Bioethics Discussion Blog: “Saviour Siblings” vs “"Whoops I did it again" Kids: Any Ethical Difference?

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Friday, January 26, 2007

“Saviour Siblings” vs “"Whoops I did it again" Kids: Any Ethical Difference?

From BBC News, here is story of what a family in Minnesota did in 2000 to save their daughter from a fatal illness.

"A test-tube baby has been selected by doctors using controversial genetic screening to save the life of its older sister.
Already questions are being raised about whether the baby boy was really wanted or merely 'created as a medical commodity' to save his sister.
Doctors genetically tested the embryos of an American couple before implanting one of them in the mother's womb.
They chose the embryo that would have the exact type of cells needed to save the couple's six-year-old daughter, who is suffering from a life-threatening bone marrow deficiency."

Stem cells were taken from the resulting boy to be given to his sister to restore her damaged bone marrow.

A similar case in California in the early 1990s involved a daughter born, after genetic selection to be a bone marrow donor for her leukemic sister. Such children born to donate to their siblings are called “saviour siblings”. There, obviously, is controversy whether it is ethical to analyze a number of parental zygotes, find the appropriate one and then implant it in the uterus, anticipating the birth of a child who can donate cells to their sick sibling. Some wonder if this amounts to bringing only a "commodity" into the world. There is nothing in these stories about ‘saviour siblings” suggesting the new child is ignored or unloved.

An ethicist writing on a bioethics listserv wrote the following recently:

"Personally, I think I would have been a lot nicer to my younger brother
if I'd known he saved my life.

As to the charge that a child conceived and/or selected for this purpose
would be loved less, we don't interfere in parental reproductive
decision-making that is motivated by far worse motives. Nor is there any
evidence that saviour siblings are any less loved. In fact, I suspect
that once we have a sufficient number to study, we will find that these
kids, like the kids of IVF and ARTs in general, have better and more
attentive parent-child relations than the ‘whoops I did it again’ kids."

I wonder what my visitors think about the ethics of this practice and particularly if there should be any concern about the parental love and attention of these “saviour siblings” And what if more than just cells or bone marrow is to be donated but actual organs or parts of organs? . ..Maurice.

ADDENDUM 6-5-2008: After reading this thread, you may want to go to a thread begun on this date which discusses the issue of the adoption of a child to serve as an organ resource.

15 Comments:

At Tuesday, January 30, 2007 5:03:00 AM, Anonymous NeuroscienceGuy said...

I see no ethical problem here at all. This really sounds to me like another example of a controversy that exists only because of ignorance. People hear about something like this and ASSUME that the child is loved less and/or that the savior sibling is created only for tissue farming.

If the procedure is safe for the savior sibling, I fail to see why anyone should be opposed to this.

--NeuroscienceGuy

 
At Tuesday, January 30, 2007 1:47:00 PM, Anonymous LisaMarie said...

Aren't there serious ethical issues involved in having someone else decide whether you love your child enough to retroactively justify your decision to have them? How would the doctors involved in helping people conceive these children even begin to judge such a thing?

 
At Tuesday, January 30, 2007 2:41:00 PM, Blogger Maurice Bernstein, M.D. said...

Obviously, over the ages, there has been no push to justify or hold the parents morally or otherwise responsible for bearing the fully unexpected "Whoops! I did it" child. Well, no push except in some countries--until recently, was China an example? And predictions of whether these children would be given full love and attention was not in society's mind until a parent failed and the child was injured by the parent or in danger.
So the question is why should the parents of a child born with intent (not by some fluke in contraception) and with some pre-planned purpose be paid such attention? Some may argue to point that, in the process, those embryos not meeting the specific genetic criteria are going to be discarded. But, to me, that is simply going back to the controversy as to when personhood begins and is not related to the argument of whether a child being born for a specific beneficent purpose and with no intent to injure the child is an act to be condemmed. ..Maurice.

 
At Wednesday, January 31, 2007 12:58:00 PM, Anonymous NeuroscienceGuy said...

If one opposes "savior siblings" on the grounds that the discarded embryos were persons, shouldn't one also oppose IVF on the same grounds? Shouldn't one also react to miscarriages as if someone's child had died (hold a funeral, etc)?

If one believes that personhood begins at conception, why don't anti-abortion people hold funerals for miscarriages? When my wife had a miscarriage, none of our anti-abortion friends suggested a funeral. Quite the contrary, they dismissed the experience by saying things like, "Don't be sad, you can always have another!"

I have yet to see anyone react to a miscarriage as if someone's child had died. That tells me that no one *REALLY* believes that an 8 cell embryo is a person.

