The designer baby: right or wrong?

Science: Colorado case catches attention of bioethicists. No need to worry, doctors say.

January 14, 2001|By Bill Radford | Bill Radford,COLORADO SPRINGS GAZETTE

If you could make sure your child would be born with above-average intelligence, if you could ensure your child would have blue eyes just like you, would you?

The technology is coming to do just that. But with the technology comes the questions of how and when -- or when not -- to use it.

News last fall that genetic testing had been used to help an Englewood, Colo., couple conceive a child to help their desperately sick daughter has ignited discussion about whether we're headed for an age when doctors will develop so-called designer babies tailored to parents' wishes.

"I believe that this is inevitable," says Arthur Caplan, director of the University of Pennsylvania Center for Bioethics. "We are going to face this."

As Caplan and other bioethicists worry about the future, though, doctors on the front lines of reproductive medicine say their

track record should ease concerns about possible abuses of the constantly evolving technology.

"The people who say we are going down a slippery slope aren't the people doing the technology," says Dr. Paul Magarelli,

director of the Reproductive Medicine and Fertility Center of Southern Colorado in Colorado Springs.

Adam helps Molly

Genetic testing of embryos created by in-vitro fertilization is about 10 years old. It is used in certain cases to screen an embryo for severe genetic diseases before it's implanted in the mother's womb.

That technology took a new twist with the birth of Adam Nash, whose parents, Lisa and Jack Nash of Englewood, turned to in-vitro fertilization and genetic screening to conceive a child whose cells would be used to treat their daughter.

After four attempts elsewhere at in-vitro fertilization, Lisa Nash conceived Adam through the Colorado Center for Reproductive Medicine in Denver. The fifth attempt resulted in 15 embryos; geneticists from Chicago went to the center and extracted cells from those embryos for genetic testing. Those cells were screened to determine not just whether they were free of the disease plaguing the Nashes' daughter, Molly, but also whether they were a tissue match with Molly's.

One embryo fit the bill and was implanted into Lisa Nash. After Adam's birth in August, doctors at the University of Minnesota infused blood from the umbilical cord of then 5-week-old Adam to help Molly in her fight against Fanconi's anemia, a deadly blood disease. In October, doctors declared the procedure a success, reporting that the infused cells had begun to take over the functions of Molly's bone marrow.

Although some accounts have made it sound as if the Nashes set out solely to create a baby to help their daughter, Dr. William Schoolcraft, medical director of the Colorado Center for Reproductive Medicine, says that isn't so. The Nashes wanted another child, he says, but they were afraid he or she might suffer from the same disease afflicting Molly.

"I think they saw the part of helping Molly as just a bonus," he says. "If they could have a healthy child that could also help their other child, that would be icing on the cake."

Ethical questions

Caplan sees no ethical problem with the Nash case. The stem cells donated from Adam to his sister came from blood from Adam's umbilical cord, so the baby wasn't harmed or in pain.

But he sees the case as a possible move across not just one, but two slippery slopes.

The first, he says, is the possibility that parents and doctors could make a baby for a purpose that could mean risks for the baby - "a kidney donor, a portion of a lung, something where you would have to go in surgically and remove cells or tissues or a piece of an organ."

If the stem-cell transplant ultimately fails in the Nash case, he says, the next option would be a bone-marrow transplant, an invasive and possibly painful procedure.

"I think these kinds of issues raise important questions about why we should want children, and whether it's appropriate to have a child for purposes other than that child's own benefit," says C. Ben Mitchell, a senior fellow with the Center for Bioethics and Human Dignity and an associate professor of bioethics and contemporary culture at Trinity International University in Illinois.

Magarelli, though, dismisses fears of creating a baby to harvest a kidney or some other organ. "By the time the kidney was big enough, the other person would be dead," he says. "So it's a science-fiction fear."

The other slope Caplan sees society headed for is the one toward designer babies.

"Put aside the motive here," he says of the Nash case. "You could have a parent then say: 'That's great, I see you can do genetic testing in embryos. How about you brew me up somebody who's tall or smart.' The motive here in the Nash case, I think, is a good one. But tomorrow's motive could be less than good."

Schoolcraft, however, says the medical community is on guard to protect against misuse of the technology. Although pre-implantation screening has been going on for about a decade, he believes it continues to be done cautiously.

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