Debating the ethics
Dr. Mitalipov acknowledged the ethical concerns, but said that unlike other types of gene therapy, mitochondrial replacement therapy aims to eliminate the cause of the condition, “before it is actually passed to the child.”
While there are concerns that the technology could eventually lead to nonmedical genetic enhancements, he said, “it is up to society to regulate those issues.”
One of the most vocal critics of mitochondrial replacement techniques is Marcy Darnovsky, Ph.D., executive director of the Center for Genetics and Society in Berkeley, Calif.
“All of us should be concerned about the safety risks to any resulting children,” as well as social policy and the availability of the technique “breaking a widespread global agreement that we shouldn’t make genetic changes that will enter the human germline,” she said in an interview.
Moreover, a woman at risk of transmitting a mitochondrial disease who wants to have a healthy child is both emotionally and physically vulnerable. “Physicians treating these women have an elevated responsibility to make sure they are giving them the full picture,” she said.
In a statement issued shortly after the U.K. House of Lords approved the use of the procedure, Dr. Darnovsky said that “unlike experimental gene therapies where risks are taken on by consenting individuals, these techniques turn children into our biological experiments and forever alter the human germline in unknowable ways.”
Josephine Johnston
But Josephine Johnston, director of research at the Hastings Center, a bioethics research institute in Garrison, N.Y., who studies ethical considerations related to assisted reproductive technology, said the U.K. approach “seems like a very reasonable plan.”
And she predicts that because of the way ART is regulated in the U.K., mitochondrial donation would be tightly restricted and would likely result in about 10 of these procedures being performed over the next few years.
While germline modification – manipulating the genetics of an embryo to make a change that will be inherited to the next generation – has been considered by many to be an ethical line not to be crossed, Ms. Johnston said she hopes people can move past the slippery slope objections.
“I hope we as a human community are sophisticated enough to understand that just because we said yes to one thing, doesn’t necessarily mean we have to say yes to everything that might come after it,” she said.