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‘Saviour Siblings’? The Distinction between PGD with HLA Tissue Typing and Preimplantation HLA Tissue Typing

Winner of the Max Charlesworth Prize Essay 2006

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Abstract

One of the more controversial uses of preimplantation genetic diagnosis (PGD) involves selecting embryos with a specific tissue type so that the child to be born can act as a donor to an existing sibling who requires a haematopoietic stem cell transplant. PGD with HLA tissue typing is used to select embryos that are free of a familial genetic disease and that are also a tissue match for an existing sibling who requires a transplant. Preimplantation HLA tissue typing occurs when parents select embryos that are not at risk of a familial genetic disease to be a match for an existing sibling who requires a transplant. In Victoria, Australia, applications to use PGD with HLA tissue typing are reviewed by the Infertility Treatment Authority on a case by case basis. Preimplantation HLA tissue typing is prohibited prima facie because the embryo to be tested would not be at risk for a genetic abnormality or disease. Arguments for or against the use of PGD/HLA tissue typing are based on several key issues including the commodification and welfare of the donor child. This essay aims to show that that the same arguments apply to both PGD with HLA tissue typing and Preimplantation HLA tissue typing, and that the policy distinction between the two procedures is therefore ethically inconsistent.

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Notes

  1. In this type of transplant, the main risk of tissue incompatibility is not so much the problem described here (i.e. rejection of the transplant by the recipient) so much as the transplanted cells attacking the recipient – an effect that leads to graft-versus-host disease (Ed.).

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Acknowledgements

The author would like to thank the Fulbright Commission whose generous funding made this report possible. Special recognition is also due to Helen Szoke, Louise Johnson, and the Infertility Treatment Authority, who all graciously gave of their time to support this endeavour. Lastly, I would like to thank Neil Levy, my supervisor at the Centre for Applied Philosophy and Public Ethics.

Conflicts of Interest

None declared

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Authors and Affiliations

  1. Joint Degree Program in Law, Health and the Life Sciences, JD/MPH candidate, University Of Minnesota – Twin Cities Campus, Minneapolis, USA

    Crystal K. Liu

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  1. Crystal K. Liu
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Correspondence to Crystal K. Liu.

Additional information

The Max Charlesworth Scholarship is awarded by the Australasian Bioethics Association for the best essay addressing ethical issues in health care and medical science, written by an Australasian university student

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Liu, C.K. ‘Saviour Siblings’? The Distinction between PGD with HLA Tissue Typing and Preimplantation HLA Tissue Typing. Bioethical Inquiry 4, 65–70 (2007). https://doi.org/10.1007/s11673-007-9034-9

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  • DOI: https://doi.org/10.1007/s11673-007-9034-9

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