Umbilical cord blood has become the focus of intense efforts to collect, screen and bank haematopoietic stem cells in hundreds of repositories around the world. UCB banking has developed through a broad spectrum of overlapping banking practices, sectors and institutional forms. Superficially at least, these sectors have been widely distinguished in bioethical and policy literature between notions of the ‘public’ and the ‘private’, the commons and the market respectively. Our purpose in this paper is to reflect more (...) critically on these distinctions and to articulate the complex practical and hybrid nature of cord blood as a ‘bio-object’ that straddles binary conceptions of the blood economies. The paper draws upon Roberto Esposito’s reflections on biopolitics and his attempt to transcend the dualistic polarisations of immunity and community, or the private and the public. We suggest that his thoughts on immunitary hospitality resonate with many of the actual features and realpolitik of a necessarily internationalised and globally distributed UCB ‘immunitary regime’. (shrink)

More impetus needs to be placed on cord blood donationIn July, the Royal College of Obstetricians and Gynaecologists released a report on the uses and the potential perils of umbilical cord blood collection.1 This report has had the positive effect of drawing attention to what has hitherto been an under addressed topic of medical research and ethics. However, the focus and recommendations of the report say little about one important aspect of cord blood usage—research. (...) Such an omission, although understandable from an organisation primarily concerned with maternal and neonatal health, may nevertheless have implications for the broader applicability of the report’s recommendations, outside the immediate arena of patient care.The RCOG report deals with various aspects of cord blood collection and use—the harvesting procedure itself; cord blood transplantation treatment, either as an autologous cell transplant or as a donation for community use; and whether cord blood banking for personal use should be permitted or encouraged as a privately funded commercial enterprise. It also makes note of some of the legal and ethical issues surrounding cord blood and tissue banking more generally, concerns that will be of increasing importance as more biobanks are established worldwide. A large part of the report deals with concerns on neonatal and maternal safety and whether cord blood collection may pose a risk. These concerns may be valid and certainly, the health of mothers and children should not be compromised. The guidance provided by this report in relation to the collection procedure will undoubtedly assist maternity health professionals in this area.The main relevance of the RCOG …. (shrink)

Private cord blood banking is the practice of paying to save cord blood for potential future use. Informed by the literature on corporeal commodification and feminist theories, this article analyses women’s work in banking cord blood. This article is based on in-depth interviews with 13 women who banked in a private bank in Canada. From learning about cord blood banking to collecting cord blood and transporting it to the private (...) bank’s laboratory, women labour to ensure that cord blood is successfully banked. Private cord blood banking involves the overlap or insertion of commercial practices, and relations with clinical practices and relations that may cause tensions and confusion for women and clinical practitioners. Moreover, private banking reinforces and is reinforced by an ‘intensive mothering’ ideology. This article shows that corporeal commodification is not confined to a laboratory and the work of experts but extends into women’s everyday lives. (shrink)

BackgroundPrivate umbilical cord blood banking is a for-profit industry in which parents pay to store blood for potential future use. Governments have noted the tendency for private banks to oversell the potential for cord blood use, especially in relation to speculative cell therapies not yet supported by clinical evidence. We assessed the regulatory landscape governing private cord bank marketing in Canada.Main bodyBecause the problematic marketing of private cord blood banking for future (...) use often relates to speculative future cell therapies that do not exist and are not being advertised for current clinical use, most private blood bank marketing seems to fall outside Health Canada’s regulatory scope. However, this problematic marketing is regulated by the Competition Bureau pursuant to the Competition Act. While representations relating to future hypothetical treatments may not always be subject to the legal requirement for claim substantiation, the law also prohibits individuals and companies from knowingly or recklessly making representations that are “false or misleading in a material respect.” A representation is materially false or misleading when it could “influence a consumer’s behavior or purchasing decisions,” and consumers are likely to be considered to be “credulous and inexperienced” for the purposes of assessing an advertisement’s general impression. Because all of the potential benefit of the banking is derived from the potential future use of the biological material for health interventions directed toward the customers and their relatives, and because we know the best available medical evidence indicates a very low probability of utility in this context, we can say with confidence that some private cord blood banking claims are materially misleading. Moreover, to the extent that medical professionals are involved in private bank interactions with customers or hold ownership stakes in private banks, they are subject to professional codes, standards of practice, and potentially fiduciary obligations that further prohibit misleading marketing.ConclusionsPrivate cord blood bank marketing that advertises hypothetical future treatments can be misleading and may influence consumer behaviour. This marketing may breach existing advertising law. Regulatory bodies should enforce the law in order to help prevent public health and personal financial harm. (shrink)

