Amy and John

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Amy and John are a young couple with a five year old daughter Abby. Amy also has a nineteen year old son, Brian, from a previous relationship. They had planned on having a large family. Abby was diagnosed with leukemia when she was two years old. She has had three surgeries and is currently on the transplant list for a bone marrow transplant as well as a new kidney. A bone marrow transplant would most likely put her in remission enough to receive a new kidney. Abby is on dialysis six days a week and spends most of her time in the hospital. Abby has never been to preschool and hardly plays with children her own age, except for in the hospital daycare, when she is well enough to go there.

            Neither Amy nor John are blood matches for Abby. Brian left home when he turned eighteen, has not been tested as a possible donor, and has not made contact with the family for four months. No other close relatives are match for Abby.

            Prior to Abby getting sick, Amy and John discussed having another child. Now however, Amy and John approach Dr. Johnson, a fertility specialist, to help them have another child. They want to select various aspects of the fetus. Specifically, they want to select for a child that would have the same blood type as Abby in order to use the cord blood from the birth as a marrow transplant for Abby. They also hope that the new baby will be able to donate its kidney to Abby at a later date. During her initial meeting with the couple, Dr. Johnson notices that John does not talk much and when asked direct questions he tends to direct them towards Amy or answers with one word answers.

This concerns Dr. Johnson and she decides to sit down with Amy and John separately. When she talks with Amy, she can tell that this is their last option to save Abby’s life and Amy is clinging to the only hope she has left. Amy is well within child bearing years and having another child would pose no immediate health risks to her or the potential baby. Amy wants to begin this process as soon as possible and wonders exactly when they can begin. However, during her discussion with John, Dr. Johnson has to ask him a lot of questions before he finally blurts out that he is not alright with designing a child to be used to save Abby. He was raised a staunch Catholic and he believes that every life is sacred. He is concerned about the eggs that will be lost in the process and the potential lives they could have been as well as the idea that their new child will be used as a commodity. He states that he knows he and Amy will love the child regardless of the outcome but he is concerned about Amy’s motivations behind having this child. He is too nervous, however, to talk with Amy about his concerns and problems with the creation of their next child because he fears she will leave him if she thinks he is not on board. He is also afraid of the guilt he will feel if he does not do everything possible to save his little girl. However, he swears that he cannot tell his wife about his feelings and asks Dr. Robinson to keep them confidential. Dr. Robinson calls the couple into her office the next day to discuss the options available to the family. As Dr. Robinson, do you offer to help them create a baby with the desired blood type?

-Written by Kate Sulkowski