I prescribe one newborn baby brother…

 

By Dave Vedage

Saviour siblings, as the name suggests, are children born to donate organs to and save the lives of their sibling. The benefits are obvious; the sibling would be treated, the newborn gets to help their relative and the family gets a new member.

However, the debate surrounding saviour siblings continues to rage on. The issue has also been reignited and brought to the attention of the wider public with the recent films ‘My Sister’s Keeper’ and ‘Never Let Me Go’.

Saviour siblings are possible by using in vitro fertilization (IVF). By utilising HLA-typing and preimplantation genetic diagnosis (PGD), it can be ensured that only zygotes compatible with the existing child are implanted and that the zygotes are free of the genetic disease. The first case occurred in 2000 in the USA. Newborn baby boy Adam Nash provided umbilical stem cells to his six-year-old sister, Molly, who was suffering from bone marrow failure secondary to Fanconi anaemia. In the United Kingdom, the Human Fertilisation and Embryology Authority has since ruled that it is lawful to use modern reproductive techniques to ‘create’ a saviour sibling.

Nonetheless, there still remains significant opposition. The basis of this argument is the idea that the child is merely a means to an end. This ‘commodification’ of human life is seemingly unnatural, but is it any less valid than other common reasons for wanting and conceiving a child, such as completing a family, saving a marriage, or providing an heir? Others argue that this is the start of a slippery slope will lead to the creation of designer babies. There is quite a leap, however, between choosing a child with functioning bone marrow to one with blond hair, blue eyes and Brad Pitt’s chin.

Then there is the strain that exists between the siblings, as they come to realize their unique and very unusual relationship. One child lives only because another one needed them to be born. This could engender feelings of worthlessness and resentment. Further psychological damage could be done if the elder child dies in spite of treatment, with the saviour sibling burdening themselves with the guilt of being unable to save their brother or sister.

However, that the parents are willing to conceive another child to protect the first suggests that they are highly committed to the wellbeing of their children and that they will value the second child for its own sake as well. Their birth may have served an instrumental purpose but they are almost invariably cherished for themselves. Furthermore, they may be considered beneficiaries of IVF, PGD, and tissue typing, since were these techniques un- available, they probably would not have been born.

Welfare is a fundamental principle. The main factor when deciding whether sibling saviours are ethically acceptable should be the degree of harm involved in the donation process. Though this can be balanced by the medical benefit to the older sibling, the harm to the saviour sibling does not necessarily depend on the severity of the affected child’s condition. No medical intervention is without harm and if one must done within days or weeks of birth, this degree of harm must be weighed very carefully.

Remember, a baby is for life, not just for Christmas. 

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