This paper explores the perspectives of women who have agreed that their umbilical cord blood may be collected for a public ‘cord blood bank’, for use in transplant medicine or research. Drawing on interview data from 27 mothers who agreed to the collection and use of their umbilical cord blood, these choices and the informed consent process are explored. It is shown that the needs of sick children requiring transplants are prominent in narrative (...) accounts of cord blood banking, together with high expectations for future applications of stem cells. Given this dynamic, a concern arises that the complex and multiple uses of tissues and related data might be oversimplified in the consent process. In conclusion, the positive finding of a commitment to mutuality in cord blood banking among these women is underlined, and its implications for the wider debate on cord blood banking are discussed. (shrink)

Over the past decade, umbilical cord blood (UCB) has routinely been used as a source of haematopoietic stem cells for allogeneic stem cell transplants in the treatment of a range of malignant and non-malignant conditions affecting children and adults. UCB banks are a necessary part of the UCB transplant program, but their establishment has raised a number of important scientific, ethical and political issues. This paper examines the scientific and clinical evidence that has provided the basis for the (...) establishment of UCB banks. We also discuss the major ethical issues that UCB banks raise, including ownership of cord blood, processes for obtaining consent for its collection and storage, and confidentiality. Finally, we review other concerns about commercial non-altruistic banking, including concerns about social justice, equity of access and equity of care. (shrink)

BackgroundUmbilical cord banks are a central component, as umbilical cord tissue providers, in both medical treatment and scientific research with stem cells. But, whereas the creation of umbilical cord banks is seen as successful practice, it is perceived as a risky style of play by others. This article examines and discusses the ethical, medical and legal considerations that arise from the operation of umbilical cord banks in Mexico.DiscussionA number of experts have stated that the use of (...) umbilical cord goes beyond the mere utilization of human tissues for the purpose of treatment. This tissue is also used in research studies: genetic studies, studies to evaluate the effectiveness of new antibiotics, studies to identify new proteins, etc. Meanwhile, others claim that the law and other norms for the functioning of cord banks are not consistent and are poorly defined. Some of these critics point out that the confidentiality of donor information is handled differently in different places. The fact that private cord banks offer their services as "biological insurance" in order to obtain informed consent by promising the parents that the tissue that will be stored insures the health of their child in the future raises the issue of whether the consent is freely given or given under coercion. Another consideration that must be made in relation to privately owned cord banks has to do with the ownership of the stored umbilical cord.SummaryConflicts between moral principles and economic interests (non-moral principles) cause dilemmas in the clinical practice of umbilical cord blood storage and use especially in privately owned banks. This article presents a reflection and some of the guidelines that must be followed by umbilical cord banks in order to deal with these conflicts. This reflection is based on the fundamental notions of ethics and public health and seeks to be a contribution towards the improvement of umbilical cord banks' performance. (shrink)

BackgroundThe Act Regarding the Promotion of the Appropriate Supply of Hematopoietic Stem Cells for Transplant regulates only how public banks store and provide umbilical cord blood for research or transplantation. Japan had no laws to regulate how the private banks manage the procedures, harvesting, preparation, and storage of such blood. As a result, the status of UCB distribution remains unknown. We conducted a survey to investigate the current status of UCB storage and provision to private biobanks by (...) Japanese institutions that handle childbirth.MethodsQuestionnaire forms were mailed to 3,277 facilities handling childbirth that were registered in the Japan Council for Quality Health Care website.ResultsOf the 1,192 institutions handling childbirth that participated in the survey, 34.4% responded that they currently provide UCB to private biobanks, while 16.1% of facilities did so in the past. Moreover, some institutions currently provide or formerly provided UCB to medical treatment facilities, research institutions, companies, or overseas treatment facilities, research institutions, or companies. A certain number of institutions handling childbirth did not even provide explanations or obtain consent when the UCB was harvested from private bank users.ConclusionsThis is the first study to determine the status of UCB provision to private banks by Japanese institutions handling childbirth. Future studies will need to examine in detail how institutions handling childbirth provide explanations to private bank users and UCB providers as well as how these institutions obtain consent. (shrink)

