Embryo Selection - Brutes or Angels: Human Possibility in the Age of Biotechnology - page 95

from blood of a non-sibling, blood relative, but none of molly's relatives
were closely enough matched genetically to serve as a donor. The third best
source is from imperfectly but sufficiently well-matched, unrelated donors
registered with the national marrow Program. for cases reported to the
international Bone marrow Transplant registry between 1978 and 1994,
fanconi anemia patients' two-year survival rates after bone marrow trans-
plants from identically matched sibling donors and from matched unrelated
donors were 66 percent and 29 percent, respectively (Carreau 2006, 93).
faced with these statistics and molly's certain death if a suitable donor was
not found, the nashes set out to use ivf and PGD to have a child, a savior
sibling, whose umbilical cord blood could save their daughter (fig. 3.3).
The family used an ivf clinic in Denver and arranged for embryos at
the six- to eight-cell stage to be flown to the reproductive Genetics insti-
tute in Chicago for PGD. Two tests were performed on one cell from each
embryo, one for fanconi anemia and the other for hlA (human leukocyte
antigen) type. 10 The latter test identified embryos that would produce a
child with hsCs compatible with molly. in late 1999, after five rounds of
ivf and PGD, at a cost of $100,000, PGD clinicians found one disease-free
embryo with the proper hlA type. This embryo was transferred to the
uterus of lisa nash, who gave birth to a son, Adam nash, in August 2000.
Cells from Adam's umbilical cord were frozen and flown to a University of
minnesota clinic in minneapolis to await transplantation into molly. After
getting chemo- and radiation therapy to kill the leukemic cells in her bone
marrow, molly received Adam's cord blood cells, and by January 2001,
molly was cured of fanconi anemia.
What new ethical issues arose when the nashes used the “stacked” tech-
nologies of ivf, PGD, and stem cell transplantation (fig. 3.3) to create a
savior sibling? Bioethicist Jeffrey Kahn and law professor Ana mastroianni
(2004) identify at least five such issues: (1) parents' motivation, (2) future
physical and psychological risks to the donor, (3) a “slippery slope” toward
embryo selection for other non-disease traits, (4) therapeutic uses of PGD,
and (5) unintended consequences of the stacked technologies.