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Saviour sibling case causes controversy in Switzerland
Swiss parents of an ill child have practiced a form of ‘reproductive tourism’ by traveling to Belgium to have PGD and tissue typing, which is illegal in Switzerland [Duke, K. Lancet 368;355-356]. Their new daughter, Elodie, was born from an embryo chosen to be a tissue match for her elder brother, Noah, who suffers from granulomatous disease. The siblings have undergone a bone marrow transplant procedure and Noah’s health is improving.
The story is controversial in two ways. First, Noah’s parents had to go to Belgium for the in vitro fertilization treatment, allowing them to bypass Switzerland’s ban. Swiss authorities are now debating whether PGD should be made legal in their country. Belgian law does not specifically prohibit PGD; it is neither sanctioned nor illegal. Many European countries have vague laws regarding PGD and this allows people from countries where it is illegal to find treatment elsewhere. Elodie was born in Switzerland and the treatment to help her brother was conducted in Geneva.
The second issue concerns the fact that Noah and Elodie both had to undergo a bone marrow transplant operation. In most cases where a sibling is created to help another, stem cells from the new child’s umbilical cord are transplanted into the elder child. The new child does not need to undergo an invasive and painful experience in order to help their sibling; this helps to justify their creation for people who may find it ethically problematic. However, Elodie was too small at birth and there were not enough stem cells in her cord blood for the transplant procedure. Therefore surgery was carried out. While both children have recovered from the procedure, opponents of PGD and tissue typing argue that a child should not be created simply as a means to an ends, to undergo invasive surgery for which they will derive no benefit. The UK Human Fertilisation and Embryology Authority has as one of their guidelines for approving requests for PGD that only cord blood should be taken. Supporters of PGD and tissue typing counter that while it is the norm for only the cord blood to be used, bone marrow transplants between siblings are a common practice.