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Ethics for an Edited Embryo

By Michael Cook

Editing of a gene in a human embryo may have ticked some regulatory boxes but this does not address some huge ethical issues.

It will probably be described as one of the most important inventions of the 21st century. After just 4–5 years, CRISPR gene-editing technology is racing ahead, creating myriad opportunities for improving medical treatment.

Take the possibility of replacement organs. Since pigs are roughly the same size as humans, why not use their hearts or lungs? One very good reason not to is that pig DNA contains porcine endogenous retroviruses (PERV). But just a few weeks ago a team bred pigs whose PERVs have been removed. A pig-to-human organ transplant may only be 2 years away.

Great news.

Other uses of CRISPR are far more unsettling. In August, American and Korean scientists published in Nature the details of how they successfully edited a single gene in human embryos (http://tinyurl.com/y95z6uhq). A team led by Shoukhrat Mitalipov of Oregon Health and Science University used CRISPR to eliminate a gene, MYBPC3, linked to a heart disorder. All the embryos were destroyed before they were a few days old.

The highly-anticipated paper was technically strong, innovative and rigorous. For many biologists, the news was spine-tingling. There are about 10,000 harmful single-gene mutations that cause ailments ranging breast cancer to Tay-Sachs disease, a lethal disorder which is relatively common among Ashkenazi Jews.

Everyone knows that editing the human genome has momentous ethical implications. The changes will be passed to the progeny of “grown-up embryos”. Therefore Mitalipov’s team took great care to dot their ethical “I’s and cross their “T’s. “Even though this preliminary effort was found to be safe and effective, it is crucial that we continue to proceed with the utmost caution, paying the highest attention to ethical considerations,” said one of the authors.

Of course, this depends on what counts as ethical considerations. The paper in Nature merely noted how Mitalipov’s team had complied with all the relevant regulations. Let’s list just a few of the problems that he did not address.

What about the embryos? In this experiment, dozens of embryos were created, and all were destroyed. Is it ethical to treat human embryos as fodder for laboratory experiments? After all, if they had been implanted, they would have become babies.

Why wasn’t this technique tested first on animal embryos? Did Mitalipov rush into experiments on human embryos rather than higher animals and non-human primates because it was more newsworthy and because it would attract more funding?

Where did the eggs come from to create the embryos? The researcher paid a dozen women to “donate” eggs. But egg donation is a potentially dangerous procedure that is strongly criticised by some feminists. If the technique takes off, thousands of eggs will be needed, creating a mini-industry in “egg-farming” so there is enormous potential for exploiting young women.

What about designer babies? Some scoff at the idea. “This has been widely reported as the dawn of the era of the designer,” says Alta Charo, who was the co-chair of an important American report on gene editing. “And it’s not.”

But most disagree with her. If may not be noon-time, but it certainly is dawn for designer babies. David Albert Jones of the UK’s Anscombe Institute wrote a blistering critique: “We are manufacturing new human beings for manipulation and quality control, and experimenting on them with the aim of forging greater eugenic control over human reproduction.”

What does the law say? Nothing too definite, but modification of the human genome is regarded everywhere with deep misgivings. According to the UN’s Universal Declaration on the Human Genome and Human Rights, germ line intervention is potentially “contrary to human dignity”. And as UNESCO’s International Bioethics Committee has stated, gene editing could “jeopardize the inherent and therefore equal dignity of all human beings and renew eugenics”.

Is it a kind of eugenics? It could be. Not Nazi-style eugenics, but privatised eugenics for creating bespoke children. As soon as the technology becomes safe and cheap, rogue scientists will start offering designer baby services in countries that lack proper regulation, like Cyprus, Ukraine or Mexico.

As Vivek Wadhwa, a technology expert from Carnegie-Mellon, wrote in the Washington Post: “CRISPR’s seductiveness is beginning to overtake the calls for caution”.


Michael Cook is editor of BioEdge, an online bioethics newsletter.