The British Parliament has recently approved regulations to allow techniques ‘to prevent the transmission of serious mitochondrial disease from a mother to her child’. The regulations term these techniques ‘mitochondrial donation’, but in the popular media, the issue has been discussed under the heading of ‘three parent’ babies or ‘three parent’ embryos. This paper examines the language of the debate, with particular reference to one of the techniques approved. It concludes that the terminology of ‘mitochondrial donation’ is scientifically inaccurate and ethically misleading, while the popular media description of ‘three parent’ embryos is broadly accurate, at least for one technique. This latter phrase also has the great merit, from an ethical perspective, of drawing attention to the ‘other woman’, the egg donor. She takes risks with her health in order to provide the egg which supplies the body of the embryo. Without her, this embryo simply would not exist.
Report of Secondary Legislation Scrutiny Committee. 23rd Report of Session 2014–15.
2.
Human Fertilisation and Embryology Act 1990 as amended, Section 35A.
3.
The Human Fertilisation and Embryology (Mitochondrial Donation) Regulations 2015.
4.
Barber S and Border P. Mitochondrial donation. Commons Library Standard Note Published 29 January 2015 | Standard notes SN06833.
5.
WatermeyerRRoweG. Evaluation of Human Fertilisation and Embryology Authority (HFEA): mitochondrial replacement consultation, Cardiff; UK & Norwich, UK: Human Fertilisation and Embryology Authority, 2013, pp. 78–78.
6.
Knapton S. Three-parent baby technique no more sinister than blood transfusion, says Robert Winston. Telegraph, 1 Feb 2015.
7.
The Human Fertilisation and Embryology (Mitochondrial Donation) Regulations 2015, section 4.
8.
Nuffield Council on Human Bioethics. Novel Techniques for the Prevention of Mitochondrial DNA Disorders: An Ethical Review, London: Nuffield Council, 2012.
9.
Nuffield Council on Human Bioethics. Novel Techniques for the Prevention of Mitochondrial DNA Disorders: An Ethical Review, London: Nuffield Council, 2012.
10.
Nuffield Council for Bioethics. Emerging Techniques to Prevent Inherited Mitochondrial Disorders: Ethical Issues. London: Nuffield Council 2012, Response by the Medical Research Council and the Wellcome Trust.
Dialogue by Design. Medical frontiers: debating mitochondria replacement, Annex IV: Summary of the 2012 open consultation questionnaire. Prepared by Dialogue by Design, 2013: 8, 26, 36, 41.
13.
Barber S and Border P. Mitochondrial Donation. Commons Library Standard Note Published 29 January 2015 | Standard notes SN06833: 22.
14.
The example of mitochondria might seem to be an exception to this rule, for it seems most probable that these structures developed from what were once independent organisms existing symbiotically within a host organism. So these ‘parts’ did exist before the ‘whole’. However, the transition here from endosymbiotic organisms (whole-to-whole relationship) to organelles (part-to-whole relationship) is utterly unlike manufacture. The parts were not produced separately, as parts, immediately prior to the assembly of the whole. Rather, the new kind of living organism evolves from previous living organisms (a whole evolving from wholes). In any case, mitochondria are now well-integrated parts of a whole, as they have been for well over a billion years. They are not organisms that could exist independently outside a cell.
The egg contains approximately 300,000 copies of the 16,569 base-pair mitochondrial genome compared to one copy of the 3,031,042,417 base-pair nuclear genome. I am indebted to Neville Cobbe for pointing this out to me.
Because other processes may mimic, but be distinct from, true embryological development, the task of distinguishing embryos from gametes and from ‘pseudoembryos’ may not always be straightforward.72–74.
26.
This paper focuses on MST because there are further complications in relation to PNT. For while MST starts with three gametes, combines elements of the two eggs, and generates one ‘three parent’ embryo by fertilisation, PNT starts with four gametes, generates two embryos by IVF, and then deconstructs these embryos. The PNT embryo is not itself generated by fertilisation, directly from gametes, but by reconstruction from two embryos, in a process very similar to somatic cell nuclear transfer (that is, cloning). PNT thus strains our understanding of biological parenthood perhaps to breaking point, notwithstanding that the embryo produced is very like an embryo generated by the ‘three parent’ MST technique.
27.
Department of Health. Mitochondrial Donation: Government Response to the Consultation on Draft Regulations to Permit the Use of New Treatment Techniques to Prevent the Transmission of a Serious Mitochondrial Disease from Mother to Child. 2014, p.15.
28.
ReinhardtKDowlingDMorrowE. Mitochondrial replacement, evolution and the clinic. Science2013; 341: 1345–1346.
29.
Morrow E. Secondary Legislation Scrutiny Committee Human Fertilisation and Embryology (Mitochondrial Donation) Regulations 2015 Written Evidence: 35.
30.
On some problems with genetic reductionism see Neumann-Held and Rehmann-Sutter75.
31.
Dialogue by Design. Medical Frontiers: Debating Mitochondria Replacement, Annex IV: Summary of the 2012 Open Consultation Questionnaire, London, UK: Dialogue by Design, 2013, pp. 25–25.
32.
SykesB. The Seven Daughters of Eve, New York: WW Norton & Company Inc, 2002.
33.
Callaway E. Genetic Adam and Eve did not live too far apart in time: Studies re-date ‘Y-chromosome Adam' and ‘mitochondrial Eve'. Nature News, 6 August 2013.
Report of Secondary Legislation Scrutiny Committee 23rd Report of Session 2014–15, paragraph 25.
37.
Nuffield Council on Human Bioethics. Novel Techniques for the Prevention of Mitochondrial DNA Disorders: An Ethical Review, London: Nuffield Council, 2012. 88 (5.2).
38.
