Ethik Med (2000) 12:16–29 Ethische Fragen zur Stammzellentransplantation aus Nabelschnurblut Bert Gordijn, Henk Olthuis Ethical issues with regard to transplantation of cord blood stem cells Abstract. 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 transplanta- tion, 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 estab- lishment of banks for frozen cord blood samples and the structural implementa- tion of cord blood transplantation can be justified. The main ethical issues con- cerning cord blood stem cell transplantation can be divided into at least six groups of questions that are closely related. First, there are ethical issues con- cerning the status of the treatment. Must cord blood transplantation somehow still be considered an „investigational“ treatment or can it be regarded as accept- ed 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 dis- tribution 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 com- municated 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 in- creasingly need answers to these ethical questions. Only thoughtful analysis of the attendant ethical issues of the establishment of banks for frozen blood sam- ples and the structural implementation of cord blood transplantation can miti- gate potential problems. Key words: Cord blood transplantation – Ownership – Informed consent – Privacy – Confidentiality – Genetic testing – fairness Zusammenfassung. Im vergangenen Jahrzehnt wurden weltweit Nabelschnur- blutbanken errichtet. Dies kann jedoch nicht als unproblematisch betrachtet wer- den, sondern ruft vielmehr eine Reihe ethischer Probleme hervor bzw. könnte in der Zukunft bestimmte ethische Fragen aufwerfen. Die wichtigsten ethischen Probleme hinsichtlich der Nabelschnurblutstammzellen-Transplantation lassen sich in zumindest sechs Problemgruppen fassen, die eng miteinander in Bezie- Bert Gordijn Fachbereich Ethik, Philosophie und Geschichte der Medizin, Katholische Universität Nijme- gen, Postfach 9101, 6500 HB Nijmegen, Niederlande © Springer-Verlag 2000