Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Stratenum, 6.131, PO Box 85500, 3508 GA Utrecht, The Netherlands.
J Med Ethics. 2011 Feb;37(2):97-100. doi: 10.1136/jme.2010.037481. Epub 2010 Nov 11.
Recent preclinical studies have shown the feasibility of specific variants of nuclear transfer to prevent mitochondrial DNA disorders. Nuclear transfer could be a valuable reproductive option for carriers of mitochondrial mutations. A clinical application of nuclear transfer, however, would entail germ-line modification, more specifically a germ-line modification of the mitochondrial genome. One of the most prominent objections against germ-line modification is the fear that it would become possible to alter 'essential characteristics' of a future person, thereby possibly violating the child's right to an open future. As only the nuclear DNA would contain the ingredients for individual characteristics, modification of the mtDNA is often considered less controversial than modification of the nuclear DNA. This paper discusses the tenability of this dichotomy. After having clarified the concept of germ-line modification, it argues that modification of the mtDNA is not substantively different from modification of the nuclear DNA in terms of its effects on the identity of the future person. Subsequently the paper assesses how this conclusion affects the moral evaluation of nuclear transfer to prevent mtDNA disorders. It concludes that the moral acceptability of germ-line modification does not depend on whether it alters the identity of the future child-all germ-line modifications do-but on whether it safeguards the child's right to an open future. If nuclear transfer to prevent mtDNA disorders becomes safe and effective, then dismissing it because it involves germ-line modification is unjustified.
最近的临床前研究表明，特定类型的核转移可以防止线粒体 DNA 疾病。对于线粒体突变的携带者来说，核转移可能是一种有价值的生殖选择。然而，核转移的临床应用将需要进行种系修饰，更具体地说，是线粒体基因组的种系修饰。反对种系修饰最突出的一个观点是担心它可能会使改变未来人的“基本特征”成为可能，从而可能侵犯孩子对未来的开放性权利。由于只有核 DNA 才包含个体特征的成分，因此，与核 DNA 的修饰相比，mtDNA 的修饰通常被认为争议性较小。本文讨论了这种二分法的合理性。在澄清了种系修饰的概念之后，本文认为，就其对未来人的身份的影响而言，mtDNA 的修饰与核 DNA 的修饰在实质上没有区别。随后，本文评估了这一结论如何影响预防 mtDNA 疾病的核转移的道德评估。它的结论是，种系修饰的道德可接受性不取决于它是否改变了未来孩子的身份——所有种系修饰都会改变——而取决于它是否保障了孩子对未来的开放性权利。如果预防 mtDNA 疾病的核转移变得安全有效，那么因为它涉及种系修饰而将其摒弃是不合理的。
