How do we respond to genome editing?
Alexander Massmann and Keith Fox, authors of Modifying our Genes consider the issues, and misconceptions surrounding genome editing.
In the current pandemic, COVID vaccines have captured the news, displacing for a while another highly significant biomedical topic: genome editing with CRISPR-Cas9. This is a new technology, discovered less than ten years ago, which enables scientists to modify genes in anything that lives, from micro-organisms to people. Genome editing provides significant opportunities, but many people raise moral questions about its use in humans. There was a public outcry, also among many scientists, when in November 2018 a Chinese scientist claimed to have successfully modified the DNA of twins to make them HIV resistant.
In the debate about genome editing in humans, various hot topics still require discussion: what can scientists do with genome editing and what uses should be permitted? Should it be restricted to therapeutic applications? Should it be legal to enhance abilities in otherwise healthy individuals and should parents be allowed to choose enhancements for their children? For both therapeutic and enhancement uses, the genetic modification of human embryos is a special concern. We are making a contribution to this important debate with this book on genome editing in humans. We write for lay people, from a Christian perspective, but we hope to persuade people with other beliefs and outlooks as well.
Misconceptions in Thinking about Genome Editing
Treating disease and looking after the vulnerable and disadvantaged are significant commitments for Christians. We should not accept disease with a misplaced fatalism that sees everything as God’s will. There is a temptation to think that alterations to the human genome mean that we are ‘playing God’. However, we should not dismiss the technology out of hand if it can be part of the God-given arsenal of techniques for alleviating human suffering. We use drugs for treating disease and transplants for replacing defective organs. Is a DNA transplant any different? A common misconception is that what is natural should be the criterion in deciding the ethics of genome editing. Yet if humans are created in the image of God, genome editing could be one more practical step in cooperating with God the creator.
Another common misconception says that we are really nothing more than the sum of our genes and that our DNA determines everything about us. Genes are important, and even a simple error in our DNA can have very serious consequences. However, many other factors affect our physical development and our personalities, from the food that we eat to the stresses and pleasures that we experience. There are many genes that influence intelligence, but on the whole, a good education is much more important. There are real limitations to what genome editing will be able to achieve.
Genome editing is a powerful tool that could be used to treat or prevent disease. For example, conditions such as cystic fibrosis or sickle cell disease could be avoided by editing the early embryo. However, we rarely hear about existing alternatives to genetic modification. Pre-implantation diagnosis followed by IVF could achieve similar goals, and would not change any genes.
Does it follow that biomedical interventions are justified for any medical purpose? A common misconception is that improvements in health vindicate any genetic modification. However, there are many people who see strength and opportunity in what seems like disease and weakness to others. These stories can illustrate what the Apostle Paul meant when he wrote about his ‘thorn in the flesh’. Presumably this was a physical condition he had, but surprisingly he learned that God’s power is made perfect in his weakness.
Besides the treatment or the prevention of medical conditions, genome editing could also be used to enhance abilities in healthy people. Some of us have genes that support remarkable athletic abilities. Would it be right to give our children the best start in life, by endowing them with an optimal combination of genes for particular abilities? Again there is a very powerful misconception here. It is very tempting to assume that faster or brighter bodies will lead to more fulfilled lives or even better people. This is indeed a misconception; empirical evidence tells us that having more of something we desire does not necessarily make us happier! Moreover, would enhancements for a child alter the relationship between the parent and the child, who has been conceived with chosen characteristics?
For some people genome editing appears similar to eugenics. However, to equate genome editing simply with eugenics would be another misconception. In spite of our critical remarks, we argue that we should use genome editing to tackle particular genetic diseases. Nevertheless, the history of eugenics warns us not to side-line people who don’t fit our preconceived personal or social views. We need to offer robust support to people with disabilities. Beyond that, using biotechnology to ‘optimise’ our own bodies means to fall for a misconception that was underlying eugenics as it was practiced in the twentieth century.
At the end of the day, if we accept that increased capabilities do not necessarily mean a better life, and if we also suggest that genome editing can be a good thing in particular cases, how then are we to evaluate various proposals of how genome editing should be used? Welcome to a fascinating debate!
Alexander Massmann is a postdoctoral researcher at the Faculty of Divinity at the University of Cambridge.
Keith R. Fox is Professor of biochemistry, editor of Nucleic Acids Research and has published over 200 peer-reviewed science research papers.