Bioethical catch-22: the moratorium on federal funding of fetal tissue transplantation research and the NIH revitalization amendments.
In 1988, a moratorium on the use of federal funds for fetal tissue transplantation research (FTTR) halted the promise of a cure for millions of Americans suffering from Parkinson's disease, diabetes, and other debilitating conditions. Since the moratorium began, private and international experimentation continues with mixed success. In the foreground, however, the debate rages over federal funding for fetal tissue transplantation from induced abortions into humans. In the House of Representatives and the Senate, the debate culminated with the passage of the National Institutes of Health (NIH) Revitalization Amendments. In addition to authorizing NIH programs, the $5.4 billion bill included measures designed to overturn the moratorium on federal funding for the transplantation research. Brimming with controversy, the bill was forwarded to the White House where it met President Bush's promised veto. The veto was sustained when the House failed to rally the two-thirds majority vote necessary to override a veto, leaving the moratorium intact and the controversy alive. Modified measures were introduced in both Houses of Congress, but a Senate filibuster in the last hours of the session foreclosed a second veto and placed the bill on the 1993 calendar. The field of fetal tissue research, currently a fraction of human health research but with the potential for a six billion dollar industry, is the focus of inevitable controversy. FTTR, as a sub-field, presents a volatile combination of the politics of abortion, the international research race, and the cries of millions of Americans suffering from Parkinson's disease and other crippling debilitations. Thus, using fetal tissue as a potential cure commands the interest and the passion of many. FTTR from induced abortions distinguishes itself from federally approved fetal tissue research because it connects a potentially beneficial health pursuit with a critically divisive moral issue of our day--abortion. By its very nature, FTTR cannot automatically enjoy the approval given to other research pursuits, primarily because at its very core lies an unresolved ethical issue. This issue is found in the connection between the procedures of aborting the fetus, harvesting the tissue, and transplanting it into a needy recipient. Unlike transplantation from ectopic pregnancies or spontaneous abortions, which are permitted by the ban, FTTR directly links decisions and procedures immersed in the moral controversy over induced abortion. This Comment outlines the debate over the transplantation research affected by the moratorium on the use of federal funds for FTTR. Whether fetal tissue from induced abortions should be procured for transplantation into humans, and if so, how its use can be regulated is a significant contemporary challenge for public policy makers. Part I of this Comment delineates the formation of public policy on the issue. Part II explains the content of the NIH Amendments as a new direction for public policy. Part III discusses the potential benefits and risks of federal funding of FTTR. Finally, part IV addresses whether the executive ban or the legislative measure is a sound, farsighted public policy.
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D037881:Aborted Fetus; D000028:Abortion, Induced / Q000592:standards; D026683:Advisory Committees; D035843:Biomedical Research; D003657:Decision Making; D033001:Directed Tissue Donation; D004992:Ethics, Medical; D035082:Federal Government; D005260:Female; D033042:Fetal Research; D016332:Fetal Tissue Transplantation / Q000191:economics / Q000331:legislation & jurisprudence*; D005380:Financing, Government / Q000331:legislation & jurisprudence*; D033161:Government Regulation; D006805:Human Experimentation; D006801:Humans; D009014:Morals; D009316:National Institutes of Health (U.S.); D010300:Parkinson Disease / Q000628:therapy; D011247:Pregnancy; D037841:Pregnant People; D011640:Public Policy; D012109:Research Support as Topic / Q000331:legislation & jurisprudence*; D040841:Resource Allocation; D018570:Risk Assessment; D014019:Tissue Donors / Q000331:legislation & jurisprudence; D009927:Tissue and Organ Procurement; D014481:United States