Michelle Taylor-Sands

SAVIOUR SIBLINGS AND COLLECTIVE FAMILY INTERESTS

AbstractIn this article, I will explore the ethical concerns arising out of the use of preimplantation tissue typing (PTT) to create saviour siblings. There are two main ethical concerns about the welfare of the child to be born as a result of PTT. The first is whether the child to be born is treated as a commodity, as simply a means to save the life of his or her sibling. The second is whether the child to be born will be harmed as a result of PTT, either physically, psychologically or socially. These two ethical concerns reflect an individualistic approach to the welfare of the child, whose interests are treated as largely separate to the interests of other family members. I will argue that the welfare of the child born as a result of PTT should be conceived more broadly to include not only the child’s individual interests, but also the collective interests the child shares with his or her family. I base this broader conception of welfare on the notion of human flourishing, which recognises that the welfare of a child is inextricably connected to the welfare of the intimate collective that is his or her family. The collective interests of intimate family members are particularly relevant in the context of PTT, as the members are engaged in a shared journey to save the life of an ill child.

Saviour siblings : a relational approach to the welfare of the child in selective reproduction

1. Introduction 2. Selective Reproduction: Ethics and the law 3. The Welfare of the Child to be Born 4. A Relational Approach to the Welfare of the Child 5. A Relational Model for Selective Reproduction 6. A Relational Framework for Regulating Saviour Sibling Selection 7. Conclusion

Summary of Saviour Siblings

Selective reproduction is an area where the law often lags behind the science. There is increasing pressure on governments to reconsider the ethical issues raised by selective reproductive technologies and regulate accordingly. Genetic screening technologies involving preimplantation genetic diagnosis raise important ethical questions about the welfare of the child to be born. Should parents be allowed to select a child with particular traits or characteristics? How does selection impact on the identity of the child who is born? Are children who are selected for a particular purpose harmed or treated as commodities? How far should the state interfere with reproductive choice? To date, concerns about the welfare of the child in selective reproduction have focused on the individual interests of the child to be born. Saviour Siblings 1 re-evaluates the welfare of the child through the controversial topic of saviour sibling selection using applied ethics. Drawing on relational feminist and communitarian ethics, I argue that the welfare of the child to be born is inextricably linked with the welfare of his/her family. I propose a new relational model for selective reproduction based on a broad conception of the welfare of …

Saviour Siblings: reply to critics

A key objective of Saviour Siblings was to begin a conversation about how we should approach the welfare of the child in the context of selective reproduction. I am very grateful to the journal and my critics for the opportunity to continue this conversation. By viewing the welfare of the child to be born through a relational lens, I challenge the prevailing orthodoxy surrounding questions of harm, benefit and moral obligation. I will address the questions raised by Stephen Wilkinson and Colin Gavaghan on these issues shortly. I would first like to deal with the primary question raised by Emily Jackson about whether my relational model differs in practice from the ‘significant harm’ approach in the UK. The overarching purpose of my book is to propose a normative framework for regulating decision-making in the ethically complex and emotionally fraught area of selective reproduction. While I agree with Jackson that protecting the childs ‘basic interests’ within my relational model provides a similar threshold level of protection to the UK ‘significant harm’ test,i this is not the focus of my book. My relational model is designed to accommodate the ‘conflict, confluence and confusion of interests’ within families seeking selective reproductionii more effectively than one centred on the interests of the child to be born (even one that recognises the childs interests are influenced by family outcomes). The aim of my devolved and collaborative decision-making model is to actively support patients to make the best decisions for their own families and according to their own values in an ethically complex area. I introduce the notion of collective family interests less as a test to determine whether selecting a saviour sibling is acceptable than to provide a clear ethical foundation on which to base the decision-making process. For decisions such as saviour …

