A technique that promotes welfare for all

Over the next few days, the media is likely to be mulling over the story of Mr and Mrs Hashmi. The couple would like to use PGD (preimplantation genetic diagnosis) to have a child both free from beta thalassaemia and who would be a suitable blood donor to two-year old Zain Hashmi. Although the media coverage has so far been relatively sympathetic to the Hashmis, the phrase 'designer baby' is inevitably in play. But how will the Human Fertilisation and Embryology Authority (HFEA), the body charged with adjudicating on the issue, approach its decision?

The HFEA doesn't have to decide whether PGD itself is acceptable: that decision has already been made. But it does have to decide whether particular uses of the technique for a specific disease or reason is acceptable. The most important part of the decision is safety and efficacy. Does the clinic in question have the skill to perform the technique and test not just for beta thalassaemia, but also for the tissue matching?

The HFEA must also make a judgement about the ethics of such a use of PGD. Is it a use which is inherently wrong because it is, at least in part, designed to help another child? If it decides that it is not always and inevitably wrong to do such a thing, it must leave the final treatment decision to the clinic concerned. For whilst the HFEA can decide which techniques can be offered in IVF clinics, it cannot adjudicate on the requests of particular patients.

When deciding whether or not to treat a particular patient, IVF clinics must consider the welfare of the child who might be born of that treatment and the welfare of any children already in the family. How does this apply to the Hashmi family? The birth of a tissue-matched baby would certainly promote the welfare of Zain, whose life could be saved by the baby's donation. The welfare of the baby would also be promoted, since it would grow up knowing that it had saved, or at least tried to save, the life of its older brother. It's hard to see how the HFEA or the clinic could rule against this case.