Transplants of umbilical cord blood have been recommended or performed to treat a variety of conditions. Cord blood is also a potential source of stem and progenitor cells with possible therapeutic applications. Nonetheless, collection and storage of cord blood raise ethical concerns with regard to patient safety, autonomy, and potential for conflict of interest. In addition, storage of umbilical cord blood in private as opposed to public banks can raise concerns about access to cord blood for transplantation.
Physicians who provide obstetrical care should be prepared to inform pregnant women of the various options regarding cord blood donation or storage and the potential uses of donated samples.
Physicians who participate in collecting umbilical cord blood for storage should:
- Ensure that collection procedures do not interfere with standard delivery practices or the safety of a newborn or the mother.
- Obtain informed consent for the collection of umbilical cord blood stem cells before the onset of labor whenever feasible. Physicians should disclose their ties to cord blood banks, public or private, as part of the informed consent process.
- Decline financial or other inducements for providing samples to cord blood banks.
- Encourage women who wish to donate umbilical cord blood to donate to a public bank if one is available when there is low risk of predisposition to a condition for which umbilical cord blood cells are therapeutically indicated:
- In view of the cost of private banking and limited likelihood of use
- To help increase availability of stem cells for transplantation
- Discuss the option of private banking of umbilical cord blood when there is a family predisposition to a condition for which umbilical cord stem cells are therapeutically indicated.
- Continue to monitor ongoing research into the safety and effectiveness of various methods of cord blood collection and use.
AMA Principles of Medical Ethics: I, V
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