Our fabricated Proposition 44 played out a scenario in which mitochondrial replacement would be required in an attempt to prevent the transmission of mitochondrial disease. Our Voter’s Guide presented three of the most salient issues that the public should consider before making their final decision. Before you vote, we wanted to provide extra issues for thought that should be weighed in your decision.
Are we messing with natural selection and propagating ‘unfit’ traits?
While mitochondrial replacement is aimed to be a magic bullet in preventing mitochondrial disease, research has been presented that shows the complexity of mitochondrial replacement. First, heteroplasmy leaves doubt when pursuing a diagnostic answer through whole mitochondrial genome testing. Second, and early embryo’s mitochondria are densely located around the pro-nucleus. There is still a chance of inadvertently adding mutant mtDNA to the resulting embryo (FDA, 2014).
In having the government allow mitochondrial replacement to occur, they open the door for potential wrongful birth and/or wrongful life lawsuits. Wrongful life lawsuits occur when a doctor fails to provide information about a child’s disability. Furthermore, wrongful birth specifically speaks to genetic information that was not made accessible to the parents in their decision making process (Andrews, 1992). Physicians become liable when they fail, “to discuss the availability of genetic services when specific assessment services are available” (Andrews 1992, 242). In the case of mitochondrial replacement, the problem becomes twofold. If a physician performs mitochondrial replacement on an embryo and the resulting child still has a mitochondrial disease, the physician could be held liable. Additionally, if a physician does not recommend mitochondrial replacement based on a healthy screening, but the resulting child develops mitochondrial disease, they would be held liable because the, “physician’s negligence… caused the birth of the deformed child” (Andrews 1992, 242).
Maternal Spindle Transfer v. Pronuclear Transfer
It is also important to note that both techniques call to mind different sets of ethical questions. Both techniques call to mind the ethical concerns raised over pre-implantation genetic diagnosis. Pre-implantation genetic diagnosis, PGD, involves testing an early embryo for genetic defects prior to implantation by removing one or more blastomeres and analyzing the DNA within (FDA 2014, 27). Opponents of PGD argue that it is a form of eugenics. However, one main difference between the techniques is the use and dispensing of embryos. Pronuclear transfer involves the fertilization of two embryos, one of which will eventually be discarded once it has served its purpose and provided healthy mitochondria (NCB). Maternal spindle transfer, however, only involves the fertilization of one embryo, because the ‘switch’ happens before fertilization. While some activists argue that fertilization is not the determining factor of life, this distinction could help garner support for maternal spindle transfer as the more humane option.
Feel free to take a look at some of the current situations surrounding mitochondrial replacement
- FDA Considers Mitochondrial Transfer
- UK Government Plans to Allow Mitochondrial Replacement
- HFEA: Consultation Report
- FDA Advisory Committee Briefing Document