Facing the Ethical Challenges of Genome Editing

    As humans we constantly stand upon a precipice, trying to straddle what is good for our species and what is ethical as a species. We are constantly faced with the question “just because we can do it, should we?” Nowhere has this become more apparent in recent years than within the field of molecular biology. Advances in genome editing—such as the CRISPR/Cas9 system—burst upon the scene several years ago, igniting the imagination of scientists for new and unique ways potentially to cure some of the world’s most debilitating illnesses. Amidst the frenzy, many urged caution and called for a “slowdown” to allow researchers, as well as the public, time to consider the ethical ramifications of various experiments. In some cases, the warning was heeded, as last year scientists internationally called for a moratorium on genome editing of human embryos—yet, not all nations were on board.

    Now, the Nuffield Council on Bioethics at King’s College London, which includes a multidiscipline array of academics, has just published the first findings of its review, looking at the potential impact of recent advances in genome editing, such as the CRISPR/Cas9 system, across many areas of biological research. The report found evidence that, given its technical advantages and rates of uptake, genome editing is already having an almost unprecedented impact on research. The Council considered the possible effects of these advances in fields such as healthcare, food production, industry, and public health.

    “We examined the way in which these technologies are being taken up in the research community and what we found is that, because of a number of advantages which they offer in relation to existing techniques for manipulating DNA, they are having an unprecedented transformative effect on the biological sciences and for that reason they have the potential to change our expectations and ambitions about human control over the biological world,” explained Nuffield Council member Karen Yeung, D.Phil., professor and director of the Centre for Technology, Law & Society at King’s College. “One of the reasons why we are undertaking this review is to encourage public deliberation. We think that the potential applications for human health are very important, but also in relation to food production where the technology is really almost ready to go, and that is why we are trying to think carefully about the ethical dimensions in order to seek to try and identify the paths of development that we believe are the most ethically appropriate.”

    With this first review published, the Council is looking to begin work on two further inquiries addressing the ethical and practical questions raised by possible uses of genome editing in different fields. The first of these will focus on the potential use of genome editing in human reproduction to avoid the transmission of heritable genetic conditions, and the second on livestock to improve systems of animal husbandry and food production.

    “Genome editing is already showing a potential to transform not only how biological research is carried out, but more importantly our expectations and ambitions for addressing challenges such as disease prevention and food security,” noted council member Andy Greenfield, Ph.D., program leader in developmental genetics at the Medical Research Council, Harwell. “Although most uses so far have been in research, the potential applications seem to be almost unlimited, given that the techniques are applicable to all organisms, from bacteria to plants, animals, and human beings.”

    In the past several years, concerns have been stirred by reports of research in countries such as China to correct disease-causing genetic mutations in nonviable embryos. Since human reproductive applications are probably the most talked about the potential application of genome-editing technologies, this raises some of the most complex ethical concerns. Genome editing could one day offer an alternative approach to preventing the inheritance of diseases such as cystic fibrosis or even cancer.

    “Genome editing is a potentially powerful set of techniques that holds many future possibilities, including that of altering certain genetic features at the embryonic stage that are known to lead to serious and life-limiting disease,” Dr. Yeung remarked. “In the U.K. and many other countries, a long path to legislative change would have to be followed before this could become a treatment option. But it is only right that we acknowledge where this new science may lead and explore the possible paths ahead to ensure the one on which we set out today is the right one. We will be very interested to hear people’s views on this aspect of genome editing technologies in our new inquiry.”

    Many have concerns about the possible use of genome editing in humans, for instance, about the risks of unintended effects due to off-target DNA alterations, and the implications of making irreversible changes that will be passed on to future generations. Furthermore, another fundamental concern is the possible orientation of research toward human enhancement, going beyond disease prevention into the engineering of “desirable” genetic characteristics. As with other technologies and innovations, the potential benefits and harms of genome editing might not be distributed equitably, and some are worried that adverse effects could cause discrimination, injustice, or disadvantage to certain individuals or groups.