Adam Nash's destiny was conceived long before his mother got pregnant.

Adam began life in a test tube, along with 14 other embryos formed from the sperm and eggs of Jack and Lisa Nash. In two days, the embryos grew from one cell to eight. At that point, a single cell was plucked from each embryo and screened for the specific genetic traits that Adam's future parents desperately desired.

Only two embryos passed the test. The stronger one was implanted into Lisa's womb, and Adam was born on Aug. 29 in Englewood, Colo. Two weeks ago, the doctors harvested stem cells from his umbilical cord and transfused them into his dying six-year-old sister, Molly. Adam and Molly are a perfect genetic match.

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As Molly received the gift of life, she held her little brother on her lap. "My brother's going to give me some of his blood to make me feel better."

An apt name, Adam; the first human being created not just for his own sake, but to preserve another's life. Aldous Huxley's fetus hatchery is open for business.

Many doctors have said Adam's birth tests the ethical limits of reprogenetics. Last June, Yury Verlinsky, the doctor who developed the screening technique used to select Adam, was lambasted at an international conference of fertility doctors.

But desperate parents are not about to let the door swing back shut. Ten other U.S. families are planning to use the same procedure in order to have healthy babies who can provide cord blood transplants to their gravely ill siblings. Two other mothers are already pregnant. And after the Nash story hit the headlines last week, Dr. Verlinsky's clinic was blitzed by calls from parents around the world.

"It's ethically one small step away from what we are doing these days," says Peter Leung, co-ordinator of a Toronto fertility clinic that offers genetic screening for $7,000. In Canada, we're supposed to be having a national debate about these matters and then make some rules. But science is on fast-forward. Adam made his debut before people had even thought to ask questions about the ethics of it all.

There's another problem with Adam's case. The idea of Adam may, at first, seem bad. But the reality of him is undeniably good, and the Nashes have done exactly what all loving, ethical, moral parents are supposed to do. "I was going to save Molly," said her mother, "no matter how."

Molly was born with Franconi's anemia, a recessive blood disorder that left her with two holes in her heart and without thumbs, hip sockets and part of her brain. She can't produce bone marrow. Without marrow from a matching donor, Franconi's children usually die by the age of 7.

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Lisa, a 34-year-old neonatal nurse, and Jack, a 35-year-old hotel manager, had longed for another child. But there was a 25 per cent chance that that child also would have Franconi's anemia. With amniocentesis, the usual method of genetic screening, they might have faced a terrible choice. "We could have found out at 18 weeks that we were going to have a sick baby and been faced with either bringing that child into the world or having a termination," said Lisa. "We didn't feel that would be ethical."

There was also only a 25 per cent chance that the new child would be a blood match for Molly.

Enter Dr. Verlinsky, the pioneer of pre-implantation genetic screening. He could offer not just a clean embryo, but a perfect donor.

They began trying in 1997. They failed four times, and the treatments cost them $50,000 U.S. "I knew we were running out of time," said one of their doctors. "Molly wouldn't live to see her seventh birthday."

The fifth time it took, and Adam was born. A few days ago, Lisa and Jack learned that the blood transfusion was successful. Molly's chance of recovery is now 90 per cent. Lisa and Jack's choice will give them two healthy children instead of one dying one. "We didn't have to think twice about it," says Lisa.

But the rest of us will. In Britain, one family wants the right to sex selection so they can have a girl. They already have four sons, and their only daughter died at 3 in a fire. They want to restore the "feminine dimension" to their family, and one psychiatrist swears this is vital for their emotional health. They're taking their case to court under the Human Rights Act. Meantime, couples with inherited disabilities such as deafness say they welcome pre-implantation genetic screening, so they can choose to have deaf children just like themselves.

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"You cannot judge us until you have been in our shoes," says Lisa. "If someone has watched a child dying from a disease and can say they wouldn't do everything they could to save that child, then fine. Unless you can say that, don't judge me."

But who will judge the ones who come next, and how?

Welcome to the future. And get used to it. E-mail: