The marketing of umbilical cord blood banking

 

One stem-cell success story has been the use of stem cells derived from umbilical cord blood. The list  (more here) of diseases treatable by transplants of such stem cells is impressive, even more so when compared to, say, embryonic stem cell treatments, which are currently used in therapies such as . . . well . . . hmmm . . . uh, let me get back to you on that one.

One gratifying aspect of the use of umbilical cord stem cells is that obtaining them carries none of the unethical aspects associated with embryonic stem cell use. Nobody is killed in collecting umbilical cord blood; after the delivery of a baby, blood is removed from a vein in the umbilical cord, causing no harm to mother or newborn.

This does not mean that there are no ethical issues surrounding umbilical cord blood. There are currently two ways to “bank” umbilical cord blood, either through public or commercial cord blood banks. The public banking option is free to the parents, strictly quality controlled, and the blood is available to any patient who needs it and is a correct match. Commercial banks, on the other hand, typically charge $500-$2000 to collect the blood, along with an annual storage fee of $110-$150; are not as quality-controlled; and the blood is available only for the exclusive (potential) use of the patient.

Ethical issues arise from the marketing tactics employed by some of the commercial banks. The premise underlying the marketing is, Bank your child’s cord blood for his or her own exclusive use, so that if your child gets a disease sometime in his or her life, we’ll have perfectly matched stem cells to treat their disease, and you’ll have peace of mind! It is not unusual for companies to advertise cord blood as “Life insurance,” or to warn that “This may be your one opportunity to save your child,” or to promise “Potential regenerative therapies from stem cells such as treatments for arthritis, heart disease, etc.”  — therapies which currently do not exist. (The quotes are from commercial websites.)

These ads are based on hype and fear: hype, because they seem to promise treatments that are not currently available and may never come to pass; fear, because they play on every parent’s concern about terrible diseases their child could contract.

(Hype and fear: aren’t those are the same tactics used to promote embryonic stem cell research?)

Embryonic stem cell research and umbilical cord stem cell therapies are ethical worlds apart in their practice, and we should aggressively oppose the former and actively pursue the latter. But we should also oppose unethical commercial exploitation of otherwise ethical therapies through false advertising. Commercial umbilical blood banks should be held to strict “Truth-in-advertising” standards, and stopped from falsely promising anything more than we know they can deliver. This might save a lot of parents their hard-earned cash.

And while we’re at it, we ought to hold the promoters of embryonic stem-cell research to the same standards of truth. This might save a lot of embryonic persons their lives.

South Korea Takes an Ethical Step Backwards

This week (Sept. 19) it was reported that the government of South Korea will invest $89 million to recommence its pursuit of human embryonic stem cells (http://www.bbc.co.uk/news/world-asia-pacific-14968613).  You may remember the scandal that erupted in 2006 when a South Korean scientist (Hwang Woo-suk) declared that he had generated human embryonic stem cells by means of cloning.  Later it was discovered that the research had been faked.  Woo-suk, who was considered a national hero before the scandal, “caused inevitable damage to the entire stem cell research community in Korea,” according to South Korea’s president, Lee Myung-bak.  The money will be invested, proclaimed Lee, to “…restore our national fame as a stem cell powerhouse.”  The BBC report ends with the oft-cited list of all the diseases that may be treated by stem cells including, “Parkinson’s disease, heart disease, stroke, arthritis, diabetes, burns and spinal cord damage.”[i]

The announcement by President Lee troubles me on several levels:

1) there is no evidence that human embryonic stem cells (hESC) can actually treat human diseases.  Yet, the technology is touted as the panacea to all the major diseases that inflict humans today.

2) thus far, the research has produced more hype than tangible hope.  Indeed, the promises of hESC therapy entice those with money to burn in the search for a magic cure.  For example, recently it was reported that Peyton Manning traveled to Europe to seek stem cell treatment for a neck injury.  ABC News referred to Manning’s efforts as a “Stem Cell Hail Mary.”  Apparently the treatment was unsuccessful.  The ABC News article included the following statements by Dr. Ruth Macklin (bioethics professor, Albert Einstein College): “We live in an era where physicians are encouraged to practice ‘evidence-based’ medicine.  However, a sports superstar has the money… to travel anywhere in the world to receive an experimental procedure that is not based on any evidence that works for his condition.”  Another stem cell researcher, Dr. Lawrence Goldstein, noted that “he was unaware of any stem cell approach that is proven to help any sort of spinal issue.”[ii]

3) hESC research, of course, destroys human embryos.  Yet we know that zygotes formed at fertilization are genetically unique with an intrinsic capacity of self-development.  The zygote does not become a human being at some later stage (e.g., implantation); it is a human being!

