MEDI7231 Study Guide - Final Guide: National Health And Medical Research Council, Leukemia, Fanconi Anemia
SAVIOUR SIBLINGS
Sheldon S, Wilkinson, S. Should selecting saviour siblings be banned? J Med Ethics. 2004;30:533-537
Introduction
Saviour sibling = a child conceived through selective in vitro fertilization as a potential source of donor
organs or cells for an existing brother or sister with a life-threatening medical condition Doctors can pick an
embryo for implantation to become a 'saviour sibling' by using tissue typing + preimplantation genetic
diagnosis (PGD)
3 main issues with this debate
Saviour siblings may be treated as commodities, and 'wrongfully instrumentalised'
A slippery slope argument, which suggests that this practice will lead to the creation of 'designer
babies'
A child welfare argument, according to which saviour siblings will be physically and/or psychological
harmed
We also must consider the situation where banning use of PGD to create saviour siblings will lead to death
of numerous children who could've been saved by sibling donation
Nash family (USA, 2000)
Molly Nash was born (1994) with Fanconi anaemia - a rare genetic condition whereby the body cannot make
healthy bone marrow, thus rare and fatal
Process
Nash obtained ethical approval for IVF in Colorado, PGD in Chicago & embryo transplant in Minnesota
IVF/PGD to ensure the absence of Fanconi anaemia & a tissue match with Molly
Molly's parents, Linda & Jack, endured 5 cycles of IVF
One embryo (of 14 created by IVF) met both criteria & was transferred into Mrs Nash in an attempt to
create a saviour sibling/ potential donor sibling for Molly
Baby Adam (2000) - umbilical cord blood was collected at time of birth & stem cells from it were successfully
used as a bone marrow graft for Molly to raise odds of survival up 55%
Hashmis family
Zain (son) has B-thalassaemia, a blood disorder that can be cured using tissue from umbilical cord of tissue-
matching sibling
Parents seeking IVF technology, genetic testing & pre-implantation tissue typing (PTT)/ HLA typing to find a
baby that:
oDid not have this genetic condition
oWill be an exact HLA match to Zain to enable stem cell/ bone marrow treatment
Court of Appeal (HFEA) granted this decision, claiming that tissue typing can be authorised under current
legislation
Whittaker family (UK, 2002)
Charlie had diamond blackfan anaemia
Not genetically inherited; a mutation instead
Charlie's parents wanted to have baby via IVF/HLA typing, not to exclude disease, but to solely match their next
child to their existing child
Unable to screen/ prevent blackfan anaemia (no PGD since it is not genetically inherited)
Find exact HLA match to Charlie
Asking for same procedure as Hashmi family, but HFEA did not approve the application
No benefit to the child
This child would only born for the purpose of bone marrow transplant and uncertainty over possibly
developing Blackfan anaemia
Instead, parent's travelled to Chicago for treatment (paid by Dr Taranissi - the fertility doctor)
This issue can be solved through treatment, rather than requiring a saviour sibling
The Nash/ Hashmi case was approved as there was a benefit to the child in certainty it would not have a
genetic disorder
IVF, PGD, HLA typing for saviour sibling production
find more resources at oneclass.com
find more resources at oneclass.com
