In the first instance, the abortionist will obviously benefit financially. Regardless of his motivation for entering the field, the doctor who performs an abortion will receive significant financial reward. While each routine first-term abortion may not individually have a big return, the sheer number that can be done in one session allows considerable profits. Unlike many other types of operation, abortions (in many countries) are subsidized through government programs, thus increasing payment reliability.
The cost of an abortion depends on the location, the facility used, the stage of pregnancy, and the type of procedure. Costs therefore vary widely, but the following provides a guide to typical costs in a few locations:
- United Kingdom: The National Health Service provides a free abortion service. If you choose to use the private system, medical abortions cost £440-£470 during the first trimester, and up to £1225 at 23 weeks gestation; surgical abortions cost from £350-£550 during the first trimester, and up to £1700 at 23 weeks.
- United States: There are large variations, but medical abortions tend to cost $300-$650 during the first trimester, and as much as $3000 for a later abortion; surgical abortions can cost $200-$1000 during the first trimester, as much as $5000 (but more commonly $700-$2000) during the second trimester, and up to $10,000 for a third-trimester abortion. Reductions may be possible with private insurance or Medicaid.
- Australia: First-trimester abortions cost $300-$800, and second-trimester abortions cost $640-$1800. Reductions may be possible with private insurance or Medicare.
The largest abortion provider in the United States is Planned Parenthood Federation of America, which posted a net profit of $85 million in 2008 on gross revenue of $1.038 billion, some of which was used to fund political strategies to protect the right to abortion.
In May 2011, Planned Parenthood Minnesota, North Dakota and South Dakota sued the state of South Dakota, challenging a new law that required women to undergo counselling before seeking abortion. The law also imposed a 72-hour delay following a woman’s initial consultation with her doctor before the abortion could be performed, and required doctors to obtain proof in writing that the counselling was completed.
The fetal tissue industry
An unintended consequence of the widespread right to abortion has been the creation of a vast and lucrative market in fetal tissue, fetal organs and fetal parts.
The fate of aborted fetuses is not often discussed. If they are disposed of by the clinic, incineration is the usual method. But where it is legal, there are financial incentives to look at alternative means of disposal.
Fetal tissue—that is, any part of the fetus’s body—can be used for research, transplantation and product development in the medical and pharmaceutical industries. Fetal tissue is attractive to researchers because it retains the potential to grow and change into different types of cells, similar to embryonic stem cells. It has been used in research since the 1930s and in transplants since the 1960s. The transplants were initially aimed at curing illnesses like Parkinson’s disease and diabetes. Some jurisdictions have introduced legislation to make sure pressure is not put on women to abort in order for tissue to be obtained (the industry being worth potentially thousands of dollars per month for a clinic).
Fetus farming is a way of obtaining whole organs that can be used in transplants. Experiments in mice have shown that fetal kidneys grow extremely quickly when transplanted into adult animals. It is easier to take a liver from an 8-month gestation fetus than to grow the liver from embryonic stem cells. While the industry as visualized in movies like The Island (2005) is still in the realm of science fiction, some jurisdictions have been worried enough to introduce legislation to prevent it (United States Congress prohibited it in 2006). In 2009, Oxford University Professor and advisor to Britain’s Human Fertilisation and Embryology Authority Sir Richard Gardner called for studies into the feasibility of transplanting fetal organs. He said he was surprised the possibility had not been considered, and that “It is probably a more realistic technique in dealing with the shortage of kidney donors than others”. Note that to harvest an organ for transplant, one would have to abort the fetus in the second or third trimester with arrangements in place for careful transfer of the tissue to the transplant facility so that it remained fresh. But in a society that allows abortion on demand, why wouldn’t this be attractive to the parents of a dying child who was desperately in need of an organ transplant?
The pharmaceutical industry
Cell lines (continually renewed cultures of specific cells in a laboratory) are used to grow the viruses used in the production of vaccines. Viruses require the presence of cells in order to replicate, and some human-specific viruses will only grow on cell lines originally derived from a sample of human tissue. They are incubated until enough virus has grown for harvest.
In the 1960s, certain cell lines (WI-38 and MRC-5) were developed from fetal tissue that came from elective abortions indicated for medical reasons. WI-38 came from lung cells of a female fetus of 3 months gestation, and MRC-5 came from lung cells of a male fetus of 14 weeks gestation. (The abortions were not conducted for the purpose of collecting cells for cell lines.) The cells currently in use have been growing independently for more than 40 years, and so were never part of the original aborted fetus’s body.
These cell lines (which are different from embryonic stem cells) have been used to manufacture vaccines for rubella (German measles), MMR (measles, mumps and rubella), hepatitis A and B, varicella (chickenpox and shingles), polio, smallpox and rabies. Further research is ongoing to develop new vaccines. The question is not whether these are useful vaccines—of course they are. The question is: can we make the same vaccines in an ethical manner? Is it necessary to use fetal cells in this process?
