Chapter 2 - Ethics of mitochondrial gene replacement therapy

Abstract

In 2015, the United Kingdom became the first country to legalize novel reproductive technologies known as mitochondrial donation or mitochondrial replacement therapy, enabling women with mitochondrial disease to have healthy, genetically related children. This chapter explores the situation in the UK and the review process that preceded legalization amid global concerns about human genetic modification. As the technique uses part of a donated egg to replace disease causing faulty mitochondria, the child (and future generations) would inherit DNA from a “third person”—the mitochondrial donor. The chapter explores the process of legalization in the UK and the social and ethical issues raised, including whether the donor is a “parent” and the implications for identity, genetic modification, and the “slippery slope,” and the potential risks for the donor. The chapter concludes by explaining why mitochondrial disease presents challenges for genetic counseling and considers alternatives to mitochondrial donation and future technologies.