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Family affairs: public and private cord blood banking in Italy

Preserving the umbilical cord blood (UCB) of a newborn child in a private biobank for possible future family uses is criticized by bioethical and biomedical literature as challenging the moral economy of donating cord blood to public banks for being used in transplantations.
  • Donation to public banks is described as embedded in the social relations of reciprocity, solidarity, and obligation to the collectivity.
  • Private preservation is instead presented as a self-interested act, disembedded from social relations.

How to avoid this asymmetrical distinction between embeddedness and disembeddedness?

By using the notion of entanglement developed by Michel Callon is possible to locate the circulation of cord blood, both in the circuit of donation and in those of private storage, according to how it is framed in a network of entangled elements, including different attachments to a distinct set of social relations and social formations.

The discourse promoting donation to public banks indeed structures its frame by detaching cord blood from family relations and re-attaching it to the social composition of the largest collectivity.
So the largest collectivity is not only defined as a web of social relations of reciprocity and solidarity, but also as a biological collective granting immunity to its members.

Cord blood as an immunity agent and as a social gift promoting mutuality gains its biomedical and social sense only if entangled in this network of bio-social relations.
The discourse promoting private banking instead constructs the family as a biological-and-affective formation, in which family preservation is embedded in family-related responsibilities and obligations, and the family is the biological collective granting immunity to its members.

Beyond the bioethical and biomedical literature

This new approach avoids positing a clear-cut boundary. It allows exploring the decision-making processes by linking emotions and expectations of mothers and prospective parents with the entanglement of banking practices, clinical applications and biological risks, and immunity protection, through the role of discourses deployed by involved institutions in shaping frames of UCB banking, social formations and the related moral values.

Different decisions about how to bank cord blood thus diverge according to the set of social and biological relations characterizing the social formations structured by discourses.

By Lorenzo Beltrame
Infographics by Eliana Fattorini

Read the related article on Public Understanding of Science