A Literature Review of Instructional Requirements when Requesting Consent to Use Aborted Fetuses in Research﻿

Takiko KATO

A Literature Review of Instructional Requirements
when Requesting Consent to Use Aborted Fetuses
in Research
Takiko KATO
Gifu University of Medical ScienceE-mail: kato@u-gifu-ms.ac.jp

Abstract
Regulation of the use of tissue from aborted human fetuses for research is enforced by various
countries and by international organizations such as the World Medical Association and theCouncil of Europe. Common requirements for permissible use are 1) approval by the relevant
institutional ethics committee, 2) determination of donation of fetal tissue after the decision toabort, and 3) consent of the donor. Some guidelines require that the father also must consent to
the fetal tissue donation, but in all cases, the woman’s consent is essential.
This paper surveys instructional requirements of donation systems pertaining to theuse of fetal tissue. A survey of the literature found that: 1) women who are potential donors areoften not in a confidential setting where they can frankly and informally discuss donating fetal
tissue with the people around them and collect ideas, 2) women want to know the intended useof the fetal tissue and the overall nature of the research, 3) although the information needed tocomprehend the research is sorely lacking in the donation instructions, women may neverthelessmake decisions under pressure.
On the basis of these results, potential donors understandably think they should be
provided with information enabling them to make an informed decision they can live with,without reservations. For these reasons, explanations currently considered “sufficient” should be
reexamined to determine whether they are truly satisfactory.
Keywords: donation of fetal tissue, decision making, consent

Introduction
The world’s first study on the use of fetal tissue
in research was England’s Peel Report (1972).1
Its findings in sections 7 to 17 covered fetal
tissue use in the fields of virology, oncology,
immunology, and congenital deformities. In
Appendix 2 of the Peel Repor t, additional
domains of research using human fetal tissue
include general fetal metabolism, endocrinology,
hematology, cardiology, alimentary tract, renal
and urinary tract, skin, amniotic fluid physiology,
placental metabolism, chromosome studies, andanatomy.

According to an in-depth summar y by
Hiratsuka,2 since the publication of an article in19873 reporting that the transplantation of fetal
cells into patients with Parkinson’s disease was
effective for nerve regeneration, global interestin the use of fetal cells increased. For instance,
today, fetal cartilage is transplanted into articularchondrocytes, fetal nasal cells are transplanted
into patients, and in the case of polio infection,
patients are given injections of fetal muscle
tissue.4 The medical use of fetal tissue became a
topic of controversy in Japan when patients withspinal cord injuries due to accidents received
transplants of nasal membrane cells from fetuses
aborted in China.5
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Journal of Philosophy and Ethics in Health Care and Medicine, No. 14, December 2020

T he Advisor y Com m it tee on the Useof Human Stem Cells in Clinical Research,appointed by the Health Sciences Council of theJapanese national Ministry of Health, Labor andWelfare (MHLW), convened from 2002 to 2006
to develop “Guidelines for the Use of Human
Stem Cells in Clinical Research.” During thisprocess, there were discussions regarding theuse of aborted fetuses for stem cell research. 6
Initially, the committee included stem cells takenfrom aborted fetuses as part of its investigation,
but later decided that “clinical research using
human stem cells taken from fetuses (including
those that were dead)” would be excluded fromthe guidelines they were developing.7 This paper
focuses mainly on studies regarding the use ofaborted fetuses that were published after theestablishment of the committee’s guidelines,
specif ically on their suggestions regarding
instructional requirements as part of the informed
consent process for donating fetal tissue forresearch.

