[The bioethical problems of umbilical cord blood: a study of institutional statements]

This article aims to explore the bioethical problems that are concentrated around the Umbilical Cord Blood. The publication in the year 2020 in Spain of the new National Umbilical Cord Blood Plan recalls the current status of the issue. The bioethical problems of umbilical cord blood have not been specially studied, rather there are few studies in this regard and above all they have focused on the controversy over its autologous use and its storage in private banks. This work, the result of reading twenty-six institutional statements from the most diverse institutions in different countries, offers a detailed and systematic enumeration of the bioethical problems that arise around the life of umbilical cord blood and proposes, fundamentally, a classification with an evolutionary criterion, that is, following the course of the Umbilical Cord Blood, from its donation to its use, passing through the problems of donors and storage. The sources used cover a period from 1998 to 2019 and are practically all the existing ones. This work offers a conclusive analysis of a synchronic nature, in which the bioethical constants are detected in the 31 years analyzed, specifically the principles of autonomy and solidarity, in addition to the so-called bioethics of expectations; and another of a diachronic nature in which the bioethical nuclei in which the questions are concentrated stand out: the lack of personalistic principles and the conflict between freedom and solidarity.

Relational autonomy: lessons from COVID-19 and twentieth-century philosophy

COVID-19 has turned many ethical principles and presuppositions upside down. More precisely, the principle of respect for autonomy has been shown to be ill suited to face the ethical challenges posed by the current health crisis. Individual wishes and choices have been subordinated to public interests. Patients have received trial therapies under extraordinary procedures of informed consent. The principle of respect for autonomy, at least in its mainstream interpretation, has been particularly questioned during this pandemic. Further reflection on the nature and value of autonomy is urgently needed. Relational autonomy has been proposed as an alternative account of autonomy that can more adequately respond to contemporary ethical issues in general and to a pandemic such as the one we are currently facing in particular. As relational autonomy is an emerging notion in current bioethics, it requires further consideration and development to be properly operationalized. This paper aims to show how six different philosophical branches--namely, philosophy of nature, philosophical anthropology, existential phenomenology, discourse ethics, hermeneutics, and cultural anthropology--have incorporated the category of relation throughout the twentieth century. We first delve into primary philosophical sources and then apply their insights to the specific field of medical ethics. Learning from the historical developments of other philosophical fields may provide illumination that will enable bioethics to experience a successful "relational turn", which has been partially initiated in contemporary bioethics but not yet achieved.

[The banks of umbilical cord blood: biomedical and bioethical issues]

This paper deals with the actuality of the Umbilical Cord Blood Banks (UCBB). Its aim is to offer the necessary notions for the understanding of their nature and of the ethical problems which they carry associated. In order to do this it will lean, on one hand, on the actual bibliography about blood of the umbilical cord and its present and future applications, and on the other hand, on the document of the European Group of Ethics where this issue is discussed. It is of special interest here the existence of the banks called "autologous" that, for some authors, seem to contradict the principle of solidarity. This work will examine, amidst others, this question, and it will suggest a solution articulating both "liberty" and "solidarity". Other topics such as respect to confidentiality, informed consent and integrity of the body will be approached.