It Takes Three to Tango:

What Christianity Tells Us About Mitochondrial Replacement Therapy

Cindy Won

MRT: Mitochondrial Replacement Therapy

IVF: In Vitro Fertilization

 

High school and college students alike fondly refer to the mitochondria as “the powerhouse of the cell” because it ensures that our cells create energy for our body. What happens, then, if our mitochondria do not function because the genes that encode them are mutated? Although rare, approximately 1,000 to 4,000 babies in the United States every year are born with such conditions (1). This results in a host of devastating health problems, such as Leigh Syndrome and Kearns-Sayre Syndrome (2), which severely decrease life expectancy and quality of life.

 

However, a sliver of hope does exist: in 2016, a Jordanian woman, a carrier of faulty mitochondria, gave birth in Mexico to a healthy baby, helped by a team of physicians from New Hope Fertility Center in New York. In 2017, a Ukranian woman gave birth to a healthy baby boy, despite the fact that she too carried faulty mitochondria. And in 2019, a Greek woman gave birth to a healthy baby boy after previous failed in vitro fertilization (IVF) attempts (3).

 

All three of these women utilized mitochondrial replacement therapy (MRT), a form of IVF which allows carriers of dysfunctional mitochondrial DNA to conceive healthy children. During the MRT process, the nucleus from an egg with unhealthy mitochondria is transferred into a second donor egg with healthy mitochondria. This unique hybrid egg is then fertilized with sperm by IVF, and the resulting embryo is subsequently transferred into the mother’s womb. Although originally intended strictly as a mitochondrial treatment, this method has also been used by couples for whom traditional IVF has not been successful or maternal aging is of concern.

 

In the United States, however, MRT and all associated research efforts have been banned by the “Renewable Rider” law, which prohibits the Food and Drug Administration (FDA) from acknowledging or reviewing any clinical trials involving modifications to the germline. Because of its connection with IVF and the possibility that adverse changes to mitochondrial DNA persist into future generations, MRT is often attacked by the “pro-life” side of the abortion debate.  Representatives Robert Aderholt and Harold Rogers, who are the most vocal of MRT’s opponents, argue that the usage of MRT does not favor preservation of the embryo, primarily citing their ethical concerns of the risk of permanent effects of gene editing. 

How does our faith guide our usage of technology in a manner that respects human creation?

Despite its empirical success in other countries, MRT’s murky political future in the U.S. should motivate further investigation of its costs and benefits. Even beyond our limited understanding of MRT on a biological level, MRT raises several key ethical concerns. If three individuals are contributing biological components to a child, then who counts as a parent? Who has rights over the progeny (4)? And taking a step beyond the murkiness of parenthood, how and where should scientists draw the line in determining when technologies like MRT should be applied? 

 

 

For the Christian, this question raises a larger one: how does our faith guide our usage of technology in a manner that respects human creation? In medicine, the usage of technology is often categorized into two main purposes: restoration of baseline proper function and changes that are not necessary for proper function (e.g. selection of embryos with specific traits for non-medical reasons). But who determines this distinction? Try to fit MRT into this paradigm, for example. From a biological perspective, we see that mitochondria are restored to their proper, baseline function; however, some Christians may interpret MRT as something which interferes with God’s natural creation.

 

According to these Christians, the human body is sacrosanct, with Scripture proclaiming that God is the Creator, making every individual in His image. Thus, the human body must be treated with utmost respect, in all of its different forms (Psalm 139:14). Oftentimes, this perspective has been used in pro-life arguments against abortion to assert that both the egg and the sperm need to be preserved as they are and that human life begins at conception. Because MRT utilizes the cellular materials from two eggs instead of one, as in traditional conception, MRT apparently violates the above principle. The idea is that by using it, we are interfering with and disrespecting the proper plan that God originally had for life, as He created it in the womb. 

 

Unfortunately, this perspective misses the crucial element of human redemption through the compassion of Jesus Christ. God is not a disinterested Creator who watches creation from afar; rather, He sent His one and only Son to die on the cross to redeem His human creation (John 3:16-17). This truth changes our posture, focusing our attention on alleviating the suffering of others. We can see this in Scripture through Jesus’ encounter with a blind man. When Jesus first meets him, He defends him against charges of sin, showing that the man was born blind in order to bring glory to God (John 9:3). At first glance, this sounds like God predestined this man to blindness for His glory. This mindset could suggest that we should remain complacent when it comes to disease—because, what if an individual’s struggle with a disease is a part of God’s plan? In some sense, the verse seems to strengthen the anti-MRT perspective. If difficulties in life, such as disease, were tools to bring glory to God, then any type of unprecedented intervention, such as MRT, may interfere with God’s plan and purpose. But the story does not end on this note. Instead, the focus is on Jesus’s love and compassion for the suffering of others, on his goal as the Savior to redeem and save the world of sin by sacrificing Himself on the cross. Ultimately, Jesus healed the blind man as a testament to God’s power, restoring His creation without hesitation. Withholding this potential gift from others in this present day would not reflect Christ’s compassion.