1. Conditions governing the
donation of fetal tissue
Different countries as well as international
institutions, such as the Council of Europe andthe World Medical Association, have their own
regulations governing the use of fetal tissue
obtained from induced abortions for research.
Most countries and institutions state that fetal
tissue use in research is permissible as long as
certain conditions are met. These conditions canbe broadly grouped into three categories.8
First, there are conditions to be met forethics committee approval. For example, Section
35 of the 1972 Peel Report stipulated that ethics
committee approval was to be granted, provided
the committee agreed (a) on the validity of
the research, (b) that the required information
could not be obtained in any other way, and(c) that the investigators had the necessary
facilities and skill. 9 The Peel Code, given at
the end of the Peel Report, reemphasized thesepoints. The British Medical Association (BMA)“Guidelines on the Use of Fetal Tissue” (1988),
which served as a bridge between the Peel
Report and the Polkinghorne Report (1989) that
followed, stipulated that every project involving
transplantation of fetal tissue must be approved4by the local ethical research committee.” 10
Section 7.5 of the Polkinghorne Report similarly
specified that “The ethics committee should
satisfy itself inter alia of the validity of theresearch, that the required information cannot
be obtained in any other way, and that theinvestigators have the necessary facilities andskill.”11
The Australian National Health and Medical
Research Council (NHMRC)’s “Statement on
Ethical Conduct in Research involving Humans”(1992) stipulates that “The research must be
conducted only in instit utions that have aproperly constituted ethics committee, and only
according to written protocols approved by the
ethics committees of all institutions involved.”12
The 2002 revision of the American Medical
Association’s (AMA) “Current Opinions of theCouncil on Ethical and Judicial Affairs: E-2.10
Fetal Research Guidelines,” states that “competentpeer review committees, review boards, oradvisor y boards should be available, whenappropriate, to protect against the possible abuses
that could arise in such research.”13 Although the
Swiss Academy of Medical Science’s “MedicoEthical Guidelines for the Transplantation of
Human Fetal Tissue” (1998) is specific to theindividual transplant, section 1.7 states that:“Any transplantation of foetal tissue must takeplace within the framework of a research projectthat has been checked and approved by the
responsible Ethical Committee.”14
The second category of conditions relates
to preventing situations in which a woman
purposely gets pregnant with the intention of
having an abortion in order to donate the fetus
to research. In such cases, all of the following
conditions apply: 1) no compensation for the
donation of fetal tissue can be offered, 2)
the woman donating the fetal tissue may notdesignate who the recipient will be, 3) mutual
anonymity must be maintained between the donorof the fetal tissue and the transplant recipient, 4)
the timing of the abortion and the procedure mustnot be changed, and 5) the decision to donate
must not precede the decision to abort.
Finally, there are conditions related todonor consent. Although conditions regarding
the father of the fetus may vary (for example:
1) When possible, obtaining the consent of “themale partner of the pregnant woman,” that is, theA Literature Review of Instructional Requirements when Requesting Consent to Use Aborted Fetuses in Research﻿

person thought to be the father, is also needed, 2)“The male partner of the pregnant woman” must
not object to the donation, or 3) The woman’s
consent alone is sufficient, since the woman’s
consent is always essential.
Next, we will look at how information
should be provided to potential donors of fetal
tissue, based on recent research focused on what
is involved in a woman’s consent for donation.

2. The relationship between thedecision to abort and the decision
to donate
Let us revisit what the Polkinghorne Report says
regarding women’s consent to donate fetal tissue.
4.2 It has been argued that knowledge ofthe use of fetal tissue could inf luence a
mother’s decisions to have her pregnancy
terminated. It has been suggested that theuse of fetal tissue could place women underpressure when reaching a decision or resultin more abortions taking place. It has evenbeen put to us that someone could become
pregnant in order to make a fetus available
for medical use. In our view, pregnancy
undertaken to such an end would be an
ethically unacceptable use of the fetus as
an instrument (treating it as a “thing”).
It is not possible fully to discern people’s
motivations, but it is possible to limit thedegree to which morally dubious wishes canbe implemented. To this end we recommend,
not only the separation of the decisions
relating to abortion and the subsequent useof fetal tissue, but also procedures which
will make it impossible for a mother tospecify that fetal tissue, which she makes
available, should be used in a particular way.
The Polkinghorne Report was concernedthat women might get pregnant and abort the
pregnancy with the aim of donating fetal tissue:“It has been argued that knowledge of the use of
fetal tissue could influence mothers’ decisions
to have their pregnancies terminated.” Was thisa reasonable concern? A number of studies havelooked at what women think about fetal tissue
donations, and these studies are summarized
below.

