Genome editing, a new technology in the medical field today, has proved its effectiveness in 2015. A doctor in United Kingdom had used a technique called Transcription Activator-like Effector Nucleases (TALENs) to treat a patient of leukemia. Genome editing works by having doctors directly treat patients by editing their DNA, and effectively ‘cut’ out the genes causing diseases. Many other gene editing technologies like TALENs have also emerged, of which Clustered Regularly Interspaced Short Palindromic Repeats/CRISPR associated protein 9 (CRISPR/ Cas9) is one of the most popular one today. However, many controversies have emerged regarding the ethics of human genome editing.
Therapeutic Gene Therapy
Genome editing has been used in treatment of previously untreatable diseases and has provided potential in many others. Researchers has looked into treatment of AIDS, particularly using Zinc-Finger Nucleases (ZFNs) technology. ZFNs targets and knock out the CCR5 gene, to slow down the infection of HIV. Beyond somatic gene therapy, Green explored the possibility of preventing the transfer of hereditary diseases with the aid of germline gene vaccines. Furthermore, outside of somatic or germline editing, current studies have utilised CRISPR to help researchers identify genetic mutations that weaken cancer cells. This aids in the development of drugs that specifically target at eliminating these cancer cells, while sparing normal cells. Utilitarianism considers the action that achieves maximum utility as the most ethical. Hence, in the future, investment and support for genome editing can open up many possibilities in the medical field, most notably in the eradication of untreatable diseases plaguing mankind. This can be representative of the achievement of maximum utility in the progression of the human race.
While gene therapy as vast potential in the medical field, it also has its fair share of controversies, especially in germline gene therapy. As therapeutic germline gene editing is being performed, selection for certain desirable genes tend to happen, which can lead to smaller gene pool in the human population. This could potentially work against human evolution. The entire connotation of ‘desirable genes’ indicates that one would have to judge if particular genes are good or bad. While certain genes, such as those that are responsible for diseases, like Severe combined immunodeficiency (SCID), can be clearly deemed as undesirable genes, there are others that are debatable. Genes that are perceived to be undesirable now could be naturally selected for in the future. One such example is the gene responsible for sickle cell anaemia, a disease which produces abnormal red blood cells in humans. However, this ‘bad’ gene actually helped develop resistance against malaria. Furthermore, studies have shown that infections are more likely to occur between genetically similar hosts, commonly known as the ‘Monoculture effect’. First discovered in plants, but later proven that it takes effect on mammals as well. Human genome editing could very well risk the occurrence of an epidemic with a lack of gene diversity. Hence, under this new perspective, eventual outcome of treating will result in the weakening of the human race as a whole, showing that human genome editing is possibly unethical.
Non-therapeutic Gene Modifications
The ability to manipulate the human genome can also lead to non-therapeutic modifications of the human body, such as changes in physical appearance or ability. This, however, can lead to questions of the inequality that could be created and the safety risks associated with the use of this technology. As previously stated, human genome editing can be used to cure life-threatening diseases, so the idea of using the same techniques for non-medical needs has not been the focus of studies. In 2017, scientists of the National Academies of Sciences and National Academy of Medicine concluded that the research into somatic gene editing for non-therapeutic enhancements should not proceed due to the lack of public consensus of the possible social impact presented by gene editing for enhancements. The gap that could be created will split the public between people who can receive the treatment and gain higher social status, and the people who cannot afford the treatment, but yearn to close the gap to rise to the social rank of the aforementioned. Another concern that surrounds genetic enhancements is the safety risk associated with changing strands of DNA. Problems have been discovered when testing the CRISPR/Cas9-mediated method of genetic engineering. It was found that genes other than the target of these treatments were also being affected, which can lead to undesired traits. While an acceptable risk for curing life-threatening diseases, the same risk may not equate when attempting to enhance for non-medical reasons.
In “The Case against Perfection”, Sandel considers four existing genome editing technologies and how each began as an attempt to treat a disease or prevent a genetic disorder now beckons as an instrument for human improvement and consumer choice, leading to the possibility of babies made tailored to parental or societal wants and needs. Kant’s theory describes the duties of being human includes not using others as a means to an end and treating everyone with dignity. If future children are produced with the purpose of attending to a societal need or accomplishing a predetermined purpose, the human life could be reduced to a means to an end. This does not ethically align to Kant’s theory. The utilitarian ethical theory would support non-therapeutic modifications as the quality of life of the baby will be improved while society will reap the benefits of an “improved” generation of children.