Experts discuss mitochondrial replacement therapy and the future of U.S. policy
By Nirban Bhatia
Last month, The Petrie-Flom Center for Health Law Policy, Biotechnology, and Bioethics at Harvard Law School organized a panel of academics from around the globe to present their research and perspectives on mitochondrial replacement therapy (MRT), a highly controversial treatment that is currently prohibited in the United States.
The MRT process takes healthy mitochondria from a donor’s egg and then replaces its nucleus with the mother’s nucleus. This procedure is primarily done so women with mutant mitochondrial DNA can have biological children without any mitochondrial disease. Mitochondrial disease is known to cause serious issues such as oxygen deprivation, which can leave people bed-ridden or in a wheelchair with severe impairments. While this treatment serves as a great solution for a number of women, experts are not entirely sold on its benefits.
Each individual panelist was allotted a brief amount of time to highlight the major findings from their work. While the content during the first half of the presentations revolved around the in-depth biology of MRT and the various techniques used, the conversation steadily transitioned into a more interdisciplinary realm, ultimately concluding with a social and bioethical lens on the issue.
Currently, MRT is banned in the United States due to unresolved debates about the value of the procedure versus the ethical issues it presents. In terms of public opinion, a study conducted by medical faculty at Columbia University found that 90% of women interested in having children would undergo MRT to have a child. Although there is public support, the relatively niche use of MRT seems to explain why it has not been a significant priority for our nation.
Multiple panelists made references to the United Kingdom, which unlike the United States, allows MRT if a given clinic has a special license and a patient is approved by a review board.
While a UK-based model would be difficult to emulate due to the fragmented health care system in the United States, there are also significant philosophical roadblocks in the U.S. As discussed by Dr. César Palacios-González, a Fellow at The Oxford Uehiro Centre for Practical Ethics, many are concerned that MRTs will pave the way for the increased use of other gene-editing technologies such as CRISPR. Additionally, some critics believe the approval of the unborn child would be necessary to ethically use MRT.
In contrast, supporters believe that barring MRT in the United States infringes upon reproductive freedom, an issue that is consistently brought up in health policy discussions. Many claim their moral and fundamental right to undergo whatever procedures they desire, especially if the procedure can improve health outcomes for many children annually.
Although this panel discussion did not result in any decisions or outcomes, it laid out a highly informative and thorough landscape of the MRT dispute currently troubling policymakers in the United States. You can watch the full discussion here.