Takiko KATOFirst, in 1994, Anderson et al.15 surveyed
527 women attending a large family-planning
clinic in the center of Edinburgh and 167 womenattending the Royal Infirmary of Edinburgh,
all of whom were pregnant and requestingterminations. Only 6% of the women said they
thought it was unjustifiable to use fetal tissue
for research. Of the 94% of women who feltthat research use was justifiable, 87% felt that
research for fetal tissue transplantation was rightin principle, and 86% of them would allow theirown fetus to be used.
In 1995, Martin et al. published a study
conducted in Toronto, of a random sample of
475 women, aged 18-40 years, selected from thefamily practice registry of an urban teaching
hospital. Of the 272 responses, 266 were used fortheir analysis.
A total of 32 (12.0%) reported that theywould be more likely to have an abor tion
if they could donate tissue for fetal tissuetransplantation, 178 (66.9%) stated that theywould not be more likely to do so, and 56 (21.1%)
were uncertain. Furthermore, 122 (45.9%) of thewomen who said they would consider an abortion
if they became pregnant were asked how theywould feel about having an abortion if they knewthat tissue from the fetus could help someone
suffering from Parkinson’s disease; of a totalof 112 responses (some from outside the poolconsidering abortion) with 83 (45.6%) stating thatthey would feel better, 4 (2.22%) worse, and 25(13.7%) uncertain.16
More recently, in 2008, Pfeffer published astudy using focus group discussions to find out
what matters to British women when they think
about donating an aborted fetus for stem cellresearch and how stem cell research and therapies
might influence their views.17 The next section
looks at this study in more detail.

3. What do women think of using
aborted fetuses in research?—
Pfeffer’s study
Pfeffer’s study recruited 41 participants into 6
focus groups. The recruiter excluded women
who had undergone a termination under section
E of the grounds allowed for abortion, in the
British Abortion Act of 1967, (if the child wereborn, it would suffer from physical or mental
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Journal of Philosophy and Ethics in Health Care and Medicine, No. 14, December 2020

abnor malities). Potential par ticipants were
provided with an information sheet outlining the
purpose of the research and what participation
would involve. The facilitator asked participants
to discuss the donation of aborted fetuses ingeneral; how, when, where, and by whom women
undergoing an abortion should be approachedabout donating the fetus to stem cell research; thekind of information they should be given; and if
and why donation of an aborted fetus might differ
from donation of other body tissue.
Pfeffer extracted several points from thisstudy. First, she mentioned the words used.
Where the topic under discussion was somehow
troubling, participants preferred “fetus” to“baby” and occasionally even avoided that term
altogether, by using words or phrases which
depersonalized it altogether, such as “a bunchof cells,” “dead matter and it doesn’t do any
growing,” “a thing,” or “an accident.”
Second, Pfeffer mentioned how participants
responded to questions about donating aborted
fetuses to research with an example of theutilitarian position. Stem cell research was
welcomed as a “good thing,” and participantsin ever y group approvingly mentioned thetherapeutic goals. However, Pfeffer pointed
out that participants’ enthusiasm for medical
research noticeably diminished as the discussion
developed. By the end of the focus groups,
participants tended to refuse donation altogether.
Finally, Pfeffer pointed out that participants
were unclear about the nature of stem cellresearch.

4. Suggestions from a comparisonof Pfeffer’s study with a Japaneseinterview survey
Saito conducted an inter view sur vey of 18
people who could potentially be asked to donate
eggs or fertilized eggs for research on humanembryos (distinct from Pfeffer’s study of womenconsidering abortion). The sample consistedof 3 people being treated for infertility, 8 forgynecological conditions, 2 for gender dysphoria,
and 5 other people with positions of interest on
this issue.18 The first finding was that virtually
all the participants said that if they were asked
to donate embryos or eggs to research, it would
be too difficult for them to understand what6

