Preimplantation genetic diagnosis is a technique which was originally developed as an alternative to prenatal diagnosis for couples at high risk of transmitting a genetic defect. It allows scientists to check specific genetic defects of the embryo obtained through in vitro fertilization so that only embryos not affected by the tested disease or balanced for the tested chromosomes can be replaced. Recently, case reports reveal that clinicians applying PGD are increasingly confronted with requests by parents with an affected child whishing (...) for PGD not only to test IVF-created embryos for genetic disease but also to test for a nondisease trial related to immune compatibility with a child in the family in need of a hematopoietic stem cell transplant. Only embryos HLA matched with an existing sibling in need of a compatible donor of haematopoietic stem cells would be transferred. In this article, our main objective is not to answer the question of the ethical permissibility of this technique. We rather want to clarify some anthropological options underpinning this technique, which have to be taken into account for an ethical evaluation. By virtue of its very being, the human person is multidimensional: open to itself, to another and to society. This multidimensional character of the human person is a real challenge in the field of human genetics and medically assisted reproduction: a couple never decides solely for itself, but its decision has an enormous impact on their offspring; the physician is a necessary third person in the decision making process; a parental decision is influenced by and ma y change the public support of PGD. First we have to evaluate the request of the couple to use PGD in order to create a donor sibling. The main ethical argument against this kind of request is the instrumentalization of the future child. The child becomes an instrument to cure another child. One of the fundamental rules underlying Western moral thinking is the Kantian imperative. The second formulation of the categorical imperative goes as follows: ‘Act in such a way that you always treat humanity, whether in your own person or the person of any other, never simply as a means, but always at the same time as an end’. From this perspective we advance the ethical requirement to surpass the apparent discrepancy between the need of the parents to produce a healthy child and the desire of parents to have a child. Second, the physician should take into account the fact that a technological innovation may have such a compelling character that human reproductive freedom will be restricted rather than enlarged. Thus the physician should be guarded from engaging in so-called medical futile acts. Third, the experience of the donor child will be discussed. It could be argued that a heavy burden is placed on the donor child. The transplantation may fail and this may give the child a fundamental sense of unworthiness and deficiency and a feeling of not being able to live up to the expectations. The psychological impact of stem cell donation among siblings should indeed not be underestimated. Finally, on societal level, the need for instant success has contributed to ever more invasive reproductive technologies. We question however that reproductive success does not necessarily depends on the invasiveness of the techniques. Parents should be given time to put meaning on their lack of reproductive omnipotence. (shrink)

By using tissue typing in conjunction with preimplantation genetic diagnosis doctors are able to pick a human embryo for implantation which, if all goes well, will become a “saviour sibling”, a brother or sister capable of donating life-saving tissue to an existing child.This paper addresses the question of whether this form of selection should be banned and concludes that it should not. Three main prohibitionist arguments are considered and found wanting: the claim that saviour siblings would be treated as commodities; (...) a slippery slope argument, which suggests that this practice will lead to the creation of so-called “designer babies”; and a child welfare argument, according to which saviour siblings will be physically and/or psychologically harmed. (shrink)

Pre-implantation genetic diagnosis became well known in Malaysia after the birth of the first Malaysian ‘designer baby’, Yau Tak in 2004. Two years later, the Malaysian Medical Council implemented the first and only regulation on the use of Pre-implantation Genetic Diagnosis in this country. The birth of Yau Tak triggered a public outcry because PGD was used for non-medical sex selection thus, raising concerns about PGD and its implications for the society. This study aims to explore participants’ perceptions of the (...) future implications of PGD for the Malaysian society. We conducted in-depth interviews with 21 participants over a period of one year, using a semi-structured questionnaire. Findings reveal that responses varied substantially among the participants; there was a broad acceptance as well as rejection of PGD. Contentious ethical, legal and social issues of PGD were raised during the discussions, including intolerance to and discrimination against people with genetic disabilities; societal pressure and the ‘slippery slope’ of PGD were raised during the discussions. This study also highlights participants’ legal standpoint, and major issues regarding PGD in relation to the accuracy of diagnosis. At the social policy level, considerations are given to access as well as the impact of this technology on families, women and physicians. Given these different perceptions of the use of PGD, and its implications and conflicts, policies and regulations of the use of PGD have to be dealt with on a case-by-case basis while taking into consideration of the risk–benefit balance, since its application will impact the lives of so many people in the society. (shrink)

Conceiving a child by way of embryo selection and tissue matching to benefit a sick sibling is generally justified on the grounds that as well as the potential to save the sick child, there is a benefit for the new baby. The new baby is selected so he or she will not have the disease suffered by the first child. It is not possible, however, to select against conditions for which there is no test and Jamie Whitaker’s birth is a (...) case where the process of in vitro fertilisation with tissue matching is viewed as being of benefit only to a third party—the sick child. Some people object to using the technology for this purpose. There are also good reasons to argue that the technology should be used to save a sick child, and that it would be morally remiss for Jamie’s parents not to consent to the use of his cord blood. (shrink)

Since human reproduction is arguably both irrational and immoral, those who seek help before conceiving could be advised it is all right not to have children.

Preimplantation genetic diagnosis—the risks are unknown and human dignity could be compromisedMerle Spriggs argues that there are no good reasons to prevent a couple utilising preimplantation genetic diagnosis when the sole aim of the procedure is that the resultant child is a compatible umbilical cord blood donor for a sick sibling.1 I agree with much of the argument to support this, however, I believe Spriggs has omitted one important point and underplayed another.The risk of PGD to the child born as (...) a result of this process has not been fully studied. Therefore the parents are exposing the child to potential …. (shrink)

Despite the therapeutic potential of human embryonic stem (HES) cells, many people believe that HES cell research should be banned. The reason is that the present method of extracting HES cells involves the destruction of the embryo, which for many is the beginning of a person. This paper examines a number of compromise solutions such as parthenogenesis, the use of defective embryos, genetically creating a "pseudo embryo" that can never form a placenta, and determining embryo death, and argues that none (...) of these proposals are likely to satisfy embryoists, that is, those who regard the embryo as a person. This paper then proposes a method of extracting HES cells, what might be called the Blastocyst Transfer Method, that meets the ethical requirements of embryoists, and it considers some possible concerns regarding this method. It concludes by encouraging future HES cell research to investigate this method. (shrink)

Human reproductive cloning has not yet resulted in any live births. There has been widespread condemnation of the practice in both the scientific world and the public sphere, and many countries explicitly outlaw the practice. Concerns about the procedure range from uncertainties about its physical safety to questions about the psychological well-being of clones. Yet, key aspects such as the philosophical implications of harm to future entities and a comparison with established reproductive technologies such as in vitro fertilisation are often (...) overlooked in discussions about HRC. Furthermore, there are people who are willing to use the technology. Several scientists have been outspoken in their intent to pursue HRC. The importance of concerns about the physical safety of children created by HRC and comparisons with concerns about the safety of IVF are discussed. A model to be used to determine when it is acceptable to use HRC and other new assisted reproductive technologies, balancing reproductive freedom and safety concerns, is proposed. Justifications underpinning potential applications of HRC are discussed, and it is determined that these are highly analogous to rationalisations used to justify IVF treatment. It is concluded that people wishing to conceive using HRC should have a prima facie negative right to do so. (shrink)