What Is the Value of Three-Parent IVF?

• Published in: The Hastings Center report Vol. 46; no. 4; pp. 38 - 47
• Main Author: Rulli, Tina
• Format: Journal Article
• Language: English
• Published: United States Blackwell Publishing Ltd 01.07.2016; The Hastings Center
• Subjects: Anonymity; Biomedical technology; Children; Deoxyribonucleic acid; DNA; Ethics; Ethics, Medical; Female; Fertilization in Vitro - ethics; Genetic Engineering - ethics; Human genetics; Humans; In vitro fertilization; Male; Medical genetics; Mitochondria; Mitochondrial diseases; Mitochondrial Diseases - prevention & control; Mitochondrial DNA; Mothers; Opportunity costs; Privacy; Reproductive Techniques, Assisted - ethics; Social ethics; Social policy; Tissue Donors - ethics
• ISSN: 0093-0334; 1552-146X
• DOI: 10.1002/hast.594

In February 2016, the Institute of Medicine released a report, commissioned by the United States Food and Drug Administration, on the ethical and social‐policy implications of so‐called three‐parent in vitro fertilization. The IOM endorses commencement of clinical trials on three‐parent IVF, subject to some initial limitations. Also called mitochondrial replacement or transfer, three‐parent IVF is an intervention comprising two distinct procedures in which the genetic materials of three people—the DNA of the father and mother and the mitochondrial DNA of an egg donor—can be used to create a child. Three‐parent IVF would enable a woman with mitochondrial disease to have a genetically related child without transmitting the disease to the child. The possibility for three‐parent children has prompted criticism from many corners. Critics have pointed to ethical issues including safety concerns and risks to children, genetic and germline engineering concerns, the potential exploitation of the third‐parent egg donor, donor anonymity and privacy, and objections to creating babies with three parents, which undermines natural and traditional conceptions of procreation. Additionally, developing the technology would involve experimenting on, manipulating, and disposing of embryos. Although the IOM report considers the ethical concerns about the value of the three‐parent IVF technology, the IOM failed to give due attention to an important objection to the development of this technology: three‐parent IVF lacks the social value necessary to make investment of public resources in it ethical. Unlike the other concerns, this objection is not based on conservativism about new reproductive technologies or default favoritism of the status quo. I argue that the technology does not meet a plausible social value standard to render public research investment into its development ethical. Proponents of three‐parent IVF make inaccurate and exaggerated claims that it will eradicate mitochondrial disease and save lives. Were these claims true, proponents would have a strong case for the social value of the technology. But three‐parent IVF alone will not eradicate mitochondrial disease, and it will not save lives. Rather, it can create healthy lives. As I discuss, the moral distinction is crucial. Most importantly, investment in three‐parent IVF comes at the opportunity cost of researching treatment for mitochondrial disease that would benefit actual, living disease sufferers.