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.