Ethical issues in umbilical cord blood banking. Working Group on Ethical Issues in Umbilical Cord Blood Banking.
OBJECTIVE
Banking umbilical cord blood (UCB) to be used as a source of stem cells for transplantation is associated with a set of ethical issues. An examination of these issues is needed to inform public policy and to raise the awareness of prospective parents, clinicians, and investigators.


METHODS
Individuals with expertise in anthropology, blood banking, bone marrow transplantation, ethics, law, obstetrics, pediatrics, and the social sciences were invited to join the Working Group on Ethical Issues in Umbilical Cord Blood Banking.


METHODS
Members were assigned topics to present to the Working Group. Following independent reviews, background materials were sent to the Working Group.


METHODS
Individual presentations of topics at a 2-day meeting were followed by extensive group discussions in which consensus emerged. A writing committee then drafted a document that was circulated to the entire Working Group. After 3 rounds of comments over several months, all but 1 member of the Working Group agreed with the presentation of our conclusions.


CONCLUSIONS
(1) Umbilical cord blood technology is promising although it has several investigational aspects; (2) during this investigational phase, secure linkage should be maintained of stored UCB to the identity of the donor; (3) UCB banking for autologous use is associated with even greater uncertainty than banking for allogeneic use; (4) marketing practices for UCB banking in the private sector need close attention; (5) more data are needed to ensure that recruitment for banking and use of UCB are equitable; and (6) the process of obtaining informed consent for collection of UCB should begin before labor and delivery.
Sugarman
J
J
Division of General Internal Medicine, Duke University Medical Center, Durham, NC 27710, USA.
Kaalund
V
V
Kodish
E
E
Marshall
M F
MF
Reisner
E G
EG
Wilfond
B S
BS
Wolpe
P R
PR
D035843:Biomedical Research; D001771:Blood Banks / Q000592:standards*; D001782:Blood Donors; D003132:Commerce; D003219:Confidentiality; D032921:Consensus; D033001:Directed Tissue Donation; D030881:Disclosure; D015507:Drugs, Investigational; D004992:Ethics, Medical; D035082:Federal Government; D005260:Female; D005312:Fetal Blood; D033161:Government Regulation; D018380:Hematopoietic Stem Cell Transplantation / Q000592:standards*; D006801:Humans; D007258:Informed Consent; D028681:Moral Obligations; D033282:Parental Consent; D018579:Patient Selection; D011247:Pregnancy; D037841:Pregnant People; D017149:Private Sector; D011640:Public Policy; D040841:Resource Allocation; D018570:Risk Assessment; D035703:Therapies, Investigational; D009927:Tissue and Organ Procurement; D014182:Transplantation, Autologous; D014184:Transplantation, Homologous
D015507:Drugs, Investigational