Law lords give the go ahead for creation of “saviour siblings”

Lords gives the go ahead for “saviour siblings”

BMJ

Clare Dyer

legal correspondent

The United Kingdom’s highest court last week gave the go ahead for the creation of “saviour siblings” to give umbilical cord, blood, or bone marrow to try to save the life of a brother or sister. Five judges in the House of Lords unanimously ruled that the law that set up the Human Embryology and Fertilisation Authority gives the authority the power to licence, alone or separately, both preimplantation genetic diagnosis and tissue typing on embryos used in treatment for in vitro fertilisation.

The ruling, upholding an appeal court judgment in April 2003, removes all doubt for Raj and Shahana Hashmi, who have been trying to produce a sibling with the same tissue type as their son Zain, aged six, who was born with bthalassaemia major. The couple, from Leeds, have so far had six unsuccessful attempts at in vitro fertilisation, but each time they either failed to produce an embryo of the right tissue type or the pregnancy ended in a miscarriage.

The case was taken to the House of Lords by Josephine Quintavalle and her campaigning group, Comment on Reproductive Ethics (CORE), who argued that the Human Embryology and Fertilisation Authority had no power to licence the creation of a baby to save the life of another.

The arguments hinged on the wording of the Human Fertilisation and Embryology Act 1990. Lawyers for Mrs Quintavalle, who had won her case in the high court (BMJ 2003;326:11) before the judge’s ruling was overturned by the appeal court (BMJ 2003;326:782), argued in the House of Lords that the act’s wording allowed the authority to licence preimplantation genetic diagnosis but not tissue typing.

But the law lords decided that the authority’s discretion was wide enough even to allow the selection of an embryo’s characteristics on social grounds, although it was unlikely that such a licence would be granted. Lord Hoffmann said that the technique of taking a single cell from an embryo and testing it for genetic disorders and tissue compatibility was “a way to save the Hashmi family from having to play dice with conception.” He noted that parliament had said nothing about, for example, sex selection and that the Warnock committee report, which preceded the act, had made no positive recommendation but said that it should be kept under review.

“In my opinion the only reasonable inference is that parliament intended to leave the matter to the authority to decide. And once one says that the concept of suitability can include gender selection on social grounds, it is impossible to say that selection on the grounds of any other characteristics which the mother might desire was positively excluded from the discretion of the authority, however unlikely it might be that the authority would actually allow selection on that ground.”

Lord Brown said, “In the unlikely event that the authority were to propose licensing genetic selection for purely social reasons, parliament would surely act at once to remove that possibility.”