ii. INFORMED CONSENT

1. A phased consent policy for cord blood donation. Vawter DE, Rogers-Chrysler G, Clay M, Pittelko L , Therkelsen D, Kim D et al. Transfusion 2002; 42:1268-1274.

This article focuses on ethical and policy questions concerning when consent may be sought for the collection and donation of cord blood. It reviews the advantages and disadvantages of alternative times for securing consent, challenges common objections to seeking consent during labor or after collection, and describes a phased consent process – a process that permits consent during early labor to the ex utero collection of cord blood followed by after-consent collection to donation. The phased consent policy attends to the unique characteristics of cord blood collection and donation, respects donors and their families, maximizes the number and diversity of cord blood units collected, preserves the relationship between providers and patients, an preserves public trust in cord blood and other types of tissue banking.

2. Knowledge and attitudes of pregnant women with regard to collection, testing and banking of cord blood stem cells. Fernandez CV, Gordon K, Van den HM, Taweel S, Baylis F. CMAJ 2003; 168:695-698.

A questionnaire examining sociodemographic factors and women’s attitudes to cord blood banking was distributed to 650 women attending antenatal clinics. A total of 443 (68%) responded. More than half reported poor or very poor knowledge about cord blood banking. Many thought that physicians should talk to pregnant women about the collection of cord blood. Most of the women (86%) would elect to store cord blood in a public bank, many citing altruism as the reason for this choice. A much smaller proportion (14%) would elect private banking, indicating that they would feel guilty if the blood had not been stored.

3. Optimization of informed consent for umbilical cord blood banking. Sugarman J, Kurtzberg J, Box TL, Horner RD. Am J Obstet Gynecol 2002; 187:1642-1646.

The purpose of the project was to evaluate the informed consent process for donation to a public umbilical cord blood bank. Telephone interviews were conducted with 170 women who had donated their newborn infants’ umbilical cord blood. 98.6% of the women reported that all their questions had been answered, but almost one-quarter did not know how to contact the cord blood bank. Further, a substantial proportion of the respondents did not understand the full range of alternatives to donation and incorrectly endorsed potential benefits.