Adam Nash, the test tube baby whose living cells were used to save his older sister, is a child whose parents love him dearly. Critics who say there is an ethical problem with his birth don't consider that his parents desperately wanted a second child and that his birth was not just about his use to others. They also confuse testing for a gene with implanting another gene. Choosing the actual genetic traits of the embryo brings societies of genetically engineered "super people" to mind. With the Nash family, however, images of genetically engineered "super people" do not apply: a cell from Adam's embryo was tested for the gene related to Fanconi anemia and to see if it would be a match for his sister Molly. The Nash family wanted another child. The fact that Adam's genes helped the Nash daughter, Molly, was a natural bonus.
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On the surface, the Nash case involves a matching donor giving cells to help a sibling. This is a common process that has benefited patients in need of bone marrow for decades. The ethical question that arises is whether the parents chose Adam's embryo because his genes were genetically compatible with his terminally ill sister's.
People are concerned that Adam Nash was treated as an object - not a human - whose birth was an action solely to save others. However, his birth was not simply a factor of potential usefulness.
Genetic testing was done to determine which of Lisa Nash's harvested embryos would become a healthy child. Adam's embryo proved to be healthy and by luck his genes were compatible with his sister's. Adam was born because tests showed that his life would not be afflicted by a terminal disease. Without this determination by tests, the Nashes would not have had another child.
When debating the morality of Adam's birth, we should ask whether he will be loved and honored by his family as an individual, instead of whether Adam was loved for his specific traits. There is no doubt that the Nash parents wanted their second child. The genetic testing was done to assure that he would live a healthy life.
Ethicists are concerned that Adam would be less of a person because only his cells were needed. However, having the child save the life of his sibling "can be a very unifying thing for the family," said John D. Arras, Director of the Undergraduate Program in Bioethics. "Children often offer bone marrow and that doesn't mean the family views the child as non-loved," Arras said.
The parents should not be chastised for using Preimplantation Genetic Diagnosis (PGD) to conceive their second child, said James F. Childress, Director of the Institute for Practical Ethics at the University's Center for Biomedical Ethics.
PGD involves scientists removing one cell from an embryo to test for specific traits. "In this particular case it's hard to fault the parents because of the lethal condition and the fact that they did want another child," Childress said.
Ethicists worry about risks posed to Adam as a cell donor, but the cell removal process is not painful, and it does not actually use cells from the body of the newborn. "The process takes cells from the umbilical cord, so there is no risk to the donor," Childress said.
The ethical question revolves around whether Adam's existence is contingent on his sister's health, said Paul Lombardo, director of the Program in Law and Medicine. "Bioethicists are split on this issue over whether or not it violates the principle that humans not be treated as objects or used for other people's benefits, but we already allow people to choose embryos" through reproductive therapy, Lombardo said.
"Since this reproductive therapy is basically unregulated, they have no business telling parents they can't have a baby to save their child," he said.
Criticisms of Adam Nash's conception are based on "misplaced, abstract moralities," Arras said.
The procedure just affirmed what was already in his genes. Moral issues about gene manipulation are unfounded because nothing was added to Adam to enhance him or make him into a "super person"
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