Case Study

Let us read the following case and think about the questions concerning this issue.

Make a life to save a life

Peggy Brickman, University of Georgia

Jack and Lisa Nash’s only daughter Molly was born with a rare, incurable genetic condition called Fanconi anemia, which rendered her body unable to produce enough blood cells. Neither Jack not Lisa had the disease since the mutation of FANCC gene is recessive and both of them only carried one recessive FANCC gene. 
To safe Molly’s life, bone marrow transfer may be carried out. In order to find a correct match for tissue transplantation, a specific group of protein on the surface of white blood cells called HLA (human leukocyte antigen) should be matched.  The best chance of Molly to find a bone marrow match was with a sibling.
After discussion, Jack and Liza decided to screen for an embryo that was free of Fanconi anemia and HLA proteins matched with Molly.  This is the first example of the use of pre-implantation genetic screening to select for a baby solely for treating its sibling.
After four in vitro fertilization attempts, Lisa Nash gave birth to a baby boy, Adam, on August 29, 2000.  Adam’s placenta was gathered immediately and all the cord blood saved.  Molly started chemotherapy to destroy her bone marrow and received a transfusion of the cord blood cells a month later.  Today Molly, Adam, and new little sister Delaine are all doing well.  The transplant cured Molly’s bone marrow failure, but she still suffers from Fanconi anemia and visits the doctors 35-40 times a year to screen for solid-tumor cancers.  A common cold could have dreadful consequences for her, but her bone marrow is functioning normally.

Copyright held by the National Center for Case Study Teaching in Science, University at Buffalo, State University of New York, all rights reserved. Used with permission.
  1. Suggest TWO reasons which allow the Nashes to use this technique.
  2. Suggest TWO reasons which against the Nashes to use this technique.
  3. As a general consideration, can you list the criteria for deciding which genetic traits should be screened and which should not?  Explain your answer.
  4. What regulations should be set for parents who want to hire this technique?
  5. How should we handle the embryos being screened with diseases? How should we handle the embryos screened healthy but not implanted into the mother’s uterus?
  6. Not everyone can pay for the cost of having embryo screening, what problem it will bring to the society?  Can you think of any solutions?
  7. After genetic screening, the selected embryo will have a genetic profile.  Who have the right to see this profile, its parents? Doctors? Insurance companies?  Explain your answer.
Suggested answers