According to biomedical discourse, cord blood has been transformed from ‘waste’ to ‘clinical gold’ because of its potential for use in treatments. Private cord blood banks deploy clinical discourse to market their services to prospective parents, encouraging them to pay to bank cord blood as a form of ‘biological insurance’ to ensure their child’s future health. Social scientists have examined new forms of (bio)value produced in biological materials emergent with contemporary biotechnologies. This paper (...) contributes to this literature by examining the social and technical production of value in cord blood units collected for private banking. Value, in this paper is defined as a socio-cultural concept in which an object is made meaningful, or valuable, through its relations with social actors and within specific regimes of value. I draw on in-depth interviews with women who banked cord blood and key informants in private banks in Canada, to analyze how social actors produced cord blood as a valuable biological object. I show that a cord blood unit holds promissory value for women who bank and profit value for private banks and that these values are folded into each other and the biological material itself. Analyzing how specific cord blood units are made valuable provides insight into the multiple and possibly competing values of biological materials and the tensions that may arise between social actors and forms of knowledge during the valuing process. (shrink)

One of the most intriguing bio-objects in the emerging field of regenerative medicine is umbilical cord blood. Employed in existing haematological therapies, but also loaded with potentialities for future uses, cord blood has been lately the focus of a regulatory debate which confronts public and private forms of biobanking. This article explores the political and anthropological side of this debate, describing the ways in which different health practices related to the umbilical cord (and to its (...) symbolic sibling, the placenta) have been involved in processes of societal production and reproduction. Through the use of ethnological and historical data, and their comparison with current practices, I contend that the technical manipulation of cords and placentas goes much longer into the past than what a first glance suggests, and that these two objects can be understood as biological spaces in which forms of social belonging and versions of the societal bond are at play. The current conflict between public and private cord blood banks is therefore interpreted as part of a longer history of bodily practices, and as reflecting recent mutations in the biopolitical constitution of advanced liberal societies. (shrink)

'An alarming and illuminating book. The story of how we have allowed private corporations to patent genes, to stockpile human tissue, and in short to make profits out of what many people feel ought to be common goods is a shocking one. No one with any interest at all in medicine and society and how they interact should miss this book, and it should be required reading for every medical student,'--Philip Pullman.

This paper challenges the traditional account of vulnerability in healthcare which conceptualizes vulnerability as a list of identifiable subpopulations. This list of ‘usual suspects’, focusing on groups from lower resource settings, is a narrow account of vulnerability. In this article we argue that in certain circumstances middle-class individuals can be also rendered vulnerable. We propose a relational and layered account of vulnerability and explore this concept using the case study of cord blood (CB) banking. In the first section, (...) two different approaches to ‘vulnerability’ are contrasted: categorical versus layered. In the second section, we describe CB banking and present a case study of CB banking in Argentina. We examine the types of pressure that middle-class pregnant women feel when considering CB collection and storage. In section three, we use the CB banking case study to critique the categorical approach to vulnerability: this model is unable to account for the ways in which these women are vulnerable. A layered account of vulnerability identifies several ways in which middle-class women are vulnerable. Finally, by utilizing the layered approach, this paper suggests how public health policies could be designed to overcome vulnerabilities. (shrink)

Umbilical cord blood banking is one of many biomedical innovations that confront pregnant women with new choices about what they should do to secure their own and their child’s best interests. Many mothers can now choose to donate their baby’s umbilical cord blood (UCB) to a public cord blood bank or pay to store it in a private cord blood bank. Donation to a public bank is widely regarded as (...) an altruistic act of civic responsibility. Paying to store UCB may be regarded as a “unique opportunity” to provide “insurance” for the child’s future. This paper reports findings from a survey of Australian women that investigated the decision to either donate or store UCB. We conclude that mothers are faced with competing discourses that force them to choose between being a “good mother” and fulfilling their role as a “good citizen.” We discuss this finding with reference to the concept of value pluralism. (shrink)

Definition of the problem: Cord blood banks have been and are still being set up in many modern states all over the world. Cord blood transplantation, however, gives rise to a specific set of ethical problems, that must be cleared up and analyzed before full responsibility can be assumed and the establishment of banks for frozen cord blood samples and the structural implementation of cord blood transplantation can be justified. The main ethical (...) issues concerning cord blood stem cell transplantation can be divided into at least six groups of questions that are closely related. First, there are ethical issues concerning the status of the treatment. Must cord blood transplantation somehow still be considered an „investigational” treatment or can it be regarded as accepted therapy? Second, we must face the question of the ownership of the placental tissue. Third, there are questions regarding the fairness in the collection and distribution of cord blood. Fourth, there is the issue of informed consent. Fifth, there is the question of whether how new data from medical testing will be communicated to the parents or the donor. Finally, questions related to privacy and confidentiality need to be addressed. Conclusion: As it is likely in the years to come that the supply and demand for cord blood will grow, clinicians will increasingly need answers to these ethical questions. Only thoughtful analysis of the attendant ethical issues of the establishment of banks for frozen blood samples and the structural implementation of cord blood transplantation can mitigate potential problems. (shrink)

