by Stephanie Cook
On February 3rd, the House of Commons in the British Parliament voted overwhelmingly in favor of the use of Mitochondrial Replacement Therapy (MRT). And once the law is signed off by the House of Lords later this month (considered a mere formality), the UK will become the first country in the world to allow what the media have dubbed the birth of “babies with three parents.”
My first reaction when reading these rather dramatic headlines was a sense of ambiguity, of “Gosh, genetic engineering scares me, whatever next?” But this was instantly followed by “Isn’t this what scientific research is all about – curing diseases and saving lives?” I am a parent, and anything to do with pregnancy, childhood, and above all the wellbeing of parents and children, is of concern to me. Which means that the concept of ending suffering sounds like a wonderful idea. But then why do I (and judging by the amount of controversy this has caused, a lot of other people) feel so uneasy about this new development? I decided to find out more.
First of all, what is Mitochondrial Replacement Therapy? In a nutshell, MRT consists of two new IVF techniques that can prevent the passage of inheritable mitochondrial mutations from mother to child, mutations that can cause a plethora of incurable diseases. Mitochondria are the “powerhouse” cells of the human body, tiny organelles in the cytoplasm of a cell that help produce the energy needed for the cell to function. They contain their own DNA, separate from that of the nucleus. When sperm and egg meet to make an embryo, only the mitochondria of the mother make it through, and if they have mutations (i.e. don’t function correctly), they can cause incurable diseases in that couple’s future child.
Scientists are now able to create an embryo that combines genetic material from both parents as well as a female donor, or, as the media would have it, the “third parent.” The mother’s failing mitochondria are extracted and replaced with the donor’s healthy ones, thus eradicating the mutation. The resulting baby would have DNA from three parties rather than two, with approximately 99.9% of genetic material from mother and father, and roughly .1% from the mitochondrial donor. If the baby is female, she would be able to pass on this “recreated” gene to her offspring.
This is why MRT is different to other procedures involving third party DNA, such as organ donation (to which it has been compared), and also gene therapy. For the first time, a genetically engineered change could be passed on to future generations, albeit only via the maternal line. If the baby is male, he will not pass on the new gene (I will not go into the more minute scientific details of all this, as my head is spinning enough already).
At any rate, this is where the subject of ethics comes into play. If we cross this threshold, and start screening out diseases, how far away are we from screening out things like undesirable characteristics, hair and skin color, ultimately leading to “designer babies”? When does an embryo become a human being? How do you legally deal with the fact that a child is born with genetic material from three “parents”? How will the future child deal with this fact? And do we really need MRT?
We already have reliable ways of avoiding mitochondrial disease, argues Dr. David King, director of Human Genetics Alert. There is prenatal scanning at 11 weeks of pregnancy, and at a more elaborate level, pre-implantation genetic diagnosis, where prospective parents going through IVF can opt to have only the healthiest embryo implanted. While the former method might detect mitochondrial mutations, however, and the latter reduce the risk of developing such problems, neither is able to prevent them from occurring. And sadly, nothing can be done for those children born with mitochondrial disease. Reading about the horrendous suffering families affected by this have to go through is heartbreaking.
Uncertainty and safety are another concern. Opponents of the procedure claim that there haven’t been enough studies, that it’s way too early to move from research into practice, that we simply do not know what the consequences for future generations will be, that we’re dealing with techniques that are potentially dangerous and impossible to monitor. “Is it defensible to make alterations at a genetic level whose impact on future children we simply don’t know?” asks Fiona Bruce, a Conservative Member of Parliament, claiming that scientists don’t yet fully understand the interactions between the DNA in the mitochondria and the DNA in the nucleus, and whether the newly constructed cell could be potentially harmful for the future child’s health and personality.
Potential risk, however, seems inevitable in the advancement of modern medicine. Prof. Doug Turnbull, professor of neurology at Newcastle University, leader of the team developing MRT, argues: “My view is pragmatic. We are talking about preventing what can be serious disorders. We need to do adequate research before clinical trials, but we should accept some risks. If you opt for zero risk, no innovation is possible.” Britain’s Human Fertilisation and Embryology Authority (HFEA), which regulates fertility treatments, has been scrupulous in assessing the risks of MRT – even more scrupulous than with procedures such as IVF, which are now well established and accepted. In fact, at no other time in the history of scientific research in Britain has an institution been more thorough in evaluating scientific, ethical and public opinion and gained support in all three. Researchers such as Turnbull argue that we need to trust and support those institutions, and that where disease and suffering can be eradicated, medicine shouldn’t hesitate. The notion of “designing” a baby is absolutely not what this new procedure is about.
In fact, 99.9% of the future child’s genetic make-up – some 23,000 genes – are found in the nucleus of the cell, a combination of the mother and father’s genes that code for characteristics such as personality traits, hair and eye color, etc. The amount of mitochondrial DNA received from the donor is minute – a mere 37 genes (.1% overall), and its function is the coding for proteins that produce energy for the cell, with no bearing on the future child’s characteristics.
To be using terminology such as “three-parent babies” is thus highly misleading, and is casting an ugly shadow on the debate where none should be. “Just as nothing of importance changes about a person when he receives a heart transplant, nothing of moral importance changes when a cell receives a mitochondrial transplant,” says Professor Julian Savulescu, chair in Practical Ethics and director for the Institute for Science and Ethics at the University of Oxford. Any more suffering that could quite easily be avoided would be unethical. Prof. Dame Sally Davies, Chief Medical Officer for England, puts it like this: “We have an opportunity to let parents have their own, healthy children, and we need to take it.” And isn’t that opportunity Prof. Davies is talking about what we need to focus on?
This subject is certainly huge, and quite overwhelming. But what it all comes down to is this: we, the human race, have been given this amazing gift of scientific knowledge and progress, of finding ways to make life better, for us and for our offspring. As parents, we want the best for our children. Shouldn’t we have to right to make a choice here? Do we need to be completely in favor of genetic engineering? No! But those of us who want to benefit from its ability to cure disease should be free to do so. As parents, we have to make choices about our children’s education, lifestyle, health and much, much more every single day. Thinking about what makes a parent a parent is a start. I don’t believe donating .1% of genetic material qualifies. After all, there are numerous children out there who live in family set-ups that consist of one, two, three or more parents, genetic or not. And isn’t being a parent about so much more than genetics?
Stephanie Cook, originally from Germany, is married to an Englishman, is the mother of two amazing girls, and currently resides in Northern California. She love the multicultural nature of her life and enjoys learning something new every day.