Is it necessary?
The PER.C6 technology is based on the PER.C6 fetal cell line, which was developed from embryonic retinal cultures taken from a 1985 elective abortion. This is an example of newer technology, developed to industry standards and marketed by the company Crucell as a “safe and cost-effective manufacturing system for high-yield, large-scale production of vaccines, recombinant proteins including monoclonal antibodies, and gene therapy products”.
It is not necessary to use aborted fetal tissue for these processes. It would be possible to make vaccines and monoclonal therapies with recombinant DNA technology, or using human tissue from another source.
It would be possible to develop future vaccines without culture of human diploid cells for the attenuation of the virus and its growth. Vaccine could be prepared from the genome of the virus and its antigens. This would be a scientifically valid and ethical alternative. However, it will be difficult to change a practice that is already in place and upon which a whole industry is built—not only due to cost but also the challenge of having manufacturers agree that an alternative is necessary.
If alternatives are not available and you are concerned about using vaccines that were developed using tissue from aborted fetuses, what should you do?
The ethics of vaccine use
The ethical concern for Christians is that by using these vaccines we are somehow complicit in the abortions that led to the death of the fetuses used to harvest the original cells for culture. To be complicit means to be a partner in an evil act.
Moral complicity can be judged by asking several questions:
- Have you had any role in causing the wrong act? Did we intend the original abortion? In this case, obviously not. Whatever the ‘medical indications’ for the abortion were, we were not involved in the original decision.
- Are you facilitating the wrong act directly? Does our action (using the vaccine) promote the performance of the morally wrong act (the abortion)? Again, the answer is no—the collection of the fetal cells has long since passed.
- Does your action perpetuate the moral wrong? No. By using the vaccine now, we do not promote further abortions for this particular purpose. However, we still can let manufacturers know we object to the use of fetal cells for ongoing development of vaccines.
In other words, we did not cooperate in the performing of the abortion that led to the death of the fetus whose tissue was used in developing the cell lines used in producing virus vaccines. Therefore, using the vaccines is morally justified, since we are not morally complicit in the original abortions.
Furthermore, we have an important moral reason for using the vaccines: the protection against potentially life-threatening infectious diseases. Not only do we help those we vaccinate directly (for example, children), but we also make these diseases less common, thus benefitting the general community—including pregnant women, whose unborn children could be adversely affected by infections such as rubella. Immunization has been demonstrated to be one of the most effective medical interventions available to prevent disease, estimated to save 3 million lives per year throughout the world. This argument for allowing the use of vaccines produced using fetal cell lines is supported by the Vatican.
Parents with specific concerns regarding immunization should discuss the issue with their local doctor before deciding against such an important medical intervention.
The cosmetics industry
The new technology of stem cells has found its way to the beauty department. Biotechnology companies have started developing anti-ageing cosmetics using fetal stem cells, marketed as ‘cosmeceuticals’—a topical application with active ingredients that apparently have medical-type benefits.
Enormous financial investments have been made in embryonic stem-cell technologies worldwide, with little return so far. At the 2008 World Stem Cell Summit held in Madison, Wisconsin, the mood was pessimistic:
Commercialization is “excruciatingly slow”, said Michael Haider, CEO of BioE Inc., a St Paul company that extracts stem cells from blood in human umbilical cords. “I’m not aware of a successful stem-cell company. If you thought gene therapy was difficult, then [stem cells] are astronomically difficult.”
Some people hope that cosmetic applications will be one way to get some money back. Like all cosmetics these products need to be safe, but unlike pharmaceuticals, they don’t have to prove that they actually do what they say they do (much to the manufacturer’s relief, as this process of documenting efficacy is long and costly—though it would be interesting to see how many face creams passed the test!).
This use of stem cells on skin arose from the successful application of fetal tissue to treat burn victims. Skin cells taken from an aborted male fetus of 14 weeks gestation were used to grow sheets of skin that healed children’s burn wounds without scarring, in research at the University Hospital of Lausanne, Switzerland. The team went on to use the fetal cells to develop a cell bank, to be the ongoing supply for a cream designed to reduce the signs of ageing, improve skin texture and reduce wrinkles. The active ingredient (Processed Skin Cell Proteins, or PSP) has been trademarked by Neocutis, a company founded as a spin-off from the Lausanne University Hospital, with the research team becoming the founding entrepreneurs.
