From saviour sibling to saviour embryo in 7 easy pages

A  philosopher, Robert Sparrow, and a stem cell scientist, David Cram, from Monash University in Victoria, Australia, in the May edition of Reproductive Medicine Online argue the case for  ‘Saviour embryos?  Preimplantation genetic diagnosis as a therapeutic technology.’ (*)

Reading this title quickly you might question what is new in this proposal.  Read it again carefully and you will see that they are talking exclusively about embryos, and not full-term ‘saviour’ sibling babies.

CORE has always argued that the selection of a specific in vitro embryo as a potential tissue match for a sick sibling (or other family member for that matter) is an ethical nasty.  First spare a thought for the unlucky embryos who do not have the matching tissue.  They will be ‘allowed to cease to exist’ is how somebody from the HFEA euphemistically described their fatal destiny. The remaining ones, fortunate enough to escape that fate, are selected not for their own sake, but for no other reason than the benefit of somebody else.

The tissue that is sought to date in ‘saviour’ sibling arrangements is the cord blood discarded at the birth of the designed baby, but the harvesting of bone marrow and liver tissue are already a discussed possibility for the future. Or even a kidney. After all, some are saying, nature has kindly provided us with two of these organs and we do not necessarily need the second one.  UK legislation has recently left some of these options open.

We have drawn attention to the huge psychological burden this practice puts on the ‘saviour’ in question, especially if the therapy is not successful and the older child is not cured.  And if the sick child were to have a later relapse and tissue other than cord blood is required, what are the implications for the donor?  Bone marrow extraction hurts, and a kidney cannot be removed painlessly. But could the ‘saviour’ ever refuse?

The assurance was always that the resulting baby would be loved for its own sake, an argument we find difficult to accept; he or she would inevitably know that they were in this world thanks primarily to the original selection process which was based on tissue-matching qualities alone. Other  proponents like to argue, pragmatically or cynically, that whatever else it is always better to be born than not.

But with this latest proposal from Monash University in Victoria, these previous arguments are discarded. The hype and justification about the balancing act between tissue from one sibling and gratitude from the other is laid aside as the scientists have now come up with a new proposition.

Why actually bother implanting the chosen embryo, with the risk that the pregnancy does not go to term, or the worry that the sick child gets worse while the pregnancy continues?  Why not simply select the ‘saviour’ embryos and not bother with implantation at all.  Instead turn them directly into embryonic stem cells and hey presto you have instant therapeutic tissue, without the discomfort and time wasting of attempted pregnancies and complicated deliveries.

This is currently just a proposal, and any presumption that it is easy to develop embryonic stem cells, and that these could be used for therapeutic purposes, is highly hypothetical.  Scientific history is showing that real therapy deriving from the use of embryonic stem cells is proving extremely unlikely, but this is, nevertheless, a very good example of further goal post shifting in the ethics of assisted reproduction.

The authors even suggest that if destructive research on human embryos is already permitted in many countries worldwide, would this not be a more ethical solution given that the embryos would be sacrificed not in the interests of academic research but for the direct benefit of others?

Once the human embryo is viewed simply as a commodity, a means to any end, and not accorded the rightful status of a unique human being, it is obvious that arguments can be made to defend any practice whatsoever.  That ruthless slippery slope …

The abstract to the article in Reproductive BioMedicine Online ends with the following chilling conclusion:

‘While the creation of saviour embryos would involve a significant shift in the rationale for IVF and PGD, it is suggested here that the urgent need of an existing individual should be prioritised over any obligations that might exist in relation to the creation or destruction of human embryos.’

References:

www.journals.elsevierhealth.com/periodicals/rbmo/current

Reproductive BioMedicine Online (2010) 20, 667–674

Saviour embryos? Preimplantation genetic diagnosis as a therapeutic technology

Robert Sparrow a,*, David Cramb b,a Centre for Human Bioethics, Faculty of Arts, Monash University, Vic. 3800, Australia; b Monash Immunology and Stem Cell Laboratories, Faculty of Medicine, Nursing and Health Sciences, Monash University, Vic. 3800, Australia * Corresponding author.E-mail address: Robert.Sparrow@arts.monash.edu.au (R Sparrow).

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