Biomedical Engineering Reference
In-Depth Information
those not receiving good news would learn about the non-contractual prac-
tice of revealing good news, and by default they would deduce their likely
hD status.
ethical dilemmas can also arise when parents ask a physician for help in
conceiving a child with one or more particular non-disease traits. if a phy-
sician's personal values tell him or her that the parents' request is not in the
best interest of the unborn child, he or she is faced with having to choose
between acting on his or her own values and respecting the procreative au-
tonomy of parents. A rare example of this is requesting PGD to conceive
a savior sibling to provide immunologically compatible stem cells or tis-
sue for an existing family member needing a transplant. Who is the physi-
cian's patient in this case? Whose interest should be held paramount—the
mother who must risk invasive procedures, the father, the unborn child,
or the sick family member?
Savior Siblings
A famous savior sibling case is that of the nash family from Denver in which
parents used ivf and PGD to obtain a child whose umbilical cord blood
was used as a source of
hemopoietic stem cells (HSCs)
to save the life of their
daughter with a rare form of leukemia. Bioethicists have studied and writ-
ten much about this case because it raises moral issues encountered with
PGD that are now rare but could become more common in the near future.
in 1999, molly nash was five years old and suffered from fanconi ane-
mia, a rare genetic disease that causes leukemia. molly was born with the
disease. Both of her parents are genetic carriers of the disease, giving them
a 25 percent chance of having a child with the disease, but they were un-
aware of this prior to molly's birth. molly could survive only if she received
an hsC transplant from the bone marrow, peripheral blood, or umbilical
cord blood of a compatible donor. ensuring immunological compatibility
between donor cells and the recipient is important in order to avoid rejec-
tion of donor tissues or organs by the recipient's immune system.
for children in molly's position, the best source of hsCs is a geneti-
cally matched sibling, but molly had no siblings. The next best source is
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