4) other types of stem cell research, such as somatic stem cells and induced pluripotent stem cells, show far more promise for present and future therapy than hESCs.  Furthermore, somatic stem cells and induced pluripotent stem cell research are not ethically problematic because they do not entail the destruction of embryos.

It is unfortunate that South Korea has renewed its pursuit of the unethical practice of hESC research.  It could instead follow the example of several Japanese scientists (e.g., Shinya Yamanaka and Kazutoshi Takahashi of Kyoto University) who have researched ways to reprogram skin tissue in mice to mimic embryonic stem cells.  In the end, South Korea’s effort to become a “stem cell powerhouse” will be overshadowed by its moral compromise.


[i] http://www.bbc.co.uk/news/world-asia-pacific-14968613

[ii] http://abcnews.go.com/blogs/health/2011/09/19/peyton-mannings-stem-cell-hail-mary/

See also The Center for Bioethics and Human Dignity website for the story on Peyton Manning.  http://cbhd.org/ is an excellent source for bioethical news.

Of horcruxes, stem cells, and the quest for immortality: the bioethics of Harry Potter

 

CBHD has partnered with author Austin Boyd and publishing house Zondervan for a suspense-fiction series entitled The Pandora Files. The first installment, Nobody’s Child, is about designer babies, body parts sales, and the thorny ethical issues they engender. It is a laudable effort to use the power of story to get people thinking about important issues; to show us rather than to tell us something is often the better strategy, and highlights the power of all the arts, whether visual, written, or performed, to touch hearts as well as minds.

I recently finished reading with my family one of the more wildly popular contemporary works of fiction, and found many points of contact for thinking about current bioethical issues. I realize that J.K. Rowling did not write the Harry Potter series as a bioethical parable, but the themes in her writing and the values her characters espouse are striking in their applicability.

(Warning: SPOILERS) In the series, an evil wizard named Lord Voldemort is obsessed with power, and with his own mortality. In the effort to overcome death, he resorts to what is the worst of imaginable dark magic: the creation of horcruxes. In order to make a horcrux one must commit murder, and the process causes irreparable damage to one’s own soul.

Harry Potter, a student wizard, is a leader of the resistance to Lord Voldemort. Guided by the Gandalf-esque wizard Dumbledore, he grows into his task over the course of seven very exciting (and very long) books. Dumbledore asserts repeatedly that the primary strength the resistance enjoys resides not in any magical power, but rather in the power of love — not the mushy, romantic sort, but the real thing,  self-sacrificing agape-style love. In fact, Harry goes knowingly to his death in order to defeat Voldemort; then, after a brief post-mortem sojourn in King’s Cross (who could miss that symbolism?) he returns and — well, I won’t spoil the entire story for the three people who haven’t read it or seen the movies.

Even in these novels written ostensibly for children, there are shadows of deeper and darker motifs, parallels to our world. The themes of thirst for power and desire for immortality are all too familiar to us, driving much of the most ethically questionable science. That Voldemort would resort to killing in his quest to live forever should have a familiar ring as well: we just make it sound much more civilized when we say “We disaggregate an embryo in a laboratory dish in order to obtain the stem cells that will be the key to regenerative medicine.” Voldemort does terrible damage to his soul each time he kills to make a horcrux;  who can tell what damage we do to our cultural soul when killing human embryos, our own young, becomes accepted by a large portion of the scientific and public community?

Again, Rowling did not intend to write a bioethical thriller as Austin Boyd is doing. But a person reading her books might just feel a bit more the danger inherent in the quest for power, and sense more keenly the contradiction and, indeed, evil, of killing another in order to benefit oneself. And when practices redolent of those values, such as embryonic stem cell research, are brought up, the reader might remember the words of one of the leaders of the resistance who said, “Every human life is worth the same, and worth saving;” and espouse Dumbledore’s prescription of self-giving love as a potent form of resistance to the evil around us.

Another Point for Adult Stem Cells?

A recent development in (Adult) Stem Cell research has proven effective in repairing the heart muscles of mice after a heart attack! Although the procedure has only proven effective–thus far–on mice, the promise of cell reactivation repairing muscle after a heart attack is nothing to sneeze at.

“The researchers examined the hearts of mice at various time points after the operation [procedure that replicates the effects of a heart attack]. They found heart cells expressing Wt1 just two days after the injury. The cells were initially in the heart’s outer layer, but by two weeks after surgery they had moved inside and clustered around the site of the injury. The cells had also changed in size and shape, and looked just like cardiomyocytes.”

This success is another reminder that we (scientists and researchers of today) are still needlessly pursuing the less than ethical embryonic stem cell research that requires the destruction of human embryos, the ending of human lives.   When comparing the two it is difficult to not concede to the preeminence of embryonic alternatives, and still the federal government wishes to fund the destruction of embryos.

While the battle continues, it looks like embryonic alternatives still have the upper hand.

For more information on stem cell research check out this website.