search agenda for increasing the science base underlying medically assisted conception.2 This report dealt exclusively with issues related to in vitro fertilization (IVF), but its recommendations regarding the development of research policy and practice oversight, the establishment of research programs coordinated by the National Institutes of Health, multicentered data collection, and improvements in communication among researchers and clinical practioners could apply to other aspects of fetal research and fetal tissue research as well. Yet, until President Clinton lifted the federal moratorium (which had been extended following controversy about fetal tissue transplantation research) in January 1993 (58 FR 7468), nothing changed.
In 1992, following the recommendation of the IOM Program Committee, the National Academy of Sciences and the Institute of Medicine decided to support with their own funds a project, proposed by the IOM Board on Health Promotion and Disease Prevention, to examine the current state of fetal research and fetal tissue research. The IOM convened a committee to plan a conference on the topic. This report is the result of the committee's efforts.
The initial aim was to help inform private funders, who often lack the formalized peer review systems used by government funding agencies, about new and promising areas of research in the field and, thus, to serve as an outside assessment of research priorities. The committee, formed in 1992, was comprised of senior scientists, broadly knowledgeable in the field, but not themselves directly involved in human fetal studies. Although time and funds did not permit full elaboration of a detailed research agenda, the conference did provide an overview of current research and a forum for discussion of key questions for the future: What are the important problems in fetal research that can be approached with current or developing technology? What are the ethical boundaries?
The conference, organized into four sessions and involving 24 speakers, was held June 20–22 in Irvine, California. The first session introduced some of the ethical and legal issues of research with fetuses and fetal tissues; the following sessions on preembryo research, fetal research, and fetal tissue transplantation formed the main scientific portion of the conference (Appendix A). Discussion periods encouraged interaction among the speakers and conference participants, including other scientists, physicians, and bioethicists, as well as governmental advisers and public health and health industry representatives (Appendix B).
This report begins with an overview of fetal research and research with fetal tissue, followed by a short history and background regarding the regulatory and legislative actions governing this research over the past 30 years. These sections are provided to add breadth for the reader unfamiliar with the field and its complicated legislative history. The main body of the report summarizes the conference presentations and discussions. A glossary of terms is included and all