the research entailed, including aspects suchas what the purpose of the research was, why
their cooperation was being requested, andhow donation would benefit society. Pfeffer’s
study similarly suggested that the focus group
participants did not have a clear understandingof what stem cell researchers were actually doingin their labs. Examples of participants’ questions
included: Did the researchers use the entire fetus?
Did they use organs and cells? Was the fetus
still alive during the experiment? If so, when an
organ was removed, did they try to revive thefetus and keep it alive? Or, was removal more
like getting a blood test? Both of these studies
suggest that women were likely to be asked fortheir consent when they did not have an adequate
understanding of what the research entailed.
Moreover, Saito descr ibed how those
whose consent was actually requested had said
that it was difficult to understand what level ofresearch they would be donating to, whether theywould directly benefit from it, or whether it was
foundational research that would make a social
contribution. These responses mirrored that ofa focus group participant in Pfeffer’s study, who
said, “I think a lot of us do not know what stem
cell research actually is.” Women being asked
to donate to research may feel they are being
asked for their consent without an adequate
understanding of what that research is.
Furthermore, Saito noted that participants
with gender dysphoria (GD), gynecologicalconditions, and infertility feel differently withregards to donating gametes and embryos toresearch, and calls attention to the need to taketheir different feelings into consideration. Saito’s
observation is consistent with Pfeffer’s viewthat the ways people think and talk about theirfetuses differ, depending on whether the child
was lost due to miscarriage, fetal abnormalities,
or other reasons. Other researchers have also
focused on the importance of women’s word
choice and its relationship with their attitudes
toward their fetuses. Tsuge, for example, focusedon the connotations of the phrase “sur plus
embryo,” which could connote the researcher’s
perception that if an embryo were to be disposedof, it should be fine to use it for research. Saito
describes how perceiving things as potential
waste or something that could be discarded plays
a role in researchers’ ability to see eggs, fertilizedA Literature Review of Instructional Requirements when Requesting Consent to Use Aborted Fetuses in Research﻿

eggs, and fetuses as raw materials or resources,
and suggests that one aspect of research-related
word choice is that it influences how society ingeneral relates to research.19
In addition, Saito interviewed the potential
egg donors regarding their wishes on what levelof explanation they would need to be able togive informed consent. Saito provides examples
of concerns raised by interviewees, including:“To properly listen to explanations about every
use, understand and consent to them would takeconsiderable time,” and, “It seems to me thatsince we do not understand the current state of
the use of eggs and embryos in research, you
cannot simply say that ‘it will be fine if just thepeople who get a good explanation and consent,
donate!’” There is reason to assume that thesecomments would apply equally to explanations
provided regarding the use of aborted fetuses.
Women are being asked to consider donating
their aborted fetus at the very moment when they
are about to go through with a difficult personal
decision to abort the pregnancy, a decision thatstill involves significant social stigmatization.
For example, the Polkinghorne Report statesin section 2. “Ethical Basis”, that there were
objections to using tissue obtained by induced
abortion. A number of submissions suggested
that the act of inducing abortion is so morally
reprehensible that it taints beyond acceptability
any possible beneficial use of the fetal material so
obtained—and that, consequently, a woman who
decided to have an abortion (which should becondemned) was, morally, no longer in a position
to decide the use of the fetus.
While taking these kinds of opinions into
account, the Polkinghorne Report authors statethat they are unable to endorse them (2.6).
Regarding the use of aborted fetuses, they notethat the use of fetal tissue from termination ofpregnancy has been justified by analogy withthe use of human organs that have become
available as a result of morally questionablecircumstances, such as careless accidents or evenmurder (2.8). However, the report also notes
viewpoints questioning the analogy between
using an aborted fetus and using organs that
became available as a result of an accident orother misfortune, as not entirely appropriate,
since the person (the woman) consenting to theuse of the specimen also made the specimen

