Skyllar Kuppinger
As you probably know, many diseases are genetic--that is, they are caused by harmful variations in the structure of our DNA. If there was a way to replace the disease-causing nucleotides with new ones, millions of people could potentially be cured. With the development of CRISPR-Cas9, this idea is not as far-fetched as it may sound.
CRISPR-Cas9 is a gene editing tool that uses a molecule called a restriction enzyme to cut pieces of DNA at a specific sequence. With this method, the harmful section of DNA can be removed and placed with a therapeutic one (Shwartz 2018). CRISPR-Cas9 is still being developed for use in humans, but thus far it has proved to be more efficient and successful than any other past method of genome editing (Farrell et al. 2019). The development of such a powerful tool forces the scientific community to address moral concerns such as regulation of use, establishing which genes are appropriate to edit, and ensuring accessibility of treatment.
Genome editing was originally proposed as a way to treat diseases caused by somatic mutations, but it can actually be used on any sequence of DNA. This gives rise to the issue of the ethicality of editing germline DNA. Somatic cells are bodily cells that are not passed on to one’s offspring. A mutation in a somatic cell of an individual will be passed onto the cells that derive from the mutated one via mitosis, but it will not be transferred to that individual’s children. On the other hand, germ cells (sperm and egg) are involved in reproduction, so the DNA within a germ cell will be present in one’s children. This means that altering the DNA in a sperm, egg, or embryo will affect the child and all of the child’s future offspring, which complicates the picture quite a bit (NHGRI 2018).
At the Second International Summit on Human Genome Editing, Chinese researcher He Jiankui announced that he had edited the genes of two human embryos and that they had been brought to term (NHGRI 2018). This sparked immediate controversy from scientists across the world, some claiming that Jiankui should be removed from his affiliations. Most scientists agree that since germline editing affects future generations, its effects are complicated and hard to predict. For example, CRISPR-Cas9 brings with it the risk of targeting the wrong gene, which could result in countless health problems. Thus, many argue that it is unethical to carry out experiments, such as Jiankui’s, until strict guidelines are developed to ensure proper oversight. As stated by Robert Truog, director of the Center for Bioethics at Harvard Medical School, this issue is less about the morals of germline editing itself and more about the oversight and responsibility of the scientific community (Caplan et al. 2015). With such a powerful biological tool, how can we ensure safe regulation of its use?
Another hurdle that must be crossed regarding genome editing is deciding which genes should be edited and which should not. It is widely accepted that disease prevention is an ethical use of CRISPR-Cas9, but should we be allowed to edit other genes too, such as those controlling appearance or intelligence? Is it acceptable to edit such aspects of a child while he/she is just an embryo and therefore has no say over the decision?
There are already a growing number of in vitro fertilization clinics that allow parents the option of choosing their baby’s gender (NHGRI 2018). When CRISPR-Cas9 is approved for use in humans, parents will have even more control over the characteristics of their child, and limits will need to be put in place. This also leads into the concern of accessibility of the new technology: will genome editing be affordable, or will it simply further the divide between classes, allowing the rich to enhance their children and create “designer babies”? In order to prevent a eugenicist-level manipulation of human traits, strict regulations on the use of CRISPR-Cas9 will need to be put in place.
Widespread use of CRISPR-Cas9 may not be a reality yet, but it likely will be in a few years. When this happens, the scientific community will have to bear the huge responsibility of oversight of this new technology. This reminds us that in a world where medical treatment is constantly advancing, we must consider our obligation as scientists and as humans to ensure that the treatment is used safely and for the betterment of society.
References:
CRISPR-Cas9 is a gene editing tool that uses a molecule called a restriction enzyme to cut pieces of DNA at a specific sequence. With this method, the harmful section of DNA can be removed and placed with a therapeutic one (Shwartz 2018). CRISPR-Cas9 is still being developed for use in humans, but thus far it has proved to be more efficient and successful than any other past method of genome editing (Farrell et al. 2019). The development of such a powerful tool forces the scientific community to address moral concerns such as regulation of use, establishing which genes are appropriate to edit, and ensuring accessibility of treatment.
