What Is the Value of Three‐Parent IVF?
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Institute of Medicine of the National Academies “Ethical and Social Policy Considerations of Novel Techniques for Prevention of Maternal Transmission of Mitochondrial DNA Diseases ” accessed February 6 2016 http://iom.nationalacademies.org/Reports/2016/Mitochondrial‐Replacement‐Techniques.aspx.
The committee endorses limited investigations in only women with undisputed and severe clinical symptoms of mitochondrial disease. Initial investigations are limited to male embryos in order to prevent transmission of genetic modifications to their offspring.
In the United Kingdom fertility clinics will apply for licenses for clinical use. The process is bypassing clinical trials which are for the study of safety and efficacy; seeDepartment of Health “Appendix 2: Draft Human Fertilisation and Embryology (Mitochondrial Donation) Regulations 2015” [Department of Health response to the legal opinion by Lord Brennan QC] accessed September 30 2015 http://www.publications.parliament.uk/pa/ld201415/ldselect/ldsecleg/99/9905.htm.
C.Pritchard “The Girl with Three Biological Parents ” BBC September 1 2014 http://www.bbc.com/news/magazine‐28986843.
Caplan A., 2015, Is It Ethical to Create Babies from Three DNA Sources? Absolutely, Wired
Bredenoord A., 2011, Ethics of Mitochondrial Gene Replacement: From Bench to Bedside, BMJ, 342, 87
Baylis “The Ethics of Creating Children with Three Genetic Parents ” 532‐33; Darnovsky “A Slippery Slope.”
Bredenoord and Braude “From Bench to Bedside ” 88.
Amato et al. “Three‐Parent in Vitro Fertilization ” 31; Darnovsky “A Slippery Slopes ” cites the figure at 1 in 5 000.
Amato et al. “Three‐Parent in Vitro Fertilization ” 31; Bredenoord Pennings and De Wert “Ooplasmic and Nuclear Transfer to Prevent Mitochondrial DNA Disorders” 669.
These details of the procedures come from Torjesen “UK Moves a Step Closer.”
Cha A. E., FDA Panel Debates Technique That Would Create Embryos with Three Genetic Parents, Washington Post
The cost is not yet determined but since it involves IVF it will be at least as costly as IVF. The average cost of in vitro fertilization per cycle in the United States is $12 400; see American Society for Reproductive Medicine “Frequently Asked Questions about Infertility ” accessed September 30 2015 https://www.asrm.org/awards/index.aspx?id=3012. However less than 50 percent of women will experience success in one cycle; most require several cycles. See American Pregnancy Association “In Vitro Fertilization: Side Effects and Risks ” accessed September 30 2015 http://americanpregnancy.org/infertility/in‐vitro‐fertilization/.
For concerns see Amato et al. “Three‐Parent In Vitro Fertilization ” 32; Bredenoord and Braude “From Bench to Bedside ” 87.
Emanuel Wendler and Grady “What Makes Clinical Research Ethical? ” 2703.
See Rieder “Don't Make a Three‐Parent Baby.”
With pronuclear transfer the technology is used after fertilization yet fertilization would not have occurred but for the intended use of the technology in the laboratory.
Parfit D., 1984, Reasons and Persons, 351
Feinberg J., 1987, Harm to Others, 97
Heyd Genethics 14‐15.
Amato et al. “Three‐Parent In Vitro Fertilization ” 35.
Bredenoord and Braude “From Bench to Bedside ” 88.
Bredenoord Pennings and De Wert “Ooplasmic and Nuclear Transfer to Prevent Mitochondrial DNA Disorders ” 674.
Johnson “Tri‐Parenthood ” 517.
M.Smith “FDA Considering 3‐Parent Embryos ” CNN February 27 2014 http://www.cnn.com/2014/02/26/health/ivf‐mitochondria/.
Caplan “Is It Ethical?”
Darnovsky M., Genetically Modified Babies, New York Times
Shire E., Why We Shouldn't Freak Out over Three‐Person IVF, Daily Beast
L.Smith‐Spark “UK Takes Step toward ‘Three‐Parent’ Babies ” CNN June 28 2013 http://www.cnn.com/2013/06/28/health/uk‐health‐dna‐ivf/; the article also cites Dr. David King arguing the counterpoint—that the technology offers no medical benefit.
J.Gallagher “MPs Say Yes to Three‐Person Babies ” BBC February 3 2015 http://www.bbc.com/news/health‐31069173.
This is also noted by Baylis “The Ethics of Creating Children with Three Genetic Parents ” 533; Darnovsky “A Slippery Slope”; and Rieder “Don't Make a Three‐Parent Baby.”
Haslanger S., 2009, Family, Ancestry and Self: What Is the Moral Significance of Biological Ties, Adoption and Culture, 2, 10.1353/ado.2009.0001
Witt C., 2005, Adoption Matters: Philosophical and Feminist Essays, 135
Haslanger “Family Ancestry and Self ” 31.
Williams B., 1982, Moral Luck, 1
Rulli “Preferring a Genetically‐Related Child.”
Rieder “Don't Make a Three‐Parent Baby.”
Bredenoord Pennings and De Wert “Ooplasmic and Nuclear Transfer to Prevent Mitochondrial DNA Disorders ” 676; Darnovsky “A Slippery Slope.”
Baylis “The Ethics of Creating Children with Three Genetic Parents ” 532‐33.
Emanuel Wendler and Grady “What Makes Clinical Research Ethical? ” 2703‐04.
Johnson “Tri‐Parenthood ” 517‐18; Baylis “The Ethics of Creating Children with Three Genetic Parents ” 534.
Council for Responsible Genetics “Gene Watch: The Patient Perspective ” accessed September 30 2015 http://www.councilforresponsiblegenetics.org/GeneWatch/GeneWatchPage.aspx?pageId=541.
Smeets “Preventing the Transmission ” 608.
For a very recent development in mitochondrial disease treatment seeH.Maet al. “Metabolic Rescue in Pluripotent Cells from Patients with mtDNA Disease ”234‐38.
Thanks to Allison Drake‐Schmitz for this example. Another relevant example would be the use of folic acid prior to conception to decrease the risk of neural tube defects.
Office on Women's Health Hashimoto's Disease Fact Sheet accessed September 30 2015 http://www.womenshealth.gov/publications/our‐publications/fact‐sheet/hashimoto‐disease.html#j.
Philosophers rarely make this distinction but bioethicists should.
For examples of such arguments see Amato et al. “Three‐Parent In Vitro Fertilization ” 35; Bredenoord and Braude “From Bench to Bedside ” 88; Bredenoord Pennings and De Wert “Ooplasmic and Nuclear Transfer to Prevent Mitochondrial DNA Disorders ” 673.