Beyond Therapeutic Justifications for Epigenome Modification to Have Children

Abstract: Reliance on certain epigenome modifications of mammalian ova from one animal and parthenogenic stem cells from another enables the production of healthy rodents without reliance on sperm. This proof of principle in mammals raises the prospect of using these techniques in human beings to, for example, enable two women to have genetically related children without reliance on sperm. For opposite-sex couples, commentators such as John Harris defend assisted reproductive treatments (ARTs) as ‘therapeutic’ insofar as the interventions compensate for anatomical or physiological obstacles to gamete production or fertilization. Yet the argument that ARTS are therapeutic for same-sex couples fails to be persuasive since those couples are situationally infertile but otherwise without obstructions of anatomy or physiology. I argue that for moral purposes we do better to understand ARTs not as therapeutic but as prosthetic. Just as an artificial limb does not cure an amputated arm, it does confer use of an arm, so far as possible. In a similar way, ARTs do not cure anatomical and physiological obstacles to fertilization so much as they confer genetically related children on people otherwise unable to have them, so far as possible. This characterization dispenses with an interpretation of ARTS as therapeutic by underlining how all people rely on ARTs in a prosthetic way, epigenome modification no less than other ARTs. For that reason, this characterization confers a prima facie entitlement to epigenome modification to have children – should it become possible – without regard to infertility rooted only in disease and disorder.

Keywords: ethics, assisted reproductive treatments, synthetic gametes