How to save your dying child if no donors are available

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Your child is suffering from a serious medical condition and needs a bone marrow or stem cell transplant in order to survive. People have offered to become donors, but none of them are a match: what do you do? A technique called PTT (pre-implantation tissue typing) allows parents to select embryos with the same tissue type to their suffering child, creating a ‘saviour sibling’ that can act as a donor. 

PTT works in conjunction with traditional IVF procedures. The embryos are genetically screened and some of those which are found to have the desired tissue type are implanted into the mother’s uterus. 9 months later the ‘saviour sibling’ is born and its umbilical cord blood (which contains stem cells) is collected and later transplanted into the dying sibling. Transplants from a tissue-matched sibling are much more effective than transplants from alternative tissue-matched sources.

cord blood
A bag of umbilical cord blood.

This procedure sits in the middle of an ethical minefield. In some cases it may be the only way to save a dying child; however the commodification of the saviour sibling in order to save another child is difficult to justify.

“We are not creating this saviour sibling to be a child in its own right. We have created it—designed it—to be a source of spare parts for an existing child.”

– Richard Nicholson, editor of the Bulletin of Medical Ethics

This is true; however we could argue that parents do not need to justify their reasoning for having a child. Some births occur by accident, some parents have children to act as a trustworthy heir to their company, others may have a second child to keep the first child company: the point is that children are commonly brought into the world to serve  a specific purpose, so giving birth to a saviour sibling should not be treated differently.

Another disadvantage to PTT is that it is an invasive process, and we still don’t know the long-term health effects of tampering with embryos. It could be that by creating a saviour sibling, parents are inadvertently putting the health of their child at risk; however this is a small price to pay if it means saving an older sibling.

There is a simple way to sweep this ethical minefield, which is to use stem cells from a patient’s own umbilical cord. Unfortunately this isn’t an option in most cases, because families didn’t have the foresight to collect and save blood from the umbilical cord. It would make sense for families to do this in the future, especially if they suspect that their child may one day suffer from a blood condition.

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