Comparison between Public and Private Umbilical Cord Blood Banks - Research Paper Example

 Comparison between Public and Private Umbilical Cord Blood Banks (Pros and Cons Of Each) Abstract Umbilical cord blood is a recent method of collecting haematopoietic stem cells that has found numerous uses in the medical arena after the born marrow and peripheral blood. Fortunately, it is quite a painless procedure carried out during child birth compared to other methods of stem cells harvesting. The document conducts a critical analysis and comparison of the two banking methods: private and public UCB banking to evaluate the best option that should be adopted. Based on the ethical, social good and utility aspects, the analysis recommends public UCB banking. Critically investigating into the public banking it does not cost the donor/patient to collect, test or store the UCB product like private banking. Other than limited use for family or autologous purposes, the product is offered for the common good to treat potential beneficial from the public. Finally, accessible cord blood donation and use information in the public banking facilities offer accurate and guiding information compared to private UCB banks. Keywords: Cord Blood, UCB (Umbilical Cord Blood), Expectant Mothers, Patients, Donation, Autologous, Allogenic, Utility, Stem Cells, Storage Fees, Public Good, Financial Gain, Opportunity, Introduction Cord blood is used for various medical purposes in treatment of a range of diseases. Umbilical cord blood (UCB) is a rich source of haematopoietic stem cell besides the peripheral and born marrow blood. Cord blood banking hence entails harvesting and storage of the cord’s stem cells after delivery from the newborn’s umbilical veins from the section of the cord attached to the placental. Over the years, both public and private cord blood banking units emerged and invested to store the stem cells for future use, incase patients required them to treat malignant and non malignant disorders. This hence gave maternal patients the power and option to choose between the two. According to ACOG Committee Opinions, “Public banks have promoted allogenic (related or unrelated) donation, analogous to the current collection of whole blood units across U.S, while Private banks were initially developed to store stem cells from umbilical cord blood for autologous use (similar individual donor and recipient) by a child if the child develops disease later in life” (2008). Therefore, cord blood banking became an issue of controversy; it concerns ethical aspects and the utility of stem cells after long time storage. The sections below critically look at the pros and cons of each. Support for public UCB Economical viable Most families and pregnant women already strive to meet their daily needs and provide comfortable lifestyle for their household. While the governments push to offer affordable care to the society inclusive the maternal patients, expectant parents should be aware of the available cost free public UCB banking. It’s a much economical method where patients donating to the bank should not cost them anything. To collect cord blood, public UCB banks do not charge a fee, instead the government caters for the collection and storage of the stem cells to only recover their cost after the unit’s use, by charging the patient or his insurance (AABB, n.d). On the contrary, private banks are quite expensive for a common expectant woman whom would have to to make a choice to pay the standing fees suppose the procedure was mandatory. Private UCB banks are commercial and out to make a profit besides their health service contribution to the society. This type require targeted expectant mother to pay fees for registration, collection of the cord blood and later, annual storage fees to keep the blood until a later date when it may be required. Through the Congress, cord blood donation and banking has been available to all willing expectant mothers without necessarily draining household’s resources. Benefit to the larger community Public UCB banking differs with private ones over their medical utility and moral importance. Cord blood donations by patients is not limited for analogous use, but is made accessible to the wider society to treat those whom would meet the match. Referring to Sheremeta, public UCBs are based on altruistic donations as public resources for the public good, where physicians are given the right through the donor’s consent to retrieve the donated UCB unit from the trustee (bank) for potential beneficiaries whom scientifically qualify for its use (2006). For this reason the public banks have a fiduciary obligation to act in the best interest of the beneficiaries, but be compliant to the agreement with the donor. It implies that though donated in a specific public bank, it could be assigned to another public trustee to treat a patient thousand miles away in a state. Some parents sign in strictly for allogenic use or in combination with research purposes. For the latter, it enhances medical benefits, because even when the cord blood after testing is found inadequate for a patient’s transplant, it’s still consumed in medical research to improve future treatments to human diseases/condition. From Canadian research conducted by Armson, 86, 67, 39 and 33 % of the surveyed pregnant women preferred to store their UCB in public banks, for research purposes, gene therapy and drug manufacturing investigations, respectively (2005). Accurate of information to guide the patient and reality Most individuals end up taking uninformed decisions over the UCB banking they should