Pro & Con: should PGD be used to produce children who are suitable donors for stem cell transplants?(Opinion)

YES

More than 10 years ago, an ethical debate erupted within the medical community when a California couple decided to have a second child in the hope of creating a bone marrow donor for their daughter, who had leukemia.

Most of the controversy centered around whether the parents would choose to have an abortion if amniocentesis showed that the fetus would not be a match. But today, preimplantation genetic diagnosis (PGD) makes saving the life of that sibling a much easier ethical dilemma. First, we need not get into a debate on abortion since the procedure eliminates that difficult choice. Although some opponents cite the issue of the remaining embryos created for the procedure, I see that as far less troubling than an abortion. In addition, the issue of remaining embryos is not unique to PGD; it has to be tackled by anyone undergoing in vitro fertilization treatments.

Second, there are fewer physical risks for the mother with PGD, since she will not have to undergo amniocentesis or the possibility of one or more abortions.

And the possibility of saving an ill child far outweighs any of the minor physical or emotional risks from PGD. Using it to save an ill child is also much easier to defend ethically than using the technology for sex selection. The situation is also not without benefits for the child who will be a donor. All children are special, but this child will know that he or she has given a gift to their sibling and to their entire family. It is also likely to create a special bond between the two siblings. At a minimum, it's a neutral outcome for the new child but hopefully it could be an enormously positive experience for the entire family. And the benefit of being born into a family where the child is wanted and presumably loved should not be discounted.

There is potential harm to the new child if the parents conceive him or her solely for the purpose of saving the other child. For this reason, it's essential that parents understand that the best outcome is to create a child they want in order to save one that they already have. Once the new child is born, the question of any future needs to donate his or her stem cells creates separate ethical and legal concerns. The new child must be treated with independent respect and not seen as merely a source of future stem cells.

With this and other issues, voluntary informed consent and understanding are critical to the proper and ethical use of this procedure. But overall, the physical and psychological risks are minimal and this procedure should continue to be used as a safe and appropriate way to potentially save ill children.