Faculty Bibliography

PIP: Researchers believe fetal tissue can be easily transplanted into and cure people with incurable debilitating diseases such as Parkinson's disease. In 1988, the Reagan Administration stopped funding transplantation research of fetal tissue from induced abortions. An advisory panel later decided that it is an acceptable public policy as long as certain conditions a re met. Yet the Bush Administration continued the ban. In 1992, it erroneously claimed that transplantation research could use alternative sources of fetal tissue. 1 alternative is fetal tissue obtained from ectopic pregnancies. Yet spontaneously aborted ectopic pregnancies tend not to produce recognizable or viable in culture fetal tissue and if they do the tissue has been ischemic for days. Ectopic pregnancies requiring surgical sterilization tend to be morphologically abnormal. The only likelihood of viable fetal tissue form ectopic pregnancies is a fetus with myocardial contractility before surgery. The administration also recommended use of fetal tissue from spontaneous abortions but these fetuses often have a major chromosomal or other fatal defect. Researchers cannot use chromosomally abnormal fetal tissue since it growth, development, and function are unreliable. Expulsion of the necrotic fetus tends to occur a couple of weeks after death. The Bush Administration also proposed use of tissue from stillbirths but their tissue tends to be nonviable and the tissue, even if it were viable, is generally not at the developmental stage needed for transplantation. The placenta and yolk sac were other suggested alternatives, but the placenta is likely to be less immunogenic than embryonic tissue. It can help develop certain cell lines which produce insulin or neurotransmitters like dopamine, however. The yolk sac could replace fetal liver cells in transplantation. Nevertheless the only advantage of using the suggested alternatives is the perception of them raising less ethical concern than fetal tissue from an induced abortion.

Minnesota's recently enacted HealthRight legislation places the state at the forefront of American health reform. How did the state manage to overcome the policy gridlock in evidence in other states and at the national level? And how well does the legislation fare under close ethical scrutiny? Among the most important factors that permitted Minnesota to enact reforms were the explicit linkage in the legislative debate of the goal of cost containment to the desire to expand access, the public perception that HealthRight is incremental and consistent with earlier reform efforts in Minnesota, and the lengthy public debate that preceded the enactment of HealthRight. Although it endeavors to create a fair and efficient health care system, it is not at all certain that HealthRight, in its present form, will achieve these normative goals.