Saviour Siblings Saved!

Two attempts to amend the Human Fertilisation and Embryology Bill’s provision to allow ‘saviour siblings’ failed in the House of Commons yesterday. The first attempt was to block the practice and failed 342 to 163. The second attempt was to limit the provision to life-threatening cases. It was defeated 318 to 149. As it stands the Bill allows embryo testing and hence selection for ‘saviour siblings’ provided that “there is a significant risk that a person [the sibling ‘to be saved’] … will have or develop a serious physical or mental disability, serious illness or any other serious medical condition.”

So called ‘saviour siblings’ are children that are born so that they can be a tissue match for older sibling who suffers from a condition requiring, for example, umbilical cord blood or bone marrow.

A popular argument mounted by those seeking to amend this part of the Bill was that to create a child in order to be a donor instrumentalises and so mistreats that child. Children, the argument runs, are to be valued for themselves not because of what they can do for another. The BBC reports conservative MP David Burrowes as saying that it was an “important principle” that a child should not be “deliberately created to be used for the benefit of another, no matter how pressing the need.”

However it is hard to see why we should accept this principle or why it should override other considerations. If we grant, plausibly, that intentions matter in our judgements of the actions of others and also that acting on such intentions can plausibly be restricted through policy, then we are still faced with some difficult inconsistencies.

There are myriad examples of parents having a child for the benefit of another, most of which we think are perfectly acceptable. Think here of issues about heirs – having a (male) child to carry on the family name or to inherit and look after the family business. The beneficiary of the child’s existence is the family. The child is born not for itself but for the continuing good of the family. Think also of couples who are trying for a second child because they believe (rightly or wrongly) that the only child will be better off with a sibling. Some people have children for company, some to be just like them, to be the great athletes that they never could be and some to make their parents happy. In each of these cases the child is created to benefit another.

Even if we judge in these cases that the intent of the parents is wrong, it is far from clear that the wrongness is sufficient to prohibit such choices. Clearly, the needs involved in these cases aren’t nearly as pressing as the saviour sibling case. I suspect though that in the cases cited we would think that the situation is more complex. Our reasons and intentions are complex. It is far from clear that the parents of saviour siblings would be any different from other parents once the trauma associated with a very sick child has been dealt with. Having a saviour sibling certainly does not preclude these other intentions and it certainly does not rule out the loving the child in itself. Indeed it may make it more likely.

Further reading:
Sheldon, S and Wilkinson, S. J. Med. Ethics 2004; 30; 533-537

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