take. Without sufficient information, they are lured into profit gain programs with speculative information over the use of their USC blood and benefit of storing for analogous/family use. Compared to the public, Skabla argues that private UCB banking is thrown to the public through media advertisement with very little details and capable of exploiting the emotional vulnerabilities of expectant mothers to adopt their programs via misleading information and marketing strategies (2007). Contrary, public banking offers patients and the general public important and relevant information to guide their decisions. One, AAP and ACOG experts recommend public allogeneic UCB banking because most conditions that could be treated through analogous stem cells did already exist in the newborns cord blood, and a range of information offered by private bankers for marketing is based on unsubstantiated claims (Muza, 2012). Counter Arguments Benefit for familial use Private UCB banks are often discredited based on the moral outcry. Supporters for public storage claims that chances of ever one using their hematopoietic stem cells are estimated to vary between 1 in 20 000 or 200 000 (Samuel, Kerridge and O’Brien, 2008). However, in cases where a family has member (sibling or parent) has developed the need for stem cells transplant (depending with disease), private banks would suitably store the UCB product for the intended analogous use. The life of an existing sibling could be saved through the stem cell transplant from a compatible relative (newborn sibling). Such storage of cord blood in private banks acts as a biological insurance offering mothers opportunities to store UCB product for the intended and suspected family use (AAP, 2007). It’s an efficient way to solve specified hereditary disorders in family and reduces the testing and match search for compatibility performed in public UCB banks. Private business with value Like any other commercial business, private UCB banking is not for charity. Investors and entrepreneurs are out to make a profit from the opportunity in the healthcare industry. Though accused of potential conflicts of interests in recruitment of patients to register with them, there exists a mutual agreement between the patient and bank. Normally, the patient enters into a contract with the bailee (bank) who offer specified services (e.g. collection, testing and storage) over the stem cells, but in exchange of expressed monetary value. Despite the charges, what patients enjoy is the delegated right/power to direct how and by whom the stem cells would be used on which is not given in public banking. Unlike the public banks often financed by governments, private banks need to charge the fee to offer the quality service to their clients and perform recommended procedures. For the public it’s a delayed cost transferred to the recipient of the UCB product which is not charged by the private banking for analogous use. Educates the society Fortunately, public UCB banking also benefit from advertisement and the limited information offered to the public through private banking. Again patients have a choice have to enter into agreements with the private bank or not. Similarly, as private business entities their target market as expectant mothers does not necessary imply their exploitation and in case of marketing the strategy would always be biased to private UCB banking. Fortunately, public banking has dedicated limited efforts to educate and advertise to the public, which has given private banks a better position to create business opportunities among less informed patients/public. Conclusion UCB banking is a complex issue that touches on ethical, utility, social justice and legal aspects. From the above justification and preferences, the analysis indicate that public UCB blood banking offers more social good, has wide use in medical activities and minimal chances of being misinformed that private banking. Reference List AABB. (n.d). Umbilical Cord Blood Donations. Retrieved from http://www.aabb.org/sa/facilities/celltherapy/Pages/cordbloodfaqs.aspx AAP. 2007. Cord Blood Banking for Future Transplantation. Pediatrics, 119 (1), 167-170. Retrieved from http://pediatrics.aappublications.org/content/119/1/165.full ACOG Committee Opinions. (2009, February). Umbilical Cord Blood banking. Retrieved from http://www.acog.org/Resources-And-Publications/Committee-Opinions/Committee-on-Obstetric-Practice/Umbilical-Cord-Blood-Banking Armson, A. (2005). Umbilical Cord Blood Banking: Implications for Perinatal Care Providers. J Obstet Gynaecol Can, 27(3), 263–274. http://sogc.org/wp-content/uploads/2013/01/156E-CPG-March2005.pdf Muza, S. (2012, September 21). “Should We Private Bank Our Baby’s Cord Blood?” Information That Can Help You Answer That Question. Retrieved from http://www.scienceandsensibility.org/tag/cord-blood-banking/ Samuel, G.N., Kerridge, I.H. & O’Brien, T.A. 2008. Umbilical cord blood banking: public good or private benefit? The medical Journal of Australia 188 (9): 533-535. https://www.mja.com.au/journal/2008/188/9/umbilical-cord-blood-banking-public-good-or-private-benefit Sheremeta,L. (2006).Public Meets Private: Challenges for Informed Consent and Umbilical Cord Blood Banking in Canada. Health law Review, 15 (2). http://www.hli.ualberta.ca/HealthLawJournals/~/media/hli/Publications/HLR/15-2-4-Sheremeta.pdf Skabla, P.L. (2007) Umbilical Cord Blood: Advocating Donation and Comparing Public vs Private UCB Banking. Masters and Doctoral projects paper 116. http://utdr.utoledo.edu/cgi/viewcontent.cgi?article=1415&context=graduate-projects Read More