The title of this section is taken from an article by Dickenson46.
39.
Border P. Preventing Mitochondrial Disease. POSTnote 431 March 2013, Updated October 2014: 4.
40.
JayaprakasanKHerbertMMoodyE. Estimating the risks of ovarian hyperstimulation syndrome (OHSS): implications for egg donation for research. Hum Fertil2007; 10.3: 183–187. doi:10.1080/14647270601021743.
41.
StewardRGShahAAYehJS. Oocyte number as a predictor for ovarian hyperstimulation syndrome and live birth: an analysis of 256,381 in vitro fertilization cycles. Fertil Steril2014; 101.4: 967–973.
42.
CamporesiSBonioloG. Fearing a non-existing Minotaur? The ethical challenges of research on cytoplasmic hybrid embryos. J Med Ethics2008; 34: 821–825: 823.
43.
HFEA Chief Executive’s letters: CE(11)02 – donation review: preparing for implementation, http://www.hfea.gov.uk/6855.html (accessed 25 March 2015).
MingerS. Interspecies SCNT-derived human embryos a new way forward for regenerative medicine. Regen Med2007; 2: 103–106.
46.
DickensonD. The lady vanishes: What’s missing in the stem cell debate. J Bioeth Inq2006; 3: 43–54.
47.
BaylisF. Animal eggs for stem cell research: a path not worth taking. Am J Bioeth2008; 8: 18–32.
48.
ParfitD. Reasons and Persons, Oxford: Oxford University Press, 1984, pp. 355–355.
49.
Dialogue by Design. Medical Frontiers: Debating Mitochondria Replacement, Annex IV: Summary of the 2012 Open Consultation Questionnaire, London: Dialogue by Design, 2013, pp. 47–47.
50.
Department of Health Review of the Human Fertilisation and Embryology Act: Proposals for revised legislation (including establishment of the Regulatory Authority for Tissue and Embryos) December 2006, The Stationery Office.
51.
Department of Health Human Tissue and Embryos (Draft) Bill, May 2007, Section 35A.
52.
JonesDA. Is the creation of admixed embryos ‘an offense against human dignity’?Human Reproduct Genetic Ethics2010; 16.1: 87–114.
53.
HFEA. A Report on the Findings of the Consultation Hybrids and Chimeras, London: HFEA, 2007.
54.
House of Commons Science and Technology Committee (SCT). Fifth report of session 2006–07. Government Proposals for the Regulation of Hybrid and Chimera Embryos, London: Stationery Office, 2007. (HC 272-I).
55.
BaylisF. The HFEA public consultation process on hybrids and chimeras: informed, effective, and meaningful?Kennedy Inst Ethics J2009; 19.1: 41–62.
56.
GatelyP. The Commons Science and Technology Committee inquiry into hybrid embryo research 2007: credible, reliable and objective?Human Reproduct Genetic Ethics2011; 17: 84–109.
57.
JonesDA. What does the British public think about human–animal hybrid embryos?J Med Ethics2009; 35: 168–170.
HFEA Press release. HFEA to consult on ethics of ‘mitochondria transfer’. 19 January 2012, http://www.hfea.gov.uk/6898.html (accessed 25 March 2015).
61.
Nuffield Council on Human Bioethics. Novel Techniques for the Prevention of Mitochondrial DNA Disorders: An Ethical Review. London: Nuffield Council 2012, pp.88–89.
62.
Nuffield Council on Human Bioethics. Novel Techniques for the Prevention of Mitochondrial DNA Disorders: An Ethical Review, London: Nuffield Council, 2012, pp. 89–89.
63.
HFEA. Mitochondria replacement consultation: advice to Government. March 2013.
64.
ClarkeRvan der StoepR. Medical Frontiers: Debating Mitochondria Replacement, Annex I: Summary of Evidence, London: Office for Public management, 2013.
65.
RudatK. Medical Frontiers: Debating Mitochondria Replacement, Annex III: Public Representative Survey, London: Office for Public management, 2013.
66.
Dialogue by Design. Medical Frontiers: Debating Mitochondria Replacement, Annex IV: Summary of the 2012 Open Consultation Questionnaire, London: Dialogue by Design, 2013, pp. 58–66.
67.
SheikhS. Medical Frontiers: Debating Mitochondria Replacement, Annex II: Deliberative Public Workshops, London: Office for Public management, 2013, pp. 20–20.
68.
SheikhS. Medical Frontiers: Debating Mitochondria Replacement, Annex II: Deliberative Public Workshops, London: Office for Public management, 2013, pp. 21–21.
69.
Department of Health. Mitochondrial Donation: Government response to the consultation on draft regulations to permit the use of new treatment techniques to prevent the transmission of a serious mitochondrial disease from mother to child. July 2014, Annex B: 45-46.
70.
Department of Health. Mitochondrial Donation: Government response to the consultation on draft regulations to permit the use of new treatment techniques to prevent the transmission of a serious mitochondrial disease from mother to child. July 2014: 27.
71.
Dialogue by Design. Medical Frontiers: Debating Mitochondria Replacement, Annex IV: Summary of the 2012 Open Consultation Questionnaire, London: Dialogue by Design, 2013, pp. 45–45.
72.
SuarezAHuarteJ. Is this Cell a Human Being?, Berlin: Springer, 2011.
73.
JonesDA. Review of Suarez A, Huarte J. Is this cell a human being?Linacre Quarterly2013; 80: 186–189.
74.
WattH. Embryos and pseudoembryos: parthenotes, reprogrammed oocytes and headless clones. J Med Ethics2007; 33: 554–556.
75.
Neumann-Held EM and Rehmann-Sutter C. (eds) Genes in Development: Re-Reading the Molecular Paradigm. Durham, NC: Duke University Press, 2006.