Genome editing was originally proposed as a way to treat diseases caused by somatic mutations, but it can actually be used on any sequence of DNA. This gives rise to the issue of the ethicality of editing germline DNA. Somatic cells are bodily cells that are not passed on to one’s offspring. A mutation in a somatic cell of an individual will be passed onto the cells that derive from the mutated one via mitosis, but it will not be transferred to that individual’s children. On the other hand, germ cells (sperm and egg) are involved in reproduction, so the DNA within a germ cell will be present in one’s children. This means that altering the DNA in a sperm, egg, or embryo will affect the child and all of the child’s future offspring, which complicates the picture quite a bit (NHGRI 2018).
At the Second International Summit on Human Genome Editing, Chinese researcher He Jiankui announced that he had edited the genes of two human embryos and that they had been brought to term (NHGRI 2018). This sparked immediate controversy from scientists across the world, some claiming that Jiankui should be removed from his affiliations. Most scientists agree that since germline editing affects future generations, its effects are complicated and hard to predict. For example, CRISPR-Cas9 brings with it the risk of targeting the wrong gene, which could result in countless health problems. Thus, many argue that it is unethical to carry out experiments, such as Jiankui’s, until strict guidelines are developed to ensure proper oversight. As stated by Robert Truog, director of the Center for Bioethics at Harvard Medical School, this issue is less about the morals of germline editing itself and more about the oversight and responsibility of the scientific community (Caplan et al. 2015). With such a powerful biological tool, how can we ensure safe regulation of its use?
Another hurdle that must be crossed regarding genome editing is deciding which genes should be edited and which should not. It is widely accepted that disease prevention is an ethical use of CRISPR-Cas9, but should we be allowed to edit other genes too, such as those controlling appearance or intelligence? Is it acceptable to edit such aspects of a child while he/she is just an embryo and therefore has no say over the decision?
There are already a growing number of in vitro fertilization clinics that allow parents the option of choosing their baby’s gender (NHGRI 2018). When CRISPR-Cas9 is approved for use in humans, parents will have even more control over the characteristics of their child, and limits will need to be put in place. This also leads into the concern of accessibility of the new technology: will genome editing be affordable, or will it simply further the divide between classes, allowing the rich to enhance their children and create “designer babies”? In order to prevent a eugenicist-level manipulation of human traits, strict regulations on the use of CRISPR-Cas9 will need to be put in place.
Widespread use of CRISPR-Cas9 may not be a reality yet, but it likely will be in a few years. When this happens, the scientific community will have to bear the huge responsibility of oversight of this new technology. This reminds us that in a world where medical treatment is constantly advancing, we must consider our obligation as scientists and as humans to ensure that the treatment is used safely and for the betterment of society.
References:
- Caplan, A. L., Parent, B., Plunkett, C., & Shen, M. 2015. The ethical challenges created by crispr. EMBO Rep. 16: 1421-1426. doi:10.15252/embr.201541337
- Farrell, M., Foulkes, A. L., Lazaro-Munoz, G.,Giusti- Rodriguez, P., & Soda, T. 2019. Legal and ethical implications of crispr applications in psychiatry. North Carol Law Rev. 97(5):1359-1398. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6927684/
- Shwartz, M. Crispr is a revolutionary gene-editing tool, but it’s not without risk [internet]. California (CA): Stanford Medicine; [date unknown]. Available from: https://stanmed.stanford.edu/2018winter/CRISPR-for-gene-editing-is-revolutionary-but-it-comes-with-risks.html
- What are the ethical concerns of genome editing? [internet]. [place unknown]: National Human Genome Research Institute; [date unknown]. Available from https://www.genome.gov/about-genomics/policy-issues/Genome-Editing/ethical-concerns
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