Mitochondrial Replacement Techniques, Scientific Tourism, and the Global Politics of Science

Abstract

The United Kingdom is the first and so far only country to pass explicit legislation allowing for the licensed use of the new reproductive technology known as mitochondrial replacement therapy. The techniques used in this technology may prevent the transmission of mitochondrial DNA diseases, but they are controversial because they involve the manipulation of oocytes or embryos and the transfer of genetic material. Some commentators have even suggested that MRT constitutes germline genome modification. All eyes were on the United Kingdom as the most likely location for the first MRT birth, so it was a shock when, on September 27, 2016, an announcement went out that the first baby to result from use of the intervention had already been born. In New York City, United States‐based scientist John Zhang used maternal spindle transfer (one of the recognized MRT methods) to generate five embryos for a woman carrying oocytes with deleterious mutations of the mitochondrial DNA. Zhang then shipped the only euploid embryo to Mexico, where it was transferred to the mother's uterus. Zhang's team's travel across international borders to carry out experimental procedures represents a form of scientific tourism that has not been properly ethically explored; it can, however, have seriously detrimental effects for developing countries.

Towards a Global Germline Ethics?

“…This can be seen, for example, in the consequences of Zhang's Mexican MRT tourism and its effects on global scientific justice. 43 Another feature of the variegated regulatory landscape for controversial technologies is concern, among countries with high scientific capacity but restrictive regulation, about remaining internationally competitive, when researchers in other countries may take advantage of lower regulatory thresholds to forge ahead. This was a prominent factor in the embryo research debates of the early 2000s.…”

Biomedicine, self and society: An agenda for collaboration and engagement

“…At the same time, there is a too common tendency to frame financially poorer nations solely as beneficiaries of healthcare knowledge, as opposed to producers of it ( White et al , 2014). Without attention to the different roles that low income countries can, should, and do play with respect to the production of biomedical and other health-related knowledges and the actualization of new biotechnologies, we may fail to confront the problems of global scientific as well as health justice ( Chan et al ., 2017). Novel, spatial analyses of contemporary biomedicine must be attentive to the consequences of its glocalization ( Robertson, 2012)—the ways in which biomedical ideas, actions, and artefacts not only circulate internationally, but are simultaneously localised and particularised.…”

Whence and whither ‘modern medical law’?

“…The emergence of mitochondrial replacement therapies has seen scientists flout regulation by taking their work abroad to countries where it is either unregulated or regulation is poorly enforced. 132 The continuing need for robust research regulation has been exposed by abuses in regenerative medicine, including the Paulo Macchiarini scandal 133 that spanned countries and institutions (again drawing attention to the need for health law to work across jurisdictions). Concerns about conflicts of interests and research integrity (or the lack of it) have attracted public, academic and parliamentary attention.…”