Medical Frontiers: Debating Mitochondria Replacement

The following is my submission to the HFEA's Consultation questionnaire on behalf of Affinity.  It is presented here as a coherent piece rather than in answer to the seven constrained questions of the Consultation.  It was later cut and pasted to fit into the Consultation's boxes.

Affinity is a partnership of more than 1,200 churches and represents one of the largest groups of evangelical Christians in the UK and Ireland.

We wish to begin our submission by affirming four basic facts, informed by biology and biblical reflection, which underpin our entire submission.  First, human life begins at fertilisation.  Second, all human life is precious and therefore deserves to be protected.  Third, in vitro fertilisation (IVF) procedures always destroy human embryos.  Fourth, because IVF is integral to maternal spindle transfer (MST) and pronuclear transfer (PNT), we are opposed to the use and legalization of these two novel procedures.

None of this is to deny compassion towards those who suffer from mitochondrial diseases.  And we understand the desire of some sufferers to have children, who are not only genetically related, but also free from such diseases.  However, while we are neither anti-progress nor anti-science, we maintain that medical research must be conducted within robust bioethical boundaries.  Inevitably, this means that some prospective scientific procedures will be forbidden.  We maintain that MST and PNT should be in this prohibited category.

Three other broad considerations strengthen our case.

First, there are medical reasons.  While the creation of genetically-modified children is intuitively wrong, a more objectively-based disapproval rests upon its inherent eugenic nature.  The primary function of medicine is to treat and, where possible, provide cures for human disorders.  MST and PNT are neither treatments nor cures for current mitochondrial disease sufferers.  The only purpose of MST and PNT is to prevent future patients ever being born.  We regard this as sub-standard medicine.  Indeed, this sort of negative genetic manipulation is properly described as, modern-day eugenics. 

Furthermore, MST and PNT depend upon ova and embryo donations.  These are intrinsically unsafe practices that can be hazardous and exploitative for the women donors, as well as undeniably destructive for the embryos.  Procedures involving the donation of human gametes and genetic material are entirely different, bioethically and socially, from those involving somatic tissues and organs, such as blood and kidney donations.  The former challenge the very meaning and purpose of human life and personal identity.  Because PNT is akin to cloning via somatic cell nuclear transfer (SCNT), we are concerned that its continued use, though known to cause disastrous outcomes in animal experimentation, may encourage renewed calls to decriminalize human reproductive cloning.

Second, there are sociological reasons.  The creation of embryos with genetic material derived from three parents (one paternal and two maternal) in the case of MST, or even four (two paternal and two maternal) parents in some cases of PNT, is not only abnormal, but it will also engender serious consequences for child identity, parent-child relationships and family structures.  Parenthood is more than a DNA contribution.  The germline 'therapeutic' nature of MST and PNT not only crosses a key scientific Rubicon, but it also presages unknown, unpredictable and potentially dangerous, medical and psychological sequelae for those involved, particularly for the child and for future generations.  In most other countries worldwide, including those within Europe, such procedures remain illegal, based on sound bioethical principles.

Third, there are general reasons.  The designation ‘mitochondria replacement’ has, like other bioethical terminology, been subjected to lexical engineering.  It is not the mitochondria that are replaced, but rather the spindle or pronuclei, namely, the nuclear genes, that are actually donated and transferred.  Every bioethical issue is associated with the ‘slippery slope’ argument.  If legally sanctioned for mitochondrial diseases, these, and other similarly controversial, novel methods will be more readily approved for additional medical conditions.  Moreover, if modifications to mitochondrial DNA were to be permitted, what will prevent the subsequent modification of nuclear DNA?  The required safeguards must be established in law by Parliament, rather than by the HFEA, which, in the past, has, at times, proved to be an inadequate regulator.

In conclusion, we consider that mitochondria replacement techniques, namely, MST and PNT, should not be approved for human clinical treatment purposes, and that future research in this area should be halted.  The medical, bioethical and personal costs of creating genetically-modified babies, essentially the restructuring of human life, are too great.  In other words, the law should not be changed.

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