{"id":349,"date":"2010-04-15T12:48:34","date_gmt":"2010-04-15T11:48:34","guid":{"rendered":"https:\/\/blogs.bmj.com\/medical-ethics\/?p=349"},"modified":"2010-04-15T14:05:04","modified_gmt":"2010-04-15T13:05:04","slug":"you-and-me-and-baby-makes-more-than-three","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/medical-ethics\/2010\/04\/15\/you-and-me-and-baby-makes-more-than-three\/","title":{"rendered":"You and Me and Baby Makes more than Three"},"content":{"rendered":"<p>News emerged last night of a new technique for avoiding mitochondrial disease.\u00a0 From what I can tell, the technique looks like a version of Somatic Cell Nuclear Transfer, and it involves removing the nucleus from a fertilised egg and placing it into an enucleated donor egg.\u00a0 Doing this means that any problems with the mitochondria in the original egg can be sidestepped.<!--more--><\/p>\n<p>It also means that, in essence, the resultant baby would have three biological parents, inasmuch as it would be the product of three distinct gametes.<\/p>\n<p>The <a href=\"http:\/\/www.england-legislation.hmso.gov.uk\/acts\/acts2008\/ukpga_20080022_en_2#pt1-pb2-l1g3\">HFE Act 2008<\/a> would seem to allow room for\u00a0the use of the technique without a substantial change in the law; although it forbids the implantation of an egg or embryo the genetic material of which has\u00a0been altered, there is leeway granted in respect of mitochondrial disease:<\/p>\n<blockquote><p>Regulations may provide that\u2014<\/p>\n<p>(a) an egg can be a permitted egg, or<\/p>\n<p>(b) an embryo can be a permitted embryo,<\/p>\n<p>even though the egg or embryo has had applied to it in prescribed circumstances a prescribed process designed to prevent the transmission of serious mitochondrial disease.<\/p><\/blockquote>\n<p>(I&#8217;m willing to be corrected in my understanding by any lawyers who happen to be reading this; but from what I can make out, the law as it stands requires alterations to the regulations rather than new legislation.)<\/p>\n<p>The procedure, it seems to me, ought to be welcomed &#8211; and welcomed pretty unequivocally, and for obvious reasons.\u00a0 However, the\u00a0media have felt the need\u00a0to dig out at least some dissenting voices.\u00a0 The BBC&#8217;s dissenter of choice\u00a0is <a href=\"http:\/\/www.srtp.org.uk\/whatisrt.shtml#WhoAreWe\">Donald Bruce<\/a>, whose background is in chemistry and theology, but who still apparently counts as an &#8220;ethics expert&#8221;, having been &#8220;former director of the Society, Religion and Technology Project of the Church of Scotland&#8221;.<\/p>\n<p>He says that &#8220;the research raise[s] important ethical issues as well as potential risks&#8221;.<\/p>\n<blockquote><p>&#8220;If the Newcastle results are taken forward to medical application, they need to be applied under very strict controls, and only where serious disease is otherwise likely to result.&#8221;<\/p>\n<p>The work raised several ethical problems, he explained, including safety risks, children with DNA from two mothers, and making genetic changes to unborn children.<\/p><\/blockquote>\n<p>This looks to me like his standard response to just about anything, and there&#8217;s a range of canards there, all of which are very easily dealt with.<\/p>\n<p>First, the safety risks.\u00a0 It is, of course, possible that there are big risks with the technique.\u00a0 There are risks with <em>all<\/em> medical interventions, and arguably more known unknowns and unknown unknowns with new interventions.\u00a0 That, of course, is not a reason to hinder them, and it&#8217;s not a reason to hinder this, either.\u00a0 At most, it&#8217;s a reason to take\u00a0care &#8211; which\u00a0is exactly what we&#8217;d want anyway.<\/p>\n<p>Besides, we wouldn&#8217;t use the technique simply for the hell of it anyway.\u00a0 It&#8217;s only an option when there&#8217;s a serious chance of a catastrophic illness.\u00a0 So even if there are dangers with the technique, these have to be balanced against the dangers of natural conception that risks the illness.\u00a0 That is: even if (for the nonce) the technique is dangerous, it doesn&#8217;t follow that it&#8217;s the <em>most<\/em> dangerous option.<\/p>\n<p>(On this point, <a href=\"http:\/\/news.sky.com\/skynews\/Home\/UK-News\/DNA-Is-For-The-First-Time-Transferred-From-One-Human-Egg-To-Another-To-Help-Stop-Inherited-Diseases\/Article\/201004215602112?lpos=UK_News_Second_UK_News_Article_Teaser_Region_6&amp;lid=ARTICLE_15602112_DNA_Is_For_The_First_Time_Transferred_From_One_Human_Egg_To_Another_To_Help_Stop_Inherited_Diseases\">Sky quotes Alison Murdoch<\/a>, who seems to be right on the money: &#8220;They have to decide whether to have no children or go on getting pregnant and having babies that die because they are abnormal, or they could take a risk on a new treatment that we know can virtually eliminate mitochondrial disease.&#8221;\u00a0 That is to say, the real ethical problem has to do with <em>not<\/em> exploiting the opportunities presented by the technique.)<\/p>\n<p>I\u00a0don&#8217;t understand why &#8220;children with DNA from two mothers&#8221; is a worry &#8211; I have DNA from countless millions of mothers, right back to my last common ancestor with\u00a0a jar of Marmite.\u00a0 Moreover, mitochondrial DNA mutates very slowly anyway, so my mitochondria are likely to be pretty much the same as those from a lrge tranche of humanity &#8211; and Indo-European humanity espcecially.