Corporate Governments as model litigants

Government litigants often enjoy power advantages over their opponents, including knowledge, money and experience. These advantages have led some jurisdictions to adopt model litigant rules for governments. One example is the Commonwealth of Australia. The Commonwealth Model Litigant Rules govern conduct in litigation and are in addition to the usual civil procedure, ethical and professional conduct rules that apply to all litigants. Governments and their agencies are held to a higher standard than other litigants because of their nature as public bodies and the resource and power advantages they enjoy over individual citizens. In this paper, we will suggest that there are similarities between corporations and governments, in particular the power they wield as repeat players, their increasingly public roles and the impacts they have on citizens and communities, that justify applying a model litigant code to them. We begin in Part I by explaining the rationale for the application to governments of model litigant rules. In Part II we identify the similarities between corporations and governments that justify applying model litigant obligations to corporations. We also explore the potential unfairness that can arise when the litigation conduct of government litigants, especially regulators, is constrained by model litigant rules but the corporations against whom they litigate are not similarly constrained. We then consider, in Part III, whether existing professional codes of ethics and civil procedure rules are sufficient, by themselves, to affect the litigation conduct of corporations. We argue that corporate litigation behaviour is more likely to be affected by specific rules for corporations, rather than generic rules applicable to all litigants or to a corporation’s legal advisers. In Part IV we consider the application of modern principles of corporate social responsibility to the litigation conduct of corporations. We conclude that whilst these principles can guide the development of a model litigant code for corporations, they are by themselves too general (and, perhaps, too contested) to be that code. Finally, in Part V we propose an outline of a model litigant code for corporations and we make some suggestions for implementation. Legal Ethics, Volume 10, No. 2

Comparing Non-Medical Sex Selection and Saviour Sibling Selection in the Case of JS and LS v Patient Review Panel: Beyond the Welfare of the Child?

The national ethical guidelines relevant to assisted reproductive technology (ART) have recently been reviewed by the National Health and Medical Research Council (NHMRC). The review process paid particular attention to the issue of non-medical sex selection, although ultimately, the updated ethical guidelines maintain the pre-consultation position of a prohibition on non-medical sex selection. Whilst this recent review process provided a public forum for debate and discussion of this ethically contentious issue, the Victorian case of JS and LS v Patient Review Panel (Health and Privacy) [2011] VCAT 856 provides a rare instance where the prohibition on non-medical sex selection has been explored by a court or tribunal in Australia. This paper analyses the reasoning in that decision, focusing specifically on how the Victorian Civil and Administrative Tribunal applied the statutory framework relevant to ART and its comparison to other uses of embryo selection technologies. The Tribunal relied heavily upon the welfare-of-the-child principle under the Assisted Reproductive Treatment Act 2008 (Vic). The Tribunal also compared non-medical sex selection with saviour sibling selection (that is, where a child is purposely conceived as a matched tissue donor for an existing child of the family). Our analysis leads us to conclude that the Tribunal’s reasoning fails to adequately justify the denial of the applicants’ request to utilize ART services to select the sex of their prospective child.

Response to ‘A relational approach to Saviour Siblings?’ by Selgelid

In his concise argument, ‘A relational approach to saviour siblings?’, Selgelid reiterates some of the arguments raised in the author meets critics discussion of my book, Saviour Siblings. In this response, I highlight an important misunderstanding in one of the arguments put forward by Selgelid, which forms the basis of a large portion of his analysis. Contrary to what Selgelid contends, I do not use the deafness case in my discussion of the non-identity problem to contend that the case of selecting for deafness is ethically different from the case of saviour siblings. As I state in my reply, I use the case of deafness not as a comparator for saviour siblings but rather to illustrate the different categories of risk that apply in selection cases. Given this confusion, I restate my objection to relying on the non-identity problem in evaluating risk of harm associated with the embryo biopsy process for preimplantation genetic diagnosis. Finally, I reiterate that the individual interests of saviour siblings remain important in the decision-making matrix and emphasise that Saviour Siblings offers a more contextualised approach to the welfare of the child in selective reproduction, which includes both individual and collective interests.