Consultation on Mitochondria Replacement- Guidelines for Completing the Consultation
Consultation on Mitochondria Replacement- Guidelines for Completing the Consultation
The Human Fertilisation and Embryology Authority (HFEA) has launched a public consultation to gauge support for the legalisation of mitochondrial replacement, an IVF-based reproductive technology which would allow the creation of children with three genetic parents.
Filling in the consultation
You cansend your response to the consultation as a Word document to .
Alternatively, you can respond via the online form on the HFEA website available at: You will need to register with the HFEA in order to complete the consultation in this way.
The consultation is made up of seven questions. You do not need to answer all seven questions, but we encourage you to answer questions 1, 3, 6 & 7.
What is mitochondria replacement?
Mitochondrial replacement is designed to prevent parents from passing mitochondrial diseases on to their children. Mitochondria are small organelles that help our bodies to create energy. Because almost every cell in the human body relies on their energy, faulty mitochondria can lead to a variety of diseases, including heart disease and muscle failure. Mitochondrial replacement works by removing the nucleus- the ‘core’- from an egg or embryo with faulty mitochondria and inserting it into a donor egg or embryo with healthy mitochondria. The resulting child would contain genetic information from the father’s sperm, the mother’s egg, and the donor’s mitochondria.
Ethical issues
There are a number of serious ethical concerns involved in mitochondria replacement:
1)The protection of human life from conception until natural death. Mitochondria replacement is an IVF-based treatment, which means that it will involve the creation of a number of human embryos, the selection and implantation of the most ‘viable’, and the destruction of the remaining embryos. Every embryo destroyed is a life lost.
2)It is wrong to allow parents and/or doctors to determine the value of a human life on the basis of ability or disability. Every child created will be aware that he or she was ‘selected’ from a group of potential brothers and sisters, some of whom will have been discarded as a result of potential disabilities or illnesses.
3)Any child born through mitochondria replacement will contain genetic material from three ‘parents’ (two mothers and a father). This is bound to cause confusion and pain for both the parents and the child. Eventually both the child and the donor may wish to pursue a parent-child relationship.
4)Mitochondria replacement carries unknown risks, and could lead to children being born with serious abnormalities and defects. Any genetic problems will not only affect the child conceived through its use, but every subsequent generation. It is a permanent, irreparable alteration of humanity’s shared genetic history.
Question 1: Permissibility of new techniques
Having read the information on this website about the two mitochondria replacement techniques, what are your views on offering (one or both of) these techniques to people at risk of passing on mitochondrial disease to their child? You may wish to address the two techniques separately.
This question is asking your opinion on the permissibility of mitochondria replacement. The HFEA is consulting on two mitochondrial replacement techniques: the ‘egg repair’ technique and the ‘embryo repair’ technique. Although only the ‘embryo repair’ method necessitates the destruction of a fertilised egg (and therefore a human life), both techniques rely on IVF, which results in the destruction of human embryos. For this reason, Christian Concern urges you to explain that you are against both techniques.
You can find out more about the two proposed techniques on the HFEA website by following this link:
Question 2: Changing the germ line
Do you think there are social and ethical implications to changing the germ line in the way the techniques do? If so, what are they?
This question is asking your opinion on the social and ethical implications of permanently altering an embryo’s genetic make-up. Your response could include: the moral implications of selecting an embryo on the basis of its health; the normalisation of genetic modification, which may routinize the selection of embryos on the basis of other inheritable traits (e.g. eye colour); the unknowable effects that genetic modification will have on future generations; the moral ambiguity of making decisions for these future generations.
Question 3: Implications for identity
Considering the possible impact of mitochondria replacement on a person's sense of identity, do you think there are social and ethical implications? If so, what are they?
By combining the mother’s egg, the father’s sperm, and the donor’s mitochondria, mitochondria replacement creates children with three genetic ‘parents’: two ‘mothers’ and a father. Question three is asking how this will affect any children born through this technique. Your response could include: the complementary roles of motherhood and fatherhood, which would be confused by the addition of a third party; the confusion that a child with three genetic parents will feel; the conflicting rights of the ‘parents’ involved; the difficulty of managing a child’s relationship with their mitochondria donor.
Question 4: The status of the mitochondria donor
a) In your view how does the donation of mitochondria compare to existing types of donation? Please specify what you think this means for the status of a mitochondria donor.
b) Thinking about your response to 4a, what information about the mitochondria donor do you think a child should have? (Choose one response only)
- The child should get no information
- The child should be able to get medical and personal information about the mitochondria donor, but never know their identity
- The child should be able to get medical and personal information about the mitochondria donor and be able to contact them once the child reaches the age of 18
- Other
- I do not think mitochondria replacement should be permitted in treatment at all
Question four is a two part question. The first part asks you to compare mitochondria donors to donors of other material. You may wish to distinguish between donations that save lives- such as blood donation- and donations that result in the loss of embryonic life, such as egg or mitochondria donation.
Part two asks you what information you think a child born through mitochondria donation should have about his or her mitochondria donor. You are asked to choose from a list of options. We urge you to select ‘I do not think mitochondria replacement should be permitted in treatment at all’. You may wish to refer to your answers in questions 1- 3.
Question 5: Regulation of mitochondria replacement
If the law changed to allow mitochondria replacement to take place in a specialist clinic regulated by the HFEA, how should decisions be made on who can access this treatment? (Choose one response only):
- Clinics and their patients should decide when mitochondria replacement is appropriate in individual cases
- The regulator should decide which mitochondrial diseases are serious enough to require mitochondria replacement and, just for these diseases, permit clinics and patients to decide when it is appropriate in individual cases
- The regulator should decide which mitochondrial diseases are serious enough to require mitochondria replacement and also decide, just for these diseases, when it is appropriate in individual cases
- I do not think mitochondria replacement should be permitted in treatment at all
Please explain your choice.
This question asks how a body (such as the HFEA) would regulate mitochondria replacement. As with question 4B, we urge you to select ‘I do not think mitochondria replacement should be permitted in treatment at all’.
Question 6: Should the law be changed?
In Question 1, we asked for your views on these techniques. Please could you now tell us if you think the law should be changed to allow (one or both of) these techniques to be made available to people who are at risk of passing on mitochondrial disease to their child? You may wish to address the two techniques separately.
This question is asking your opinion on legalising mitochondria replacement (it is currently illegal in humans). We urge you to explain that you do not believe the law should be changed. You may wish to refer to your answers in questions 1 - 5.
Question 7: Further considerations
Are there any other considerations you think decision makers should take into account when deciding whether or not to permit mitochondria replacement?
This question is asking you to discuss any other ethical implications that you did not have the opportunity to mention in the previous six questions. We urge you to highlight that the proposed changes are significant since they will fundamentally alter the way in which life is created. Whilst, by nature, all children have two biological parents of the opposite sex, children conceived through mitochondria replacement will effectively have two mothers and a father. The possibility of having children with same-sex biological parents is a major step and will haves serious ethical implications and emotional risks for children which must be considered.