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Savior Siblings
Belinda Bennett

The term “savior sibling” is used to refer to a child conceived using in vitro fertilization
with the intention that the child will, upon birth, be a compatible donor for another
child who is ill (Spriggs and Savulescu 2002). Using preimplantation genetic diagno-
sis (PGD), an embryo can be tested genetically to see if it is affected by a genetic
condition (see genetic testing). Using tissue typing techniques, the embryo can
also be tested to see if it would be a compatible donor for an existing child (Verlinsky
et al. 2004). Subject to legal and regulatory requirements in the jurisdiction in which
the procedure takes place, it may be possible for prospective parents to select
between embryos and to choose one that would be a compatible donor for an exist-
ing child who is ill. The debate over savior siblings links in with broader debates
about “designer babies” (see reproductive technology), although it has been
argued that characterizing savior siblings as being on a slippery slope toward
“designer babies” fails to appreciate the important differences between these catego-
ries, including the difference between using PGD to create a savior sibling so as to
save a child’s life, and selecting designer babies on the basis of trivial characteristics
such as hair color (Sheldon and Wilkinson 2004: 534–5).
Although it is possible to use natural conception to attempt to conceive a child
who would be a compatible donor, the use of PGD allows the couple to avoid abortion
(see abortion) when prenatal testing shows that the fetus is not tissue-compatible
(Pennings et al. 2002: 535; Devolder 2005: 582). It could be argued, however, that
PGD leads to the unnecessary destruction of healthy but noncompatible embryos,
although Boyle and Savulescu (2001: 1242) argue that it would be inconsistent to
prohibit destruction of PGD embryos given that society permits the destruction of
unwanted healthy fetuses and that unwanted healthy embryos could be donated to
other couples.
One objection to the creation of savior siblings is that it treats the child created to
be a donor as a means to an end rather than valuing the child for him- or herself.
This is thus seen as offending the Kantian principle of not using people as a means
(see kant, immanuel). Yet critics of this argument reply that this principle is not
offended provided the child is not treated solely as a means to an end, and that the
argument fails to take account of the range of reasons people decide to have a child,
such as to provide care for a parent, as company for an existing child, to provide an
heir, or to help with a family business (Boyle and Savulescu 2001: 1241; Pennings
et al. 2002: 536; Sheldon and Wilkinson 2004: 534; Devolder 2005: 584).
Concerns have also been expressed over the psychological welfare of the child
who knows that he/she was conceived to be a donor (for discussion of these argu-
ments, see Boyle and Savulescu 2001: 1241–2; Pennings et al. 2002: 537; Sheldon and

The International Encyclopedia of Ethics. Edited by Hugh LaFollette, print pages 4710–4712.
© 2013 Blackwell Publishing Ltd. Published 2013 by Blackwell Publishing Ltd.
DOI: 10.1002/ 9781444367072.wbiee753
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Wilkinson 2004: 535–7; Devolder 2005: 584; Herbert 2008: 346–9; Then 2009:
45–6), although arguably having saved the life of a family member through donation
could lead to increased self-esteem (Pennings et al. 2002: 537) and it is argued that
there is no reason to believe that a child who is conceived as a matched tissue donor
will not be loved by his/her parents (Devolder 2005: 584). Furthermore, as Boyle
and Savulescu point out (2001: 1242), “the alternative for the child who was con-
ceived to provide stem cells is not another life in which he or she was conceived in
another way.” Instead, the savior sibling would not have been born at all.
Finally, there is the question of the types of tissue savior siblings should be
expected to donate (Devolder 2005: 584–5) and the best means of protecting
the interests of the child who has been conceived to provide compatible tissue until
the child is old enough to make decisions about donation of tissue (Wolf et al. 2003).
Donation of umbilical cord blood is regarded as ethically acceptable and donation of
bone marrow by children to siblings is also generally accepted (Pennings et al. 2002:
537; Devolder 2005: 584). The general issue of donation of tissue or organs by
children has been the subject of debate and is not limited to issues relating to savior
siblings (Devolder 2005: 584–5; see organ transplantation). Furthermore, dona-
tion of tissue from a living child will be subject to legal and regulatory requirements
of the relevant jurisdiction (Herbert 2008; Then 2009).

See also: abortion; genetic testing; kant, immanuel; organ

transplantation; reproductive technology

REFERENCES
Boyle, Robert J., and Julian Savulescu 2001. “Ethics of Using Preimplantation Genetic
Diagnosis to Select a Stem Cell Donor for an Existing Person,” British Medical Journal,
vol. 323, pp. 1240–3.
Devolder, K. 2005. “Preimplantation HLA Typing: Having Children to Save Our Loved
Ones,” Journal of Medical Ethics, vol. 31, pp. 582–6.
Herbert, Nicole 2008. “Creating a Life to Save a Life: An Issue Inadequately Addressed by the
Current Legal Framework Under Which Minors are Permitted to Donate Tissue and
Organs,” Southern California Interdisciplinary Law Journal, vol 17, pp. 337–79.
Pennings, G., R. Schots, and I. Liebaers 2002. “Ethical Considerations on Preimplantation
Genetic Diagnosis for HLA Typing to Match a Future Child as a Donor of Haematopoietic
Stem Cells to a Sibling,” Human Reproduction, vol. 17, no. 3, pp. 534–8.
Sheldon, S., and S. Wilkinson 2004. “Should Selecting Saviour Siblings be Banned?,” Journal
of Medical Ethics, vol. 30, pp. 533–7.
Spriggs, M., and J. Savulescu 2002. “Saviour Siblings,” Journal of Medical Ethics, vol. 28, p. 289.
Then, Shih-Ning 2009. “The Legality of Tissue Transplants for the Benefit of Family Members
in the UK and Australia: Implications for Saviour Siblings,” Medical Law International,
vol. 10, pp. 23–64.
Verlinsky, Yury, Svetlana Rechitsky, Tatyana Sharapova, Randy Morris, Mohammed
Taranissi, and Anver Kuliev 2004. “Preimplantation HLA Testing,” JAMA, vol. 291,
pp. 2079–85.
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Wolf, Susan M., Jeffrey P. Kahn, and John E. Wagner 2003. “Using Preimplantation Genetic
Diagnosis to Create a Stem Cell Donor: Issues, Guidelines and Limits,” Journal of Law,
Medicine and Ethics, vol. 31, pp. 327–39.

FURTHER READINGS
Glover, Jonathan 2006. Choosing Children: The Ethical Dilemmas of Genetic Intervention.
Oxford: Clarendon Press.
Knoppers, Bartha M., and Rosario M. Isasi 2004. “Regulatory Approaches to Reproductive
Genetic Testing,” Human Reproduction, vol. 19, no. 12, pp. 2696–701.
Scott, Rosamund 2007. Choosing Between Possible Lives: Law and Ethics of Prenatal and
Preimplantation Genetic Diagnosis. Oxford: Hart.
Wilkinson, Stephen 2010. Choosing Tomorrow’s Children: The Ethics of Selective Reproduction.
Oxford: Clarendon Press.