Biology 103
2000 First Web Report

Bone Marrow Deficiency, Genetics and Abortion
Joseph Santini

My paper is about Pre-implantation Genetic Diagnosis [PGD]. This is a recently developed procedure allowing parents and doctors to select an embryo with specific traits. It is used primarily to select embryos which do not have specific genetic abnormalities present in the parents. My paper concerns a new case in which this was not the only factor in determination of selection of embryos: the case of Adam Nash. Lisa and Jack Nash had an older daughter, named Molly, who had recently developed Fanconi's Anemia, [1] a rare genetic disease. They attempted to create a baby using PGD which not only did not have Fanconi's but was also a perfect bone marrow match for Molly. After fifteen tries, Adam Nash was born. [2]

PGD is a complicated procedure involving in-vitro fertilization. First, the mother is induced to super-ovulate; she is given hormones to make her overproduce eggs. These eggs are collected by a doctor who begins the in-vitro fertilization process, fertilizing the eggs with sperm of the woman's choice. After three days, the resulting embryos have divided into the eight-cell level. At this point, the doctor removes one of the embryos and drills into it gently, removing one single cell and analyzing it to see if the genetic abnormality is present. If it is, the embryo is destroyed; if it is not, then it and preferably two other embryos like it are implanted in the mother. If no embryos show freedom from the disease, then the cycle is begun again and all the embryos are destroyed. [3]

PGD itself is very controversial, inciting angry cries from politicians, doctors and anti-abortion groups. This particular case, however, has raised an even greater storm of controversy; Adam Nash was chosen, not only for his disease-free status, but for his bone marrow status and genetic composition. This, to pro-life groups, smacks of eugenics; the same issue concerns many doctors. The GenEthics consortium has case literature eerily like the story of Adam Nash, to be used in aiding doctors think about ethics. [4] In Germany, where there are Embryo Protection Laws, the procedure is currently not permitted, but in a legal battle [5].

What interests me about this case is that it is concerned in many places with the determination of what life is. Is life a single cell or a grouping of 8 cells? Is life at that level considered human? Pro-life groups would say so, but I am not personally so sure. That it has the potential to become human I have no doubt, but a twig has the potential to become a table, yet destroying the twig would not necessarily prevent the table's existence. Also, this case is very different from an abortion. The parents want the baby in question. Granted, Adam Nash's genes were chosen, but by his birth two children came into being - both he and his sister. The parents themselves have no such uncertainty. They do not want their children to have diseases. The problem is this statement's closeness to "I do not want diseased children," which is ethically shaky.


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