Ethical considerations

On PGD in combination with HLA, ethical discussions have taken place and are ongoing at the moment, mainly because the procedure involves embryo selection (Pennings 2002, Edwards 2004, Robertson 2004, Devolder 2005, De Wert 2005). In case of embryo selection based on HLA typing the ethical discussion is even stronger since the selection here is based on a non-disease trait and opponents claim that the child to be born is instrumentalized.

The question of the motivation of the couples also may raise concerns. They could be tempted to have an additional child solely for the purpose of furthering the interest of the existing sibling and not because they desire another baby. This difficult ethical issue can be partially addressed by a careful genetic and psychological counselling of the couples to ascertain their real motivation.

Considerable numbers of embryos were needed to identify one closely matched with the sick sibling, although all embryos resulted unaffected but non-HLA matched, not transferred to the patients, are usually frozen for future possible use, in case the couples wish to have more unaffected children.

However, most consider these criticisms a minor concern when compared with the possibility of saving a child’s life from a devastating disease.

 

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