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Open Access 01-12-2017 | Scientifc Contribution

Are there moral differences between maternal spindle transfer and pronuclear transfer?

Published in: Medicine, Health Care and Philosophy | Issue 4/2017

Abstract

This paper examines whether there are moral differences between the mitochondrial replacement techniques that have been recently developed in order to help women afflicted by mitochondrial DNA diseases to have genetically related children absent such conditions: maternal spindle transfer (MST) and pronuclear transfer (PNT). Firstly, it examines whether there is a moral difference between MST and PNT in terms of the divide between somatic interventions and germline interventions. Secondly, it considers whether PNT and MST are morally distinct under a therapy/creation optic. Finally, it investigates whether there is a moral difference between MST and PNT from a human embryo destruction point of view. I conclude, contra recent arguments, that regarding the first two points there is no moral differences between PNT and MST; and that regarding the third one MST is morally preferable to PNT, but only if we hold a gradualist account of the moral value of human embryos where zygotes have slight moral value.

Only one case of mitochondrial DNA inheritance via the paternal line has been documented in the academic literature (Schwartz and Vissing 2002).

Even when the name ‘mitochondrial replacement techniques’ is controversial I use it because it has secured a foothold within the academic debate, see Palacios-González (2016, p. 40). The name is controversial because the techniques transfer nuclear DNA and thus a better term would be ‘nuclear replacement techniques’. Paying attention to this fact is important in order no to mischaracterise the techniques as intentionally replacing mitochondria, as Tina Rulli does: “MRTs replace the defective mitochondria [emphasis added] from the intended genetic mother’s egg with the healthy mitochondria from a donor woman’s egg” (Rulli 2016b, p. 2). Newson and Wrigley (2017) have recently proposed and defended the term ‘mitochondrial targeting techniques’.

During the chromosome transfer there can be unintentional carryover of pathological mitochondria. The mtDNA disease could manifest if the pathological mitochondria carryover is substantive (Yamada et al. 2016).

For a review of the issues that have been explored in the literature see: ‘Ethics of mitochondrial replacement techniques: a Habermasian perspective’ (Palacios-González 2017a).

Although this situation is feasible it is not the standard practice in reproductive scenarios.

The case just described is structurally symmetric to other very well known non-identity cases, for example ‘the 14 years old girl’ case described by Parfit in his ‘Reasons and Persons’ (Parfit 1984, p. 358).

For an overview of the non-identity problem see Roberts (2015). For an exposition of why there is no such thing as a non-identity problem see Boonin (2008, 2014).

Even when much of the MRTs literature presupposes that ‘numerical identity follows the nuclear genome’ this position has not been argued for.

This fact about PNT was first identified by Palacios-González (2016, note. 12 p. 46, 2017b) and Rulli (2016a).

This is also true of MST: the clinical decision to employ MST affects the timing of conception.

In actuality, there is no metaphysical impossibility for the same gametes to fuse, but the probability of that being the case is negligible.

This conclusion also follows, in most cases, if we hold a weak origin view, as shown by Rulli (2016b). According to the weak origin view the numerical identity of the individual persists as long as it is the same egg that that is fertilised. In other words, a change in sperm is not identify-affecting. This conclusion also follows because the clinical decision to employ PNT affects the timing of conception in a matter of months, and not only to days, given the time needed for the ovarian stimulation to take place.

In a paper that was published while this paper was under review, Tina Rulli has also pointed out that the clinical decision to employ PNT alters the timing of conception and thus it should not be characterised as therapeutic. One issue with Rulli’s paper is that throughout it she fails to properly specify when she is talking about ‘the clinical decision to employ PNT’ and when she is talking about ‘the process of PNT’. For example: “But PNT does not treat an existing person or a person who is on its way into existence. Rather the child will exist just because PNT is selected to be used in her creation” (Rulli 2016b, p. 5).

I am aware that most cases can be modified to produce non-identity scenarios.

Two real life cases could be as follow: L’s parents could have a change of heart in the last second about PNT, or there could be confusion in the clinic and embryo L could be transferred to the intending mother without the process of PNT occurring. Supposing the process of PNT is safe and effective both these scenarios would leave L worse off than she would otherwise have been, since the alternative in both cases is for the process of PNT to ensue and L not to have a mtDNA disease.

In her treatment of PNT Rulli misses this important point, for she only focuses on the possible benefits that the process of PNT could confer: “There is a trivial sense in which the child produced by PNT is benefited—that is, she is not harmed as she could have been had PNT not been used” (Rulli 2016b, p. 4).

Supposing that the individual’s life is still not a wrongful one.

Assuming that her life is still not a wrongful one.

Under a ‘numerical identity follows the nuclear genome’ account only one embryo is destroyed, under the organism view account two embryos are destroyed.

Here I am using person in the Lockean sense: a person is “a thinking intelligent being, that has reason and reflection, and can consider itself as itself, the same thinking thing in different times and places” (Locke 1975, p. 335).

Here I am drawing from Green’s (2002) “Benefiting From ‘Evil’”.

It is important to emphasise that I am assuming that both techniques are equally safe and effective.

There has been proof of principle that a human live birth is possible after MST and PNT (Zhang et al. 2016; Coghlan 2017).

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Title: Are there moral differences between maternal spindle transfer and pronuclear transfer?
Publication date: 01-12-2017
Published in: Medicine, Health Care and Philosophy / Issue 4/2017
Print ISSN: 1386-7423
Electronic ISSN: 1572-8633
DOI: https://doi.org/10.1007/s11019-017-9772-3

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