Mitochondrial Donation

Executive Summary

Many individuals desire to have children and must utilize in vitro fertilization. One such method is through mitochondrial transfer. However, there are concerns relating to ethics and legalities concerning in vitro fertilization and mitochondrial transfer in particular. Therefore, the HFEA policy was established in order to show that the government has no control in an individual’s reproductive freedom. Thus, the HFEA policy currently utilized in the UK has been tailored to meet the needs of citizens and justifies the use of mitochondrial transfer. The goal of this policy brief is to explain why and how this policy is beneficial in the UK and why other nations should adopt similar policies. On February 3, 2015, the UK’s House of Commons passed legislation that allows mitochondrial transfer or donation. On February 24, 2015, the UK’s House of Lords approved this legislation. Due to this passage, mitochondrial transfer or donation is allowed as another form of in vitro fertilization (IVF) for those individuals that possess mitochondrial diseases. Significantly, mitochondrial diseases are inherited by the child and, currently, there is no known cure . The passage of this legislation is historical because the UK is now the first nation in the world to approve this type of controversial treatment. This is significant because the opposition equates mitochondrial transfer with gamete and embryo donation. The treatment is officially called mitochondrial DNA replacement therapy and involves removing the damaged DNA from the nucleus of the egg and replaces it with health DNA from a donor. The treatment will be strictly regulated, as is gamete and embryo production. Thus, treatment providers will be required to obtain a license from the Human Fertilisation and Embryology Authority (HFEA) . Although the appropriate regulatory measures are currently in place, the UK will need to remain flexible and capable of altering public policy based on the legal, social, ethical, and economic concerns that will change as time passes and more research is conducted regarding mitochondrial transfer.

Rise, Support, and Opposition of In Vitro Fertilization

Mitochondrial transfer signifies one way that medical technology has advanced in recent years. In fact, this treatment has the potential to become a vital component in reproductive healthcare for those that are unable to have children due to mitochondrial disease. Significantly, medically assisted reproduction has proliferated after the successful journey IVF since the first “test tube” baby, Louise Brown, was born in 1976. Although many providers of this technology are driven by the desire to earn profit, there are immense opportunities as a result of the progress, research, and development of IVF. Despite the opportunities, there are detractors to the technology. For example, some religions are strongly opposed to the procedure because it (meaning the procedure) goes against what God intended . In contrast, other opponents to the procedure contend that it is not ‘natural’ and confuses the issue of parenthood .

As research shows, the UK is advanced in comparison to the rest of the world in medically aided reproductive techniques. In fact, the United States is the only other nation that comes close to the UK’s level of technology in this respect. As a result, the UK is burdened with setting the legal and social standards for other countries to follow relating to IVF treatments. As a result, this could result in a trial and error process in order to develop the most acceptable policies. However, one fact has been firmly established: Mitochondrial DNA replacement therapy needs to be regulated, yet remain flexible, as the world continues to learn about the possibilities, challenges, and futures of IVF procedures.

Mitochondrial Transfer

In utero, the child inherits the genetic material of its mother through the egg cell. However, scientists have developed two techniques that can be used to produce a healthy child through mitochondrial DNA replacement therapy: pronuclear transfer and maternal spindle transfer . In pronuclear transfer, two embryos are produced and combined in order to create a healthy embryo by destroying the embryo extracted from the donor egg. In maternal spindle transfer, the egg is manipulated outside the womb, leading to the extraction of faulty DNA and replacing it with stable DNA obtained from a donor . These methods have been the subject of three separate scientific reviews in 2011, 2013, and 2014. Within these reviews, an HFEA expert panel, the Nuffield Council on Bioethics, and an HFEA public consultant all concurred that these techniques were safe and recommended to the government that they should be introduced, albeit with a watchful eye overseeing the process . As such, this type of reproductive therapy is believed to have the potential to promulgate an entirely different genus that is man-made. However, there is trepidation that some scientists will not be able to control themselves from engaging in the creation of an entirely different genus, or taking advantage of donors or parents biological matter without their knowledge.

Ethical and Legal Concerns

Although this cutting edge technology opens new doors for individuals that wish to become parents, it also raises ethical and legal concerns. For instance, it is scientifically known that all surgical procedures and/or techniques have a risk of disease and infection. However, this concern is minor in comparison to concerns regarding altering the normal reproductive process. In fact, all IVF techniques intervene or circumvent natural processes. As a result, there is always fear that providers may abuse the system and/or irreparable harm to those involved, including the child(ren) produced. Furthermore, there are concerns regarding the possibility that these methods could yield unexpected results. On the positive side, prospective parents can use IVF procedures to select the sex of a child and prohibit certain diseases from occurring in the child. However, IVF procedures could potentially be used to produce an animal/human species or a ‘savior child,’ designed to save an ill child or other related person. Therefore, it is crucial to have proper controls in place to test for the different conditions that could be present in donors. Legally, there are concerns as to whether or not the government has the right to control reproductive freedom. Within the UK, the voters have established that the government does not have the right to control reproductive freedom. However, the voters were not enamored by the negative implications associated with IVF, such as automatic sex selection or the combination of human and animal genetics. Furthermore, it was found that politicians were opposed to these donation techniques, but not opposed to implementing the procedure for public consumption with strict regulation, as well as continuing research. Politicians find themselves in a difficult position because they do not have the right to control when and how individuals elect to have children. In contrast, politicians are burdened with the responsibility to protect the public through policies that promote the greater good of society. As a result, it is necessary for politicians to weigh the benefits of assisting women to bear children when other means are not viable options, as well as the negative concoctions. In response, the UK has selected the former approach and has enacted regulatory policies to accomplish this goal.

Conclusion and Recommendations

It is established through the research that the UK has conducted thorough background analysis regarding the institution of HFEA. Furthermore, it is apparent that the UK has considered the available data regarding mitochondrial transfer, as well as considered the ethical and legal concerns. Based on all available information, the HFEA was instituted and is deemed to be the most effective regulation for clinics and physicians that offer this treatment. As such, the UK is the world leader in this technology, causing it to establish the criteria and standards that the entire world will consider when implementing their own policies. Therefore, it has been important for the legislation and regulation of mitochondrial transfer to be effective and thorough. However, and perhaps most importantly, the legislation is flexible, a necessity due to the changing nature of the field and rapid advancements in scientific technology. Thus, acceptable allowances for further research have been established and will continue to occur.

Although there are ethical concerns in relation to mitochondrial transfer, it has been proven to be medically safe. In many situations, mitochondrial transfer has been instrumental in allowing individuals to have children and save lives. Through the HFEA survey, it was established that people are entitled to their unique belief systems, and they are allowed to not utilize this technique. However, it was also established that mitochondrial transfer must be available as an option for a condition that has no known cure.

Based on this information, it is recommended that other countries adopt regulations like HFEA in order to provide needed services to their citizens.

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