On Feb. 3, 2015 the British parliament voted to permit a new and highly controversial experimental medical procedure allowing genetic material from three individuals – two women and a man – for the "creation" of a healthy baby. Immediately after the story broke a number of ethical concerns emerged and the slippery slope that the procedure is setting in motion a phenomenon of "designer babies" in a modern world already prepared to discount such consequences.
Another set of fears centered on the procedure being new and untested, raising the specter of experimenting on a fragile human life with possible devastating consequences if it fails in the implementation stage. How to understand the procedure in the first place and more importantly, what are the possible issues to contemplate from an Islamic ethical perspective and moral worldview?
The medical procedure can simply be described as a preemptive scientific attempt to address a genetic defect in the mitochondria – the small source of power inside cells – and up to this point there is no cure for those born with it. In Britain about 100 cases of mitochondrial genetic defects are recorded each year and, without a cure, those born with the defect have a lifelong debilitating and painful existence, chronically lacking energy to function, suffering and often leading to death.
Organ donations and various genetic therapies are currently available and in use across the world, but the mitochondrial procedure is new and maybe a little different regarding pushing the boundaries. Mitochondria are a structural part of cells and contain their own small genomes that provide needed functions for normal life to emerge. As it stands, humans have some 22,000 genes while cellular mitochondria has 37 genes – a very small number of actual genes that does not impact height, color of hair, skin or eyes. The procedure involves removing damaged mitochondria from one cell and replacing it with a healthy one donated from another woman, and thus the news of the baby from the genetic material of two women and one man. Is this really a baby from two women and one man due to this procedure, and what is different about it from donating a kidney or other body part?
The ethical and moral issues involved are not to be discounted even though it is still very early in the process and the experimental procedures are confined to such obvious and medically necessary cases. Can we stop the train once it leaves the station? Who will make the determination on possible other, more intrusive procedures as skill levels in this area improve and choice-based gene manipulations are contemplated?
From an Islamic legal perspective it is not a clear-cut case of prohibition, and let me raise some questions that might help shape the debate on the procedure. One, Islamic law considers the cells at the early stage as living biological material with the potential of being a full human being since it is believed that the soul enters the fetus at 120 days and not before. Does this impact how we view or consider this procedure, which is set to remove certain defects that for sure harm emergent life in the womb? Second, since all of humanity comes from the same single origin or, from the same soul if you will, i.e., human genes are traced back to a single set that then replicated with changes occurring over time, does it make it permissible to utilize a non-corporeal or non-essence biological and genetic matter to remedy a defect in the transmission from the earlier and original primordial sets of genetic material? Would this make a difference if it were from a family member related to either husband or wife?
Third, if the main genes that form the basis of life come from a husband and wife, legally married by a valid contract, would introducing healthy mitochondria to remove a real harm produce a third-party claim to the child and subsequent inheritance rights? The first two points are more straightforward when it comes to interpretation and reaching a determination. It is the third that is the most difficult to answer and complicates the medical determination altogether. I am leaving aside the argument of necessity as it needs to be debated on a case-by-case basis.
The medical procedure is cutting edge and provides remedies for a small group of effected patients who will find comfort if it is proven successful in the long run. As medicine pushes into the outer limits of the possible it is up to the religious community to raise moral and ethical questions, but to do so in partnership and in pursuit of finding solutions to serious and pressing challenges. It is the role of the scientist to pursue the limits of knowledge and the ethicists' role is to navigate through text to find facility for the emergent and challenging multi-layered contexts.