CYIL vol. 9 (2018)

CYIL 9 ȍ2018Ȏ MITOCHONDRIAL REPLACEMENT THERAPY IN THE LIGHT OF THE CONVENTION… a treatment? And if treatment, what entity does it treat – the embryo, the future baby crying in a cradle, the donors of oocyte and sperm? Is it ethical to insert genes of a third person into a child, even though it resembles adding a grain of salt to the sea? Apart from these and many other questions, the Convention on Human Rights and Biomedicine (hereinafter “the Convention on Biomedicine”) makes us wonder what the destiny of the genetic change will be. The answer is rather straightforward: a female embryo, having been born and grown up, will transmit the change to her descendants; however, a male embryo will never transmit the genetic change to his offspring. Since Article 13 prohibits any genetic modifications transmissible to the next generations, it seems that MRT could only be carried out in male embryos. We will call this possibility the practice of “selective MRT” and analyse whether it could be considered impermissible due to its discriminatory nature. Mitochondrial replacement therapy There are many controversies related to modern genetics in a medical context, ranging from the questions of safety of gene therapy 2 to prenatal genetic screening ethics 3 to embryo- destructive research. 4 Mitochondrial replacement therapy (MRT) represents one of the most controversial medical procedures these days. Carrying the media label of creation of “three- parent babies”, 5 MRT is destined to draw the public’s attention. However provoking its popular name is, it is also very inaccurate and rather misleading. A mitochondrion is an organelle, a specialized membrane-bound compartment within a cell, which is responsible for the production of the cell’s energy. 6 Depending on the cell type, there might be hundreds or even thousands of mitochondria in each cell: especially rich in mitochondria are liver cells which can contain about 2,000 mitochondria per cell. 7 Apart 2 The high sensitivity with which society approaches the risks of gene therapies may be illustrated by the case of Jesse Gelsinger, the first known person to have died in a gene therapy clinical trial in 1999, whose death significantly hindered the whole field of gene therapy for a very long time. See WILSON, James A. A History Lesson from Stem Cells. Science. (2009, Vol. 324, No. 5928), pp. 727-728. accessed 22 May 2018, PHILIPKOSKI, Kristen. Another Chance for Gene Therapy? Wired. (1 October 1999.) accessed 22 May 2018. 3 In summer 2017, the CBS report briefly turned the world’s attention to Iceland, stating that almost 100 per cent of foetuses with Down syndrome are aborted in the country. This only revived the controversy surrounding the practice of prenatal screening which aims at detecting genetic disorders in foetuses, given the fact that many pregnant women choose abortion in case of the presence of such a disorder. See QUINONES, Julian, LAJKA, Arijeta. “What kind of society do you want to live in?”: Inside the country where Down syndrome is disappearing. CBS News. (15 August 2017.) accessed 19 May 2018. 4 Closely related to the abortion controversy, the debate on the moral and legal permissibility of embryo- destructive research is robust and fierce. See for example ŠOLC, Martin. Reflections of Ethical Debate in the International Law Regulation of Stem Cell Research. In Czech Yearbook of Public & Private International Law. Česká ročenka mezinárodního práva veřejného a soukromého. Vol. 8. Česká společnost pro mezinárodní právo, Praha 2017, pp. 428-433. 5 This term appears in many sources including popular science texts, some of which are cited below. 6 See POLLARD, Thomas D., EARNSHAW, William C., LIPPINCOTT-SCHWARTZ, Jennifer. Cell Biology. 2 nd edition. Elsevier, New York 2008, p. 5. For a closer introduction to biology of mitochondria, see ibid., pp. 331-337. 7 ALBERTS, Bruce, JOHNSON, Alexander, LEWIS, Julian, RAFF, Martin, ROBERTS, Keith, WALTER, Peter. Molecular Biology of the Cell. Reference Edition. 5 th edition. Garland Science, New York 2008, pp. 815-816. 1.

281