\u00a0 And, anyway: <em>who cares<\/em>?\u00a0 I mean, seriously: why on Earth is anyone bothered by the provenance of a person&#8217;s genes?\u00a0 My relationship with my parents has to do with them having played a major part in my formation; and though I can trace certain of my traits to one or the other of them &#8211; height from my mother, the &#8220;Whimster gap&#8221; between my front teeth to my father, hair from Satan himself &#8211; to suggest that genetics does or ought to make the blindest difference to that relationship\u00a0is pretty much incomprehensible: it misses just about everything that&#8217;s important in human interaction.<\/p>\n<p>Finally, Bruce is simply wrong about making genetic changes to unborn children.\u00a0 First, it&#8217;s not obvious why we shouldn&#8217;t make such changes, and so, until he says more, I think we&#8217;re entitled to find his claim a bit paltry.\u00a0 Second, though, it&#8217;s stretching things a bit to equate a newly-fertilised egg with a child.\u00a0 Though the cell contains DNA that will produce a child, that&#8217;s not the same by a long shot.\u00a0 For one thing, it&#8217;ll also produce the placenta, so unless you think that the placenta has the same status as a child, it&#8217;s hard to see how the fertilised egg does simply by virtue of genetic identity.\u00a0 Third &#8211; which follows from this &#8211; a single blood cell from an adult contains all the DNA to recreate them.\u00a0 Yet a blood cell doesn&#8217;t have the same moral status as a person.\u00a0 Ditto the undifferentiated cell being referred to here.\u00a0 Finally, <em>persons<\/em> count; but I&#8217;m not so sure about humans <em>qua<\/em> humans, or human cells <em>qua<\/em> human.\u00a0 Bruce seems to ignore that important metaphysical distinction.<\/p>\n<p>So much for Donald Bruce.\u00a0 The <a href=\"http:\/\/www.dailymail.co.uk\/health\/article-1266000\/Designer-baby-parents-hereditary-diseases-ready-years.html\">coverage in the <em>Mail<\/em><\/a> is surprisingly good, all things considered; however, they wheel out Josephine Quintavalle as their token Jeremiah, and her comment is even more empty-headed than Bruce&#8217;s, complaining that it&#8217;s a step toward reproductive cloning (which it isn&#8217;t at all, given that the nucleus is fertilised from, er, two parents &#8211; but, anyway: is reproductive cloning so bad?), and that<\/p>\n<blockquote><p>We know very little about the beginning of life and it is extraordinary how willing we are to break down one of the most obvious barriers, which is that it takes a sperm and an egg to create an embryo. We have got to find better ways to cure these diseases.<\/p><\/blockquote>\n<p>This just makes me think that Quintavalle has no idea at all of what she&#8217;s talking about, and &#8211; like Bruce &#8211; has a very small stock of statements that she tries to stick to a wide range of situations.\u00a0 I&#8217;ll keep an eye on the CORE website, though, to see if anything more substantial appears.<\/p>\n<p>(Incidentally, I am amused by the number of comments left on the <em>Mail<\/em>&#8216;s site complaining that the technique is unnatural.\u00a0 Comments left by people by means of a series of devices that allow near-enough real-time interaction with potentially millions of people, potentially over thousands of kilometres.\u00a0 Yeah.\u00a0 Damn that unnaturalness.)<\/p>\n<p><em><a href=\"http:\/\/www.independent.co.uk\/news\/science\/dna-breakthrough-may-prevent-inherited-diseases-1944926.html\">The Independent<\/a><\/em> gives reasonable coverage (albeit via a Press Association re-hash), with no brain-dribble from nay-sayers (though I&#8217;ll keep my eye on the columnists over the next few days).\u00a0 The same applies to <a href=\"http:\/\/www.timesonline.co.uk\/tol\/news\/science\/genetics\/article7097547.ece\"><em>The Times<\/em><\/a>\u00a0and the <a href=\"http:\/\/www.telegraph.co.uk\/health\/healthnews\/7590384\/DNA-breakthrough-could-eliminate-devastating-inherited-conditions.html\"><em>Telegraph<\/em><\/a>\u00a0and <a href=\"http:\/\/www.guardian.co.uk\/science\/2010\/apr\/14\/scientists-gene-swap-technique-disease\"><em>The Guardian<\/em><\/a>.\u00a0 (Actually, come to think of it, all their stories are pretty much identical, which is pretty damning: it suggests that all they do is change the byline of the press-release.\u00a0 At least the <em>Indy<\/em> had the decency to say that that&#8217;s what it&#8217;s doing.)<!--TrendMD v2.4.8--><\/p>\n","protected":false},"excerpt":{"rendered":"<p>News emerged last night of a new technique for avoiding mitochondrial disease.\u00a0 From what I can tell, the technique looks like a version of Somatic Cell Nuclear Transfer, and it involves removing the nucleus from a fertilised egg and placing it into an enucleated donor egg.\u00a0 Doing this means that any problems with the mitochondria [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/medical-ethics\/2010\/04\/15\/you-and-me-and-baby-makes-more-than-three\/\">Read More&#8230;<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[511,591],"tags":[317],"class_list":["post-349","post","type-post","status-publish","format-standard","hentry","category-in-the-news","category-life-and-death","tag-research"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.5 - 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