Genug ist Genug: A Fetus Is Not a Kidney

Abstract

Genug ist Genug: A Fetus Is Not a Kidney The Yiddish expression ist genug translates roughly into English as is enough. Setting a boundary or horizon rather than advancing a fundamental rule, the expression is an aphorism rather than a principle. One suspects it is a universal aphorism, known to parents if not to philosophers in every culture. Its terseness conveys a sense of indignation at a request for tolerance pushed beyond some perhaps unspoken limit. Surprisingly, when considering the ethics of fetal tissue transplantation, is enough not only captures the predictable frustration of anti-abortion forces but also resonates strongly for many who are inclined to tolerate abortion politically and legally, if not to welcome it morally. For these individuals, the tremendous new potential for using fetal tissue to treat severe and all-too-common illnesses causes not anticipation but concern. Why should the development of a form of therapy predicted to be enormously beneficial trouble those who accept legalized abortion and most forms of fetal research? After all, patients with Parkinsons disease, and those with other diseases potentially treatable via fetal tissues, often suffer terribly, and fetal remains, if not used for transplantation, will probably only be discarded. Women have a legal right to abortion, and cadavers, whether fetal or otherwise, cannot really be said to have any interests one way or another. Why, then, should anyone not opposed to legalized abortion object to therapeutic use of fetal tissue? Framing the issue in this fashion, however, requires accepting a set of moral blinders formed by two assumptions: 1) that use of cadaveric fetal tissue for transplantation is fundamentally equivalent to its use in teaching or research; and 2) that this use of fetal tissue can be isolated from its origin in elective abortions such that judgments about the status of the fetus and abortion are immune from any bias introduced by successful transplants. A different vision would see in fetal tissue transplantation a problematic conceptual and linguistic amalgamation of transplantation and abortion that renews ambivalance about the legitimacy of society's claims on cadavers, magnifies tensions found in prior fetal research debates, and accents widespread concerns about the casual use of elective abortion as a primary means of family planning. The querulous response is enough results from an intuition that transplantation of tissue from fetal cadavers threatens ethical values and our social ethods much more powerfully than does either legalized abortion or modest fetal research. These difficulties require restraint in both our language and our practices to prevent harmful shifts in our attitudes toward fetuses and elective abortion while permitting pursuit of medical benefits for those desperately in need. Marvelous Uses for Fetal Tissue In order fully to appreciate the powerful motivations toward using fetal tissue, we must abandon any pretense that it holds promise for only a narrow range of diseases. Providing new tissues and cells is a logical response to many types of cellular dysfunction (for example, pancreatic cells in diabetes and dopamine-producing neural cells in Parkinsons disease). Since fetal precursor cells are undifferentiated, they probably have important advantages over fully developed cells. Fetal cells are likely to grow rapidly and integrated with recipients' tissues, producing needed cell products under normal regulatory control. The biological principle underlying these therapies indeed suggests a much vaster range of possible applications. [1] Other avenues for research include the use of fetal neural cells in the treatment of Huntington disease, Alzheimers disease, spinal cord or other neural tissue injuries, and possibly some forms of cortical blindness. …