• Sinderion
    27
    I'm trying to get a handle on mitochondrial replacement techniques and the ethical implications of permitting its use. Currently there are safety concerns, which I'm not going into here. I'm more interested in exploring the other aspects of the debate pertaining to the ethical concerns if this were allowed and if it was safe.

    Some background: MRT addresses the problem that some women with mitochondrial DNA (mtDNA) diseases have; essentially it would serve to allow women to have children without passing on these mtDNA diseases. The procedure itself basically involves 3 parties: a man, one woman affected with an mtDNA disease, and a donor woman. Without going into too much detail, suffice to say that the man and the affected woman contribute nuclear DNA, and the donor contributes the mitochondrial DNA. One relevant implication is that the resulting child would have three genetic parents (although the donor contributes only 1% of the child's genetic makeup)

    Ethical Issue(s)

    The main ethical issue (or at least the one I feel is the most accessible) concerns the child's identity. There is a concern as to what impact this might have on the child's identity, should s/he grow up with the knowledge that s/he has three genetic parents. I think it is pretty safe to assume that this knowledge can have an effect on the child. While there are too many unknowns (for me), if we assume that

    1) At least some children will be born as a result of MRT, if it is approved
    2) At least some children will be (non-negligibly) adversely affected by having three genetic parents

    I think we can get the ball rolling on this particular discussion. I think some parallels can be drawn to children who are adopted/orphans (though there are definitely relevant differences).

    Preliminary Thoughts:

    There's definitely a tension between the desire of the parents to have a child and the potential implications it has for a child to grow up with the knowledge that s/he has three parents. Part of the answer would have to involve research into the extent of the impact this would have, but even if we do assume that there is some non-negligible adverse effect on the child's future, is that in and of itself grounds to prevent the parents from having the child? Consider: If this is the legitimate reason to ban MRT, should it also be policy to prevent abusive parents from conceiving again? What about couples who do not have the financial means to support a child?

    There's also the fact that we already have IVF as an established alternative reproductive technique (ART). This raises issues on both sides of the fence. Since we have already condoned a similar ART, an argument against MRT would have to focus on the differences between IVF and MRT, or it would have to mount an argument against all ART.

    On the other hand, since we already have existing means for prospective mothers with mitochondrial diseases to have children, any argument for MRT would have to justify that against IVF/adoption. This would likely entail an argument involving the importance individuals place on having genetically related offspring.

    Some other ethical considerations that may be pertinent:
    1) Slippery slope into other ethically questionable medical practices (e.g. designer babies, eugenics?)
    2) Since MRT involves genetic modification of the germ cell (at least when producing female offspring) there is a potential charge of "playing God".

    Final notes: I realize there are vocal antinatalists on this forum, but I hope even the most convicted antinatalist will at least concede that a personal antinatalist moral conviction does not automatically translate into an antinatalist public policy.

    Sources:
    http://www.nationalacademies.org/hmd/reports/2016/Mitochondrial-Replacement-Techniques (p 6-8, 82, 83)
    https://en.wikipedia.org/wiki/Mitochondrial_donation#Technique
  • BC
    13.2k
    Children are already being born under unusual circumstances which are going to require later, and perhaps difficult, explanations.

    Gay men hiring a surrogate woman (maybe even a surrogate man) to breed and bear a child for them could be difficult to explain in the future, especially if the child grows up in a society more hostile towards surrogacy or gay parenthood than anyone expected.

    Straight couples using surrogate mothers is already a somewhat contentious issue, especially when the mother is from a developing country, and the parents are quite well off citizens of a developed country.

    Some people object to IVF.

    Sperm banks (a recent Canadian case) don't always provide accurate information to prospective recipients of the sperm. A recent donor father had a history of serious mental illness. He was described as being brilliant, successful, and very creative. He was none of those things. In fact, he had a criminal record on top of everything else. The sperm bank took his word for his own condition. (How do we know this? The sperm bank accidentally sent the electronic file to the recipient parents. They seem to have problems at that business.)

    So, if people can figure out how to tell a child that the reason he or she is bi-polar or schizophrenic is that Mummy and Daddy were defective, and he or she is the child of a mentally ill sperm donor--someone even more defective--I think people can figure out how to tell a child that she was the beneficiary of gene therapy to solve her mother's defective mitochondrial DNA problem.

    The genetic lines rolls the dice every time conception occurs. Who knows what long term consequences may result? Probably nothing, but... no one knows.

    When it comes to scientists screwing around with DNA, I worry most about their appraisal of their own knowledge. "Yes, we know what we are doing. Nothing can go wrong." is a viewpoint that has gotten us into deep doo doo on a number of occasions. For that very reason, the [western] science establishments is recommending that certain areas of research into genetics should be suspended until risks can be more adequately investigated.

    Should people be cloned? Maybe it's possible, maybe it can be done safely, but that doesn't mean it should be done. Can faulty DNA be fixed, once and for all time? Maybe, but we want to know for sure that the cure will not be worse than the disease.

    Is all this high-tech stuff ethical? My guess that whatever we think now, it will be deemed ethically appropriate in the future. True, the Catholic Church (and some others) refuse to accept the virtue of birth control, family planning, and so on, but most religious organizations accept it. The group that might have the biggest problems are Mormons who conduct marriages of long-dead ancestors. How they will handle a three-way, don't know.
  • TheMadFool
    13.8k
    I thought ethical issues related to genetics were primarily concerned about the perceived offense in playing God. Didn't know people's feelings were in the equation too.
  • Sinderion
    27
    I think you'll find that looking past the media fuelled controversy over "playing God" , there are other, less media-friendly bioethical issues to discuss. When it comes to enhancement in general, there's a question of the tension between the haves and have nots. Whether it implies that enhancement (genetic or otherwise) should therefore be made publicly available. If you do make enhancements publicly available, and given our highly competitive society, will that in turn infringe upon a person's choice not to enhance? Is there a relevant distinction between treating a disease vs improving upon what's natural; and how does that affect the duties doctors have, if we grant that doctors have a duty to treat illnesses?

    To be honest the whole playing God argument is a tired one, which I personally think is obstructing more nuanced, public discussion about genetic enhancement and it's implications (which is not to say that there is no nuanced discussion)
  • TheMadFool
    13.8k
    It may be a narrow outlook but I think doctors, barring psychiatrists, take physical wellbeing as more important than psychological wellbeing. Most would consider the psychological impact of genetic cures to physical illnesses a small price to pay. The benefits of genetic cures would, presumably, far outweigh the costs. Of course if the cures have major side-effects it's a different story.
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