Takiko KATO

available for use by deciding to terminate it (i.e.,
to abort it). That is, these viewpoints seem tochallenge this analogy based on the belief that thedecision to abort is the woman’s decision to end
her special relationship with the fetus and thathaving destroyed that relationship, she should nolonger be allowed to make any decision regarding
its use.
Af ter listening to and st udying manydifferent viewpoints in this way, the Polkinghorne
Report ultimately states that “because abortion
is a decision of moral ambiguity and perplexity
for many, reached only through a conf lict ofconsiderations, it seems too harsh a judgmentof the mother’s relation to her fetus to supposethat she is no longer in a special position withregard to it, following an abortion” (2.8), andrecommends that “fetal tissue which has become
available following spontaneous abortion or deathin utero should be dealt with in the same way as
tissue derived from therapeutic abortion” (2.9).
The Advisory Committee on the Use of
Human Stem Cells in Clinical Research (of the
MHLW Health Sciences Council) did not holddiscussions on points raised in the Polkinghorne
Report, such as whether only tissue obtained
from spontaneous miscarriages should be usedor whether a person deciding to have an abortion
should be able to make the decision regarding
the use of the fetus (regardless of whether
more weight should be given to the moral
condemnation of abortion or to the woman’s
having terminated her relationship with thefetus). Therefore, these viewpoints have notbeen adequately discussed in Japan. However,as we consider the Polkinghorne Committee’s
argument on why a person deciding to have an
abortion should still be able to make the decision
regarding use of the fetus, the opinion of oneof Saito’s participants seems reasonable: that“…it would seem callous to refuse to make the
donation after being told it would be for a patientwith an intractable disease.” In situations where
pregnant women opting for elective abortion are
asked to consent freely to the use of the aborted
fetus, the issue that especially needs to be
discussed is the possibility that the women may
be driven to consent to donate in order to makeamends for having had the abortion.
Similarly, one could consider an opinion
from another of Saito’s participants: “Depending
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Journal of Philosophy and Ethics in Health Care and Medicine, No. 14, December 2020

on the person, they may be overwhelmed bytheir feelings due to their surgery (an ovarian
resection), so asking them to donate the ovary
before the operation (whatever the purpose)
would be unrealistic, wouldn’t it? I think somepeople would also feel hurt.” Another relevant
issue concer ning the timing of a donationinquiry is found in the opinion of a woman in
one of Pfeffer’s focus groups, who said, “It’sterrible [to ask] on the day [of the operation]. I
really think that’s awful.” Beginning with theWorld Medical Association’s Statement on Fetal
Tissue Transplantation, which states that: “A
final decision regarding abortion is made before
initiating discussion of the transplantation useof fetal tissue”20, most guidelines stipulate thatthe informed consent process take place in thesame order: after a woman has decided to havean abortion, she is given an explanation regarding
the uses of fetal tissue, and then her consent
to donate the fetal tissue may be obtained. As
discussed previously, this is based on the ideathat the decision to abort must precede thedecision to donate, from the perspective thatwomen donating fetal tissue should be prevented
from becoming pregnant in order to make the
donation, and from designating the recipient of
the tissue. However, because it is not realistic inpractice to seek consent after the abortion has
been performed, an explanation regarding theuse of fetal tissue is to be provided after the final
decision to abort has been made, but before theabortion is performed.
Although research about using aborted
fet uses may not be directly perfor med onpreg na nt women, suit able ca re should betaken when obtaining informed consent fromthem. This is important, given that “getting an
explanation and being asked on the day of theprocedure for your consent” has been shown toelicit some bewilderment, that pregnant womenconstitute a vulnerable population, and that evenwhen donation concerns embryos and eggs,“depending on the person, there are also people
who would be hurt [if asked to donate them].” It
is clear that when donation concerns an aborted
fetus, extreme care must be taken.