A new market has been created by the arrival of the baby-boomer generation at a stage when work needs to be done if they are to avoid looking their age. This group includes many individuals with the determination and resources to stay ‘young’ at any cost. According to one report, “The global anti-aging market for the boomer generation was worth $162.2 billion in 2008. This should reach $274.5 billion in 2013…”
What cosmetics are available for those with the will and wallet to proceed? At the budget end you can buy ‘miracle’ serums developed from fetal cell technologies (all unproven as to efficacy, remember), such as Voss Laboratories’ Amatokin, 25 ml for $69.99; Neocutis’s Journee Bio-Restorative Day Cream with PSP, 1 oz for $120; or ReVive Skincare’s Peau Magnifique, 4 x 1 ml bottles for $US1,500, £930 or $AU2,500, depending on where you shop. The products are expensive because they have a limited shelf life and are not mass-produced.
At the more exclusive end of the line, you can go to a clinic at an international tourist destination and receive an injection of fetal stem cells for a ‘mere’ $US25,000/£15,000 per session. Cited benefits include improvements in appearance, sleep, libido and general quality of life. The clinics, operating without regulation or external supervision, apparently exist (or have existed) in Barbados, Ecuador, Russia and the Ukraine. These centres do not just give beauty treatments, but also stem-cell remedies for a wide variety of problems. The director of King’s College London stem-cell biology laboratory, Dr Stephen Minger, commented that the therapies were “not based on scientific evidence”.
The Institute for Regenerative Medicine (IRM) in Barbados was closed down in 2007 after business slowed following a critical BBC television report. It named the Institute as one of the clinics using stem cells from aborted fetuses and dismembered babies that were imported from the Ukraine. The Institute’s Scientific Director, Professor Yuliy Baltaytis, had another stem-cell treatment centre closed down in Hungary in July 2009 for illegal practices, which once again cost the equivalent of $US25,000 each. Shipments from the Ukraine were also received at the Budapest clinic.
In 1995, the trafficking of babies from the Ukraine was already well known, with arrests on record for doctors in Lvov who had sold newborn babies to foreigners. Even then it was said it have been going on for a decade.
In 2006, BBC reporter Matthew Hill published an exposé on the possible kidnapping and murder of babies in Ukrainian hospitals to furnish the international stem-cell trade with lucrative biological material. Reporters interviewing many women in the Ukraine at the time found an atmosphere of fear, with many claiming that their babies had been stolen; that they had been told they had died but then were not allowed to see them.
In 2003, the authorities had agreed to exhume around 30 bodies of infants (pre- and full-term) from a cemetery used by maternity hospital number six in the city of Kharkiv. One campaigner was allowed into the autopsy to gather video evidence. She gave that footage to the BBC and the Council of Europe. The pictures apparently show tiny dismembered bodies stripped of organs (which is not standard post-mortem practice). Some injuries could be the result of harvesting stem cells from the bone marrow. Hospital authorities denied the allegations.
In August 2005, Ms Ruth-Gaby Vermot-Mangold was sent by the Council of Europe to investigate the maternity clinic in Kharkiv at the centre of the allegations. She expressed “extreme concern about the disappearance of new-born babies in the country and allegations of trafficking of babies for adoption and of fetuses for scientific purposes”.
In response, the Council of Europe recommended in 2008 that the authorities of the countries concerned reopen investigations into the disappearance of newborn babies.
The Institute of Cryobiology in Kharkiv, which supplied the IRM with stem cells, refused to be interviewed for the BBC documentary. The scandal affected many clinics around the world that had their use of fetal and umbilical stem cells called into question, and a number of clinics remain tainted by association. Some clinics have subsequently chosen to use only autologous adult stem cells (harvested from the patients themselves) in order to avoid the legal, ethical and political consequences of using either embryonic stem cells or umbilical cord blood from undisclosed sources.
Concerns have also been expressed over the lack of evidence that any of the treatments work, not to mention the direct-selling methods used to entice vulnerable patients into having often exorbitantly priced treatments with no guarantee of success. A 2011 edition of Nature highlighted the problem, and the United States Food and Drug Administration (FDA) is responding by clamping down on the proliferation of unapproved stem-cell treatments being offered to Americans. Currently the FDA is involved in a court case demanding that Regenerative Sciences of Broomfield, Colorado, which has a clinic treating patients with their own adult stem cells for $7000-$9000 per treatment, stop selling its adult stem-cell product Regenexx, on grounds of concerns about safety and efficacy. The International Society for Stem Cell Research (ISSCR) has established a service that, on request, will judge whether a treatment or clinic provides a safe and effective treatment, although practitioners in the field complain that their real intention is to outlaw these centres completely.
As long as there are financial rewards, human fetuses will be viewed through the lens of profit. Enterprises such as these will continue until there is significant public outcry at the harm being caused. Those involved in the business may initially feel repugnance, but we know from experience that they will quickly become desensitized to the horror of their actions.
