Adopting Saviour Sons and Daughters: Is it Ethical?
First read the January 26 2007 thread “'Saviour Siblings' vs ’Whoops I did it again’ Kids: Any Ethical Difference?" Then, consider this advertisement by a company allegedly providing for a price the adoption of an orphan child from somewhere in the world for love and care and attention but also as a resource for the parents to use to procure organs for themselves or also presumably for their present children. Though this advertisement has been found to be a hoax, there still is an ethical question to be resolved. Even though it would seem that the company implies care, attention and legality in process of the adoption, would the use of such an adopted child to obtain organs, blood or tissue for a member of the family be ethically different than the adding a child to the family by natural means or by in vitro fertilization or other artificial reproductive techniques to love, care and to provide attention but also as a similar resource for a brother or sister?
Here is a comment on this very topic from an ethicist writing to a bioethics listserv and who has given me permission to reproduce his comment here.
I am not horrified at this hoax nor at the planned-but-not-done
European TV "Organ Recipient Idol" show, I do believe that both do have the presumably intended effect of calling more of the public's attention to the need for more donor organs. But...whether or not this ad was hoax, the ethical issue(s) of having or adopting a child with the intention of using them as organ, marrow, fluid etc donors for an existing sibling is a real problem. (Just yesterday the NYTimes ran an article about a seemingly effective sibling to sibling transplant)
People beget children for a host of reasons, some of which reasons I would consider irrational yet not want the state to prohibit. And some few other reasons that would justify state intervention. In the case of begetting a child in order to have it serve as a donor, say for a sibling, I think there are fuzzy limits we can set. That is, we can allow "donations" from the new child that are in accord with what we would expect an adult (with decisional capacity)to readily volunteer to donate to his/her sibling or immediate family member in need. These would include donations that pose no or minimal risk to the donor. This is sort of an "average reasonable sibling" standard.For example, we would expect that an adult sibling would have no hesitation about donating blood if his/her sibling needed a transfusion and no hesitation about donating bone marrow. That,I think is a "reasonable" assumption to make about what "average" adults would be willing to do, and can apply that to justify taking similar 'donations" from a sibling who does not yet have capacity.
However, as I just said, that approach might be easily justifiable when it comes to blood, or a bit of tissue, or bone marrow, but I am not at all sure if it could be used to justify harvesting (for example) a kidney from a child who lacks capacity. I have no idea how the fuzzy line in this approach could be sharpened. Nor.for example, what we should do with or about parents who want to initiate a pregnancy and later abort it in order to harvest from the fetus, tissue or cells
needed to (try) to save the life of an existing child of theirs.
Adopting a child with the intent of using it as a donor seems beyond the pale. Children-adopted or not- are not property of their parents. It is more like society giving parents presumptive custody of the born child on the assumption that they will care for the child and always act in its best interests (If they fail in that, society will take way that custody) Adopting a child solely for the purpose of using it as a donor seems akin to slavery. Grasping at straws for prohibiting this, perhaps we can assume that parents who conceive a child in order to save its sibling will likely love and care for their "donor child," whereas we cannot make the same assumption about people who adopt a child solely in order to use it as a donor.
So even though the advertisement under discussion is found to be simply a hoax, there still remains the basis of an important ethics discussion. What should be the ethical and humanitarian basis for adoption of a child? Should it be to raise the child out of poverty or harm and bring it into a stable, supportive, loving and caring family? May it also include the parents intent to provide themselves with the satisfaction of having a child which they were unable to create on their own? But what if the main motivation, despite willingness to care and love the child, was to provide an organ resource for some immediate personal need? Is such a reason for adoption ethical? Would this represent parental conflict of interest in which the parents own medical interests trump the child’s interest for a better and healthier life? ..Maurice.
posted by Maurice Bernstein, M.D. @ 3:39:00 PM
2 comments
2 Comments:
I just read the thread on Test-Tube babies beforehand, and think my views relate to both issues.
The creating of children with the primary intention to harvest [it] (and I describe it as harvesting because the act of taking of or from is exactly the same as harvesting of or from) is WRONG. As is adopting children with the primary intent to harvest [it]. Whether adopting a child or creating a child, the same ethical question comes into concern. Is this right?
I can bet that a lot of people would be against this idea for a number of reasons, whether they be religious or ethical or political. Now, I am not a religious person but even I agree that "playing God" can get you in trouble. If we start to create babies with the intent to use their particular beneficial qualities as an aid to our existing children, where does the line get drawn? The fact that a savior sibling was created in the first place, is indication enough to suggest desperation and grief on the parents behalf. Imagine what a desperate parent would be willing to do to save their child?
Now, I am not in any way saying that love and care towards a savior sibling would be compromised or any less than a naturally born sibling. However, this child was created for a primary purpose and that will always be the main reason the child came to be. If adopted children can have abandonment issues, what is to say a savior child does not have issues of whether or not they are loved based on their parents want or their parents need. So many psychological factors on the child's part also need to be considered and also, the consequences.
Furthermore, using adopted children for harvesting organs, blood and what not is the same as buying cattle for its tender flanks. A parent might say, "we only wanted marrow or blood" but at the end of the day, you're still milking the cow aren't you? Parents do not own people. As the above comments stated, parents are only given custody, nothing more. It is our responsibility as a society to draw the line between what is acceptable and what is not acceptable for parents to do. We cannot control whether a parent loves their child or not and the reasons why. However we can prevent whether a parent makes medical decisions for a child that has no voice! Is it so bad to commit abortion for an unwanted child that cannot be afforded? Is that so much more worse than having a child or adopting a child for the purposes of harvesting? Because f so, humanity has a long way to go before we are even sane.
Ror
If the recent failed Mississippi state constitutional amendment "Yes on 26", "The Personhood Amendment" had become law and a fertilized ovum as a zygote was already legally designated as a "person", what would that do the "saviour sibling" to be even considered. After all, the zygote is a person and should have all the legal protection which personhood permits. Thus, if the zygote was found not to meet the genetic requirements sought for, not to allow that person to be implanted, develop and be born would represent a criminal act. At least an adopted "saviour" is already born. ..Maurice.
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