 

Though we cannot perform miracles as Jesus did, God has given humans the ability to support and promote human life (James 1:17). As He states in Genesis 1:26, God has “...[made] mankind in [His] image, in [His] likeness.” God has granted humans the means to heal through technology and science. Thus, restoration of a biological condition, especially if feasible and under the consent of the individual, is an expression of compassion, similar to that of Christ when he “had compassion on [the crowds] and healed their sick” (Matthew 14:14). Science can provide us with the tools to innovate and develop new technology to heal others, but it is only by emulating Christ’s grasp of intense suffering and empathy for the suffering of humankind that technology, such as MRT, can be guided properly. 

 

Although we, as humans, have been granted this immense privilege, we should also briefly acknowledge two caveats. Respect for human life must be at the forefront, and alleviating the suffering of others, however it may be defined, must be the utmost priority. Suffering and healing are both incredibly nuanced, and as easy as it seems to categorize and classify degrees of suffering, suffering in and of itself is an individual experience. By no means does this paradigm point to ableism and eugenics, that somehow individuals who are “restored” are valued more than those who are not. All humankind, no matter how, has been made in the image of God, fearfully and wonderfully made (Genesis 1:27, Psalm 139:14). Furthermore, we must not forget that Jesus cared for and defended the blind man (John 9:3). We must also acknowledge that technology is not always the answer to healing all suffering. For instance, despite the apparent benefits of telehealth, patients with chronic, complex health conditions often require in-person evaluations over a longer period of time, which is necessary for long-term follow-up and in-person care (5). Thus, discretion must be exercised in evaluating the intentions behind its development and its usage.

Science can provide us with the tools to innovate and develop new technology to heal others, but it is only by emulating Christ’s grasp of intense suffering and empathy for the suffering of humankind that technology, such as MRT, can be guided properly.

Furthermore, while it is clear that technology does hold this incredible power to heal, it does have its limitations. We still do not have the means to restore and heal certain conditions, for God has hidden matters from our hearts and our own, limited understanding (Psalm 147:5, Proverbs 25:2). In fact, we may not until the Second Coming, through which Christ will redeem and heal all disease and disability (Revelation 21:4). MRT, for instance, needs to be continuously monitored long-term in order to determine whether any negative effects arise later in life. Because of this limitation, technology must be guided and upheld by listening and hearing the voices of the hurt.

 

To conclude, we return to our particular case of MRT. Although other countries such as the United Kingdom, Greece, and Ukraine have authorized clinical trials and usage of MRT, a number of conservative Christians have prevented and blocked the use of MRT in the United States. Thus, parents, physicians, and stakeholders alike need to continue to advocate for this treatment and to educate individuals in power who may misconstrue MRT’s complexity and its potential for good. This is a powerful opportunity to emulate Christ’s empathy, always seeking to act with the same compassion that Jesus exhibited when he died to heal us of our sin. We should further extend this paradigm to guide the development and implementation of technology in other areas of medicine, as seen with the exploration of brain-chip interfaces as a therapeutic to restore vision. In a world that is constantly seeking to innovate new ways to change our lives, we may have lost sight of the original purpose in serving others with the gift of technology. Keeping this perspective in mind provides us with a humble posture, an opportunity to imitate Christ’s compassion.

(1) Mullin, Emily, et al. “Proponents Start Push to Lift U.S. Ban on 'Three-Parent IVF'.”

(2) Tachibana, Masahito, et al. “Mitochondrial Replacement Therapy and Assisted Reproductive Technology: A Paradigm Shift toward Treatment of Genetic Diseases in Gametes or in Early Embryos.”

(3) Christofaro, Beatrice. “A Baby in Greece Was Born with 3 Parents after Doctors Used an Experimental Technique to Make 'Medical History'.”

(4) While the concept of parenthood will not be discussed at length in this piece to avoid oversimplification, the discussion can be further explored in this resource: Adashi Eli Y., Cohen I. Glenn. “Ideology v. Beneficence.”

(5) Hall, Josh. “Why ‘Zoom medicine’ is not the answer to all our ills.”

Cindy Won graduated from Brown in 2020 with an Sc.B. in Biochemistry & Molecular Biology.

Photo by Ashley Yae, RISD '23.

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