Posted on September 29, 2016 at 6:23 AM
This blog has discussed Mitochondrial Transfer, also referred to as Mitochondrial Replacement Techniques (MRTs), several times in the past (HERE and HERE to link a few.). The reason for further comment is that Dr. John Zhang, a New York-based fertility specialist admitted that he assisted in the successful fertilization and healthy delivery of a now 5 month old baby boy using the technique of Mitochondrial Transfer called Spindle Nuclear Transfer. The parents were from Jordan and the procedure was performed in Mexico, “where rules don’t exist [that legally prevent performance of the procedure].” Both Dr. Zhang and Sean Murray, an executive of the Australian Mitochondrial Disease Foundation have ethically justified the decision to perform the procedure in Mexico (to get around bans in other countries such as the US) with the claim that the procedure saves lives (Zhang: “To save lives is the ethical thing to do” and Murray: “This is about saving lives and offering hope to a community.”)
Saving lives is certainly a laudable endeavor. But does the technique really save lives?
The goal of the technique is to remove the diseased maternal mitochondria and replace the mitochondria with healthy donor mitochondria. In this particular case, five donated eggs from an otherwise healthy woman had the cell bodies removed and replaced with the nuclei of eggs from the mother, and these altered eggs were subsequently fertilized by with the father’s sperm. It is unclear whether all of these fertilized eggs were all used in the implantation or if some were destroyed by failure of the technique or purposefully destroyed after genetic testing showed mitochondrial abnormalities. Obviously one egg successfully survived the process to become the (presumably) healthy baby boy. But what about the other four?
More generally, whose life was being saved by the technique? The technique does not cure an individual who already has the disease. It prevents such an individual from being conceived in the first place, creating and selecting another individual conceived in a manner that does not have the diseased mitochondria.
So, it is likely that individuals are destroyed in the process of “creating” the mitochondrial diease-free individual, and, no actual specific individual is being “saved” by this technique.
It is very important to correctly define our terms before we have the ethical discussion to determine the right thing to do.