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The perils of human gene editing for reproduction

by Marcy DarnovskyWashington Examiner
March 8th, 2016

Untitled Document

A new generation of genetic engineering techniques, collectively known as "gene editing," is being hailed as a game-changer in the life sciences. The highest-profile of the new methods, CRISPR, was developed just a few years ago and has already attracted hundreds of millions of dollars in biotech investments, sparked a round of patent wars and prompted predictions about a Nobel Prize.

Gene editing is one of those "dual use" technologies: It enables both novel approaches to basic biological research, and the literal redesign of life forms, ecosystems and even societies. Some of its proposed uses may be beneficial, but others would likely trigger far-reaching negative consequences.

That's especially true when it comes to "editing" human genes.

Targeting dysfunctional DNA in the tissues of individual consenting patients would be a form of medical treatment, albeit one that needs to be very carefully studied, tested and considered in light of its eventual affordability and accessibility. Experiments using older genetic modification methods were largely unsuccessful and sometimes tragic, with some deaths in clinical trials. Recent developments, including CRISPR, which is cheaper, more efficient and more accurate, raise hopes that "gene therapy" may yet deserve that name.

An altogether different matter would be changing the genes in human gametes or embryos in order to create what would be, in every sense, genetically modified people. Around the world for several decades, inheritable genetic modification altering the genes that are passed down to future children and generations has been widely considered a no-go zone. Several dozen countries, including most of those with developed biotechnology sectors, have established laws against it. Inheritable genetic modification is also prohibited by a binding transnational treaty, the Council of Europe's Convention on Human Rights and Biomedicine.

Unfortunately, in the United States we have not yet had a thoughtful public policy discussion about inheritable genetic modification. That kind of democratic consideration a broadly inclusive process of meaningful deliberation is urgently needed now.

In certain limited circles, the debate is well underway. Some scientists and futurists are openly enthusiastic about the prospect of genetically "enhanced" humans, and dismiss the dangerous societal consequences that observers across the political spectrum think likely to follow. We can't do a controlled experiment in a laboratory to quantify these social risks, but we can and should anticipate the dynamics that could be set in motion.

It's all too easy to foresee how commercial and national competition could kick in, with fertility clinics offering the latest "upgrades" to would-be parents who could afford them. Social pressures to give one's children the "best start in life" would encourage efforts to select traits valued by mainstream society. Some for example, leaner or larger muscles, less need for sleep are already being named as targets for genetic manipulation. Others, especially higher intelligence, may remain too complex to engineer genetically, though that hasn't stopped prominent researchers from hunting for "genius genes."

Even if genetically modified children were simply purported to be smarter, the social outcomes could be nasty. Gene editing to make or try to make "better humans" could usher in a new kind of consumer-based high-tech eugenics. And that kind of social change, once set in motion, could be as difficult to reverse as the genetic changes in question.

While some explicitly support this kind of "liberal eugenics," others who want to go ahead with gene editing for reproduction say we should use it only to prevent the transmission of severe inherited diseases. That argument sounds reasonable at first, but it fails on several grounds.

The first problem that in the immediate future, it would be much too unsafe is uncontroversial. Currently, no responsible scientist or fertility doctor would ignore the many serious unresolved risks. And though gene editing is being refined and improved for a range of plant and animal applications, some believe that "safe enough" for human experimentation is a long way off, and perhaps unattainable.

Secondly, manipulating the genes of future children is not necessary in order to prevent the transmission of genetic disease. All prospective parents who know they run that risk can have unaffected children by using third-party eggs or sperm. And in nearly every case, parents can have children who are unaffected and genetically related to both of them by using a 25-year-old embryo-screening technique that's now common in fertility clinics. This technique too raises ethical questions about trait selection and can be already is being misused. But it is far safer to choose among existing options than to manufacture new ones, and embryo selection is far less likely to produce new forms of discrimination and social inequality than inheritable gene editing.

Finally, it would be challenging if not impossible to permit reproductive gene editing for serious medical conditions while preventing its use for enhancement efforts. The Food and Drug Administration has little authority to control "off-label" uses of drugs, and would be similarly hamstrung in regulating genetic interventions. Creating a back door to the human genome for one kind of trait engineering would mean relinquishing control over all kinds.

In short, human gene editing for reproduction would be unsafe, is unneeded for medical purposes, and would be dangerously unacceptable on societal grounds. We need not and should not run those risks.

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