CRISPR/CAS9 is “the new thing” in genetics. What sounds like gobbledygook is in fact a very powerful method to change the DNA within a live cell – in a bacterium, a plant, an animal, or even a human person… By and large, DNA is the biological blueprint of living things (“by and large” indeed), and to make changes here could mean to tweak or re-design a living being (although this may still be a fairly big “could”). This process is also called genome editing. John Parrington, associate professor in molecular pharmacology in Oxford, just wrote a book on this procedure. With CRISPR in mind, he says:
“The words ‘revolutionary’ and ‘breakthrough’ can be overused in media reports about new scientific discoveries … But every once in a while, a scientific discovery is made whose impact on society is likely to be so immense that even an abundance of superlatives may not do it full justice. Genome editing looks set to be such a discovery.”
So should we do it? The prospect of deep interventions into what plays such an important role in the functioning of the human body, even in all life on earth, may seem to some a highly exciting prospect. Others may find it eerie. To some, the expression “playing God” comes to mind – typically meant in a negative way. Others think we should stay more neutral and descriptive in our choice of words, but then again others think that playing God is exactly what we should do…
The GENETHICS blog is going to look at various issues involved in genome modification. The angle from which I’m approaching this is ethics, i.e., the discussion of what is the good or right way to act (and Christian ethics more specifically, but more on that adjective below). But first of all, what can CRISPR do? Attempts to cure or prevent certain diseases come to mind especially. A particular group of illnesses is primarily attributed to very slight irregularities in a person’s DNA – so-called monogenic diseases. The World Health Organization lists these seven illnesses as prime examples: thalassaemia, sickle cell anaemia, haemophillia, cystic fibrosis, Tay Sachs disease, fragile X syndrome (more properly speaking a disability), and Huntingdon’s disease. Such conditions significantly affect the life quality of millions of people worldwide, often in quite harmful ways. The treatment, by contrast, would be tailor-made for the patient. Certain forms of cancer – although by no means all of them – can also be treated this way. There are two children (link, link) who have been treated with a modification of the genes involved in their immune system (with a method very similar to CRISPR), and so far it looks like a success. There is also a growing discussion of modifying even the DNA of a fertilised egg cell before it is implanted in a woman’s womb, which poses yet again new questions.
Beyond therapy, gene editing sparks the imagination of thinkers who wonder about tweaking human capabilities – so-called enhancements. While there may be a single gene that is crucially involved in a certain disease, there is certainly not any single gene for intelligence or athleticism. These are very complex phenomena. Nonetheless, there may be genetic modifications that increase the power of memory or muscle strength. For the largest part, the avenue of genetic “enhancement” is much more futuristic than the therapy avenue. It seems, however, that certain measures work in mice. Certainly a mouse is a very different sort of animal than a human person, so research schemes can in no way be simply transferred “from mouse to man”.
But the prospect of “tinkering” with human DNA gives us much to ponder: Is an “enhancement” a desirable thing to have? Or if anything desirable is by definition an enhancement, what can count as a true enhancement? Some also question if we should use genetic modifications for the purpose of healing. What are the risks? What are the social consequences? Are we running the danger of treating our bodies in a purely instrumental manner? From the perspective of Christian ethics, there are questions about the relationship between genetic interventions and the integrity of creation. Reflection on Biblical traditions may shed new light on what traits in an organism are desirable and how such evaluations are done. But to talk about Christian ethics should not at all be understood in an exclusivist sense. Christian ethics would misunderstand its own task if it were not eager to enter into dialogue with the most varied voices in a pluralist world.
In sum, gene editing, and the use of CRISPR in humans in particular, poses many significant moral questions. Often a closer look at the science involved will be very helpful. To approach the moral questions, the issues require careful teasing apart both from a philosophical and a theological perspective. So stay tuned!
Edit: a qualification to the WHO’s listing of fragile x syndrome as a monogenic disease was inserted as well as a qualification of the role of DNA for the overall organism.