A response to saviour siblings: a relational approach to the welfare of the child in selective reproduction

Much of the debate over the acceptability, or not, of choosing embryos in order to ensure that the resulting child would be a good tissue match for a sick older sibling, has focussed upon the question of whether the so-called ‘saviour sibling’ would be harmed. In one corner are those who maintain that the child might suffer psychologically from the knowledge that they were conceived in order to save another's life. There are also concerns that the child might feel guilty if the transplant is unsuccessful, or that they might come under pressure to undergo repeated transfusions or even organ donation in the future. Of course, a child conceived in the normal way might also feel obliged to act as a tissue donor for a sick brother or sister. In order to ensure that their consent is genuine, doctors will commonly offer siblings the option of a ‘contrived medical excuse’: that is, if they do not wish to donate, their family might be told that they are not a suitable donor. It will be harder to employ such tactics when a child was conceived in order to be a good tissue match