Mitochondrial disease is a genetic deformity, known to be the root of a number of serious health issues including Alzheimer’s and diabetes affecting around 150 children a year in the UK. In 2013, the UK government announced plans to support three-patient IVF treatment, a technique that involves replacing unhealthy mitochondria in the egg with healthy DNA from a third party, in order to eliminate the risk of the disease in the child. This technique has been likened to cloning by some and many believe that it is a step towards eugenics; however it may be an effective way of improving the lives of many children and their parents.
The Intuitive Argument
There is no doubt that by eliminating the faulty genes that cause mitochondrial disease, the future lives of many children and their parents would be improved. This would not only be evident in those who were directly involved with the treatment, but also in their future generations for whom these genes would be eradicated. By effectively eliminating this otherwise untreatable condition, many people would be spared from on-going, arduous treatment, which is supportive as opposed to preventative.
It could be argued that this is not treatment of the disease but is in fact, the creation of a new person, free of the faulty genes. The decision would lie solely with the parents as to whether this treatment should be used on their embryo, a choice that is impossible for future generations to be involved in, but one that will ultimately affect them directly for the rest of their life. Although less than 0.06% of the DNA in the final fertilised egg is from the donor, this DNA is passed from generation to generation, including any genetic traits acquired from the treatment. Regardless of the nature of the trait, there are knock-on effects that must be considered and that will effect generations to come. Without clinical trials, the exact level of these effects is unknown.
The legalisation of the use of three-patient IVF is very much a radical step, giving parents and doctors the opportunity to ‘play God’. If the technique is used only to treat medical conditions, its use would certainly be very beneficial to both parents and children (as mentioned above) however, without a sufficient amount of legislation and monitoring there is the possibility that parents are allowed to start controlling more aspects in their child such as desired characteristics. This raises questions as to who should be given the responsibility and power to make this radical step, and where can the line be drawn?
With sufficient legislation and constant monitoring, the use of three-patient IVF could be effectively used to improve the lives of many. Providing that the guidelines were outlined clearly, parents and doctors have the opportunity to eliminate this debilitating disease, and would be prevented from using this technology to create children with desired characteristics. The use of genetic engineering to prevent further generations from suffering from mitochondrial diseases is a step in the right direction, but one that has significant implications and must be observed carefully.
The Consequentialist Argument
Addressing the problem of three-parent IVF from a consequentialist point of view is inherently difficult, as the long-term effects of the procedure have not been adequately documented; critics are worried that it could introduce genetic errors into the human genepool, potentially creating new diseases. When the consequences of an act remain to be seen, it is very difficult to claim that it is ‘right’ from a consequentialist standpoint.
If a mother has the defective mitochondrial gene, it will definitely be inherited, and all of her children will develop some form of mitochondrial disease (although the severity varies). This eliminates all other courses of action for the mother to have her own healthy biological children; in this sense, the ‘good’ consequence is having a healthy child, and it can only be seen as ‘right’ to give women this opportunity.
Additionally, the procedure has the added benefit of removing negative consequences; such as the physical pain, emotional pain, and financial burden on families which arise from having to manage mitochondrial diseases. However, there have been concerns raised by some experts that patients could be at greater risk of cancer and premature aging. Furthermore, any children born after the procedure- and in fact their children- will need to be monitored for the rest of their lives, as there could be “unknown risks due to the heritable genetic changes”. Critics point out that arguments for the procedure have been over-simplified, causing MPs in the UK to pass legislation despite being ill-informed.
Another issue raised is the potential for treatments to begin editing out undesirable inheritable traits, which would amount to eugenics; similar to the policies enacted by fascist regimes in WWII. Consequentialism is of little help here, as there can be no way of telling whether or not three-parent IVF would lead to widespread human genetic engineering in the sense of eugenics or even ‘designer babies’. Certainly, strict legislation would be required to ensure that only legitimate conditions qualify for the treatment, but at what point do we distinguish between ‘disorder’ and ‘diversity’?
Numerous cultural and religious objections to the practice also exist; the Catholic Church is opposed to all forms of treatment which destroy embryos– although one method does exist which involves using an unfertilised egg. Many cultures regard the concept of families and bloodlines as being extremely important, and three-parent IVF is considered ‘un-pure’ or a dilution of parenthood.
In conclusion, the consequentialist argument proposed here suggests that three-parent IVF is indeed a step in the wrong direction. Despite the obvious benefits; the unknown health-risks and issue of eugenics coupled with strong religious and cultural opposition affirm this viewpoint. In addition, the vast majority of people with mitochondrial disease display mild or even no symptoms, reducing the significance of beneficial consequences.
20: Harry Popplewell, Sophia Rawlins, Harry Morgan, Matthew Wayland