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10/07/2016

More on Gene Editing

One version of the headline of a news item in Nature this week is, “UK bioethicists eye designer babies and CRISPR cows.” The UK’s Nuffield Council on Bioethics has just released a report, “Genome editing: an ethical review.”  The full report and a short summary are available for download here.

I must say that my understanding of recent bioethical reflection in the UK leads me to believe that the Nuffield Council’s position will, eventually, tend toward “let’s press ahead with any use of this as long as we can convince ourselves that the benefits are worth pursuing.”  The approach will likely be a focus on near-term benefit-risk assessments that sideline larger ethical concerns about the implications of certain applications—e.g., edits of human genes that can be passed on from generation to generation—that seem abstract or “religiously motivated” (my term here, not theirs).

But I have not been through the full report.  The short form does provide a quick listing of many salient ethical concerns, such as:

  • ·       Relative ethical merits of editing genes to treat a specific disease in an existing individual vs more momentous steps like editing human embryos (along with the resultant issues of the inherent ethics of the necessary experiments, and a potential “demand” for embryos for research), or future attempts at genetic enhancement of humans;
  • ·       Ecologic risks of using “gene drives” to alter pest populations in the wild, or even using genetic editing in an attempt to re-introduce extinct species;
  • ·       Potential for creative recklessness by amateurs or creative malevolence for military use;
  • ·       The potential for using gene editing to make plants or animals for food hardier, e.g., by making pigs or cows disease-resistant.

The Council says some of the above would be of concern to at least “some people.”  The short report says that the Council concludes, “When we think about how genome editing should be used, it is important to also think about how it should be governed. Given the public interest in the use of genome editing, an approach will need to be found that acknowledges that people arrive at these questions with different values, priorities and expectations. “

Of the many issues, the Council counsels addressing two urgently:

1.       Livestock—research into gene editing of animals for food is relatively well advanced, but the regulatory regime needs to catch up, to address issues of economics, international trade, and food security.  Concerns also include animal welfare and how to label “edited” meat at the supermarket.  This is worth further, more detailed discussion, perhaps on future posts, but somehow I sense a bit more than a post-Brexit fight between the UK and the Continent over GMO foods is in view here.

 

2.       Human reproduction— One member of the Council’s Working Group said, “Human reproductive applications are perhaps the most talked about or controversial area.”  (Gee, ya think?)  From the short report:  “Of all the potential applications of genome editing that have been discussed, the one that has consistently generated most controversy is the genetic alteration of human embryos in vitro. Research undoubtedly has a very long way to go before any application of this sort could be contemplated [but never mind that it has already been at least attempted in “non-viable” human embryos] and, in the UK at least, the transfer of an edited embryo to a woman is currently prohibited by law. Nevertheless, such applications are theoretically possible and there are strong moral arguments for them, at least for limited purposes, as well as against. The principal challenges are the very difficult questions of what would be required to demonstrate safety and efficacy, and of resolving the ethical arguments for and against attempting it. It is therefore appropriate to consider carefully how to respond to this possibility before it becomes a practical choice. Addressing these difficult questions now will help to meet concerns that technology is rushing ahead of public debate and allow such debate to influence the development of the technology, distinguish acceptable from unacceptable aims, and reduce the uncertainty and ambiguity for researchers and potential recipients of the technology.”

I agree with the urgency, but the Council’s statement sounds to me a bit too sanguine, too “proactive” or “progressive,” too favorable to the prospect of altering individual human genomes fundamentally.  As I have said previously on this blog, I believe that editing of human embryos or germ cells should simply not be done, at least for now, and probably not ever.  Ethical discussions should not be informed by a “proactive” stance, but rather by a “presumption to forbear.”  And I suspect, that like “three parent babies” (see Mark McQuain’s September 29 post), and like IVF, we will be presented with a fait accompli from somewhere before the ethical arguments are “resolved.”

 

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