Cord blood is the blood present in both the placenta and the umbilical cord, containing hematopoietic stem cells responsible for producing blood cells (red and white cells and platelets) and therefore has a keen interest from a medical standpoint. These cells could be used to treat blood disorders (leukemia, lymphoma) and could replace bone marrow transplants in some cases. In 2015, in France there were 126 cord blood transplants. Collecting and using blood from the placenta or umbilical cord is not an ethical issue, when it is performed with the mother’s consent and if the child and the mother are respected, according to the birth circumstances. This type of transplant is very useful for therapy and for research purposes.
Regulated by the French bioethics law, as for other cell or organ donations, the donation is anonymous, free and meant for collective use.
The parents filed an appeal, arguing that both their families were afflicted with cancer and they wished to protect their child with the idea that cord blood cells could possibly contribute to his future therapy if he was diagnosed with one of these cancers some day. Their purpose was to ensure that their child’s cord blood be conserved (by paying a private British company). The current law allows this only in cases where a particular patient has a genuine necessity for the cord blood. The only exception is for cases of donation to the newborn or his brothers or sisters who have a genuine therapeutic need, duly documented before blood sampling, which is not the case here.
This court decision raises ethical issues and is a disputed element on several levels.
–The blood was drawn “by anticipation”, although no one can be sure that the child will one day develop a disorder. So this provision is not medically founded.
According to Dr. Luc Douay, Hematology Professor at the Pierre and Marie Curie University in Paris, “at this stage of our research, there is no scientific proof that umbilical cords contain cells which could one day treat all kinds of pathologies, especially cancer, nor regenerate tissues.”
The French Biomedicine Agency which manages cord blood donations and the blood banks for preserving this blood, indicates on its web site that “preserving the cord blood of one’s child in a bank in order to treat him with his own cells in the event of his becoming sick in the future, is currently unfounded scientifically according to a panel of experts.” According to the rapporteur for the 2011 bioethics law, Jean Leonetti, this is “an ethical transgression and a scientific fantasy. It is an attempt to calm the parents’ anxiety by giving them the illusion that keeping the umbilical cord will protect them from any possible disease. “
– Opening access to private blood banks for hypothetical future use for oneself weakens the principle of national solidarity for organ donation.
This is an implicit acceptation of a first and a second-class medicine. Our current system is based on sharing, volunteering, anonymity, and gratuity. In France, preserving is only allowed for treating other patients freely and anonymously. Only the French Blood Placenta Network which is composed of 28 maternity clinics and 11 banks is allowed to preserve cellular therapy preparations.
Journalist and Dr. Jean-Yves Nau declares that the Grasse court’s vice-president bypassed the law, “in full knowledge that his judgment has a disturbing effect on the French system which has been patiently built up over the years and is regulated in the bioethics laws”. This ruling highly threatens to set a legal precedent and could weaken the donation and preservation system which is barely functioning in France and which should be encouraged. Professor Ibrahim Yakoub-Agha, transplant Director at the Lille Medical Center specifies: “We’ll be seeing transactions for business, rather than for medical reasons”.