Exploring the Bioethical Landscape of Mitochondrial Replacement Techniques

In the last decades, new reproducing methods have emerged and have challenged our views on how one should procreate and, subsequently, what type of family one should have. In this context, Mitochondrial Replacement Techniques (MRTs) have made their appearance, as promising new Assisted Reproduction Techniques (ARTs) which could prevent the transmission of mtDNA disorders. Such disorders are maternally inherited, affect cellular energy production, and are often associated with a broad spectrum of debilitating diseases, ranging from mild symptoms to life-threatening conditions. The development of MRTs offers new opportunities for some people affected by such disorders to have genetically related healthy offspring, reducing the risks of transmitting mutated mtDNA. Although this is a significant discovery, MRTs have been subjected to substantial legal, ethical, scientific, and societal debate. This thesis aims to explore these aspects, assess the current state of research and advancement of MRTs, and focus on the several ethical considerations that surround them. To do so, in the first Chapter an overview of these techniques will be offered, along with an examination of the current regulatory landscape under which they are currently being researched. Being a new technology, MRTs are critically examined in ethical debates, just like any other new ART. Such critiques are essential, in general, for determining whether a new technology can be considered ethically acceptable. A central point of the thesis, addressed in the second chapter, is the examination of various objections and observations raised by opponents of these techniques, evaluating the validity of their arguments and considering how they might contribute to an ethically grounded assessment of MRTs. Particular attention will be given to concerns related to the allocation of available resources and the actual safety and efficacy of these techniques. In this regard, possible reasons for caution regarding implementing MRTs arise, considering that their central goal is to achieve a genetic connection with offspring (without mtDNA disorders). This raises a critical point in examining these techniques: whether the desire to maintain a genetic connection with one's offspring is sufficient to justify the implementation of MRTs. The third chapter will therefore focus on this question, necessarily addressing concepts related to reproductive freedom and parenthood. Following this, the focus will shift to the possible extension of MRTs to areas beyond mtDNA disorders, specifically for couples with functioning ovaries/non-traditional families and for couples facing oocyte-related infertility. Finally, an overview of the exploration conducted will be offered, claiming that while MRTs hold great potential, we should proceed with a cautious approach, balancing the complex interplay of ethical, scientific, and social considerations.