In the Journals

Special Issue! Private, the Public, and the Hybrid in Umbilical Cord Blood Banking

“First, it critically examines the dichotomy between public and private cord blood banks, and shows that the mechanism and network of cord blood banks is far more complex than indicated by the dichotomy of the public and the private. …

“Second, there is an increased interest in the social, ethical and political aspects of cord blood banking as a location where scientific, economic, governmental and personal expectations converge. Cord blood banking attracts various actors with common, and competing, interests, including regulators, scientists, business people, medical staff, donors, patients and customers. Although academic publications have appeared on some of the contested values and discourses around UCB banking, such as waste, gift, hope, insurance and venture…, there is still little we understand about the collaborations, alliances and competition among these actors and stakeholders, as the processes involved in cord blood banking remain opaque. This special issue brings together the perspectives of midwives, managers in cord blood banks, parents, scientists and policymakers in different countries. Their standpoints highlight various perspectives on cord blood banks, as well as how a panoply of opinions and actions come about in their specific socio-cultural, economic and political context.”

As such, the articles’ abstract are below. Enjoy!

Hybrid practices in cord blood banking. Rethinking the commodification of human tissues in the bioeconomy

Christine Hauskeller and Lorenzo Beltrame

The STS and bioethical literature on umbilical cord blood (UCB) banking nowadays discusses the field as divided into opposite institutional arrangements, public versus private banking. Public banks represent a model-sharing economy; private banks represent a market economy that capitalizes hopes and tissues, and new hybrid forms that are emerging. We challenge that this distinction is analytically valuable for understanding the various forms of marketization, commodification and biovalue production that mark the UCB economy. Our analysis of current UCB banking practices, especially hybrid ones, and their inherent visions of the future, shows that hybrid UCB banking criss-crosses the different economic models and concepts of commodification. The private, public, hybrid distinction is thus inadequate for a critical analysis of the complex UCB bioeconomies. Drawing on the perspective of social welfare systems analysis, however, the tripartite distinction emphasizes an important ethical and biopolitical commitment to equality in current and future health care.

The multiple roles of cord blood banks in Taiwan: competition and collaboration

Hung-Chieh Chang

In Taiwan, as in many countries where national cord blood donation programs are not available, cord blood donation and banking services are provided by non-governmental sectors. This article discusses: (1) the various cord blood banking models to critically examine the public and private binary; and (2) the collaboration and networking between cord blood banks and other institutions as strategies in response to strict governance and fierce competition. This article, based on fieldwork in Taiwan, gives an overview of cord blood banking models in Taiwan and shows the interdependent relationship among different stakeholders in the generation of stem cell knowledge. The concept of “bionetworking” is drawn upon to analyze the networks that cord blood banks establish with various stakeholders. I argue that, through analyzing networks and activities that cord blood banks engaged in and their relation with science, our understandings of stem cell knowledge and therapies production can be deepened.

Following the banking cycle of umbilical cord blood in India: the disparity between pre-banking persuasion and post-banking utilization

Prasanna Kumar Patra and Margaret Sleeboom-Faulkner

To address critique of the rare uptake of umbilical cord blood (UCB) in private banks, hybrid-banking models would combine the advantages of “public UCB banking” and private UCB banking by responding to both market forces and public needs. We question both by following the cycle of UCB banking in India: the circulation and stagnation of UCB as waste, gift, biological insurance, enclaved good, source of saving lives and commodity through various practices of public, private and hybrid UCB banking. Making the journey from “recruitment,” “collection” and “banking” to “research” and “therapy” allowed us to identify concerns about the transparency of this cycle. Drawing on archival research and fieldwork interviews with different stakeholders in UCB banks in India, this article shows how private/hybrid cord blood banks are competing for their market share and its implication for the circulation of UCB: speculation, stagnation and opacity.

Contested expectations: the cord blood economy in South Korea

Yeonbo Jeong

Stem cells from umbilical cord blood are now being actively used in transplants, as well as for a wide range of other medical, research, therapeutic, and commercial purposes. In this incipient stage of stem cell treatments and products, however, expectations about the benefits, use, and distribution of cord blood stem cells vary significantly among relevant companies, scientists, donors, patients, and governments. Focusing on the use of cord blood in South Korea, this paper examines the contested expectations that exist among the parties involved with the donation and use of cord blood, and how the distribution of cord blood stem cells reflects these disparities. The emergence of cord blood economy has been accompanied by contested expectations related to an array of issues, including altruism, motherhood, wealth, nationalism, sharing, and ethical justification. Although donors often remain interested in the prospective use of the biomaterials, their concerns and expectations have been overlooked.

The collection of “quality” umbilical cord blood for stem cell treatments: conflicts, compromises, and clinical pragmatism

Laura L. Machin

Incentives have been proposed to National Health Service (NHS) hospitals to encourage the collection of “quality” umbilical cord blood (UCB) to treat people with blood disorders. As UCB is collected immediately after a woman has given birth, maternity practices have come under scrutiny. Sixty-two interviews were conducted between 2009 and 2010 with those working on maternity wards, and in UCB collection and banking. Ethical approval was granted by the university institution and the NHS Research Ethics Committee. Participants perceived a conflict between acquiring a “quality” UCB sample for blood disease sufferers and concerns for maternal and neonatal health. Options to overcome the conflict were compromises that demonstrated that those most powerful in the debates are those conducting maternity practices, whilst those involved in the banking of UCB have less influence perhaps as a consequence of the lower priority of “quality” UCB collection in relation to maternal and neonatal health.

One Response to Special Issue! Private, the Public, and the Hybrid in Umbilical Cord Blood Banking

  1. Pingback: In the Journals – September 2016, part one by Aaron Seaman - Bioethics Research Library

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