Humans have been engineering life since early prehistory. Through selective breeding, we have been exploiting beneficial traits in plants and animals for millennia (Darwin 1859, 61). Yet, selective breeding is a very slow and often unpredictable process. But as soon as the code of life, DNA, was discovered, things started to change. In the early 70’s scientists started to modify directly the genetic code of plants, bacteria and small mammals. Two decades later, there was the first foray into human genetic engineering. And yet, up until recently, gene editing was tremendously complex and expensive. And when it came to human engineering, very dangerous.
The stakes, however, have changed once again after the discovery of a new gene-editing technique termed CRISPR, which is short for clustered regularly interspaced short palindromic repeats. Originally found in bacteria, the CRISPR system stores snippets of the DNA of each virus that has invaded the bacterium during its lifetime. If the same virus attacks again, the bacterium can use the stored snippets to recognise the infecting virus and cut its DNA via an enzyme (the enzyme Cas9 is most often cited in literature, but other similar enzymes also exist). This permanently disables the attacking virus (Doudna and Charpentier 2014, 1077). Researchers managed to modify this system in order to edit genomes in the lab. By substituting the infecting virus with a synthetic piece of genetic material termed “guide RNA”, scientists were able to cut the cell’s genome at a specific location allowing the addition or silencing of genes (Qi et al. 2013, 1173).
This new technique made gene editing vastly cheaper, faster, and more accurate. Although this technique is only a few years old, scientists have already successfully corrected mutations associated with Alzheimer’s disease (Komor et al. 2016, 422), eliminated HIV genes from the cells of mice (Yin et al. 2017, 1168), and edited out a gene that can cause blindness (Li et al. 2018, 55). First applied to human embryos in 2015, CRISPR was used to replace a gene that can cause a potentially fatal blood disorder (Liang et al. 2015, 363). Although these embryos were never transferred into a woman’s uterus, this act sparked a huge debate amongst the scientific community about the ethical consequences of such an accomplishment. Ethical concerns aside, CRISPR can also not be deemed completely safe yet. Some of the risks it carries is the potential of unwanted mutations – termed “off-target” mutations (Jiang and Doudna 2017, 505) – and the possibility that the embryo might carry non-edited cells, an effect called “mosaicism” (Mehravar et al. 2018, in press). Also, two recent independent studies showed that cells edited with this technique have the potential to initiate tumors inside the host (Haapaniemi et al. 2018, 927; Ihry et al. 2018, 939). It’s therefore rather hard to justify the use of CRISPR from a consequentialist point of view since goodness of outcome is hardly guaranteed.
The ethical concerns about CRISPR became more relevant than ever very recently, when a team of Chinese scientists lead by biophysicist He Jiankui used this technique to make human embryos resistant to HIV. Unlike previous efforts, these embryos where implanted in their mother, resulting in the live birth of two twin girls. Once this was made public, He’s conduct was widely criticized by the scientific community (Cyranoski and Ledford 2018, 607). From a deontological point of view, He and his team probably didn’t intend to harm these girls or their mother. And yet, even if we set aside ethical concerns, their act is at least irresponsible given the potential adverse effects of CRISPR discussed above.
Although gene editing techniques have existed for a few decades already, once-promising techniques like zinc finger proteins (ZFs) or transcription activator-like effectors (TALEs) never yielded an actual genetically modified human like CRISPR did (Waryah et al. 2018, 60). But regardless the exact technology used, the moral question scientists, ethicists, and legislators are called to ponder upon, is whether gene editing of human embryos should be legal and if it’s indeed made legal, under which circumstances this should happen.
Arguably, people should have the freedom to choose what they do to their bodies. But when it comes to editing the genes of embryos, agents without refined cognitive abilities or free will (let’s skip the debate about the existence of free will for now), the onus is on the parents to decide on the future genetic traits of their offspring. But the moral problem is even more complex: editing human embryos results in inheritable genetic modifications. The changes in the genetic code of these future humans will be passed on their offspring. Modified humans could alter the genome of our entire species. It is therefore apparent that regardless of each individual’s take on genetic engineering, humanity as a whole is a stakeholder.
The above moral problem is coupled to a moral dilemma: on one hand, as gene editing becomes safer and more refined, avoiding the usage of genetic techniques to prevent or cure preventable diseases in a deliberate attempt to head off ethical concerns is unethical, since it condemns children to preventable suffering. On the other hand, as gene editing becomes more accepted by the public, the temptation to engineer babies with specific traits that are viewed by the society as desirable, will grow. A future where our entire species carries these desirable characteristics might seem appealing to some, but assuming that the access to genetic modification techniques will not be universal (similarly to, for example, the limited access to healthcare in many countries), this will inevitably lead to social injustice and will widen the gap between the rich and the poor. It’s easy to see how this completely opposes egalitarianism, the doctrine that all people deserve equal opportunities.
Since gene editing clearly defies egalitarianism, it would be interesting to examine this technology from a welfarist point of view. If we adopt the total view of welfarism, where we only look at the total amount of well-being produced, gene editing might appear very attractive. Sure, only few people will have access to a better health or desirable phenotypes, but this will not directly worsen the lives of the rest of the society. One might argue that curing thousands of people is more important than living in a less-equal society.
Human gene editing is intrinsically neither good or bad, it’s merely a very powerful tool. Instead of sanctioning human gene editing in its entirety, it would be more appropriate to restrict its usage to curing or preventing diseases. Like any other potentially dangerous technology, gene editing can and must be controlled by the law.
Probably gene editing efforts will continue to focus on treating or preventing diseases before an interest in engineering useful or aesthetically-pleasing traits to humans will spark. Although the possibility to cure previously incurable disorders is definitely tempting, preselecting phenotypes based on what society dictates as appealing can be dangerous. A society that ostracizes humans that carry characteristics that deviate from the norm is reminiscent of humanity’s darkest past. As the above discussion has shown, gene editing concerns humanity as a whole and only by having everyone’s participation can we make certain that further research will be guided by caution, reason, and morality.
Previously at https://www.essaysauce.com/essays/law/2018-12-5-1544048271.php since 15.10.2019