Medical ethicist red-flags new three-parent in vitro baby procedure

A prominent Canadian medical ethicist is alarmed by a vote this week in Britain’s House of Commons to approve in vitro fertilization involving genetic material from three people.

Margaret Somerville, founding director of McGill University’s Centre for Medicine, Ethics and Law, said the procedure, which aims to eliminate genetic diseases inherited from the mother, creates a “very worrying” precedent and opens the door to a future that could include designer babies.

“It’s a major, major move away from what we thought was acceptable,” Somerville said in an interview with Yahoo Canada News.

BBC News reported the Commons approved the technique Tuesday, 382-128 in a free vote.

"We’re not playing god here,” Prime Minister David Cameron said. “We’re just making sure that two parents who want a healthy baby can have one."

The measure must still be passed by the House of Lords to become law, but it’s thought the first baby conceived using the technique could be born next year.

The British-developed technique aims to replace defective mitochondrial DNA in the would-be mother’s egg, which can place the baby at risk for a variety of debilitating and potentially fatal disorders from heart defects and brain damage to liver failure and muscular dystrophy, with healthy DNA from a donor egg.

Eliminating the defective genes would conceivably eliminate the disease risk from the child, as well as its future offspring.

Somerville said permanent change to a human’s gene makeup has serious ethical implications, unlike more common somatic-cell gene therapy that does not create inheritable characteristics.

“This alters what’s called the human germline, the genes passed on from generation to generation,” she said. “The way in which you alter that child that you’re making, every descendent of that child will be altered in the same way.”

“Up until the present, one of the the few and possibly only areas where almost every ethicist in the world agreed was that we should not alter the human germline. That was ethically wrong.”

Don’t mess with the germline

The germline is considered to be held in trust for future generations.

“Which means it’s the one thing we can’t mess around with,” Somerville said. “This breaks that; this says well, we’re going to change it.

“Once you say that you’re going to do that, why would any other alternations be prohibited?”

Contacted by Yahoo Canada News, a spokeswoman for the Canadian Medical Association said the doctors’ organization does not have a policy on the issue and could not comment.

Somerville said Canada’s policies on reproductive technology are more conservative than Britain’s.

A spokesman for Health Canada pointed to a section of the Assisted Human Reproduction Act, passed in 2004. It prohibits altering the genome of a cell of a human being or in vitro embryo such that the alteration is capable of being transmitted to descendants.

"Because the definition of ‘genome’ in the AHR Act includes all the genetic information in a cell, this prohibition prevents the use of technologies intended to replace defective mitochondrial DNA in a woman’s eggs," Eric Morrissette said via email.

"At this time, it is unknown what long-term effects may occur when an embryo has mitochondrial DNA from a person unrelated to the genetic parents. This prohibition makes it illegal in Canada to knowingly create embryos that have nuclear DNA from two people and mitochondrial DNA from a third person …"

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Proponents of the three-parent technique argue manipulating mitochondrial DNA does not affect other genetic characteristics.

But Somerville agrees with skeptics who say not enough research has been done on the procedure’s long-term effects on a child physically, mentally and psychologically.

“We’re learning so much more about genetics and we’ve got no idea what this is going to mean for that kid in terms of any sort of harmful effects,” she said, pointing out the new field of epigenetics is demonstrating external factors such as environment can imprint changes to genes, some of which control behaviour.

Door opened to designer babies

And while this technique has tentatively been approved to treat inherited mitochondrial diseases, it may not end there.

“Once you step over that line and say OK, we can design a child, then why not design all the other features of the child and get exactly what you want?” Somerville argued. “It’s definitely a slippery slope.”

It also raises thorny questions of disclosure. Somerville is a strong advocate for children maintaining or at least knowing about the biological connection with their parents. She noted German courts last week ruled all children born from donated sperm or eggs have the right to know at any time who those donors were. The same rights presumably could attach to three-parent children.

According to media reports, about 150 children born in Britain annually and 6,500 children worldwide are afflicted with inherited mitochondrial defects. Somerville said the impetus for developing the technique comes out of compassion and the desire to ensure women give birth to healthy children.

“A compassionate response is good but it doesn’t mean that everything you do out of compassion is ethically acceptable.”

Somerville said the problem is that the science is adult-centred instead of putting the child at the centre.

“We’ve got to say is this right for this child when we don’t know what the long-term risks are, when we don’t know how a person who comes from three genetic parents will feel about that, who’s not born from natural human origins?”