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Babies From Three Parents

An essay [1] recently published in the Journal of Medical Ethics (JME) argues that “three-parent embryo” technologies (3-PETs) legally should be made accessible to lesbian couples where both members of the dyad want to be genetically related to the children they create.

In 2015, the UK became the first country to legalize the creation of embryos with three genetic parents.  It did so for treating a rare degenerative condition called mitochondrial DNA (mtDNA) disease, which female carriers can pass on to their progeny through infected mitochondria in their eggs.  I’ve described and commented on the two technologies in an earlier blast [2], so I will review the techniques only briefly here.

In the first, maternal spindle transfer, an IVF embryo is created using normal sperm and a genetically modified egg formed from two women, one who donates the nucleus, and the other who donates the egg sac and cytoplasm (called an enucleated egg).  The second and preferred method, called pronuclear transfer, involves creating two human embryos through IVF, one using an infected egg, the other using a non-infected egg, then killing both embryos to create a third uninfected embryo.

In both techniques, DNA from three people—two women and one man—contribute to the new person’s genome.

Presently [3], the UK only makes 3-PETs available for female carriers of the abnormalities causing mtDNA disease.  The authors of the JME article, appealing to what they call “reproductive freedom,” argue that 3-PETs should be made more widely available for non-therapeutic purposes.

“Reproductive Freedom”

The authors begin by considering the concept of “reproductive freedom.”  In its classical guise (defended by bioethicists such as John Harris and Dan Brock), it advocates for women to be left free to make reproductive choices without interference from third parties.

The authors argue that this is too narrow.  They say reproductive freedom not only entails immunities from interference, but also positive claims to “self-determination” and “self-making” through reproductive autonomy.  Failing to make available the necessary kinds of choices impedes people’s ability to “lead a good life.”  This is what is happening, they say, to lesbians who, seeking genetic inclusion rather than avoidance of disease, are effectively barred from 3-PETs.

The authors concede that limits on reproductive freedom are justified when one’s actions are likely to cause significant harm to others.  But they believe that neither of the 3-PETs mentioned above cause any such harm to anyone; they particularly refer to the children created by the techniques: “Such children are not made worse off by mitochondrial replacement techniques because the only other available ‘option’ for them is not to exist.”

Since no significant harm is caused, reproductive freedom requires that 3-PETs be made available to lesbian couples who “want” their reproductive options widened to include creating children with three genetic parents.  This, the authors argue, is a requirement of “equality.”  Barring lesbians such access “would be immoral.”

Considerations Of The Welfare Of Children

The argument that extending these techniques to lesbian couples would harm no children fails on several accounts.

First, the authors exhibit a grotesque blind spot with respect to the embryonic people who are killed executing pronuclear transfer.  Not even a mention of their welfare.  The authors no doubt would appeal to common accounts [4] of secular philosophers to deny that human embryos possesses the moral status of persons.  But the lines that these accounts [5] draw for determining which living human beings are and are not persons are arbitrary, just as arbitrary as if we drew the line of non-personhood to exclude the philosophers who propose the accounts.  The authors’ failure to mention the demise of human embryos undermines the essay’s credibility.

Second, the authors believe that a child who does not yet exist cannot be wrongfully harmed by the deliberate choices of its future caregivers.  This is specious.  Choices I make prior to bringing a child into the world can be unfair to a future child.  The woman who poisons her body using drugs prior to pregnancy, which, as a result, causes birth defects in her future child, has wronged that child.  Prior to its conception, she does something conditionally unjust by making avoidable choices that she should foresee could seriously harm any future child she conceived; when the child is conceived, the conditional injustice become an actual injustice.  The man who rapes a woman not only wrongs her but wrongs the child she conceives through his rape.

Lesbian couples, too, wrong the children they bring into existence through 3-PETs in four ways:

First, they instrumentalize the children by bringing them into existence by a subpersonal laboratory technique and denying them their right to be conceived within a male-female marriage and from that marriage’s sexual intercourse (see Donum Vitae [6], I, 6).

Second, bringing a child into the world with the intent not to provide him with both a father and a mother to parent him is against the child’s natural right to be raised by both parents.

Third, bioengineering children using techniques that may have gravely harmful [7] long-term effects [8], effects that neither the couple nor the scientific community can rule out with moral certainty, is also unjust.

Finally, by denying the children’s right to be conceived by and born to opposite-sex married parents, and by using donor sperm, the lesbian couple willingly subjects the children they create to the psychological harms [9] that are likely to arise from internal conflicts about their own parentage, especially paternity.