Critical examination of the concept of property in the body, with particular relevance to Stephen Munzer's work on umbilical cord blood.

Researchers are developing a fertility preservation technique?testicular tissue cryopreservation (TTCP)?for prepubescent boys who may become infertile as a result of their cancer treatment. Although this technique is still in development, some researchers are calling for its widespread use. They argue that if boys do not bank their tissue now, they will be unable to benefit from any therapies that might be developed in the future. There are, however, risks involved with increasing access to an investigational procedure. This article examines (...) four methods of expanding access to TTCP: (1) expansion of institutional review board (IRB)-approved research trials; (2) offering TTCP as an innovative procedure in hospitals; (3) offering TTCP as a standard practice in hospitals; and (4) commercialization of TTCP. The ethical and practical implications of each are evaluated through a comparison with umbilical cord blood banking (UCBB), a technology that has achieved widespread use based on similar claims of future benefit. (shrink)

How are we individually and as a society to handle new and emerging technologies? This challenging question underlies much of the bioethical debates of modern times. To address this question we need suitable conceptions of the new technology and ways of identifying its proper management and regulation. To establish conceptions and to find ways to handle emerging technologies we tend to use analogies extensively. The aim of this article is to investigate the role that analogies play or may play in (...) the processes of understanding and managing new technology. More precisely we aim to unveil the role of analogies as analytical devices in exploring the "being" of the new technology as well the normative function of analogies in conceptualizing the characteristics and applications of new technology. Umbilical cord blood biobanking will be used as a case to investigate these roles and functions. (shrink)

This academic paper on Ethical issues of using umbilical cord blood stem cell therapy of John Stuart Mill perspective aim to investigate the new approaches in the treatment of diseases by using umbilical cord blood stem cells. And also to study ethical issues from the use of umbilical cord blood stem cells in the treatment of diseases considered by Mill’s utilitarianism. 21st century, the medical industry was interested in organ transplantation from stem cells especially (...) stem cells from the umbilical cord to treat chronic and degenerative organ diseases, blood cancer and organ transplantation which successful and widespread throughout the world. Thailand has about 900 new children with Leukemia every year. About 50 percent are leukemia which needs to be treated correctly and urgently. In general Standardized chemotherapy but if the cancer patient has a bad prognosis Or have recurrent cancer Patients need to be treated with bone marrow transplants or stem cells to have a chance to heal. According to Mill’s Utilitarianism, the ethical concepts that determine what is the basic criterion used to determine whether it should or should not concern with the popular benefit that the criterion used is the amount of happiness that results from actions. Treating the disease using stem cells will make the patient recover from the disease, healthier and happier in life. As Mill said "The correctness of an action depends on the tendency that the action will lead to happiness. (shrink)

Advances in medical technology and information have facilitated clinical practices that favourably affect the success rates of treatment for diseases. Regenerative medicine has been the focus of the recent medical agenda, to the extent of fundamentally changing treatment paradigms. Stem cell practices, their efficacy, and associated ethical concerns have been debated intensively in many countries. Stem cell research is carried out along with the treatment of patients. Thus, various groups affected by the practices inevitably participate in the discussions. In addition (...) to discussions based on avoiding any harm, providing benefits and respecting personal autonomy and justice, problems arise owing to the lack of legal regulations for stem cell research and practice. The dimensions of the problems vary in the developing countries, with widespread use of advanced medical technology but with lack of sources allocated for healthcare, dominance of paternalistic physician–patient relationships and failure to achieve a sufficient level of awareness of patients’ rights. This article discusses the current situation of stem cell practices within the context of regenerative medicine in Turkey and ethical concerns about some of the legal regulations, such as the Regulation for Umblical Cord Blood Banking and Guidelines for Non-embryonic Stem Cell Study for Non-clinical Purposes directing the research on this issue. (shrink)

