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embryoA couple have a child with Fanconi’s Anaemia. This is a severe genetic disorder which leads to early death. It can be cured by a bone marrow transplant from a suitable match.  Siblings commonly can provide that match.

The couple want to have a child and are undergoing IVF in order to make sure that an embryo will not have Fanconi’s Anaemia. As well as screening embryos to ensure they do not have the disease they can also choose an embryo that will be a suitable match for the existing embryo. Stem cells can be taken from the umbilical cord [which is usually discarded] of the new baby and used to cure the existing child.  

Should they be able to select an embryo for this reason? What issues arise?

Answer 

It is important to look at the issue from all points of view with the concepts of the 4 pillars in mind: harm [maleficence] and benefit [beneficence], autonomy and Justice [is it fair].

 The Existing Child’s

The child has the possibility of cure from a serious condition. However how will he view his new sibling; will he feel that there is a debt of gratitude owing? Will he feel that he must be for ever grateful?

 The Parents’

IVF involves injections, egg stimulation and operations and is not without risk. However in this case the parents are going through IVF anyway because they wish to select an embryo unaffected by the disease.

The parents want another child anyway and are not just having a child to cure another. As parents they love the existing child and would want to avoid the pain and suffering of seeing their existing child suffer and die.

Parents should have autonomy – they should therefore perhaps have the right to consider the benefits and harms and make a decision for themselves.

 The Unborn Child’s

It is important that the child is loved for itself. The child may grow up thinking that they were only created to cure their sibling. If for some reason their sibling dies would they feel as if they had ‘failed’ and feel responsible?

 Society’s Point of View

It is important to look at how such decisions may affect society. Are such procedures viewed as ‘fair’ [ethical pillar of Justice]. Does using science to ensure ‘perfect’ children raise the spectre of eugenics; does it decrease tolerance of the disabled? We have recently enjoyed the Para Olympic Games but it worth remembering that many such athletes such as Ellie Simmonds and Oscar Pistorius may be nowadays aborted. Is it right to have a society that says such lives are worth less than others – is that fair?

Embryo selection may continue down a slippery slope which may lead to ‘designer babies’ where parents choose embryos according to features such as hair colour, height and sex

Many, particularly some religious groups would oppose embryo selection because it is unnatural and humans are in a way ‘playing God’.

My point of view

[you will probably be pushed to say what you think but remember that you should give your point of view after you discuss all the arguments]

Personally I feel that the benefits out weighs the harms. There is an enormous benefit to the existing child and parents who want another child and are under going embryo selection anyway. There is very little possible harm to the unborn child.

There is no evidence that decreasing disability leads to greater intolerance of those already disabled. I reject the argument that it is unnatural and therefore society should not allow it. The practise of medicine involves interfering with the natural course of illnesses and conditions to alleviate pain and suffering and prevent death. When ever a major advance is made in medicine [such as blood transfusions or IVF] there are always some that say that it is unnatural and wrong but these innovations tend to be eventually accepted by the majority of the population as being beneficial.

Emmanuelle Kant, the German philosopher stated that an action was moral if the intention was good and it did not cause harm and a further test would be if all others in society carried out that action it would not cause harm. For example if a couple were to choose the sex of their embryo it does not harm society but if everyone did so it may, so it should not be allowed. In this case, the choosing of a saviour sibling there would be no obvious harm. The slippery slope scenario can be avoided by ensuring embryo selection was performed for severe, inherited diseases only.

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