This book focuses on the use of Assisted Reproductive Technology in the context of families who seek to conceive a matching sibling donor as a source of tissue to treat an existing sick child, referred to as ‘saviour siblings’. The author considers the legal and regulatory frameworks that impact on the accessibility of this technology in Australia and the UK, and analyses the ethical and moral issues that arise from the use of the technology for this specific purpose.

Genetic screening technologies involving pre-implantation genetic diagnosis raise particular issues about selective reproduction and the welfare of the child to be born. How does selection impact on the identity of the child who is born? Are children who are selected for a particular purpose harmed or treated as commodities? How far should the state interfere with parents' reproductive choices? Currently, concerns about the welfare of the child in selective reproduction have focused on the individual interests of the child to be (...) born. This book re-evaluates the welfare of the child through the controversial topic of saviour sibling selection. Drawing on relational feminist and communitarian ethics, Michelle Taylor-Sands argues that the welfare of the child to be born is inextricably linked with the welfare of his/her family. The author proposes a relational model for selective reproduction based on a broad conception of the welfare of the child that includes both individual and collective family interests. By comparing regulation in the UK and Australia, the book maps out how law and policy might support a relational model for saviour sibling selection. With an interdisciplinary focus, Saviour Siblings: A Relational Approach to the Welfare of the Child in Selective Reproduction will be of particular interest to academics and students of bioethics and law as well as practitioners and policymakers concerned with the ethics of selective reproduction. (shrink)

By using tissue typing in conjunction with preimplantation genetic diagnosis doctors are able to pick a human embryo for implantation which, if all goes well, will become a “saviour sibling”, a brother or sister capable of donating life-saving tissue to an existing child.This paper addresses the question of whether this form of selection should be banned and concludes that it should not. Three main prohibitionist arguments are considered and found wanting: the claim that saviour siblings would be treated as commodities; (...) a slippery slope argument, which suggests that this practice will lead to the creation of so-called “designer babies”; and a child welfare argument, according to which saviour siblings will be physically and/or psychologically harmed. (shrink)

The Human Fertilisation and Embryology Authority’s recent restrictive recommendations on sex selection have highlighted the need for consideration of the plausibility of ethical arguments against sex selection. In this paper, the author suggests a parental virtues approach to some questions of reproductive ethics as a superior alternative to an exclusively harm focused approach such as the procreative liberty framework. The author formulates a virtue ethics argument against sex selection based on the idea that acceptance is a character trait of the (...) good parent. It is concluded that, because the argument presented posits a wrong in the sex selecting agent’s action that is not a harm, the argument could not function as a justification of the HFEA’s restrictive position in light of their explicit commitment to procreative liberty; it does, however, suggest that ethical approaches focused exclusively on harm fail to capture all the relevant moral considerations and thus that we should look beyond such approaches. (shrink)

The UK Human Fertilisation and Embryology Authority was right to permit tissue typing preimplantation genetic diagnosisOn July 21 2004, the Human Fertilisation and Embryology Authority , Britain’s regulatory agency for reproductive technologies, revised its policy on preimplantation genetic diagnosis for tissue typing.1,2 The authority of the HFEA to enact such a policy was affirmed by the UK’s highest court, the House of Lords, on April 28 2005.3 Preimplantation genetic diagnosis combines in vitro fertilisation with genetic testing. In PGD, embryos generally (...) undergo biopsy prior to the eight cell stage, followed by genetic testing for a particular trait. Tissue typing PGD is done to identify an embryo that is tissue matched for a child suffering from a severe disease requiring bone marrow or cord blood stem cell transplantation and for whom no living donor exists. This procedure was first performed in 2000.4 Precise matching of tissue types is critical to successful tissue transplant, and the donors of such tissues are often referred to as “saviour siblings”.Where a tissue matched individual already exists, extracting bone marrow from that individual or collecting cord blood already in storage, rather than creating a match, presents the most immediate treatment alternative. Bone marrow donation from adults or other medically competent individuals is not generally ethically contested, and bone marrow donation from medically incompetent individuals is also permissible under certain conditions.5 Where no living tissue donor exists, however, intentionally creating a donor through tissue typing PGD is among a short list of possible treatment options.The July HFEA policy change makes PGD licensable in cases where tissue typing is the only purpose of testing. Previously, PGD was licensable in the UK only for disease testing, and tissue typing PGD was permissible only when …. (shrink)

When is commodification acceptable?Preimplantation genetic diagnosis is usually restricted to couples who are eligible for in vitro fertilisation —infertile couples or those with a history of genetic disease. The Human Fertilisation and Embryology Authority in England and the Infertility Treatment Authority in Australia have both given permission for PGD with tissue typing to detect human leucocyte antigen compatibility in order to save an existing sibling with a life threatening condition. The procedure has also been carried out in the United States.1Heavy (...) criticism followed the February 2002 ruling of England’s HFEA to allow a family to try for a child who is free of thalassaemia and a “perfect match” for a sick sibling.2 Then in August …. (shrink)

Next SectionPreimplantation tissue typing has been proposed as a method for creating a tissue matched child that can serve as a haematopoietic stem cell donor to save its sick sibling in need of a stem cell transplant. Despite recent promising results, many people have expressed their disapproval of this method. This paper addresses the main concerns of these critics: the risk of preimplantation genetic diagnosis (PGD) for the child to be born; the intention to have a donor child; the limits (...) that should be placed on what may be done to the donor child, and whether the intended recipient can be someone other than a sibling. The author will show that these concerns do not constitute a sufficient ground to forbid people to use this technique to save not only a sibling, but also any other loved one’s life. Finally, the author briefly deals with two alternative scenarios: the creation of a human leukocyte antigen (HLA) matched child as an insurance policy, and the banking of HLA matched embryos. (shrink)

What is morally permissible, and what is morally obligatory? These questions form the core of a vast amount of philosophical reasoning. In his Fundamental Principles of the Metaphysics of Morals, Immanuel Kant developed a basis for the answers. In this landmark work, the German philosopher asks what sort of maxim might function as a guide to appropriate action under a given set of circumstances. By universalizing such a maxim, would morally permissible behavior not become clear? Suppose that everyone were to (...) behave in accordance with this maxim. If everyone followed the maxim in the same way without harm to civilized culture, then the behavior would be morally permissible. But what if no one followed the maxim? Would civilization thereby be at risk? In such a case, the behavior would be morally obligatory. Kant's test, known as the Categorical Imperative, is a logical proof of the Golden Rule and the centerpiece of this work. It constitutes his best-known contribution to ethical discussion, and a familiarity with his reasoning in this book is essential to students of philosophy, religion, and history. (shrink)

This book provides a clear, simple account of techniques involved in assisted reproduction and embryo research. It thoughtfully and provocatively explores controversies raised by developments in reproductive technology since the first IVF baby in 1978, such as 'saviour siblings', designer babies, reproductive cloning and embryo research.