Advances in medical technology and information have facilitated clinical practices that favourably affect the success rates of treatment for diseases. Regenerative medicine has been the focus of the recent medical agenda, to the extent of fundamentally changing treatment paradigms. Stem cell practices, their efficacy, and associated ethical concerns have been debated intensively in many countries. Stem cell research is carried out along with the treatment of patients. Thus, various groups affected by the practices inevitably participate in the discussions. In addition (...) to discussions based on avoiding any harm, providing benefits and respecting personal autonomy and justice, problems arise owing to the lack of legal regulations for stem cell research and practice. The dimensions of the problems vary in the developing countries, with widespread use of advanced medical technology but with lack of sources allocated for healthcare, dominance of paternalistic physician–patient relationships and failure to achieve a sufficient level of awareness of patients’ rights. This article discusses the current situation of stem cell practices within the context of regenerative medicine in Turkey and ethical concerns about some of the legal regulations, such as the Regulation for Umblical Cord Blood Banking and Guidelines for Non-embryonic Stem Cell Study for Non-clinical Purposes directing the research on this issue. (shrink)

Anouck Alary | : La transformation du sang placentaire en une précieuse source de cellules souches a donné naissance à partir des années 1990 à une industrie globale de conservation de sang de cordon ombilical faisant désormais concurrence à un large réseau de banques publiques de sang de cordon. Cet article explore les soubassements socioculturels liés à l’émergence de cette industrie et tente d’élucider les enjeux éthiques et politiques qu’elle pose. Si les banques publiques de sang de cordon sont porteuses (...) des valeurs d’altruisme et de solidarité nationale traditionnellement liées au modèle redistributif d’échange de sang et d’organes né après la Seconde Guerre mondiale, les banques privées renvoient, elles, à des formes de solidarité bien différentes. C’est effectivement sous couvert de la solidarité familiale et de la responsabilité morale des mères de protéger leurs enfants qu’elles définissent la conservation privée comme une forme d’ « assurance biologique » contre les risques à la santé de l’enfant. En permettant aux mères d’investir leurs tissus corporels à la fois dans le futur incertain de leurs enfants et dans des thérapies cellulaires expérimentales, ces banques promeuvent un nouveau modèle de participation du/de la patient.e à la coconstitution de futures innovations thérapeutiques. Nous inscrivons ce modèle de participation dans les reconfigurations contemporaines du biopolitique que le sociologue britannique Nikolas Rose voit s’incarner dans l’émergence d’une nouvelle forme de biocitoyenneté. L’article critique finalement ces services personnalisés en soulignant qu’ils ont le potentiel d’opérer de nouvelles formes de coercition sur les mères, dans un contexte sociopolitique caractérisé par une responsabilisation accrue des individus au regard de la « bonne gestion » de leurs risques à la santé. Ces services sont aussi jugés problématiques sur le plan éthique, au vu de leur incohérence avec un principe de justice distributive défendant l’accès égal pour chaque citoyen.ne à des soins de santé de base. | : Since the 1990s, the transformation of cord blood into a precious source of stem cells has given rise to a global cord blood bank industry, which is now competing with a large network of public cord blood banks. This article explores the sociocultural context surrounding the emergence of this industry and aims at elucidating the ethical and political concerns that this industry raises. Whereas public cord blood banks are purveyors of values such as altruism and national solidarity traditionally linked to the redistributive model of human blood and organ donation that emerged after World War Two, private banks engage very different forms of solidarity. It is indeed under the guise of family solidarity and mothers’ moral responsibility to do their best to protect their children that they come to define private preservation as a form of “biological insurance” against potential risks to their children’s health. By allowing mothers to invest their bodily tissues simultaneously in their children’s uncertain future and in experimental cell therapies, these banks promote a new model of patient participation in the development of future therapeutic innovations. This article analyzes this model as embedded in the contemporary reconfiguration of biopolitics that sociologist Nikolas Rose envisions as constituting a new form of biocitizenship. The paper finally casts a critical eye on these personalized services, in particular because of the new forms of social coercion on mothers that are brought about in a social and political context characterized by an increasing moral accountability of individuals with regard to the “good management” of their own health risks. These services also appear ethically problematic in relation to political demands of distributive justice—e.g., the ideal of equal access to basic health care for every citizen. (shrink)

