Fetal Research and Applications

A Conference Summary

Conference Committee on Fetal Research and Applications

Division of Health Promotion and Disease Prevention

INSTITUTE OF MEDICINE

NATIONAL ACADEMY PRESS
Washington, D.C.
1994



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Fetal Research and Applications: A Conference Summary Fetal Research and Applications A Conference Summary Conference Committee on Fetal Research and Applications Division of Health Promotion and Disease Prevention INSTITUTE OF MEDICINE NATIONAL ACADEMY PRESS Washington, D.C. 1994

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Fetal Research and Applications: A Conference Summary NATIONAL ACADEMY PRESS 2101 Constitution Avenue, N.W. Washington, DC 20418 NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competencies and with regard for appropriate balance. This report has been reviewed by a group other than the authors according to procedures approved by a Report Review Committee consisting of members of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The Institute of Medicine was chartered in 1970 by the National Academy of Sciences to enlist distinguished members of the appropriate professions in the examination of policy matters pertaining to the health of the public. In this, the Institute acts under the Academy's 1863 congressional charter responsibility to be an adviser to the federal government and its own initiative in identifying issues of medical care, research, and education. Dr. Kenneth I. Shine is president of the Institute of Medicine. Support for this study was provided by National Research Council funds. Library of Congress Catalog Card Number 94-67254 International Standard Book Number 0-309-05176-2 Additional copies of this report are available from: National Academy Press 2101 Constitution Avenue, N.W. Box 285 Washington, DC 20055 Call 800-624-6242 or 202-334-3313 (in the Washington Metropolitan Area) B474 Printed in the United States of America Copyright 1994 by the National Academy of Sciences. All rights reserved. The serpent has been a symbol of long life, healing, and knowledge among almost all cultures and religions since the beginning of recorded history. The image adopted as a logotype by the Institute of Medicine is based on a relief carving from ancient Greece, now held by the Staatlichemusseen in Berlin.

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Fetal Research and Applications: A Conference Summary CONFERENCE COMMITTEE ON FETAL RESEARCH AND APPLICATIONS UTA FRANCKE,* Chair, Professor of Genetics and Pediatrics, Stanford University Medical Center, Stanford, California FREDERICK C. BATTAGLIA,* Professor, Department of Pediatrics, University of Colorado Health Sciences Center, Denver, Colorado MARTHA CONSTANTINE-PATON, Professor of Biology, Yale University, New Haven, Connecticut EZRA C. DAVIDSON,* Jr., Professor and Chairman, Department of Obstetrics and Gynecology, Charles R. Drew University of Medicine and Science, King-Drew Medical Center, Los Angeles, California JOSEPH M. DAVIE,* Vice President of Research, Biogen, Inc., Cambridge, Massachusetts NEAL L. FIRST,** Professor of Reproductive Biology and Biotechnology, Department of Meat and Animal Sciences, University of Wisconsin, Madison, Wisconsin HAIG H. KAZAZIAN,* Jr., Sutland Professor of Pediatric Genetics, The Johns Hopkins University, Director, Center for Molecular Genetics, The Johns Hopkins Hospital, Baltimore, Maryland Institute of Medicine Staff CONSTANCE M. PECHURA, Study Director, Associate Director, Division of Biobehavioral Sciences and Mental Disorders GARY B. ELLIS, Director, Division of Health Promotion and Disease Prevention (to January 1993) MICHAEL STOTO, Director, Division of Health Promotion and Disease Prevention TERRI BARBA, Project Assistant Consultant JUDITH M. SCHWARTZ, Contract Writer *   Member, Institute of Medicine **   Member, National Academy of Sciences

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Fetal Research and Applications: A Conference Summary Acknowledgments The committee and staff are grateful for the time and effort of the conference speakers. These individuals shared their considerable expertise through presentations that brought clarity and focus to difficult issues, ranging from legal and ethical dilemmas to scientific challenges and opportunities. Further, their work encouraged a remarkably free exchange of ideas. We hope that this report adequately reflects these important contributions. We also wish to thank the conference participants, many of whom traveled long distances and took time out from busy schedules to attend. The discussions benefited greatly from these participants' questions and observations, and the report is richer for them. Finally, we wish to thank the Institute of Medicine and the National Academy of Sciences for supporting this conference and the individuals who provided insightful review of the report draft. Uta Francke Chair

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Fetal Research and Applications: A Conference Summary Contents INTRODUCTION   1 SETTING THE STAGE: FETAL RESEARCH, FETAL TISSUE RESEARCH, AND HISTORICAL TIMELINE OF REGULATION AND LEGISLATION   4 SESSION I ETHICAL AND LEGAL ISSUES OF FETAL RESEARCH: HISTORY AND BACKGROUND   10 SESSION II PREEMBRYO RESEARCH   15 SESSION III FETAL RESEARCH   26 SESSION IV FETAL TISSUE TRANSPLANTATION   44 HIGHLIGHTS AND THEMES   60 APPENDIXES     A   Conference Agenda   67 B   Conference Participants   73 C   Summary of Medically Assisted Conception: An Agenda for Research   78 GLOSSARY   101

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Fetal Research and Applications: A Conference Summary Fetal Research and Applications

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