Bioethics in Faith and Practice, Volume 4, Number 1

20 The Ethics of IVF community. 58 According to a 2008 study, when PGD was still a relatively young technology, 3% of IVF clinics offering PGD provided diagnoses for parents wishing to select for a genetic disease or disability, 59 a number that has undoubtedly increased in the eleven years since. Many raise here the child’s right to an open future (unlimited by disability that can be avoided), but it is worth noting that parents already make many, many decisions on behalf of their children, making this a tricky line to draw. Controversy has also arisen over parents using PGD to conceive a child who is an immunological match for an ill sibling. The human leukocyte antigen (HLA) complex is a series of genes that encode the major histocompatibility complex (MHC) proteins that mark the surface of a cell to identify it to the immune system. According to the aforementioned 2008 survey, 6% of IVF-PGD clinics have provided HLA typing to have a child who is a compatible donor for an existing child. 60 Typically, the stem cells from the child left in the umbilical cord -- usually discarded -- are harvested to be used to treat the older sibling, 61 meaning there is no physical trauma to the child during development or after birth. Some are concerned by this situation, as the second child is seemingly brought into the world primarily to serve as a donor for the first, sometimes in cases in which parents were not planning to conceive an additional child. However, there is little available evidence that unplanned children are less loved generally; some have even argued that donor children should feel a sense of pride for having contributed in this way to the family. Critics see HLA typing as using a child as a means rather than an end, but others maintain that the Kantian imperative only prohibits using a person as a means only , and parents would typically see their second child -- even if not a part of their original plan -- as an end in him/herself as well. It is also worth considering that many parents in this situation would otherwise attempt to have a child to serve as a donor by natural birth; PGD in conjunction with IVF simply makes the match more likely. However, it is still crucial to remember that in this situation, the unused embryos are usually discarded, and the saving of one life doesn’t outweigh the destruction of several others. Finally, PGD is often used for sex selection. This can be for medical reasons, such as avoiding an X-linked disease, or simply to satisfy parental preference. Usually, preferential sex selection occurs when parents already have a child (or children) of one gender and wish for their next child to be the opposite gender. Sometimes, however, in cultures where children of one gender are considered of greater value, sex selection can be the product of outright discrimination. For this reason, many countries have outlawed non-medical sex selection; the United States is one of only a few countries that still allows this practice. 62 Clearly, the slippery slope into non-medical applications of PGD is already becoming evident. As scientific understanding of the human genome has steadily increased over the last several decades, the capacity to select for non-medical traits has and will continue to grow. Further, the line between medical and non- medical traits is a blurry one, and, paradoxically, growing blurrier as our knowledge increases. Is selecting 58 Melissa Seymour Fahmy, "On the Supposed Moral Harm of Selecting for Deafness," Bioethics 25 (2011), 128-136. 59 Baruch, "Genetic Testing of Embryos: Practices and Perspectives of US in Vitro Fertilization Clinics," , 1053-1058 60 Susannah Baruch, David Kaufman and Kathy Hudson, "Genetic Testing of Embryos: Practices and Perspectives of US in Vitro Fertilization Clinics," Fertility and Sterility 89 (2008), 1053-1058. 61 Susannah Baruch, David Kaufman and Kathy Hudson, "Genetic Testing of Embryos: Practices and Perspectives of US in Vitro Fertilization Clinics," Fertility and Sterility 89 (2008), 1053-1058. 62 Susannah Baruch, David Kaufman and Kathy Hudson, "Genetic Testing of Embryos: Practices and Perspectives of US in Vitro Fertilization Clinics," Fertility and Sterility 89 (2008), 1053-1058.