What just happened?
In 2015 a team of Chinese scientists sparked a worldwide ethical debate when they used a technique to “edit” the genomes of human embryos. Although the embryos were never implanted and brought to term, the experiments led to concerns the technique would soon be used to create babies with edited-genes.
This week a Chinese researcher announced he had done just that.
He Jiankui (pronounced HEH JEE’-an-qway, with the surname first) reports that he altered a gene in a set of twins who were born this month. Seven couples seeking in-vitro fertilization (IVF) allowed He to edit a gene in embryos before implantation. The gene was edited with the intention of preventing HIV from entering the child’s cells, increasing their ability to resist possible future infection with HIV, the virus that can cause AIDS. So far, two of the children that had a gene edited have been born.
How did He Jiankui alter the gene? The Chinese scientist engaged in gene editing (or genome editing), a form of genetic engineering in which DNA is inserted, replaced, or removed from the genetic material of a cell using artificially engineered enzymes, or “molecular scissors.”
A common method of gene editing, and the process used by He Jiankui, is the CRISPR/Cas9 system. The simplistic explanation is that the “molecular scissors” (Cas9, an RNA-guided DNA enzyme) cuts an enzyme on a specific spot of DNA in the nucleus of a cell. The cell then repairs the break using a piece of single-stranded DNA that has been injected into the cell by a scientist.
Was He Jiankui’s alteration to the gene successful?
Currently, there is no independent confirmation that He Jiankui successfully edited the genes on the children. His claims have not been verified by other scientists or published in a scientific journal, though He said he will make his raw data available for third-party review. He announced the results at a recent conference and in an interview with the Associated Press (AP).
According to the AP, several scientists reviewed materials He provided to the news agency. Their conclusion is that tests so far are insufficient to say the editing worked or that it would not harm the children.
Is gene editing unethical?
The main ethical consideration for gene editing is the purpose (i.e., therapeutic or enhancement) and long-term effect. This is why the ethical issues differ for gene editing on somatic cells, non-reproductive cells that would affect only the individual being treated, and on germline cells, reproductive cells (i.e., sperm, ovum, embryonic cells) that could potentially affect not only the individual but also their offspring and future generations of their descendants.
The concern for editing germline cells is that therapeutic treatments passed along to future generations may have unexpected and unintended consequences. In essence, we would be experimenting on future generations without their consent, without knowing the outcome, and without knowing whether we can reverse the damage we cause.
The other concern is that the procedure could eventually be adopted for non-therapeutic genetic enhancement, a form of eugenics. For instance, wealthy people could create “designer children” whose genetic “improvements” (e.g., height, intelligence, longevity) would be passed along to future generations.
What is the specific concern in this situation?
Dr. Jeffrey Keenan, the president and medical director for the National Embryo Donation Center, told TGC that this situation raises three concerns:
First off, this research was apparently conducted without the approval of any recognized ethics panel, and was performed under conditions that would never have been approved by any established institutional review board. Second, there is no empirical evidence to show that disabling the CCR5 gene in an embryo will produce the desired outcome. We have no idea what the short-term or long-term consequences could be for the twins who were born, let alone the potential negative effects that could be passed down to future generations. Furthermore, very effective solutions already exist for treating and/or avoiding HIV/AIDS, so engaging in human experimentation as a possible alternative is absolutely indefensible. As an organization dedicated to protecting and preserving life in its embryonic stage, the National Embryo Donation Center is firmly opposed to this research.
Is it legal to edit the genes of embryos?
In the United States and throughout much of Europe, it is illegal to genetically engineer an embryo that will be implanted in a woman.
In China, the vice minister of science and technology ordered He Jiankui to halt his experiments, saying they were illegal and unacceptable.
How has the international community responded?
Scientists and bioethicists around the world have been nearly unanimous in denouncing the experiment by He. As Ed Yong notes at The Atlantic, ethicists and watchdogs have already called the work “monstrous,” “unconscionable,” and “a grave abuse of human rights.”
Francis S. Collins, director of the National Institutes of Health, issued a statement saying, “The need for development of binding international consensus on setting limits for this kind of research, now being debated in Hong Kong, has never been more apparent. Without such limits, the world will face the serious risk of a deluge of similarly ill-considered and unethical projects.”
Why did He conduct the gene-editing experiment?
“I feel a strong responsibility that it’s not just to make a first, but also make it an example,” He told the AP. “Society will decide what to do next” in terms of allowing or forbidding such science.
The website maintained by He’s lab says:
For billions of years, life progressed according to Darwin’s theory of evolution: random mutation in DNA, selection and reproduction. Today, human [sic] meet great challenge when the industrialization has caused great environment change. Genome sequencing and genome editing provided new powerful tools to control evolution. In our lab, we work hard to develop single molecule sequencing platform to read the genetic code of life. We aim to bring down the whole genome sequencing to the goal of $100, and make it available to everyone. As long as the genetic code is known, we use CRISPR-Cas9 to insert, edit or delete the associated gene for a particular trait. By correcting the disease genes, gaining protective alleles, we human [sic] can better live in the fast changing environment.”
What should Christians think about non-therapeutic gene editing and germline editing?
Within the realm of Christian ethics, it can be difficult to distinguish between therapy and enhancement. Additionally, not all therapy is beneficial, and not all enhancements are sinful. Nevertheless, we can still formulate some general guidelines to help us think about the moral use of medical technology.
From a Christian perspective, therapy implies fixing a malady that is a result of sin entering the world. Certain therapeutic uses of gene editing—such as correcting conditions of individual patients—may be morally unproblematic when used to cure diseases or restore broken physical systems to a healthy condition.
However, non-therapeutic gene editing for the purposes of “enhancement” is attempting to make improvements to the body that are not the result of sin or not necessarily caused by human brokenness.
Using gene editing for non-therapeutic enhancement is troubling for several reasons. For example, using the process for this purpose implies humans know how to “improve” on God’s general design for the human body. It also can imply that certain traits (such as height or a high IQ) are so preferable that they should be purposefully engineered so that they can be distributed in a way that is outside the normal distribution range for the human species. (Even He Jiankui thinks that gene editing for enhancement purposes “should be banned.”)
Other concerns include questions about the cultural and social effects of having certain humans be engineered to have the “right” traits. Creating “designer” children who possess preferred traits may cause those who lack them to be treated as inferior or sub-human. This may also lead to discrimination against groups (such as evangelicals) who are unwilling to modify their children’s genome to fit society’s preferences.
Similarly, germline editing raises problems about unintended consequences and experimenting on current and future generations without their consent. Ultimately, the reason we should oppose germline editing is because children (and future generations of children) are to be considered as gifts from God (Ps. 127:3) and not as products that we can tweak to suit our taste.