Mitochondrial donation is a wonderful opportunity

My Times column on Britain's impending decision
to allow mitochondrial donation:

Tomorrow’s vote in the House of Commons on whether
to allow mitochondrial donation has at least flushed out the
churches. Both the Catholic and Anglican churches have decided that
it is not acceptable to let a handful of desperate families apply
to the authorities to be allowed to have their own children free of
the risk of rare mitochondrial conditions that, in the words of one
parent, “strip our children of the skills they have learnt and tire
their organs one by one until they fail”.

What conceivable greater moral good overrides the need of such
families? I suspect some clerics have gone no further into the
science behind this than the headline “Three-parent children”, and
said “Yuk!” If so, they have been horribly misled. There has rarely
been a more inaccurate phrase.

The DNA inside the mitochondrion, a tiny organ inside each of
our cells, is used only to make and run the mitochondrion. So even
if you wanted to make your child into, say, a musical prodigy, you
could not do so by altering his or her mitochondrial DNA.

That DNA is 500 [this should be more like 200,000: there are
16,000 base pairs of DNA in a mitochondrion, 3 billion in a haploid
nucleus; the gene ratio is more like 500] times less in quantity
than the DNA that runs the rest of the body and contains only 37 of
our 22,000 genes. It is barely any more relevant to your
personality than the bacteria in your gut. To call somebody with
donated mitochondria a three-parent child is like calling somebody
with a kidney transplant a three-person chimera, for the gene ratio
is the same: 0.2 per cent.

What is being suggested is a microscopic transplant. Admittedly,
it is a transplant that prevents horrible diseases recurring in
future generations, too, but what’s so immoral about that?

The churches’ main argument is that we should not be rushing
into this without proper consultation and review. Rushing? This has
been debated and studied for seven years. There have been three
independent reviews of the safety and efficacy plus many
discussions of the ethics.

The opponents of new technologies are always saying things have
been rushed, as they did with fracking last week. It’s the last
refuge of the person who wants to oppose something but has seen all
his arguments shot down. And the change in the law will not create
a free-for-all but merely allow clinicians to apply to the Human
Fertilisation & Embryology Authority (HFEA) for a licence. So
each case will be scrutinised and approved by scientists, lawyers
and ethicists, who are more competent to do so than your average
MP.

Ever since Baroness Warnock’s pioneering report on embryo
research in 1984, Britain has regulated advances in genetics and
embryology by having parliament set the overall ethical and social
tone, then devolving the detail to the HFEA, an approach that is
internationally admired. The church is effectively asking
parliament to be a regulator of medical research and practice.

Shockingly, I understand that Doug Turnbull, the Newcastle
University scientist leading the mitochondrial research, had not
once been invited by the archbishops’ council — which advised the
Church of England on this decision — to present his case to them
before they issued their fatwa against mitochondrial donation.
Knowing this debate was coming (and, if passed by the Commons, it
reaches the Lords in three weeks), I went to meet Professor
Turnbull, toured his lab and asked him some searching
questions.

I listened to him presenting his case in parliament twice. I saw
no bishop there on either occasion.

Or maybe our clerics are worried about slippery slopes and thin
ends of wedges. In that case they could go back and read what
people said about heart transplants and in vitro fertilisation
(IVF) and pre-implantation genetic diagnosis (PGD; that is the
selection of healthy embryos for IVF). Those debates were full of
blood-curdling warnings about what they might lead to. As soon as
people could choose donors, or pick embryos, they would be off to
the eugenic sperm bank in search of superior genomes for designer
babies, so the pessimists insisted.

No: it turned out that people want to use IVF largely to have
their own children and to avoid horrid diseases. Transplants, IVF
and PGD have generated happiness on an almost industrial scale with
almost no ethical downsides.

The slope just isn’t slippery. We’ve gone down it gradually and
carefully if at all because life is better nearer the bottom.

The part that surprises me most about this debate is that it is
some Conservative MPs who are leading the charge against
mitochondrial transplant therapy. I thought the whole point of
being a Conservative was that, as far as possible, you believed in
leaving decisions to individuals and families rather than the
state. If you think people should be free to choose their schools,
you might also think they can be free to choose healthy
mitochondria for their children.

Here are parents unable to have children without painful
afflictions, saying that they would like the chance to try a
procedure that will remove that risk. It is surely rational to say
that, if the state considers the procedure safe, it is up to those
families to decide whether they wish to try the procedure. How can
politicians or priests possibly know what is best for mothers in
this position?

Here is what a parent, Alison Maguire, says: “For families like
us, the consideration of risk is very different from those who
object from the sidelines with no real understanding of this
disease.”

She points out that the remote risk of something going wrong in
later life for one of the donee children has to be weighed against
the vast risk they now run of a much worse outcome. “This is a risk
that many of our families would jump at the chance to take, as
actually it is not a risk at all, for us it is hope.”

In the run-up to this debate, I found it hard to believe that
anybody, however strong their religious convictions, would fail to
be swayed by the facts once they knew just how carefully this work
has been assessed from every angle. Surely, I thought, most
church-going folk are not in the business of denying people hope
merely to avoid the remote theoretical possibility of — well, of
what, exactly? I still cannot see a reasonable objection to this
magnificent piece of technology in the service of human compassion.
I hope that when it reaches the Lords some bishops say so.