There are a number of consultations currently underway but none more contentious than that on mitochondrial donation. The chance to end some of these life threatening diseases which are inherited through mutant  D N A mitochondria in the cytoplasm of ova is not disputed,  but the methods suggested raise some of the most profound questions in medical ethics.

Firstly, what ethical framework is there which can be applied  to changing future generations in perpetuity? What degree of certainty would be required to ensure that errors are not introduced especially as is now clear that babies born from I V F have a higher incidence of abnormalities. The two methods of mitochondrial  donation most favoured by experts, cell nuclear transfer, and maternal spindle transfer, are more invasive than other interventions in I V F and in truth the outcome can only be known after the birth of babies created in this way.

Reading the reports of the expert committees advising government, it is clear that this is the case from their request that children be followed up long term. Their suggestion that there should be a program of primate research also suggests uncertainty and it is not clear how this would shed light on mental health in man.

Unfortunately, Parliament in 2008 made an exception to the law which forbids the alteration of the germ line in the case of mitochondrial disease, and the right of children to know their genetic origins. Thus any child  born will never have the right to know that he or she had more than two parents.

The ethical questions are immense but are unlikely to be asked. The consultation about to open is unlikely to address questions which have such profound medical and social consequences.


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