 
At Wednesday, January 31, 2007 1:42:00 PM, Blogger Heidirific said...

Two comments here. First, neuroscienceGuy, I do know someone who had a memorial service when she had a miscarriage.

Second, this post can be two different questions. One being about genetic selection allowed by artificial forms of conception and the other of the results of that selection.

I do have concerns about selecting (or eliminating) certain conditions. Any "naturally" created children aren't selected for their genetic compatibility or any other features. It is completely up to "nature" as to what features the child will have. When we start selecting the embryo for certain features, when will it stop? I do see the possibility of eugenics here.

As to whether or not the children are loved differently, I would guess (purely a guess) that they would be loved more because they saved the older sibling. If a parent loves a child so much that they are willing to go to such extreme measures to save a child, why wouldn't it be logical that they would love the next child as much?

 
At Wednesday, January 31, 2007 8:46:00 PM, Blogger Maurice Bernstein, M.D. said...

Heidirific, could it be that the selection process regarding these particular zygotes where the intent is to find a more genetic match to eventually help cure a sibling's illness is a special case and not to be lumped with those zygotes which are being screened for certain cosmetic ideals or elimination of certain handicapping conditions often for the benefit of the parents? ..Maurice.

 
At Wednesday, February 14, 2007 7:42:00 PM, Anonymous Anonymous said...

While I have a problem with reproductive procedures that require the creation and then destruction of embryos, I don't have problem with the grounds of the selection. Well, maybe a little, but then I wonder, how many of my ancestors were conceived because more hands were needed on the farm or because a mother thought it would solidify a marriage? They were no less human, and while parental bonds may be clouded by such considerations, that is not determinative of the richness or value of ones life.

 
At Tuesday, July 29, 2008 5:26:00 PM, Anonymous SchoolStudent said...

I completely agree with the ethicist. If the parents created this baby to help their exciting child then the baby would more than likely be raised as a hero and be more loved than if the baby was a 'mistake'.
To say this is a spare parts baby is just a way to trick peoples minds by making the words sound much more sever than they really are.
The ethical issues towards the other embryos are simple. If these babies are born then they will most likely have the disease causing them to die or become very sick and not only cost the parents for hospital or the emotional cost, it will also be another bed in our hospitals that could of been saved for someone who didn't have any idea they had an illness or someone that immediately needs help. The cost to the public and to governments is much more than if the baby was chosen because it was a nice healthy embryo. There may still be a chance they had the disease but it would be much less likely.
Take this away with you; if you were in the parent’s situation then wouldn't you give anything to make the Childs quality of life the best it could be? And that goes for the Savior sibling as well as the natural born.

 
At Tuesday, January 13, 2009 5:48:00 PM, Anonymous My Sister's Keeper said...

I think a good book to read about this topic is "My Sister's Keeper" by Jodi Picoult.

 
At Tuesday, January 13, 2009 7:15:00 PM, Blogger Maurice Bernstein, M.D. said...

You can review a preview version of the book My Sister's Keeper at Google Books ..Maurice.

 
At Wednesday, March 02, 2011 8:10:00 AM, Anonymous Anonymous said...

In theory its a good idea, but what happens if the child births doesn't result in the life of the other child being saved, what happens if the sick child dies despite the saviour sibling, it could be argued that some parents would blame the child for not saving their sibling.

 
At Wednesday, March 02, 2011 8:20:00 AM, Blogger Maurice Bernstein, M.D. said...

I doubt any rational parents would blame the "saviour sibling" child who never was the responsible individual in the child's birth or utilization. ..Maurice.

 
At Tuesday, March 15, 2011 8:46:00 AM, Anonymous Anonymous said...

I think it would be difficult for a parent to be completely rational when they have just lost a child. As much as the remaining children are the priority, it is still unprobable that the parents would remain sound and rational. There have been many cases where one parent irrationally blames the other for a child's death. So there is every possibility (not a guarantee though) that the 'saviour' sibling will be blamed.

O.H.W

 
At Sunday, September 18, 2011 6:47:00 PM, Blogger ladyinred said...

It's not so much that the younger sibling would be blamed but how far do you take it. If the older one needs more and more from the younger where do you draw the line? What if it comes down to a heart or lung transplant? These are the kinds of questions I have about it.

 
At Monday, September 19, 2011 8:07:00 PM, Blogger Maurice Bernstein, M.D. said...

I doubt the birth of a saviour-sibling would ever be done to then kill the sibling to prevent the death of an older child. That killing would be a homicide. However, later in the lives of both, certainly the sibling could voluntarily donate vital organs, if needed, to the live needy brother or sister if the sibling should die. ..Maurice.

 

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