The ways to make a baby have been expanded once again. While the ways to bring a baby into this world can be the source of much bioethical debate, it was generally accepted that two people would be part of the process. After a recent decision in the British House of Commons, this given has changed – three parent in vitro fertilization (IVF) has been approved.
The way three-parent IVF works (in a very simplified explanation) is the nucleus from an egg with defective mitochondria would replace the nucleus of an egg with healthy mitochondria (see here). This means that embryos developed from this process would have two mothers and a father. This process, referred to as “mitochondrial transfer” by supporters, has been banned in every country except the United Kingdom at this point based on the germline alteration that occurs during the process (see here). However, this process has been proposed for research approval in the United States, as well (see here).
This procedure of three-parent IVF raises a myriad of bioethical concerns. Rather than address all of the potential ethical concerns created by this technique in one blog post, today I’m going to focus on ethical concerns for the child created through this process.
First, although we live in a time when family seems to have a fluid definition, we do not have children with three biological parents. This raises the need for ethical consideration of the social situation we are creating for children through this process. How will parental rights be determined? Would this be treated as a contractual agreement or a family law determination? How would custody be determined should something go awry and the relationship (be it contractual or familial) between the three parents changes? Although we could look to situations where a child was conceived through egg donation to get an idea of the answers, this is truly a field without any precedent. Second, three-parent IVF raises ethical concerns regarding potential health risks that could be manufactured through this process. Because this is new process, the children created through it are potentially at risk for health consequences that cannot be known or predicted. I cannot help but think of the situation with Dolly the sheep being cloned and suffering from many health consequences that were unforeseeable at her creation using the (then) new process of cloning. We cannot predict the future, and it is the children without a say in the matter whose future we are gambling with. Finally, there is concern about the application of the three-parent technique. At this point, the three-parent IVF technique is only being promoted to help treat infertility in older women and for treating mitochondrial disease. There is a strong concern, however, that once it is approved for these processes it will subsequently be approved for manipulation of genetic material for other reasons that may not be therapeutic in nature.