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The Mitochondrial Replacement ‘Therapy’ Myth

Bioethics

Published online on

Abstract

This article argues that two forms of mitochondrial replacement therapy, maternal spindle transfer (MST) and pro‐nuclear transfer (PNT), are not therapies at all because they do not treat children who are coming into existence. Rather, these technologies merely create healthy children where none was inevitable. Even if creating healthy lives has some value, it is not to be confused with the medical value of a cure or therapy. The article addresses a recent Bioethics article, ‘Mitochondrial Replacement: Ethics and Identity,’ by Wrigley, Wilkinson, and Appleby, who argue that PNT is morally favorable to MST due to the Non‐Identity Problem. Wrigley et al. claim that PNT, since it occurs post‐conception, preserves the identity of the resulting child, whereas MST, since it occurs pre‐conception, is an identity‐altering technique. As such, a child born with mitochondrial disease could complain that her parents failed to use PNT, but not MST. The present article argues that the authors are mistaken: both MST and PNT are identity‐affecting techniques. But this is of little matter, for we should be cautious in drawing any moral conclusions from the application of the Non‐Identity Problem to cases. The article then argues that the authors are mistaken in inferring that PNT is a type of embryonic cure or therapy for children with mitochondrial disease. The article cautions against the mistaken life‐saving rhetoric that is common in bioethics discussions of MRTs.