Ethical challenges of cord blood banks: a scoping review

Abstract

Cord blood is a rich source of hematopoietic stem cells used to treat many diseases of blood origin. Thus, storage banks were created to store and provide umbilical cord cells. With the development of diagnostic and therapeutic technologies and techniques in medicine, ethical issues have also become more widespread and complex. After the creation of the cord blood banks, efforts were made to address the ethical issues associated with such banks. The present study attempts to identify the ethical challenges in these banks in the published studies. Databases including PubMed, Scopus, Web of Science (WOS), Embase, Proquest, and Google Scholar were searched from January 1996 to January 2021. Then, the ethical challenges of the cord blood bank were extracted from the results section using thematic content analysis. 22 studies were selected based on inclusion and exclusion criteria. The ethical challenges raised in the studies included private or public ownership of the bank, fair access to banking services, informed and voluntary consent, failure to provide sufficient information to individuals about the process, confidentiality of user's information, conflict of interest of bank founders (who are commonly doctors). The findings of this study indicated that there are serious ethical concerns regarding umbilical cord blood banks. Responding clearly to these ethical challenges calls for the attention of policymakers and medical ethics professionals; this will require a clear statement of the various aspects of these banks for society.

Fresh Umbilical Cord Blood—A Source of Multipotent Stem Cells, Collection, Banking, Cryopreservation, and Ethical Concerns

“…These concerns are connected to the topic of patients’ rights and involvement in medical decisions [ 114 ]. This challenge is one of the key requirements that must be reflected in the inclusive health system [ 37 ]. One of these difficulties is respect for the autonomy and independence of persons who can refuse or accept particular treatment.…”

“…Private and public banks need individual comparisons due to their unique challenges [37] 3. UCB as a Regenerative Medicine…”

“…Another emerging issue is the debate on donations and self-preservation at UCB banks. To address this issue, various governmental and non-government bodies have drafted rules and regulations to meet and resolve maximum concerns [ 37 , 100 ]. An additional apprehension with UCB is that it should not alter routine obstetric or newborn care practices, such as delayed umbilical cord cutting and clamping, except for some of the rarest medical conditions.…”

“…An additional apprehension with UCB is that it should not alter routine obstetric or newborn care practices, such as delayed umbilical cord cutting and clamping, except for some of the rarest medical conditions. The time of clamping and cutting the cord became a point of disagreement for UCB collection for some obstetricians [ 37 ]. Table 5 shows the common challenges associated with UCB banking.…”

Tissue Engineering for Gastrointestinal and Genitourinary Tracts

“…Neonatal stem cells: Neonatal stem cells, for example, umbilical cord stem cells [28,29], retain significant dividing potential and the ability to differentiate into a large number of cell types [30]. Part of the ethical controversy also exists for these cells, although in this case, it is nevertheless reduced by the fact that destroying an embryo is unnecessary [31]. The problem is more of a social or societal nature in this case.…”