NAM Releases Report on Mitochondrial Replacement Therapy


I. Glenn Cohen (Faculty Director)
Bill of Health Blog
February 3, 2016

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From the Part II post:
My last post was a summary of the NAM’s Recommendations on Mitochondrial Replacement Therapy (MRT). Now here is my take on the report. But keep in mind the report was just released and all I could give it was a quick read, so these are really more like initial impressions:
  • Overall the report is excellent. It deeply engages with the science, is quite balanced and well written.
  • The recommendation that MRT be limited to transfer of male embryos is very clever and interesting. The idea behind it is that it will eliminate the risk of germ-line modifications being transmitted to future generations, which is the real boogy man in the picture and has been a major issue for CRISPR gene-editing. That said it has a couple of negative ramifications
    1. It will require the discard/freezing of female embryos which may anger some religious conservatives, but I am not sure they are a constituency behind MRT to begin with.
    2. It creates a gap between what will be permitted in the US v. the UK (where there is no such restriction). I suspect that few individuals will choose one over the other for this reason, i.e., this is not a likely cause of medical tourism. But if the concern is that future generations will have the modification and pass it on, all this does is mean that children born in the US will not, the UK kids will and over time with people moving, marriage, etc, the issue will manifest, though more slowly.
    3. Some may view this as a problematic form of sex selection. “Some” as in “not me,” but it is interestingly different from, for example, using sex selection to avoid sex linked disorders since the benefit does not really flow to the offspring here but instead future generations.
  • I think they give a little too short a shrift to the UK safety data and adjudicatory process I have written about here which is excellent. While every country has to decide for itself, I do think one gets the impression this is more terra icognito from the report than it is. In particular the public engagement in the UK produced some very interesting results/information that I think it useful.
Read the full post here and Part I post here.
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bioethics   biotechnology   health law policy   i. glenn cohen   international   regulation