Volume 189 - Issue 10
Umbilical cord blood banking: public good or private benefit?
Author: David E Roberts
Med J Aust 2008; 189 (10): 599-600. || doi: 10.5694/j.1326-5377.2008.tb02197.x
Published online: 17 November 2008
Published online: 17 November 2008
To the Editor: Samuel and colleagues’ article on the ethics of umbilical cord blood (UCB) banking1 reflects much of the misinformation and bias that bedevil this debate. They argue against storage of autologous stem cells from UCB for a variety of contradictory, paternalistic or ideologically driven reasons.
The indication for autologous UCB storage is in anticipation of developments in regenerative medicine, an exciting field that holds great promise; it is not in anticipation of transplantation for malignancy, which is unlikely to occur. Samuel et al acknowledge these points, yet base their criticism of autologous storage on the latter indication.
Next, they state that autologous stem cells can be easily harvested at any time in life. Perhaps, for use in transplantation; but cells obtained later in life are likely to be of little use in regenerative medicine. Capacity for in-vitro manipulation declines with age.
Third, they argue that the two alternatives of public and private UCB storage are mutually incompatible — “public good or private benefit” (my emphasis). Australia’s three public banks are close to achieving the desired number of cords (about 20 000) needed for transplantation medicine in the non-Indigenous population.2 There is no shortage, and certainly no shortage of potential donors. Why argue against autologous storage as if there is?
Fourth, the authors disapprove of the for-profit motive in private-sector medicine. That may be their ideological position, but it is paternalistic to impose that view on the rest of us. Can parents not make up their own minds on the value of autologous storage? At $2000 upfront and $150 a year, storage is not so expensive that “only a small proportion of the population are able to afford [it]”. I remind readers of media reports that the Australian Government’s Baby Bonus (now $5000) was often used to purchase luxury items such as flat-screen televisions rather than being spent on the baby’s needs.3
The authors are correct in one respect: some (but not all) private UCB banks have been deliberately deceptive and misleading in their marketing, and, in so doing, have been predatory and exploitative. However, it does not then follow that parents cannot access sound and sober health advice in the marketplace.
The public versus private UCB storage debate does have an ethical dimension, but not this one. This debate is really just a turf war.
Competing interests
I have worked as an advisor (unpaid) to Cryosite, 2002–2006, and as Alternative Medical Director (remunerated) to Biocell, 2006–07. I hold shares in Cryosite and Biocell, purchased at market value.
References
- Samuel GN, Kerridge IH, O’Brien TA. Umbilical cord blood banking: public good or private benefit? Med J Aust 2008; 188: 533-535.
- Bone Marrow Donors Worldwide. Number of donors/CBU’s per registry in BMDW. http://www.bmdw.org/index.php?id=number_donors0 (accessed Oct 2008).
- Dunlevy S. Rudd’s baby bonus crackdown. The Daily Telegraph (Sydney) 2008; 19 Mar. http://www.news.com.au/dailytelegraph/story/0,220 49,23398368-5001021,00.html (accessed Oct 2008).