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The Human Fertilisation and Embryology Authority has today decided to change its rules to allow embryos to be tested to allow families to have a child to be a tissue match for a donation to a seri-ously ill existing brother or sister.
"I am disappointed that the HFEA have decided to allow what is an essentially instrumental view of a future child to prevail," says Dr Donald Bruce, Director of Society Religion and Technology Pro-ject of the Church of Scotland. "This is not selecting embryos to avoid the child itself being seri-ously ill, but choosing the child to be born because of its potential value for the life of its sick brother or sister. This is having a child not because of what any child could give but only what a certain type of child could give."
In the process the couple would be discarding many otherwise perfectly good embryos. They are discarded not because they were simply non-viable, as may happen in normal IVF treatments, and not because they carried a severe genetic disorder, as in pre-implantation genetic diagnosis. They are discarded because they did not come up to a certain standard, that of their functional ability for someone else. "The selection of a future child because of its function or quality is a route we should not begin to go down."
The focus is understandably on the deep concern for the existing, suffering child. But this is not the only personal issue involved. There are concerns about the new child which are not often consid-ered. There is an the ethical obligation not to do harm as well as to do good. Statistically, in a cer-tain proportion of cases the procedure will work, but in some it will fail. The sick child will die de-spite the donation of cells from the new sibling. Will the donor child go through later life with a sense of failure or guilt, because the reason he or she was chosen, as against all the other discarded embryos, did not work? The very reason why the child was 'chosen' is undermined. This may not be an entirely rational reason, but it could be very real, as in the case for example of the guilt often felt by sole survivors of disasters in which everyone else was killed.
One ethical solution to the case might be if the couple, having chosen the best match embryo, were prepared to freeze the other embryos for later implantation, or perhaps donation to an infertile cou-ple, rather than just to discard them. The choice would then be the timing not the child.
The HFEA press release focuses primarily on the physical risk of the embryo testing procedure and the prospect of doing good to the sick child. It says disappointing little about the ethical dilemmas it poses.
Dr Donald Bruce is Director of Society Religion and Technology Project of the Church of Scotland The views expressed should not necessarily be taken as the views of the church's annual General Assembly since it has not as yet debated the issue.
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