Today the House of Commons considered The Human Fertilisation & Embryology (Mitochondrial Donation) Regulations 2015, which enable the Human Fertilisation and Embryology Authority (HFEA) to licence the procedure known as mitochondrial donation.
This is a subject I know a little bit about having studied Natural Sciences at university. I’ve also taken the time to read the various briefings we have been sent (for example, by the Wellcome Trust and the Church of England) to make sure that I fully understand the complex techniques involved before deciding how to vote.
By way of background, mitochondria are small structures found in our cells which generate the energy to power every part of our body. Mitochondria have their own DNA, which controls how they function. This is separate from the DNA in the nuclei of our cells, which affects our appearance, personality and other features.
At least 1 in 200 children in the UK are affected by mitochondrial DNA disease. While many are asymptomatic or have mild problems, around 1 in 6,500 develop more serious mitochondrial disorders. There is no cure for such disorders and such children are unlikely to survive childhood. Mitochondrial donation is a new procedure which offers a way for families at risk of mitochondrial disease to have healthy children.
I've been contacted by a number of constituents about today's vote, some in favour and other against. The latter raise two concerns: is it safe and is it ethical?
Is mitochondrial donation safe?
Mitochondrial donation has been scrutinised by an independent panel of scientific experts on three separate occasions, first in April 2011 then in March 2013 and then again in June 2014. On each occasion, they found no evidence to suggest that the techniques are unsafe.
It is of course impossible to say with 100% certainty that something is safe before new medical procedures or drugs are used on people. If we required such certainty, we would never licence any new procedures or drugs. However, we can say with certainty that the scientific evidence suggests that any risks are proportionate given the fact that without this procedure children will continue to be born with this disease and die in infancy.
Is mitochondrial donation ethical?
The Nuffield Council on Bioethics, the Department of Health and the HFEA have all held extensive public consultations into the ethical and social issues raised by mitochondrial donation techniques. They all found broad public support for use of these techniques within a robust regulatory framework.
Constituents who have contacted me with concerns about this procedure have raised four specific concerns:
• first, that mitochondrial donation allows for the germ-line modification of human beings. This is true, but only in relation to mitochondrial DNA, not the nuclear DNA that affects our appearance, personality and other features;
• second, that mitochondrial donation allows for the creation of human life only for it to be destroyed. It is true that one of the two techniques allows for the destruction of a zygote, the single cell formed when an egg is fertilised by a sperm. Some of my constituents will certainly consider a zygote to be a human life; others will not. However we have licensed other techniques, such as IVF, that do the same thing, so it would be inconsistent to block mitochondrial donation for this reason alone;
• third, that mitochondrial donation allows for the creation of human beings with at least three parents. I don’t believe this is true, at least not in any meaningful sense. Almost all of the genes of a child that benefits from this procedure will come from the parents who will bring it up; the mitochondrial donor will only contribute 37 genes, one thousandth of its total DNA. And these genes will not affect the child’s appearance, personality or any other features that make a person unique - they will simply allow the mitochondria to function normally so the child is free of mitochondrial disease. During the HFEA’s public dialogue exercise, most people rejected the idea that this equates to “three-parent IVF”; and
• fourth that mitochondrial donation allows for the selection of human beings with more desirable characteristics and it is therefore a form of eugenics. Again I don't think this is true. The Regulations only allow for unaltered nuclear DNA to be transferred to an egg or embryo that has unaltered, healthy mitochondria. Genetic modification of nuclear DNA will remain illegal. So the only characteristic that is being selected is healthy mitochondria.
Having considered these issues carefully, I therefore decided to vote for the Regulations and the House supported them by 382 votes to 128. For some of my constituents, worried that their children might suffer from this terrible disease, that will be very good news. But I recognise that others will be concerned by this decision. I would like to reassure them that never before has a new reproductive technology been subjected to such thorough investigation and that today’s vote will not mean it is open season for these techniques to be used by everyone and anyone. The HFEA will consider requests for treatment on a case by case basis, taking expert scientific and medical advice and only licensing the procedure if the evidence shows that it is appropriate.