Toward a Governance Structure Beyond Informed Consent: A Critical Analysis of the Popularity of Private Cord Blood Banking in Taiwan

In fewer than 10 years, umbilical cord blood has transformed from a medical waste to a lifesaving treasure that parents in Taiwan are willing to store at great expense. As a blooming industry with yearly revenues of 600-700 million NT dollars, family banks annually store the cord blood of roughly 19,000 newborns, a number that constitutes 8-10% of newborns in Taiwan each year. Yet, given the predominant role market force plays in Taiwan's cord blood banking, how does it affect people's understanding of the technology and their imagination of their individuality and relationship with one another in the future? This paper reveals how private cord blood has successfully framed the practice of cord blood banking as a form of biological insurance, thereby downplayed the uncertainties inherent in the development of science, reinforced the private nature of the cord blood stored, while impoverishing parents' understanding and imagination of an alternative biosociality where cord blood can benefit more people. Moreover, by distinguishing between private cord blood banking and medical practice, this analogy of biological insurance also co-produced a more lenient governing framework based on parents' informed consent usually suitable for consumer transaction, but unwittingly placed physicians in a more vulnerable position to guard against conflicts of interest when providing information to prospective parents and collecting cord blood during the process of delivery. Hence, by exploring the technological, social, and regulatory contexts of the popularity of Taiwan's private cord blood banking, this paper seeks to make policy suggestions beyond informed consent hoping to empower people's role both as consumers as well as biological citizens to think more critically about the technology and to govern it more adequately.