But this is not just the result of callous entrepreneurs looking at an unused ‘resource’ (the growing number of aborted fetuses as a result of abortion on demand) and trying to make a quick buck. There are other problems here—such as the cultural worship of the young and healthy, and the persistent underlying belief that the unborn are not fully human and not deserving of respect. If the use of fetal tissue continues by mavericks, how long will it be before scientists want to push past the current 14-day limit for experimentation on human embryos?
Legislation can be educative. Just as Roe v. Wade made abortion seem more acceptable, so could prohibition of fetal stem-cell therapy make it less palatable. Insufficient action in the developed world can lead to the development of substantial unethical industries that affect large numbers of people in the developing world.
- V Evans, Commercial Markets Created by Abortion, dissertation for the Licentiate (Master’s) Degree in Bioethics, Athenaeum Pontificium Regina Apostolorum, Rome, 18 November 2009. This paper has informed discussion of commercial markets created by abortion, and is an interesting read regarding the interplay of politics and the abortion industry. ↩
- A Gallegos, ‘Planned Parenthood sues states over abortion restrictions’, American Medical News, 20 June 2011. ↩
- A Johnson and C Lambert, Unplanned, Tyndale, Carol Stream, 2010. ↩
- The Fetus Farming Prohibition Act of 2006. ↩
- F Macrae, ‘Use aborted foetus organs in transplants, urges scientist’, Mail Online, 11 March 2009 (viewed 4 October 2011): www.dailymail.co.uk/sciencetech/article-1161085/Use-aborted-foetus-organs-transplants-urges-scientist.html ↩
- The Fortune 500 is an annual list compiled by Fortune magazine that ranks the top 500 US corporations by their gross revenue. ↩
- Human diploid fibroblast cell strains (HDCS), which are groups of human diploid cell strains that maintain normal human chromosomal numbers and characteristics, while dividing throughout their limited lifetime in a laboratory setting. ↩
- Crucell, Technology, Crucell, Leiden, 2009 (viewed 4 October 2011): www.crucell.com/Technology ↩
- Department of Health and Ageing, Immunisation Myths and Realities, 4th edn, Commonwealth of Australia, Canberra, 2008, p. 5. ↩
- Pontiﬁcal Academy for Life, ‘Moral reﬂections on vaccines prepared from cells derived from aborted fetuses’, National Catholic Bioethics Quarterly, vol. 6, no. 3, Autumn 2006, pp. 541-50. ↩
- These ethical arguments apply to treatments developed from long-established cell lines. For the ethics of ongoing developments, see chapter 15. ↩
- T Lee, ‘Stem cells: Time to make good on promises’, Star Tribune, 28 September 2008. ↩
- J Hohlfeld, A de Buys Roessingh, N Hirt-Burri, P Chaubert, S Gerber, C Scaletta, P Hohlfeld, and LA Applegate, ‘Tissue engineered fetal skin constructs for paediatric burns’, Lancet, vol. 366 no. 9488, 3 September 2005, pp. 840-2. ↩
- S Sugla, Anti-aging Products and Services, report highlights, BCC Research, Wellesley MA, May 2009 (viewed 4 October 2011): www.bccresearch.com/report/HLC060A.html ↩
- S Bloomfield, ‘Britons fly abroad for stem-cell makeovers’, Independent, 16 October 2005. ↩
- S Barrett, ‘The shady side of embryonic stem cell therapy’, Quackwatch, 9 September 2010. ↩
- Bloomfield, loc. cit. ↩
- R Laeuchli, ‘Illegal stem cell operation’, Budapest Times, 5 August 2009. ↩
- ‘Ukraine arrests 2 in baby-selling case’, New York Times, 3 March 1995. ↩
- M Hill, ‘Ukraine babies in stem cell probe’, BBC News, 12 December 2006 (viewed 4 October 2011): http://news.bbc.co.uk/2/hi/europe/6171083.stm ↩
- Parliamentary Assembly Council of Europe (PACE), ‘Disappearance of new-born babies in Ukraine: PACE rapporteur calls for an immediate re-opening of judicial investigations’, press release, PACE, Strasbourg, 5 September 2005 (viewed 4 October 2011): www.assembly.coe.int/ASP/Press/StopPressView.asp?ID=1673 ↩
- PACE, Recommendation 1828: Disappearance of Newborn Babies for Illegal Adoption in Europe, PACE, Strasbourg, 24 January 2008 (viewed 4 October 2011): www.assembly.coe.int/Mainf.asp?link=/Documents/AdoptedText/ta08/EREC1828.htm ↩
- D Cyranoski, ‘Texas prepares to fight for stem cells’, Nature, vol. 477, no. 7365, 22 September 2011, pp. 377-8. ↩
- Editorial, ‘Order from chaos’, Nature, vol. 466, no. 7302, 1 July 2010, pp. 7-8. ↩
- D Cyranoski, ‘FDA challenges stem-cell clinic’, Nature, vol. 466, no. 7309, 19 August 2010, p. 909. ↩