion Activists and Republicans
Planned Parenthood and the issue of fetal tissue research made headlines last summer when anti-abortion activists David Daleiden and Sandra Merritt released videos featuring Planned Parenthood employees talking about aborted fetal tissue donations taken during a sting operation. The videos have resulted in an emotionally charged political storm with prominent politicians such as Ted Cruz and Rand Paul calling for defunding Planned Parenthood, and some states such as Wisconsin and Missouri going as far as pushing for a ban on fetal tissue donations and research.


The videos released from the sting showed Planned Parenthood employees discussing fetal tissue uses and transportation costs. The goal of the videos was to try to show that Planned Parenthood was illegally selling fetal tissue, something multiple investigations across twelve states later failed to find.


Given that anti-abortion activists oppose abortion for religious and moral reasons, they naturally oppose fetal tissue research as well. Opponents to fetal tissue research such as Marco Rubio, a US senator from Florida and a current Republican presidential candidate, said that fetal tissue research has “created an incentive for people to be pushed into abortions so that those tissues can be harvested and sold for a profit.”


Some states are making an active push to outright ban fetal tissue donations. While it is illegal to sell fetal tissue, it is currently legal for a mother to choose to donate it. It is also legal to charge a small fee to cover transportation costs. Wisconsin’s Republican-dominated legislature is currently pushing for a complete ban on such fetal tissue donations.
Researchers and the Medical Community
This recent push against fetal tissue has caused growing concern in the scientific and medical community who say that such a ban or restriction would set back medical research.
Due to the emotionally and politically charged nature of abortion and fetal tissue research, many scientists are choosing to stay silent about defending fetal tissue research, something that a December Nature editorial, which was written anonymously, discussed. “US scientists who use fetal tissue are choosing to stay silent about the value of their work rather than to defend it publicly and face the real possibility of physical attack,” the editorial said. When in November, a gunman attacked a Planned Parenthood clinic and killed three people, injured nine, and called himself “a warrior for the babies,” concerns for safety were further raised for researchers and Planned Parenthood employees alike.
However not all stayed silent. Alto Charo, a bioethicist from University of Wisconsin-Madison, spoke out against Wisconsin’s current attempt to ban fetal tissue research and donations.
“No embryo or fetus is going to be lost because of the research,” said Charo. “Research needs to be regulated to protect public health and safety, but this is very different,” she says. “This is shutting down research for purely moral purposes—it’s shutting down research because people disapprove.”
A WebMD article from September, which was reviewed by an MD professional, interviewed Anita Bhattacharyya, PhD, of the University of Wisconsin-Madison, and Jorge Busciglio, PhD, of the University of California-Irvine, about the use of fetal tissue in research. When it came to Down syndrome and Alzheimer’s disease, the researchers said that animal studies are not possible due to the way the human brain is different. “For Down syndrome specifically, animals aren’t very good, because their brains and chromosomes are so different from humans”, Bhattacharyya said. Busciglio who studies human cortical neurons, a type of brain cell affected in Down syndrome and Alzheimer’s disease said that fetal tissue is necessary for such research. “It’s really critical to do some of these experiments in these types of cells,” Busciglio said. “If we don’t have these cells, we don’t have our answer.”
The Association of American Medical Colleges
The Association of American Medical Colleges released a statement signed by more than 60 medical colleges and medical organizations highlighting the medical benefits of fetal tissue research and urging lawmakers to reject proposals that would restrict access to this research. According to Nature, the AAMC statement allowed medical professionals and scientists to speak out on the issue without having their personal name attached. In the editorial, Nature said that they share the AAMC’s concerns and join the AAMC in asking US lawmakers to reject such proposals. “The current episode is a reflection of a larger politics of division that has taken hold in the United States, and which has worsened alarmingly in recent months. It is time for a de-escalation of the rhetoric and the creation of a space for calm and rational discourse,” Nature wrote.
In the AAMC release, the US Department of Health and Human Services was quoted as saying that “fetal tissue continues to be a critical resource for important efforts such as research on degenerative eye disease, human development disorders such as Down syndrome, and infectious diseases, among a host of other diseases.”


Fetal tissue research also plays an important role in vaccine development. In the same statement, the AAMC said, “In the past, human fetal tissue research has been critical in establishing permanent cell lines for use in vaccine research for diseases such as polio, hepatitis A, measles, mumps, rubella, chickenpox, and rabies. These established cell lines are currently being used to develop an Ebola vaccine.”
The AAMC also stressed in its report that the ability to donate fetal tissue for research is not linked to an increase in abortions practiced. “Nor can we reasonably expect a limitation on fetal tissue donation or research to reduce the number of abortions,” the AAMC said. “Rather, it will prevent the use of tissue that would otherwise be destroyed, hindering efforts to better understand, diagnose, and treat diseases.”
Planned Parenthood
The Nature editorial noted that fetal tissue donation for research is already rare, with only one percent of about 700 Planned Parenthood clinics even participating in tissue donation. Given the political climate, Nature expects that number to go down further. The Hill reported in September that the number of Planned Parenthood clinics that allow women to donate fetal tissue went down from six to two, pointing to the political climate as the primary cause.
Beneficiaries of vaccines and research
Should fetal research be banned or restricted, the medical and scientific community is worried that the loss of medical advances can be significant. The AAMC ended its report by saying that “as physicians and scientists, we work every day to save and improve lives. We urge lawmakers to support our ability to continue this important work by rejecting any proposals that restrict access to fetal tissue for research that has the potential to save countless lives.”
Takeaways
Given the complexity and controversy of fetal tissue research, having an understanding of stakeholder groups and how they are pitted against each other is critical to understanding this issue. Regardless of how the courts rule and what legislators choose to do, all stakeholders will be affected by the decisions as to whether or not fetal tissue research and donations should be restricted.
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On the net:
Nature Editorial:

The Atlantic:


WebMD interview:




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