No financial incentives for embryo donors

Commercial issues involved in stem cell research highlight the need for ethical guidelines for the disposition of spare embryos.

By Andis Robeznieks, amednews staff. Dec. 9, 2002.

Donating spare embryos for embryonic stem cell research is ethical -- if done correctly, according to a report from the American Society for Reproductive Medicine ethics committee published last month in the medical journal Fertility and Sterility.

"It's not a new earth-shaking opinion that other people didn't know our society supported," said committee member Lori A. Marshall, MD. "Our primary goal was to help -- and, in some ways, protect -- our patients so they could donate with full knowledge of what they're doing."

Dr. Marshall, section head of reproductive endocrinology at Virginia Mason Medical Center in Seattle, said the need for the guidelines was driven in part by the Bush administration's stem cell policy.

Current policy provides federal funding only to researchers who use stem cell lines that were in existence before Aug. 9, 2001, and were developed from embryos created for fertility treatment but no longer needed for that purpose.

"Those stem cells are useful for studies, but not for clinical trials because of the way they're cultured using nonhuman tissues," Dr. Marshall said. "So it's become clear that much of stem cell research will probably be done in the private domain.

"And we know that research that's done in the private domain certainly has other motives than just science," she added. "It's done for commercial motives, so we wanted to provide guidelines so practitioners and patients understood the issues."

Some of the most important ethical issues in the donation process include consent and timing. Dr. Marshall explained that couples must not be coerced into donating, and embryos should not be donated until couples are sure they do not desire to have any more children.

No buying or selling

She also said there should be no financial compensation for donors, because that would be the equivalent of buying and selling body parts.

"We don't want that to become an incentive for disposing of the embryos that way," Dr. Marshall said. "The embryos must be donated. They cannot be sold, and companies cannot buy them."

Couples "should know there could be commercial gains realized by the company doing the stem cell research, but they are not going to be a part of that," she said.

Another important thing for couples to know is that the embryo will be destroyed during the process of obtaining its stem cells. Dr. Marshall said she recognizes that destruction of embryos is a very controversial issue.

"It comes down to the very basic question of where does life begin and what rights do embryos have," she said. "Most people who are practicing in our field already accept a gradual assignment of rights to an embryo."

The report states that embryos have lesser status than adults and children, but regards them as "a potential human being worthy of special respect." It also states that embryo research is "ethically acceptable if it is likely to provide significant new knowledge that will benefit human health and if it is conducted in ways that accord the embryo respect."

Other key guidelines include:

Partners must both agree on the disposition of spare embryos. If they both don't agree on donating embryos for research, the embryos should not be used for research.
Abandoned embryos may be discarded, but should not be used for research or donated to another couple without prior consent.
Investigators bear the burden of justifying the worthiness of their research and must use the smallest number of embryos possible, submit proposals to an internal review board, have no satisfactory alternative to using embryos, and expect to gain important data from the research.

ADDITIONAL INFORMATION:

Weblink

American Society of Reproductive Medicine ethics committee report, "Donating spare embryos for embryonic stem-cell research," Fertility and Sterility, November (vol. 78, issue 5), in pdf (http://www.asrm.org/Media/Ethics/donatingspare.pdf)

ASRM ethics committee report, "Human somatic cell nuclear transfer (cloning)," Fertility and Sterility, November 2000 (vol. 74, issue 5), in pdf (http://www.asrm.org/Media/Ethics/cloning.pdf)