Preimplantation HLA typing: having children to save our loved ones

K Devolder

doi:10.1136/jme.2004.010348

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Law, ethics, and medicine

Preimplantation HLA typing: having children to save our loved ones

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Interests and rights
Nereo Zamperetti
Published on: 18 May 2017

Published on: 18 May 2017
Interests and rights
- Nereo Zamperetti, M.D.
- Other Contributors:
  Rinaldo Bellomo
Dear Editor,
The paper of K. Devolder[1] is very interesting and stimulating.
Unfortunately, the author takes for granted some value premises, which are not so widely accepted.
The first one is that embryos are just lumps of cells, biological matter without any dignity apart from being of some utility to us. If this is true, the consequences are obvious. Their coming to life will be justified only...
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Dear Editor,
The paper of K. Devolder[1] is very interesting and stimulating.
Unfortunately, the author takes for granted some value premises, which are not so widely accepted.
The first one is that embryos are just lumps of cells, biological matter without any dignity apart from being of some utility to us. If this is true, the consequences are obvious. Their coming to life will be justified only by the benefits we can derive from them. If no benefit can come to us (no possible HLA-matching), they can be destroyed. Or perhaps used for other any other (possibly lucrative) purpose.
The second one is that everything, which is technically possible, may be done, if economically profitable and if no major risks (valued according to the first assumption) derive for the involved subjects. The fact that embryos are not accorded any moral status and that newborn children (derived or not from pre-implantation HLA typing) are incompetent and can not oppose any refusal (while adults are free to refuse to become bone-marrow or simply blood donors) opens the doors to alternative ghastly scenarios. So, banking of HLA typed embryos, which foreshadows a sort of embryos supermarket where anyone can buy, "adopt the embryo and carry it to term, ... or use the embryo in vitro as a source of stem cells", is presented as "a valuable option". And the insurance policy scenario ("using preimplantation HLA typing to ensure that all of one's children will be HLA identical, in case one of them needs a transplant") is laid aside (for the time being) only because of its financial costs.
The whole paper leaves the bitter taste of a view of science in which those who can are allowed to do almost everything, and in which the rights of the weakest are much less important than the interests of the strongest.
We believe that the new tools that medicine continues to offer must be used with extreme prudence and attention, and only for the wellbeing and in the interests of all the subjects involved. In case of incompetent subjects (as in the case of the newborn, and - for many of us - even embryos), prudence should be much greater. Centuries ago, Immanuel Kant taught us to treat no one merely as a means to an end, but only and always as an end in his/herself. We believe that this is still the only way in which medicine and science can really serve humanity and not the other way round.
References:
1. Devolder K. Preimplantation HLA typing: having children to save our loved ones. J Med Ethics 2005;31:582-586.
Author Address:
Nereo Zamperetti, MD
Department of Anesthesia and Intensive Care Medicine
San Bortolo Hospital, Via Rodolfi, 37
36100 Vicenza
Italy
e-mail: zamperetti.n@medicivi.org
Rinaldo Bellomo, MD
Department of Intensive Care,
Austin & Repatriation Medical Center,
Heidelberg, Victoria
Australia
e-mail: Rinaldo.bellomo@austin.org.au
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Conflict of Interest:
None declared.
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