Conclusion
This review of the literature from the perspective
8of how information should be provided whenseeking informed consent from potential donors
regarding the use of fetal tissue has highlighted
the following points: 1) women who are potential
donors are often not in a confidential setting
where they can frankly and informally discuss
donating fetal tissue with the people aroundthem and collect information 2) these women
desire a more complete picture regarding the useof fetuses in research, including what the fetal
tissue is used for, what kind of discoveries suchresearch leads to, and what kind of outcomesare expected; but 3) as potential donors, they
may have to make their decision without enoughinformation to form a comprehensive picture of
the research.
In discussing how donations of fertilized
eggs for embryonic stem cell research are sought,
Tsuge points out that there are those who fearthat the belief that an embryo is the seed ofhuman life will be used to prohibit abortion, evenif others feel the fetus is only a foreign body.
Tsuge states, “if we try to objectively define
what an embryo is, a gap will be created withthe everyday perceptions and feelings of womenand couples of what an embryo is.”21 Indeed,
Pfeffer has demonstrated that when considering
the use of aborted fetuses, women’s feelings are
extremely diverse.
Historically, the Polkinghor ne Repor t
prevented donors from naming the recipient of
the fetal tissue and recommended that the donor
should not be aware of the future use of the
fetal tissue (5.3). A subsequent report, Human
Bodies, Human Choices, published in 2002
in England, Chapter 15 (Fetal Tissue) statesthat the Polkinghorne committee’s underlying
concern of avoiding termination of pregnancy
for ulterior motives remains valid. However, theapproach of providing only nonspecific consent isincreasingly out of step with modern expectations
that individuals make choices, including medical
choices, on a properly informed basis (15.13).22
Pfeffer and Saito’s research could be interpreted
as reaffirming the validity of the assertions madein Human Bodies, Human Choices from theperspective of women donors. People asked to bedonors and those asked to participate in a study
sometimes think afterward, “if only I had known
that, I would have/have not made that decision.”
It is understandable if potential donors think they

A Literature Review of Instructional Requirements when Requesting Consent to Use Aborted Fetuses in Research﻿should be provided with information that enables
them to make a decision they will later be able
to live with, without reservations. Whoever ispresenting an explanation to potential female/
male donors needs to examine carefully whether
that explanation is in fact “good” enough foreach woman/man, considering the diverse viewsof what is considered sufficient information forthem to make the “right” decision.

8

Endnotes
1 Department of Health and Social Security. 1972.
The use of fetuses and fetal material for research,
Report of the Advisory Group. Her Majesty’s
Stationery Office, London, 1-16.
2 Hiratsuka, S. 2005. Uses for the appendages of thehuman fetus (placenta, umbilical cord, amniotic
f luid, and fetal membranes). In M. Tamai (ed.)
Studies on supply systems for human fetal tissue
and the role of the fetal tissue supply coordinator:
2004 Annual Research Review [in Japanese], pp.
151-169. See also Hiratsuka, Shiho. 2009. Taking
a look at the fetus and the placenta (appendagesof the fetus) and their use. In S. Hiratsuka &M. Tamai (eds.) Life abandoned, life used [inJapanese]. Seikatsu Shoin, Tokyo, pp. 105-140.
3 Lindvall, O. et al. 1988. Fetal dopamine-richmesencephalic grafts in Parkinson’s disease.
Lancet, 1483-1484.
4 In addition to this, it has been reported that fetal
tissue transplants have been performed to treat
conditions such as Alzheimer’s disease, juvenileonset diabetes, Huntington’s disease, Hurler’s
syndrome, and female sterility. Begley, S. 1993.
Cures from the womb. Newsweek, 121(8), 42-45.
5 9 Japanese treated with aborted fetal cells in China[in Japanese]. Yomiuri Shimbun, morning edition,
July 22, 2004, p. 1.
6 The Advisory Committee on the Use of Human
Stem Cells in Clinical Research (appointed by
the Science a nd Tech nolog y Subcom m it teeof the Health Sciences Council, Ministr y of
Health, Labour and Welfare) held 25 meetingsfrom January 2002 through February 2006 andpublished its “Guidelines for the Use of Human
Stem Cells in Clinical Research” in July 2006.
7 The following press release gives details on
the reason for removal of aborted fetuses fromconsideration in the “Guidelines for the Use of

