Not unnatural selection, but genuine reasons to have a child

This week's BioNews reports on US couple Jack and Lisa Nash, who used embryo screening (preimplantation genetic diagnosis, PGD) to ensure that their second child was both free of a serious inherited condition, and a suitable blood cell donor for his dying sister. The story sparked a media frenzy, with most of the newspapers describing baby Adam as being 'created', 'designed', or even 'bred' in order to save his sister Molly. Many commentators opposed the use of PGD in this case because, although it was agreed that saving the girl's life was a good thing, it opened the floodgates to 'genetically engineered' children with eugenically designed qualities.

It was also suggested that Adam being born in this way meant he was neither wanted as much as he should be, or was wanted for the wrong reasons - he was created specifically to become a donor. This was said to be against one of the more fundamental philosophical premises of our society - people should not be treated as a means to an end, but as an end in themselves.

But simplifying the case to fit Kantian philosophy does not help. People have, and always have had children for different reasons - often a mixture of reasons. Many conceptions are unplanned (though not necessarily unwelcome), and many children who are planned can end up unwanted or unloved. So we cannot judge the Nash's for their decision - there is no evidence to suggest that they will love their second child less than the one they are trying to save. We do not worry whether those who conceive children naturally will love their second child less than their first, no matter why it was conceived - as a companion, an heir, or even an 'accident'. In fact, the reality is that the Nash's had three PGD attempts without tissue matching (though with screening for the  inherited condition) prior to conceiving Adam. This surely demonstrates their genuine desire for a healthy, second child - having one with a tissue type matching that of Molly's was merely an added bonus.

As some of the better commentaries mentioned on Thursday, the Nash case is unlikely to be the thin end of a wedge that leads us to choosing the intelligence, looks and other physical or mental qualities of our children. PGD, being an extension of IVF, is expensive, intrusive and difficult for those involved. When people can have children in the ordinary way, it is unlikely that the more unpleasant option will be chosen, no matter how much we desire intelligent, beautiful children. Not only that, but it is the case (although you could be forgiven for missing it) that such procedures are regulated in the UK. The HFEA can ensure for which people these procedures are available, and for what criteria. At present, we allow PGD for medical reasons only, but consultation is currently taking place. Instead of evoking Frankenstein imagery and worrying people about eugenics and 'designer babies', we should be extending public debate to enable further sensible guidelines to be drawn.