Macroethics and microethics of fetal and embryological collections: exploring paradigms of informed consent

Joyce El-Haddad1, Nalini Pather2,3

1Department of Anatomy, Faculty of Medicine and Health, University of New South Wales
2Academy of Medical Education, Medical School, Faculty of Medicine, University of Queensland
3Medical Education, Faculty of Medicine and Health, University of New South Wales

Objective: The aim of this study was to the perceptions of Australian stakeholders involved in embryology.
Methods: A survey was distributed via social media to embryology stakeholders. Participation was anonymous.
Results: A significant majority (61.6%; n=122/198) of respondents believed that human fetal and embryological remains obtained before the era of informed consent should be retained for educational and research purposes. Their perspective seems rooted in the belief that these collections, if utilised beneficially, should not be discarded as doing so would forfeit potential advantages. Notably, certain groups, particularly women (p<0.001), expressed a preference for procuring fetal and embryological specimens with proper informed consent for education and research (38.4%; n=76/198). A majority (56.1%; n=111/198) also endorsed the acceptance of donations from both maternal and paternal sources.
Conclusion: The ethical complexities surrounding the management of human fetal and embryological collections are multifaceted. Ethical dilemmas can be addressed at both the individual "micro ethics" level, focusing on interactions between those providing and receiving human tissue, and the broader "macro ethics" level, which encompasses the shared responsibilities of the field and society at large. The study underscores the significance of factoring in the viewpoints of stakeholders in shaping policies and guidelines concerning human fetal and embryological collections. The findings highlight a degree of societal unease surrounding collections lacking informed consent, necessitating consideration at both the broader ethical level and the individual interaction level. Overall, these insights offer valuable guidance for navigating the ethical dimensions of managing such collections in a responsible and inclusive manner.

Keywords: ethics; fetal collections; informed consent

Ethical statement: The Human Research Ethics Committee at the University of New South Wales, Sydney, Australia granted approval for this project (Approval #: HC220130).

Funding statement: -