Although the term commodification is sometimes criticised as imprecise or overused, in fact it has a complex philosophical ancestry and can never be used too much, because the phenomena that it describes are still gaining ground. The issues that commodification raises in relation to reproductive technologies include whether it is wrong to commodify human tissues generally and gametes particularly, and whether the person as subject and the person as object can be distinguished in modern biomedicine. This chapter examines three areas (...) in which commodification is a serious concern for important reproductive technologies: the sale of eggs for IVF and research, the banking of umbilical cord blood, and the use of gestational surrogates both domestically and internationally. Sales of human eggs for IVF or research are frequently disguised as “gifts”, which conceals the very real bodily risks and harms associated with ovarian hyperstimulation and egg harvesting undergone by egg “donors.” Umbilical cord banking is a fast-growing industry, with donated cord blood trading globally at very high prices; women who consent to banking of cord blood ostensibly for the potential future benefit of their child may not be informed of the likelihood that it will be traded in commercial markets or that the method used for harvesting may increase risks of jaundice in their babies. Commercial surrogacy also exploits altruism but in addition involves wrongful sale of babies, particularly in the international context. In each example, the commodification of women’s reproductive labour is masked by the manner in which ‘the lady vanishes’ under a gift model, ignoring the true economic value of their labour. (shrink)

In this paper we criticize the existing contradictions in the context of bone marrow donor records in Spain. On the one hand there is the necessity to register as many patients as possible to maximize the opportunities to access a bone marrow transplant and on the other the always important economic issue of having to perform the relevant histocompatibility tests. In fact, these records are globally coordinated with each other to provide a wide range of potential donors and make better (...) use of existing resources. It should be noted that many patients who should have a transplant but who do not achieve a sufficient donor support must follow a medical treatment with high economic costs with tragic results for many of them. For example, those suffering from certain types of leukemia, when not finding that compatible donor, must follow chemotherapy-based treatments. There are also cord blood units banks which allow performing these transplants, also coordinated at the international level. Therefore, according to the principle of reciprocity, it is not justifiable that some countries are doing an important economic effort to have a large registration while others take advantage without making an equivalent effort according to their economic and population size. (shrink)

Robust ex vivo expansion of umbilical cord blood (UCB) derived hematopoietic stem and progenitor cells (HSPCs) should enable the widespread use of UCB as a source of cells to treat hematologic and immune diseases. Novel approaches for HSPC expansion have recently been developed, setting the stage for the production of blood stem cell derived products that fulfill our current best known criteria of clinical relevance. Translating these technologies into clinical use requires bioengineering strategies to overcome challenges of (...) scale‐up, reproducibility, and product quality assurance. Clinical‐scale implementation should also define criteria and targets for cost‐effective cell manufacturing. As production strategies become more effective, new opportunities in the therapeutic use of ex vivo expanded hematopoietic cell products will emerge. Herein we examine key technological milestones that need to be met in order to move ex vivo expanded HSPC therapies from the bench‐top to the bedside in a robust and reliable manner. (shrink)

Robust ex vivo expansion of umbilical cord blood (UCB) derived hematopoietic stem and progenitor cells (HSPCs) should enable the widespread use of UCB as a source of cells to treat hematologic and immune diseases. Novel approaches for HSPC expansion have recently been developed, setting the stage for the production of blood stem cell derived products that fulfill our current best known criteria of clinical relevance. Translating these technologies into clinical use requires bioengineering strategies to overcome challenges of (...) scale‐up, reproducibility, and product quality assurance. Clinical‐scale implementation should also define criteria and targets for cost‐effective cell manufacturing. As production strategies become more effective, new opportunities in the therapeutic use of ex vivo expanded hematopoietic cell products will emerge. Herein we examine key technological milestones that need to be met in order to move ex vivo expanded HSPC therapies from the bench‐top to the bedside in a robust and reliable manner. (shrink)

It is increasingly suggested that shortages in the supply chain for human blood could be met by the development of techniques to manufacture human blood ex vivo. These techniques fall broadly under the umbrella of synthetic biology. We examine the biopolitical context surrounding the ex vivo culture of red blood cells through the linked concepts of alienation, immunity, bio-value and biosecuritization. We engage with diverse meanings of synthetic blood, and questions about how the discourses of biosecurity (...) and privatization of risk are linked to claims that the technology will address unmet needs and promote social justice. Through our discussion we contrast communitarian ideas that culturing red blood cells ‘extends the gift’ of adult blood donation with understandings of the immunitary logics that underpin the cord-blood economy. (shrink)

