The Netherlands: opening of foetal biobank has led to surge in donations of foetal tissue after abortion

The study, which involved 1,272 participants between 2008 and 2022, showed a consent rate of around 30.3% among participants informed of the donation option after the Dutch Fetal Biobank (DFB) was set up in 2017. Of the main characteristics analysed in women who consented to donation (maternal age, ethnic origin, socio-economic status, etc.), only gestational age at the time of the abortion and the reason for the abortion had an impact on the likelihood of consenting to donation. The study found an association between an increase in gestational age and a decrease in the probability of consenting to donation. This could be explained by ‘the development of symptoms of complicated mourning, postnatal depression and post-traumatic stress following termination of pregnancy’. On the other hand, women who had abortions for social reasons were found to be more likely to donate. These are often unwanted pregnancies in which the bond between mother and baby is weaker, which, according to the authors, makes women ‘more receptive to the societal benefits of donation’.

Useful donation to compensate for abortion: what about women's autonomy?

According to the authors of the study, the large proportion of women willing to donate the tissue from their aborted foetus could be explained by the fact that they feel ‘a sense of comfort or usefulness in knowing that their donation can lead to medical progress’. Offering this option would fulfil, according to the authors, ‘an ethical obligation for the medical community to inform and provide individuals with a choice that can align with their values and preferences as an alternative to burial or cremation’.  Since the creation of the biobank, patients at the University Medical Centre Amsterdam (UMC) who have decided to have an abortion are systematically informed about the possibility of donating foetal tissue. The bank was set up to facilitate access to embryonic and foetal samples up to the gestational age of 24 weeks in response to the shortage of human foetal tissue. Since its creation, the Foetal Biobank has supported a number of research projects, including studies on the development of the human spleen, tracheal development and the maturation of the human foetal intestinal epithelial barrier.

However laudable the aims of this research, it is impossible to conceal the highly problematic origin of foetal tissue from abortions and the influence of the abortion context on women's decisions. Although, according to the DFB, the possibility of donation should only be raised after the decision to have an abortion, this option could end up colouring the abortion itself with an altruistic dimension and insidiously influence women's decision to have an abortion.

The problem remains the origin of these tissues, which are considered a resource for research and the object of therapeutic hopes, even though they are derived from foetuses whose abortion has been induced. If sacrificing a life ultimately saves others, is there not a risk of trivialising abortion even further by giving it a beneficial outcome? The question also arises as to the extent to which scientific research or the development of a treatment can really benefit society if it is based on the elimination of a human being. This practice echoes the removal of organs after euthanasia. Is it possible to mitigate an act of death by the benefit of saving lives?

Further information: Organ donation and euthanasia: ethically compatible?

Photo: H. Hach