Sugarman J, Reisner E G, Kurtzberg J
Program in Medical Ethics, Duke University Medical Center, Durham, NC 27710, USA.
JAMA. 1995 Dec 13;274(22):1783-5.
Transplantation of blood cells harvested from the umbilical cord immediately after birth has been effective in repopulating the bone marrow. These placental blood transplantations may be safer than conventional bone marrow transplantations and may suspend the need to harvest bone marrow, a process fraught with difficulties. Further understanding and advancement of this emerging technology require developing large banks of placental blood. In this article, we examine some of the ethical issues associated with placental blood banking, including (1) questions about ownership of the tissue, (2) the necessity and nature of obtaining informed consent from parents for harvesting placental blood and the information-gathering process associated with it, (3) obligations to notify parents and children of the results of medical testing for infectious diseases and genetic information, (4) matters of privacy and confidentiality related to such information, and (5) the need for fair and equitable harvesting of and access to placental blood.
出生后立即采集的脐带血细胞移植已有效地使骨髓得到重新填充。这些胎盘血移植可能比传统的骨髓移植更安全,并且可能不再需要进行充满困难的骨髓采集过程。对这项新兴技术的进一步理解和发展需要建立大型胎盘血库。在本文中,我们探讨了与胎盘血库相关的一些伦理问题,包括:(1)组织所有权问题;(2)从父母处获得采集胎盘血的知情同意的必要性和性质以及与之相关的信息收集过程;(3)向父母和儿童通报传染病医学检测结果和基因信息的义务;(4)与此类信息相关的隐私和保密问题;以及(5)公平、公正地采集和获取胎盘血的必要性。