Ethische und konzeptuelle Aspekte des Mitochondrien-Transfers: („Drei-Eltern-Kind“)

Definition of the problem Although mitochondrial replacement techniques have been performed in humans and have been legalized in the UK, three crucial conceptual questions are yet unanswered: (1) Are mitochondrial replacement techniques a germline intervention? (2) Are mitochondrial replacement techniques a medically indicated therapy or an elective procedure of assisted reproduction? (3) What are the concepts of parenthood and identity behind mitochondrial replacement techniques? In our paper, we show that the ethical assessment of the procedure depends on the conceptual framing. Arguments The procedure is an intervention in the germline, which makes it necessary to include future generations in the risk assessment. The procedure has to be regarded as an elective assisted reproduction technique since there is no medical necessity for its application. This is especially important when it comes to public funding for the clinical application. The term “three-parent child” is incorrect and misleading. It implies an outdated concept of parenthood that relies solely on genetic relatedness. Hence, the negative consequences for the future child’s psychosocial development as well as for family dynamics that are stated by some commentators are unfounded. Conclusion The clarification of the three conceptual issues allows a sound ethical assessment. We conclude that the clinical implementation of mitochondrial replacement techniques is ethically acceptable as long as the safety of the procedure is further improved and it is implemented as an elective procedure of assisted reproduction without entitlement to public funding.