Insisting on the status of money as a creature of both the market and the state, this article challenges dualistic understandings of capitalist imperialism as entailing two fundamentally distinct logics, one capitalist, the other territorial. In opposition to the dual-logics position, the article argues for the distinctiveness of capitalist money in terms of a complex butunitarysocio-economic logic. The social dynamism of this logic involves the spatial-territorial extension of the domain of modern value relations, embodied in fully-capitalist money. Departing from the (...) development of coinage in ancient Greece, the article proceeds to identify the 1690s in Britain as the decisive moment in the emergence of a new and distinctively capitalist form of (world) money, institutionally based upon the Bank of England, in which state debt was thoroughly integrated with private financial markets. The crucial role of the Bank of England in this new monetary system is shown to have pivoted on its capacities to finance Britain’s inter-colonial wars. Colonialism, war, slavery and dispossession underline the omnipresence of ‘blood and dirt’ (Marx) in the development and reproduction of capitalist impersonal power as expressed in world money. Undoing the impersonal power characteristic of bourgeois money thus entails undoing the economic dispossession of the labouring poor, which forms the basis of their ‘possession’ by capital. (shrink)

Blood banks all over the world attempt to cover the demand for blood by donations from voluntary non-remunerated donors. The discussion regarding the acceptability of blood donations by haemochromatosis patients focuses on the question of whether health benefits violate the rule of the altruistic donor. Utilitarian and deontological arguments for and against the policy of accepting blood donors who need to let blood regularly in order to stay healthy are considered by this article. A closer (...) look at the procedure reveals that the confusion is due to the conflation of, on the one hand the phlebotomy, and on the other hand, the decision about the destination of the blood afterwards. The health benefits are connected to the phlebotomy and not to the donation. The morally relevant point in the decision as to whether the candidate is a truly altruistic donor is whether he donates without asking for a benefit in return. It is concluded that haemochromatosis patients can be free, voluntary, and altruistic blood donors. (shrink)

The National Blood Policy in India relies heavily on voluntary blood donors, as they are usually assumed to be associated with low levels of transfusion-transmitted infections . In India, it is mandatory to test every unit of blood collected for hepatitis B, hepatitis C, HIV/AIDS, syphilis and malaria. Donors come to the blood bank with altruistic intentions. If donors test positive to any of the five infections, their blood is discarded. Although the blood (...) policy advocates disclosure of TTI status, donors are not, in practice, informed about their results. The onus is on the donor to contact the blood bank. Out of approximately 16 000 donations in the past 2 years, 438 tested positive for TTI, including 107 for HIV. Only 20% of the donors contacted the blood bank; none of them were HIV positive. Disclosure by blood banks of TTI status by telephone or mail has resulted in serious consequences for some donors. Health providers face an ethical dilemma, in the absence of proper mechanisms in place for disclosure of test results, regarding notification to donors who may test positive but remain ignorant of their TTI status. Given the high cost of neglecting to notify infected donors, the authors strongly recommend the use of rapid tests before collecting blood, instead of the current practice, which takes 3 h to obtain results, and disclosure of results directly to the donor by a counsellor, to avoid dropouts and to ensure confidentiality. (shrink)

Sometimes, people who are otherwise eligible to donate blood are unduly deferred from donating. “Unduly” indicates a gap where a deferral policy misstates what exposes potential donors to risk and so defers more donors than is justified. Since the error is at the policy-level, it’s natural and understandable to focus criticism on reformulating or eliminating the offending policies. Policy change is undoubtedly the right goal because the policy is what prevents otherwise safe eligible donors from donating needed blood. (...) But focusing exclusively at the policy-level passes over a largely undiscussed question: if policy change takes time and there is an urgent need for blood now, then what should unduly deferred donors do in the meanwhile? Blood banks and federal agencies recommend that deferred donors donate their time or money until they become eligible, but blood is a non-fungible good: donated cash or volunteered time cannot replace a transfusion. Further, this request ignores that otherwise eligible donors could safely donate their blood in addition to their time and money. Here is the central question I will focus on in this paper: is a donor morally justified in lying on a questionnaire to donate blood if they justifiably believe that their blood poses no risk to a recipient and knows that honestly answering a donor questionnaire would unduly defer them from donating? (shrink)

The properties of DNA -- DNA as universal property -- DNA as intellectual property -- DNA as national property -- DNA as personal property -- DNA as academic property -- DNA as taxable propety.

