de Wert Guido, Liebaers Inge, Van de Velde Hilde
Faculty of Health, Medicine and Life Sciences, Research Institute Growth & Development, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands.
Stem Cells. 2007 Sep;25(9):2167-72. doi: 10.1634/stemcells.2006-0625. Epub 2007 May 24.
There has been increasing support for combining preimplantation genetic diagnosis (PGD) for specific diseases with a test for human leukocyte antigens (HLA) because the generation of HLA-matched umbilical cord blood cells may save the life of a diseased sibling. To date, this procedure has taken place in the context of conceiving another child--PGD/HLA testing type 1. However, it may well become possible to perform PGD/HLA testing outside this context, that is, to select matched embryos from which embryonic stem cells could be derived and used in cell therapy--PGD/HLA testing type 2. A proactive ethical analysis is needed and is presented in this article. Although PGD/HLA testing type 1 can be morally justified, the risks, pitfalls, and practical limitations of this procedure make it necessary to develop alternative strategies. PGD/HLA testing type 2 may provide an alternative strategy. From an ethical point of view, the controversial issue is that this procedure creates embryos purely for instrumental use. However, given the dominant view that the preimplantation embryo has only limited moral value, this alternative may be as morally justified as PGD/HLA testing type 1.
将针对特定疾病的植入前基因诊断（PGD）与人类白细胞抗原（HLA）检测相结合的做法得到了越来越多的支持，因为生成HLA匹配的脐带血细胞可能挽救患病同胞的生命。迄今为止，这一程序是在孕育另一个孩子的背景下进行的——即1型PGD/HLA检测。然而，完全有可能在这种背景之外进行PGD/HLA检测，也就是说，从可从中获取胚胎干细胞并用于细胞治疗的匹配胚胎中进行选择——即2型PGD/HLA检测。本文对此进行了积极的伦理分析。虽然1型PGD/HLA检测在道德上是合理的，但该程序的风险、缺陷和实际局限性使得有必要制定替代策略。2型PGD/HLA检测可能提供一种替代策略。从伦理角度来看，有争议的问题是，这一程序纯粹是为了工具性用途而创造胚胎。然而，鉴于植入前胚胎仅具有有限道德价值这一主流观点，这种替代方案在道德上可能与1型PGD/HLA检测一样合理。