9

10
11

12

13

14

15

16

17

18

Takiko KATO

Human Stem Cells in Clinical Research”: Using
aborted fetuses for stem cells: Research and ethics
continue to run along parallel lines [in Japanese].
Asahi Shimbun, morning edition, May 17, 2005, p.
17.
Other conditions that could be mentioned are thattissue obtained from legally performed abortions
and from fetuses that have died (i.e., fetuses
should not be kept alive artificially in order toobtain tissue) should be used and that staff directly
involved in the use of aborted fetuses should bemade aware of the research plan and should begiven the chance to conscientiously object to being
involved.
Department of Health and Social Security. 1972.
The use of fetuses and fetal material for research,
Report of the Advisory Group. Her Majesty’s
Stationery Office, London, 7-8.
British Medical Association. BMA Guidelines on
the use of fetal tissue. 1988. Lancet, 1(8594), 1119.
Her Majesty’s Stationery Office. 1989. Review ofthe guidance on the research use of fetuses andfetal material. Her Majesty’s Stationery Office,London, 16.
National Health and Medical Research Council.
1992. Statement on human experimentation andsupplementary notes. NHMRC, Canberra.
American Medical Association. 2004. Current
opinions of the council on ethical and judicial
affairs. E-2.10 Fetal Research Guidelines. In S.
Post (ed.) Encyclopedia of Bioethics, 3rd ed.,Macmillan, New York, 2674-2675.
Swiss Academy of Medical Sciences. 1999.
Medical-ethical guidelines for the transplantationof hu ma n foet al t issue. S chweizer i sche
medizinische Wochenschrift, 129(43), 1626-1631.
Anderson, F. et al. 1994. Attitudes of women tofetal tissue research. Journal of Medical Ethics,
20(1), 36-40.
M a r t i n , D. K . e t a l . 19 95. Fe t a l t i s s u etransplantation and abortion decisions: A surveyof urban women. Canadian Medical Association
Journal, 153(5), 545-552.
Pfeffer, N. 2008. What British women say mattersto them about donating an aborted fetus to stem
cell research: A focus group study. Social Science& Medicine, 66(12), 2544-2554.
Saito, Yukiko. 2005. Interviewing prospective
gamete and embr yo donors [in Japanese]. In
2004 research report from the Health & Welfare
Sciences Special Study Group on Systems for9Journal of Philosophy and Ethics in Health Care and Medicine, No. 14, December 2020

19
20

21
22

*

10

Human Embryo Research (Principal researcher:
Yasunori Yoshimura), Health & Welfare Sciences
Special Study Group on Systems for Human
Embryo Research, Tokyo, pp. 38-45. This researchis also brief ly summarized in Yukiko Saito’s
Thinking about “donating eggs: Interviews withpotential donors of eggs for medical research [inJapanese] in Tsuge, A. and Kato, S. 2007. The
sociology of genetic technologies [in Japanese]
Bunka Shobo Hakubunsha, Tokyo, 171-175.
Tsuge, Azumi. 2012. Reproductive technologies [inJapanese]. Misuzu Shobo, Tokyo, 32.
World Medical Association, WMA statement on
fetal tissue transplantation, 1989. https://www.
wma.net/policies-post/wma-statement-on-fetaltissue-transplantation (Accessed August 4, 2020)(for the Japanese translation, we refer red to
the Japan Medical Association’s 1990 National
Medical Care Yearbook, Shunjusha, Tokyo, pp.
207-209).
Tsuge, Azumi. 2012. Reproductive Technologies[in Japanese]. Misuzu Shobo, Tokyo, 86.
Depar tment of Health. 2001. Human bodies,human choices. the law on human organs andtissue in England and Wales: A consultation
report. Department of Health, London, 137. (Forthe Japanese translation, we referred to Tamai
Mariko (ed.). 2005. Studies on supply systems forhuman fetal tissue and the role of the fetal tissue
supply coordinator: 2004 Annual Research Review[in Japanese], p. 106.)
This article is an English version of the following
a r t icle a nd i ncludes upd ates: Ta k i ko K ato,
“Chuzetsu taiji no riyou doui wo motomer u
sai no jouhou teikyou no arikata ni kansur ukousatsu,” Igaku Tetsugaku Igaku Rinri (TheJapanese Association for Philosophical and EthicalResearches in Medicine), 2013, Vol.31, pp.33-41.
The author received 2013 Young Researcher Award
from JAPERM for this article.