The Indiana Court of Appeals, in JKB, Sr. v. Armour Pharmaceutical Co. ), held that the state's Blood Shield Act does not protect pharmaceutical companies that produce blood-derived products from product liability suits based on injuries attributable to tainted blood supplies. Blood shield statutes help to guarantee adequate blood supplies by limiting the liability of blood banks. This holding limits the defenses available to pharmaceutical companies sued under product liability theory.The defendant, Armour Pharmaceutical, produces (...) and sells clotting factor agents, which are derived through plasmapheresis. Plasmapheresis is a costly and complex donation process through which the plasma and red blood cells of a donor's blood are separated. After separation, the process returns the red blood cells to the donor but retains the plasma. (shrink)

This paper contributes to the calculization of evocation and erotetic implication as defined by Inferential Erotetic Logic (IEL). There is a straightforward approach to calculizing (propositional) erotetic implication which cannot be applied to evocation. First-order evocation is proven to be uncalculizable, i.e. there is no proof system, say FOE, such that for all X, Q: X evokes Q iff there is an FOE-proof for the evocation of Q by X. These results suggest a critique of the represented approaches to calculizing (...) IEL. This critique is expanded into a programmatic reconsideration of the IEL-definitions of evocation and erotetic implication. From a different point of view these definitions should be seen as desiderata that may or may not play the role of a point of orientation when setting up "rules of asking". (shrink)

The method of explication has been somewhat of a hot topic in the last 10 years. Despite the multifaceted research that has been directed at the issue, one may perceive a lack of step-by-step procedural or structural accounts of explication. This paper aims at providing a structural account of the method of explication in continuation of the works of Geo Siegwart. It is enhanced with a detailed terminology for the assessment and comparison of explications. The aim is to provide means (...) to talk about explications including their criticisms and their interrelations. There is hope that this treatment will be able to serve as a foundation to a step-by-step guide to be established for explicators. At least it should help to frame and mediate explicative disputes. In closing the enterprise will be considered an explication of ‘explication’, though consecutive explications improving on this one are undoubtedly conceivable. (shrink)

Kit Fine’s arguments in Essence and Modality are widely accepted as being a decisive blow against modal essentialism. A selection of replies exist that have done little to counter the general view that modally construed essence is out of touch with what we really mean when we make essentialist claims. I argue that Fine’s arguments fail to strike a decisive blow, and I suggest a new interpretation of the debate that shows why Fine’s arguments fall short of achieving their goal.

This encyclopedia article provides a procedural account of explication outlining each step that is part of the overall explicative effort (2). It is prefaced by a summary of the historical development of the method (1). The latter part of the article includes a rough structural theory of explication (3) and a detailed presentation of an examplary explication taken from the history of philosophy and the foundations of mathematics (4).

Causal processes can give rise to distinctive distributions in the linguistic variables that they affect. Consequently, a secure understanding of a variable's distribution can hold a key to understanding the forces that have causally shaped it. A storied distribution in linguistics has been Zipf's law, a kind of power law. In the wake of a major debate in the sciences around power-law hypotheses and the unreliability of earlier methods of evaluating them, here we re-evaluate the distributions claimed to characterize phoneme (...) frequencies. We infer the fit of power laws and three alternative distributions to 166 Australian languages, using a maximum likelihood framework. We find evidence supporting earlier results, but also nuancing them and increasing our understanding of them. Most notably, phonemic inventories appear to have a Zipfian-like frequency structure among their most-frequent members (though perhaps also a lognormal structure) but a geometric (or exponential) structure among the least-frequent. We compare these new insights the kinds of causal processes that affect the evolution of phonemic inventories over time, and identify a potential account for why, despite there being an important role for phonetic substance in phonemic change, we could still expect inventories with highly diverse phonetic content to share similar distributions of phoneme frequencies. We conclude with priorities for future work in this promising program of research. (shrink)

We argue that the need for commentary in commonly used linear calculi of natural deduction is connected to the “deletion” of illocutionary expressions that express the role of propositions as reasons, assumptions, or inferred propositions. We first analyze the formalization of an informal proof in some common calculi which do not formalize natural language illocutionary expressions, and show that in these calculi the formalizations of the example proof rely on commentary devices that have no counterpart in the original proof. We (...) then present a linear natural deduction calculus that makes use of formal illocutionary expressions in such a way that unique readability for derivations is guaranteed – thus showing that formalizing illocutionary expressions can eliminate the need for commentary. (shrink)