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Making Sense of Bioethics: Column 122: Consenting to the Unconscionable

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In recent years, scientists in industry and academia have come to rely on freshly obtained human tissue specimens for certain types of research and experimentation. Sometimes these tissues and organs can be obtained after routine sur­geries like gall bladder removal from adults or foreskin removal during the circumcision of new­borns. The use of such tissues and organs can be morally acceptable if the patient (or the parents of the newborn) provide informed con­sent. The use of cells and tissues from fetuses can also be morally acceptable when those cells are ob­tained from a natural miscarriage, and the parents provide consent. This would be equivalent to con­senting to an organ donation from their deceased child. 

Recently, however, a phe­nomenon has come to light that involves the partnering of biomedi­cal researchers with abortionists, for the purpose of securing a reliable supply of human tissues and organs. In these cases, parental consent (usually from the mother) may be sought prior to using the aborted child’s remains. Researchers claim this consent is necessary to enable the ethical use of the cells or tissues. This procedural detail is frequently described in the section called “Materials and Methods” found in scientific research papers, as, for example, in this February 2015 article on brain research in the journal Science:

“Human fetal brain tissue was obtained from the [clinic], following elective pregnancy termination and informed written maternal consents, and with approval of the local University Hos­pital Ethical Review Com­mittees.”

Planned Parenthood, the largest provider of abortions in the United States, also seeks ma­ternal consent prior to procuring fetal body parts from direct abor­tions, as chronicled by the Center for Medical Progress in their bombshell 2015 video exposé in which the sales of fetal heart, lungs, brain and liver were dis­cussed and negotiated.

The strong public outcry that followed these revelations of harvesting fetal organs was un­derstandable on the one hand, yet difficult to explain on the other, since there hadn’t been a parallel outcry when it came to the more offensive act of terminating the life of the unborn child itself. As one commentator observed, “Maybe it is not enough to be outraged at abortion on its face be­cause, I don’t know, killing is some­how worse if body parts are sold.”

Despite this inconsistency, it is nonetheless clear that the use of tis­sues and organs from direct abortions raises significant moral concerns, even if the mother’s signature may have been sought and obtained. 

Typically when we serve as a proxy for someone and give consent on their behalf, we act simply as their agent and provide an affirmation of their original wishes (“yes, he told me he wanted to donate his kidneys”). Alternatively, if we do not know the wishes of the deceased patient, we do our best to make a reasonable deci­sion based on the specifics of their situation, using a “best interest” stan­dard (“based on my friendship with him and concern for him, I think he really would have wanted to donate his kidneys). When we serve as a proxy decision maker for a fetus, an infant, or a deceased child prior to the age of reason, it is incumbent on us to make a “best interest” decision on their behalf. The assumption is that as we cared for them in life, and had their best interests in mind while they were living, we can continue to exercise that “best interest” decision-making capacity later when they are deceased.

But if the mother of an aborted child were to sign the dotted line granting permission to utilize fetal cells and organs, that consent would necessarily be void, because she would have already categorically demonstrated that she does not have the best interests of her child in mind, having arranged for the taking of that child’s life. From the ethical point of view, she has disqualified herself from being able to give valid informed consent on behalf of her now-deceased child. 

In the absence of proper in­formed consent, taking organs or tissues from the corpse would repre­sent a further violation of the integ­rity of the child’s body and constitute a failure to respect the remains of the dead. Thus, the tissues and organs of the directly aborted child should not be utilized for research, transplanta­tion or the development of therapies, but instead should be given a proper and respectful burial. In the final analysis, maternal consent cannot provide moral clearance for research­ers to utilize fetal remains from direct abortions in their research. Such permission from the mother is not, objectively speaking, an authentic form of consent but is rather a type of “sham consent” that secures the veneer of legitimacy for what is ulti­mately an unconscionable research practice.

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