ETHICAL ISSUES IN UMBILICAL-CORD BLOOD BANKING

Objective.-Banking umbilical cord blood (UCB) to be used as a source o f stem cells for transplantation is associated with a set of ethical i ssues. An examination of these issues is needed to inform public polic y and to raise the awareness of prospective parents, clinicians, and i nvestigators. Participants.-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. Evidence.-Mem bers were assigned topics to present to the Working Group. Following i ndependent reviews, background materials were sent to the Working Grou p. Consensus Process.-Individual presentations of topics at a 2-day me eting were followed by extensive group discussions in which consensus emerged. A writing committee then drafted a document that was circulat ed to the entire Working Group. After 3 rounds of comments over severa l months, all but 1 member of the Working Group agreed with the presen tation of our conclusions. Conclusions.-(1) Umbilical cord blood techn ology is promising although it has several investigational aspects; (2 ) during this investigational phase, secure linkage should be maintain ed of stored UCB to the identity of the donor; (3) UCB banking for aut ologous use is associated with even greater uncertainty than banking f or allogeneic use; (4) marketing practices for UCB banking in the priv ate sector need close attention; (5) more data are needed to ensure th at recruitment for banking and use of UCB are equitable; and (6) the p rocess of obtaining informed consent for collection of UCB should begi n before labor and delivery.