Are Savior Siblings Ethical?

[ By on March 18, 2016 ]

Molly Nash was born with a fatal genetic disorder called Faconi-anemia, in which the only treatment is a bone-marrow transplant. If it were not for her brother, Adam, she most likely would have died before her 10th birthday from leukemia. Lisa and John Nash decided to have another baby in order to save their daughter, and with the help of Dr. John Wagner, they used in-vitro fertilization to create embryos that could be tested for Fanconi anemia and for the same tissue type as Molly. After many attempts of in-vitro fertilization, they finally got a healthy embryo that could be used for a bone marrow transplant, which Molly had soon after Adam was born.

This anecdote about a savior sibling is a special case of a designer baby, and the ethical issues it presents are similar to designer babies. There are two reasons for parents to select their babies’ traits: for treating diseases or for enhancing the child’s looks. In my opinion, designing a baby based on trivial criteria (i.e. height, eye color, gender) is immoral. However, if parents select traits in order to have a healthy baby (i.e. removing genetic disorders or eradicating a cancer gene), then I believe that it is more moral. A savior sibling is a particular type of designer baby who is created to address a significant medical problem. In this sense, savior babies would be considered moral. However, the problem is that the baby itself does not benefit from the design; the sibling does. If a baby is born with a genetic disorder, then selectively aborting or changing their genetic makeup would affect them directly and is beneficial to the baby. But, if a healthy baby is designed to save a sibling, then the baby is not the one who is benefiting from the genetic engineering and did not give consent. In my opinion, this is not moral. Parents do not have the right to consent for the designed baby when it does not even help him/her? Parents always give permission for medical procedures for their underage children, but that occurs when the baby itself is benefitting. What if we look at a more extreme example in which a baby is created in order to donate one of their kidneys, which is irreplaceable, unlike bone marrow that regenerates? Kidney donations are usually a choice that the donor makes, but in this situation the child is not able to make the decision for itself. In this case, we would be valuing the designer baby’s life less than the sick baby’s, which is immoral. The savior sibling is being treated as an instrument to serve someone else rather than having its own essential value. So, can parents really make such a big decision in genetically engineering their baby when it does not necessarily benefit the baby?

If you would like to read more about the Nash case, here is an article.

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3 Comments on “Are Savior Siblings Ethical?”

  1. srwetzler

    I think that this is a really interesting ethical case because of the debate over the value of different forms of human life. Do we value the lives of babies 10 seconds after they’re born more than we do 10 seconds before they are born? Is there a difference between the two? And how do we consider the risks to the savior sibling themselves? It is possible that in the process of a savior sibling giving a kidney to their sick sibling, they could die. Do parents think that the death of that child is less important or terrible than the death of their older child?

    Another factor in this ethical dilemma is the psychological effect of being a savior sibling has on a child and adult. How would you feel if your parents only loved you because you saved your sibling? And that they took you apart to help their other child? I cannot imagine living my life knowing that I was born just for my healthy body and I think that I would always think that my parents loved me less than my older sibling. I do not think it is right for parents to bring people into this world under those circumstances or for doctors to encourage them to do so.

  2. srwetzler

    Kelley Nicholson-Flynn

    [ May 04, 2016 at 1:09 am ]

    Sara, interesting case and thanks for providing the source. I wonder if it would be fruitful to compare the savior sibling case to something like a bone marrow transplant case. Let’s say that a person has two children, one 8 years old an the other 3 years old. The older child has leukemia and needs a bone marrow transplant. The chances of matching are much higher with a close relative; sure enough, the younger child is a good match. A 3 year old obviously can’t consent to this treatment. Would a parent “use” the younger child for a bone marrow source? Is this ok? Using which frameworks. I’ve tried to give a case where the intent of conception is the only difference.

  3. srwetzler

    Jessica Benjamin

    [ May 05, 2016 at 2:32 pm ]

    I think you have brought up a very interesting moral question. As someone who has read My Sisters Keeper, the morality of having one child to save another has intrigued me for a while. One of the arguments you present is that children like Adam gain no benefit from in-vitro fertilization, but didn’t it benefit him to be tested for Fanconi anemia and other genetic disorders in the process leading up to the fertilization? Your post was very thought provoking, and I wonder if you looked into the psychological effect of being a “savior sibling”. For example, all siblings tease each other, and sometimes they go for low blows. Imagine growing up with a sibling who teases you for only being born to save their own life, do you think this would be psychologically damaging to the “savior sibling”? How does the introduction of a savior sibling affect the relationship dynamics within the family? Do you think it is an act of nepotism for a parent to risk the life of one child for another, and that the savior child will feel less loved?
    Here are two links that investigate the psychological effects if you are interested, one is to a thesis paper from Wake Forest and the second is to a paper from the Bioethics Project, and there are plenty more out there! https://wakespace.lib.wfu.edu/bitstream/handle/10339/39113/Mills_wfu_0248M_10493.pdf
    http://www.thebioethicsproject.org/essays/child-autonomy-and-the-rights-to-ones-own-body-pgd-and-parental-decision-making/

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