{"id":4620,"date":"2025-01-20T14:54:15","date_gmt":"2025-01-20T13:54:15","guid":{"rendered":"https:\/\/blogs.bmj.com\/medical-ethics\/?p=4620"},"modified":"2025-01-20T14:54:15","modified_gmt":"2025-01-20T13:54:15","slug":"should-liberal-states-permit-the-social-use-of-mitochondrial-replacement-technique-the-answer-is-yes","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/medical-ethics\/2025\/01\/20\/should-liberal-states-permit-the-social-use-of-mitochondrial-replacement-technique-the-answer-is-yes\/","title":{"rendered":"Should liberal states permit the social use of mitochondrial replacement technique? The answer is yes."},"content":{"rendered":"<p>By Marco Tang.<\/p>\n<p>What is <a href=\"https:\/\/mitocanada.org\/what-is-mitochondrial-replacement-therapy\/\">mitochondrial replacement technique<\/a> (MRT)? It involves obtaining a donor egg, removing the nDNA from the donor egg, transferring the legal mother\u2019s nDNA into the donor egg and fertilizing it with the legal father\u2019s sperm. This procedure enables women with mitochondrial disease to have children without it. What is unique is that this intervention produces an embryo with three genetic sources \u2013 the egg donor, the legal mother, and the legal father. Due to this procedure, there have been a <a href=\"https:\/\/www.theguardian.com\/science\/2023\/may\/09\/first-uk-baby-with-dna-from-three-people-born-after-new-ivf-procedure\">handful<\/a> <a href=\"https:\/\/www.npr.org\/sections\/health-shots\/2018\/06\/06\/615909572\/inside-the-ukrainian-clinic-making-3-parent-babies-for-women-who-are-infertile\">of<\/a> <a href=\"https:\/\/www.winfertility.com\/blog\/mitochondrial-replacement-therapy-explained\/#:~:text=In%20April%202019%2C%20a%20young,who%20carry%20mitochondrial%20DNA%20diseases.\">infants<\/a> in the past decade who wouldn\u2019t have been born without it. This includes the infant of a woman from <a href=\"https:\/\/jme.bmj.com\/content\/early\/2024\/02\/21\/jme-2023-109660\">Ukraine who couldn\u2019t have children due to poor oocyte quality<\/a>. This technique can thus help people who can\u2019t normally have children have genetically related children, e.g., lesbians and certain trans partners (partnerships where both partners have ovaries).<\/p>\n<p>I was first introduced to this topic last year in a graduate seminar where I read this exchange between <a href=\"https:\/\/jme.bmj.com\/content\/44\/12\/835\">Julia Cavaliere Cesar<\/a> and <a href=\"https:\/\/jme.bmj.com\/content\/45\/4\/280\">Palacios-Gonzalez<\/a>, and <a href=\"https:\/\/jme.bmj.com\/content\/44\/12\/865\">Francoise Baylis<\/a>. In this exchange, the former argues that Mill\u2019s harm principle justifies the use of MRT for lesbian and trans partners, whereas Francoise Baylis responds by arguing that the desire for genetically related children contributes to harmful social narratives on what it means to be a family. I was sympathetic to both these arguments, and this sympathy led to two questions: (1) is autonomy the only liberal commitment that justifies the social use of MRT and (2) is social harm the kind of harm Mill thought about when writing about the harm principle? My term paper was my attempt to answer these two questions, which led to <a href=\"https:\/\/jme.bmj.com\/content\/early\/2025\/01\/09\/jme-2024-110373\">my recent JME paper<\/a>.<\/p>\n<p>I ultimately defend Julia Cavaliere and Cesar Palacios-Gonzalez\u2019 view that social use of MRT for lesbian and trans partners is morally permissible. I defend two claims. The first is that the liberal commitment to the equality of opportunity also justifies the use of MRT. When we look around in places like <a href=\"https:\/\/www150.statcan.gc.ca\/n1\/pub\/11-627-m\/11-627-m2023006-eng.htm\">Canada<\/a>, <a href=\"https:\/\/academic.oup.com\/humrep\/article\/37\/11\/2611\/6751717\">the UK<\/a> or <a href=\"https:\/\/familyequality.org\/resources\/lgbtq-family-building-survey\/\">the US<\/a>, what is seen as part of the good life is having a family with one\u2019s life partner. Although having genetically related children is now how lesbians and trans partners have historically conceptualized \u201chaving a family\u201d, such couples undergo certain IVF procedures to create these biogenetic connections. For example, in <a href=\"https:\/\/extendfertility.com\/reciprocal-ivf-lgbtq-couples\/\">reciprocal IVF<\/a>, one partner donates the egg which will be fertilized and the other carries the embryo to term. MRT enables both partners to have a biogenetic relationship since both partners can contribute their eggs and carry the embryo to term. Secondly, I defend the claim that social harm, while bad, is not the kind of harm that can adequately respond to their use of Mill\u2019s harm principle. What is attractive about liberalism is that we get to live lives that conform to our own values even if they are somehow harmful to ourselves, e.g., <a href=\"https:\/\/www.jw.org\/en\/jehovahs-witnesses\/faq\/jehovahs-witnesses-why-no-blood-transfusions\/\">the Jehovah\u2019s Witness that refuses blood products<\/a> or <a href=\"https:\/\/www.citizen.co.za\/lowvelder\/news-headlines\/2014\/10\/08\/broken-bones-wont-keep-them-off-their-boards\/\">the skateboarder who breaks their bones<\/a> in their attempt to perform a trick. We allow such decisions to be made because we think such individuals can do so. We are sceptical of a government ban on such decisions for such reasons. Similarly, even in cases of socially harmful activities, e.g., <a href=\"https:\/\/www.ctpublic.org\/2023-05-25\/research-suggests-beauty-pageant-news-coverage-worsens-body-image-among-teens-young-women\">beauty pageants<\/a>, we ought to be and are sceptical of banning such events through government intervention precisely because we think people are capable of making their own decisions.<\/p>\n<p>I am sympathetic to Baylis\u2019 view that desires for genetically related children contribute to socially harmful narratives on what it means to be a family. Thus, I don\u2019t claim that liberal governments do nothing about such harmful narratives. Rather, whatever they do, they must keep in mind their liberal commitments.<\/p>\n<p>&nbsp;<\/p>\n<hr \/>\n<p><strong>Paper title<\/strong>: <a href=\"https:\/\/jme.bmj.com\/content\/early\/2025\/01\/09\/jme-2024-110373\">Liberalism and Mitochondrial Replacement Technique<\/a><\/p>\n<p><strong>Author:<\/strong> Marco Tang<\/p>\n<p><strong>Affiliations:<\/strong> University of Waterloo<\/p>\n<p><strong>Competing interests:<\/strong> None declare<\/p>\n<p>Social media accounts of post author: <a href=\"https:\/\/www.linkedin.com\/in\/tangmarco18\/\">https:\/\/www.linkedin.com\/in\/tangmarco18\/<\/a><!--TrendMD v2.4.8--><\/p>\n","protected":false},"excerpt":{"rendered":"<p>By Marco Tang. What is mitochondrial replacement technique (MRT)? It involves obtaining a donor egg, removing the nDNA from the donor egg, transferring the legal mother\u2019s nDNA into the donor egg and fertilizing it with the legal father\u2019s sperm. This procedure enables women with mitochondrial disease to have children without it. What is unique is [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/medical-ethics\/2025\/01\/20\/should-liberal-states-permit-the-social-use-of-mitochondrial-replacement-technique-the-answer-is-yes\/\">Read More&#8230;<\/a><\/p>\n","protected":false},"author":354,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[8057,2022],"tags":[],"class_list":["post-4620","post","type-post","status-publish","format-standard","hentry","category-medical-ethics","category-reproduction"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.6 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Should liberal states permit the social use of mitochondrial replacement technique? The answer is yes. - Journal of Medical Ethics blog<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/medical-ethics\/2025\/01\/20\/should-liberal-states-permit-the-social-use-of-mitochondrial-replacement-technique-the-answer-is-yes\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Should liberal states permit the social use of mitochondrial replacement technique? The answer is yes. - Journal of Medical Ethics blog\" \/>\n<meta property=\"og:description\" content=\"By Marco Tang. What is mitochondrial replacement technique (MRT)? It involves obtaining a donor egg, removing the nDNA from the donor egg, transferring the legal mother\u2019s nDNA into the donor egg and fertilizing it with the legal father\u2019s sperm. 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