With genetic editing’s promise of curing disease and customizing traits, a powerful ethical dilemma arises: should science’s ability to reshape human DNA go unchecked? Genome editing is a technique that lets scientists modify DNA at precise locations, and CRISPR-Cas9 has become a leading tool in this field. CRISPR, which stands for “clustered regularly interspaced short palindromic repeats,” takes inspiration from bacteria, which use this natural defense to cut viral DNA and fend off infections. When bacteria encounter a virus, they store segments of its DNA in CRISPR arrays. If the same virus reappears, the bacteria produce RNA that attaches to the viral DNA, and Cas9, a special enzyme, cuts and disables it.
This mechanism has been adapted to allow scientists to target and modify DNA with speed and precision. This process, adapted from bacteria, enables targeted and precise gene editing. While gene editing presents significant medical advancements, it raises ethical questions about human intervention in natural genetics, consent, and social inequality.
Current Applications and Benefits
Genome editing shows promising potential for preventing and treating human diseases. Currently, it’s applied in cells and animal models within research labs to gain insights into various conditions. There is still ongoing scientific research to evaluate its safety and effectiveness for human use, exploring its application in clinical trials for numerous diseases. These include single-gene disorders like cystic fibrosis, hemophilia, and sickle cell disease, as well as complex conditions such as cancer, heart disease, mental illness, and HIV.
In July 2019, Victoria Gray became the first patient to receive a CRISPR-based therapy for sickle cell disease (SCD) and her recovery foreshadows successful treatment for other SCD patients.
This also shows how gene editing can help prevent diseases before birth, ultimately reducing long-term healthcare costs. For instance, by editing specific genes linked to hereditary conditions such as cystic fibrosis or SCD in embryos, these diseases could be prevented from ever developing. This proactive approach not only spares individuals from the physical and emotional burdens of these illness but also alleviates the financial strain on healthcare systems. The costs associated with managing these conditions—such as frequent hospital visits, ongoing treatments, and supportive care—can be substantial. Investment in gene editing technology could create healthier generations, while significantly reducing the prevalence of these diseases.
Ethical Concerns
Most changes in gene editing are limited to somatic cells, where the changes made are not passed to other generations. However, if changes are made to germline cells (such as egg or sperm cells) or to genes of an embryo, they can be passed to future generations. This poses many concerns on the ethical challenges, including whether changes to human traits would be considered permissible.
Aside from gene editing's role in disease prevention, unethical areas of its use include the creation of "designer babies" and enhancement of physical human traits unrelated to health issues. For example, a gene may be targeted to make the human smarter, better looking, or have the ability to grow more muscle. The edits made to these genes also have to potential to not only affect the single person whose genes are edited, but also their future children. More research into this also reveals that not everyone can afford it, enhancing the imbalance of socioeconomic status. It is also argued that it may not be medically necessary due to other options currently available that most likely have to ability to help the individual reach similar results such as exercise or available drugs.
Many genome editing tools are mainly developed using a narrow group of people, mostly Caucasian, which might miss genetic differences in other ancestries that could cause unintended effects. This highlights the need to test these therapies on a wider range of genetic backgrounds to ensure fairness. There are also concerns about the treatment of animals in technology development, as different communities have different views on using non-human primates and when alternatives might be enough.
In conclusion, while genome editing, particularly through technologies like CRISPR-Cas9, holds remarkable potential for preventing and treating diseases, it also raises significant ethical and societal questions. The ability to modify human DNA introduces a powerful tool that could enhance health outcomes and reduce long-term healthcare costs. However, the implications of editing germline cells, including the creation of designer babies and potential enhancements unrelated to health, highlight the need for careful consideration and regulation. Ensuring equitable access to these advancements and addressing the disparities in research diversity are essential to prevent further social inequalities. As gene editing technologies move forward, a balanced approach that prioritizes ethical standards and broadens the scope of research is crucial in making use of their benefits.
Sources
https://news.stanford.edu/stories/2024/06/stanford-explainer-crispr-gene-editing-and-beyond#ethics Assessed and Endorsed by the Medreport Medical Review Board