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Bioethical Dilemma: Bone Marrow Donor for Sibling
Introduction
Bioethics is a discipline concerned with the morality and immorality of medical developments and technological advancements intended to enhance the life quality of human beings. Thus, bioethics examines the incorporation of the right to human values, dignity, and good health in the application of biomedical solutions in health. Unfortunately, biomedical science is a field that is widely unexplored, resulting in numerous uncertainties on the potential implications of processes like genetic engineering, cloning, eugenics, and human head transplants. However, the latest scientific developments have placed increased attention on topics like assisted reproduction, vitroferterlization, and the use of nanotechnology, i.e., minute particles to administer drugs to targeted organs in the body. That being said, the following essay examines a case study investigating whether it is ethically acceptable to have a baby whose sole purpose is to become a bone marrow donor for an ailing sibling.
Bioethical Dilemma in the Case
Mr. and Mrs. W have two sons, a two-year-old and a five-year-old. Unfortunately, their older son was diagnosed with Acute Lymphocytic Leukemia (ALL) nine months ago and was lucky to respond to his initial treatment. But, his condition recently relapsed, requiring secondary therapy using drugs with extremely high toxicity levels and fewer chances of success. Nonetheless, the parents have a second option, adopting concepts from research studies still underway, involving a bone marrow transplant and administration of a new drug to prevent rejection. Although the second solution has significantly higher chances of success, the two-year-old brother is not histocompatible with his elder brother.
Consequently, the parents plan to have another baby through vitroferterlization and genetic testing before implanting to ensure that the newborn is histocompatible with its elder brother and a perfect match to become the bone marrow donor. However, on being questioned about the reasons for having the newborn, Mrs. W realizes that they might not have made the right decision. Similarly, this essay supports that it is not ethnically acceptable to have a child for the sole purpose of becoming an organ donor to their siblings. Although the child is yet to be born, this procedure neglects several patient rights and human values that might lead to negative outcomes and diminish the life quality of the newborn. Moreover, it is not aligned with several tenets of human morality, suggesting that it might not be the best solution considering its potential benefits and harms to the parties involved.
Philosophical Paradigms to Support the Argument
Human life bears the utmost importance because it constitutes existence. Therefore, it is not appropriate to use another human being or their body parts for purposes other than the ones naturally intended. This idea is strongly supported by deontological theorists, whose principles lie in the nature of individuals actions. Deontology is a normative ethical theory in moral philosophy suggesting that the morality of people should never be based on the consequences of their actions. Rather, morality should be based on whether the act is right or wrong under specific rules (Beauchamp 348). Immanuel Kant, a renowned deontologist, emphasizes the link between individuals duty to humanity and their morality. According to Kant, in his Kantianism theory, morality is categorically imperative, meaning that morality is an unconditional command not to be tampered with for any reason, including natural inclinations (Beauchamp 349). However, the characters in the case do not pay attention to the value of the unborn childs life, thus expressing their disregard of moral principles.
Similarly, virtue ethics go hand in hand with deontological theories. Virtue ethics support attributes like prudence, fairness, honesty, integrity, fidelity, and compassion instead of rules, consequences, and an individuals duties (Vaughn 42). Therefore, judging the morality of the individuals in the case by virtue ethics concepts, they are wrong for dehumanizing another individual for the sake of pursuing medical goals that are not sustainable. Although the experimental bone marrow transplant option is reliable in preventing a relapse, it is not a proven method, thus characterized by uncertainties. An unsuccessful attempt can raise questions on the quality of the parents decision-making and parenting abilities. Moreover, such a decision is not virtuous because it does not assure fair outcomes for all parties involved.
The ethical principles of beneficence and non-maleficence advocate for practices that bring out physicians acts of kindness in the best interest of their patients. In other words, practitioners should offer high-quality medical care while ensuring no harm (Beauchamp 113). However, the physicians in the case cannot ascertain the unborn childs best interests or assure its high quality of life. According to Parikh et al., harvesting bone marrow from children is safe (p 73). Nonetheless, the procedure itself and the anesthetics used to put individuals to sleep can have adverse effects. For example, a slight error can cause tissue, nerve, and bone damage. Moreover, donors can suffer from diseases like Sickle-cell Anemia and Pulmonary Embolism in rare cases, not to mention the emotional and psychological torment that comes with occasionally going through the procedure. Thus, the procedure is not ethical because it limits practitioners from fulfilling their obligation of beneficence and non-maleficence towards the unborn child.
Counterarguments
Utilitarian approaches to bioethics determine the morality of individuals actions by focusing on the consequences or outcomes. Therefore, utilitarian theorists support that such a procedure is ethical because it will yield positive results for Joshua and his family, thus improving outcomes (Vaughn 68). It is safe to assume that Joshua will benefit tremendously from the bone marrow transplant because it is a reliable chance of survival and leading a normal life. Moreover, research by Parikh et al. reveals that most individuals experience a high sense of life satisfaction when they show devotion to their families and family members (p 85). Hence, the unborn child will find comfort knowing that it contributed to the wellness of its sibling.
Rebuttal to the Counterargument
Although going for the greatest potential benefits for all involved parties is feasible, the concept is impractical because the procedures and actions do not promise consistent results. For example, the unborn child may not like the fact that they were used as a means to support the medical improvement of their siblings without their consent. Moreover, they might suffer from physical, emotional, and mental issues that interfere with their quality of life. Additionally, vitroferterlization may not produce the desired results in the case of incompatibility. Finally, Joshua might still succumb to his condition despite several attempts to offer him help. Therefore, the procedure might not hold up to its goal of providing the most significant benefits for everyone.
Conclusion
Biomedicine is a complex field because it is still at its early developmental stages. Therefore, most procedures and experiments carried out by researchers feature several uncertainties, bringing about various ethical and moral challenges. However, it is critical to respect the lives of individuals and sustain human development in its natural state. Moreover, individuals should not be used as a means to an end but the end itself. Similarly, it is inhuman and against societal constructs to have a child for material benefits. Hence, the morality of bearing a child to act as a bone marrow donor to a sibling is questionable, unfair, uncertain, inhuman, and unethical, and thus, should not be practiced.
Works Cited
Beauchamp, Tom L., and James F. Childress. Principles of biomedical ethics. Oxford University Press, USA, 2001.
Parikh, Suhag H., et al. Ethical considerations of using a single minor donor for three bone marrow harvests for three HLAmatched siblings with primary immunodeficiency. Pediatric Blood & Cancer, 2019.
Vaughn, Lewis. Bioethics: Principles, issues, and cases. Vol. 58. New York: Oxford University Press, 2010.
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