• Choose the character everyone will play.
• Read the scripted play out together or in front of the class.
• Read through the role play section of the play and discuss the answers each character might give to the question.  If necessary, take notes. There are no right or wrong answers!
• Read the whole play through, sections 1 and 2, answering ‘in character’ in the role play section.

Kevin

Research technician, ambitious and eager to get on in the lab.

Dr Liz Brown

Lab leader, very successful in her field.

Larry and June Shannon

Parents of Sally

Dr Liz Brown

Good morning everyone, and thanks to you all for attending today’s meeting. I would like to introduce you to Larry and June Shannon (indicates to them).

Larry and June have been married for six years. They have a 4-year-old daughter, Sally, who has been diagnosed with Diamond Blackfan anaemia. Larry, would you like to take up the story?

Sally was born without any thumbs, and she didn’t seem quite ‘right’ from day one, though we didn’t know what the problem was at first. When she was two months old we found out that she had Diamond Blackfan anaemia and that her bone marrow was failing. It was not producing enough red blood cells. She has problems with her kidneys, and her immune system. … its been… its been awful (looks to June). She needs a lot of care, special drugs, trips to hospital for transfusions and she spends most nights with a needle in her arm, attached to a machine to clean the iron from her blood. Some people are only affected mildly by Diamond Blackfan anaemia and they are not very ill, but Sally has this disorder very severely.

Sally's symptoms have started getting worse… and we’ve been told that she needs a bone marrow transplant or she will eventually die (sighs deeply).

She needs a transplant from someone who is a good genetic match. We got tested, but we don’t either of us match Sally closely enough, and so far no one can find a good match anywhere else.  We’re getting desperate…. (in emotional voice)  we don’t want Sally to die… she deserves all the chances we can give her.

Sally inherited Fanconi from us. We are healthy, but we both are genetic carriers of Fanconi, and if we have another baby naturally, we have been told there is a 25% chance that the baby will also have Fanconi like Sally.

I’m really sorry to hear the problems you and Sally are living through.

Larry and June are thinking of having another child and they have asked us about using our PGD technique. They would like to use the fertility treatment IVF to conceive their next child and use PGD to make sure that the new baby is a good tissue match for Sally.

After the new baby was born, the umbilical cord, instead of being thrown away, could be kept and used to provide the transplant stem cells for Sally; there is a 95% chance that it would cure her.

It is important to realise that we would only use the umbilical cord from the new baby. The law would prevent asking the baby to donate anything else later on if the stem cell transplant fails. Children are not allowed to be donors in this country.

Well, there are some religious and pro-life groups that are opposed to IVF and PGD. Certainly during PGD we do create more embryos than we use, and we do discard some embryos. We only use the healthy embryos and in this case, only those that were also a tissue match for Sally.

Many parents find that concerns they have about discarding such early embryos – they have around 8 cells and are only 3 days old – are often outweighed by their desire to save their sick child. You will have to search your own beliefs and make the choice that is right for you and your family.

Can I just remind you all what might happen if we don't do this PGD? The chances are that Sally will die in the next two years, we mustn't forget that?

Dr Brown, can I ask if you agree with the use of PGD in our case, to produce a 'saviour sibling' for Sally?

Kevin, you seem keen, but are there some people who might object to our request?

There are some serious issues to think about, and of course we would have to get this procedure approved by the right authority. So can I ask for a show of hands as to whether you each think we should proceed or not?

Those in favour of using PGD to select a tissue match for Sally, raise your arms (count votes) and those against, raise your arms

(this question could be put to the whole class/audience and Dr Brown votes too)

So we will/will not (as voted) proceed with PGD for saviour sibling for Sally.

I wonder what other people outside this lab will think of our decision?