Cross-posted with Biopolitical Times on May 14th, 2014.
The United Kingdom may be on the verge of becoming the first country in the world to allow fertility specialists to create embryos with permanently altered genetic makeup. Parliament is expected to decide later this year whether to allow an exception to the UK law that prohibits inheritable genetic modification. If the proposal is approved, it would be limited to a very specific procedure for a very specific reason – nuclear genome transfer between two different women’s eggs for the purpose of allowing a woman to have a mostly genetically related child who does not inherit her mitochondrial dysfunction. However, it could disrupt the existing de facto international policy agreement that human germline modifications should not be permitted.
Approval of this technique – known by several terms including “mitochondrial manipulation” and “three-person embryos” – would not constitute approval for other kinds of inheritable genetic manipulations. But nowhere else in the world has a policy or technical line been drawn at this curious point. All other countries that have considered human germline modification have prohibited it, as has the UK. If a country that is a respected biomedical hub chips away at this prohibition, it could create reverberations in policy around the world.
A new report in Reproductive BioMedicine Online by Tetsuya Ishii addresses this concern. It is called “Potential impact of human mitochondrial replacement on global policy regarding germline gene modification” and in it, Ishii argues that the UK must be aware that it is making this decision within a global society.
The article addresses a number of points: ethical issues surrounding egg procurement as well as the potential slippery slope to other kinds of germline modification; safety concerns that could be much more serious than those associated with already accepted forms of assisted reproduction; and both short-term and long-term consequences to biomedical policy around the world.
In the short term, Ishii notes that a change in UK law could encourage the US, Japan, China, and Israel in particular to consider this technique as well. In the longer-term, he considers the advancing state of other genome-editing technologies (which he address more thoroughly in another recent paper inTrends in Biotechnology) and points out that when considered on a global scale,
Legalization in the UK might cause another slide down the slippery slope to full-blown germline gene modification because the slope to further genetic modification will seem less steep than is the case with the current total ban.
The importance of Ishii’s report is its examination of the full policy context of approving the proposed technique, and its insistence that responsibility in this sector now requires a global perspective. Additionally, Ishii offers conclusions in line with many recent statements (see the previous Biopolitical Times blogs below) that there is not enough data on any front to move forward in good conscience with so-called “mitochondrial replacement.” He states,
It is concluded that international harmonization is needed, as well as further ethical and practical consideration, prior to the legalization of human mitochondrial replacement…
As a member of a global society, the UK Government and Parliament should sufficiently discuss scientific, ethical and legal justifications for human mitochondrial replacement.