WELCOME
Everyone be welcome to the third journal paper discussion of our Bioethics Journal Club.
The topic is whether it is ethical to "have a child to save a child". The article is reviewed by members of the Journal Club. Unfortunately, there is no author written abstract available for this paper, however the Journal Club has prepared an excerpted summary of the paper below. It is recommended that interested visitors make an effort to locate and read the original article. Check with your local librarian for help in getting the article.
Followups by our members and comments by the visitors is located as a section below the reviews titled "Followup Comments" and is formatted so that the most recent dated comments are at the top of the section.
We invite visitors who would care to join and participate in these reviews, adding to our club membership, to do so and write me a bit about yourself to share with our other members. Please also let me know if you have any suggestions for this club.
I would like to inform our visitors that Joe Russo, a current graduate student who suggested the development of this journal club, is our moderator.
Now let's get on with the third paper! ..Maurice
Procreation for Donation: The Moral
and Political Permissibility of
"Having a Child to Save a Child"
Mark P. Aulisio, Thomas May, and Geoffrey D. Bloc
Cambridge Quarterly of Healthcare Ethics (2001), 10, 408-419.
EXCERPTED SUMMARY OF THE ARTICLE PREPARED BY THE JOURNAL CLUB
"The crisis in donor organ and tissue supply is one of the most difficult
challenges for transplant today...Herein, we address one very controversial step some
parents have taken to obtain matching tissue or organs for their needy children--
that is, having a child, in part, for the purpose of organ or tissue procurement"
Aulisio, May and Block indicate that "as a matter of social policy there is no justificatory ground for
prohibiting parents from having a child to save a child." They argue that there is nothing unethical or unlawful in our society simply to create a child for whatever reason or, indeed, for no reason at all.
With regard to what happens after the child is born, specifically with regard to "...whether or not
donation may go forward in any particular having a child to save a child case", they argue
"should depend on satisfying a best interest of the donor standard at the time of
donation just as it does in cases of minors and living-related donation." This means that if the wishes of the donor are unknown, whatever action is taken should be supported by what would be in the "best interest" of the donor. They caution that "this, of
course, will have to be considered on a case-by-case basis with attention to the
unique circumstances of each particular case."
THE REVIEWS
By Member Joe Russo, joe24_1999@yahoo.com
In the article by Aulisio et al., we are posed
with the question of whether it should be permissible
societally for children to be conceived in order that
another living child be saved. I tend to agree with
the authors that there is no justifiable reason that
it should not be permissible at least on a society
level even though particular cases may prove to be
unethical. The grounds they give is that having a
child to save a child parallels the cases of living
donor minor cases once we set aside the issue of the
child being born first. In essence if we work through
the problem of conceiving the child first, then the
cases are essentially the same and the same
considerations can be applied.
If we apply the same criteria that is applied to
the living donor cases in which the courts have found
it permissible for minor children to have consent
implied for them by their parents in cases where it is
in their best interest to donate however; we begin to
lose sight of the parallel. For instance in those
cases in which consent could be voiced for a minor
child it has been shown to be in their "best interest"
to donate based largely on emotional ties to the sick
sibling. In the case of having a child to save a child
I don't think the same criteria can be met. A child
would be conceived and born into a family in which the
older sibling was already quite ill, and in some cases
presumably without the opportunity to develop a close
relationship with the child they will donate to. Due
to this circumstance I have doubts as to whether we
could use this criteria as it is used in living donor
cases.
However I do fully agree with the authors as they
conclude that we can't call the reason for conceiving
the child as unethical if it is to help an older
sibling who is in need of a transplant. Given the
variety of reasons to conceive a child, including no
reason at all, this reason seems to hold at least
equal moral status as the majority of reasons if not
higher moral status. Therefore, although I agree with
the authors about their conclusion that as a society
we should permit the conception of children to save
another, I disagree with their assessment of how we
might arrive at that conclusion.
Write me your comments on the article and reviews by clicking here.
FOLLOWUP COMMENTS
Editorial Note: There is a more recent article on the same general subject which you may want to read. John A. Robertson, Jeffrey P. Kahn and John E. Wagner have a paper " Conception to Obtain Hematopoietic Stem Cells" Hastings Center Report 32 no 3 (2002) p. 34-40 dealing with the issue of conception by a family for the primary purpose to obtain stem cells in order to attempt to cure their child born with serious genetic based hematologic disorder. The ethics are considered regarding the current methods of creating an embryo or a developing fetus and the methods of determining whether the embryo or fetus is free of the disease and a proper match to the ill child and regarding the final outcomes of the embryo or fetus.
Date: Wed, Feb 4, 2004 4:37 PM
From: TSISS@aol.com
To: DoktorMo@aol.com
I read your article with interest, and am inclined to agree with you in general. I do, however, have a question. What if the parents conceive a child, check the embryo/ fetus
for genetic match, and finds that the fetus is a mismatch. Should they be able to abort this fetus and try again? If they are having this child primarily to save the older sibling, what would prevent this from happening, or should it be prevented?
Sincerely,
Terry L. Sissel, RN (CCU)
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This page was last updated 3/15/2004