TOPIC GUIDE: Genome Editing

"We should welcome the advent of human genome editing"

PUBLISHED: 29 Jan 2016

AUTHOR: Anwar Oduro-Kwarteng

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INTRODUCTION

In late 2015 doctors at Great Ormond Street children’s hospital in London performed successful ground breaking treatment on 17 month old Layla Richards, who at the time was gravely ill with an incurable form of leukaemia. In the first human use of a new technology [Ref: BBC News], the doctors effectively ‘edited out’ the disease with the use of ‘molecular scissors’, named TALENS, which “edit out genes to create specialised killer cells which could hunt out and eradicate her leukaemia.” [Ref: Telegraph] The case made headlines around the world in what appeared to be another example of the power of genome editing in the field of medicine and science. The scientific breakthrough which caused most excitement in the process was the Crispr-Cas9 tool, which has the ability to alter DNA and potentially replace faulty human genes with healthy ones [Ref: BBC News]. Supporters of genome editing emphasise the potential impact the new technology could have on genetically carried diseases, such as Huntingtons or Sickle Cell Anaemia but, despite the potential benefits, there are critics who question both the infancy of the technology, as well as the ethical implications which surround the ability to modify human beings. Crucially, critics are concerned with germline editing [Ref: Genetherapy.net] which some suggest is the next logical stage in genome modification – and genetically modified humans - with experiments already taking place on non-viable embryos in China [Ref: Telegraph]. This debate takes place at the intersection between ethics and medicine, forcing society to consider the shifting boundaries of scientific experimentation and ethics; and weighing this against the impact such a breakthrough technology could have on mankind in the future. Given the complexity of the issue, are we right to welcome the advent of human genetic editing?

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Genome Editing DEBATE IN CONTEXT

This section provides a summary of the key issues in the debate, set in the context of recent discussions and the competing positions that have been adopted.

What Is Human Genome editing?
Genetic therapies aimed at curing illness are not new, and since the 1990’s scientists have had the ability to insert new DNA into patients with genetic conditions, with varying results [Ref: BBC News]. However, the new technology potentially takes us beyond this capacity, because: “With conventional gene therapy, it is only possible to add genes. With gene editing, though, genes can also be disabled.” [Ref: New Scientist] In this respect, we can view genome editing as the process of editing ‘in’ or editing ‘out’ specific genes, by identifying faulty or irregular strands of DNA, and correcting them – “Crispr can be thought of as a pair of molecular scissors guided by satnav” [Ref: Guardian]. Potentially, this means that diseases involving faulty genes such as Beta Thalassemia, Haemophilia, Cystic Fibrosis and Muscular Dystrophy could be treated by locating the faulty gene, cutting it out of the DNA sequence, and replacing it with a functioning version of the same gene. There are two types of therapy that genome editing encompasses – germline therapy and somatic therapy. Germline editing is undoubtedly the more controversial of the two, and would involve editing DNA during embryonic development – resulting in permanent changes which are passed on to subsequent generations - which may in theory mean that hereditary diseases such as Huntingtons could be eradicated [Ref: BBC News]. Somatic editing on the other hand, only concentrates on specific cells, and changes are not passed on to subsequent generations [Ref: Genetherapy.net].

Changing what it means to be human?
In December, many of the world’s foremost geneticists attended a conference in Washington to discuss the ethics of genome editing [Ref: Guardian]. Considering the profound impact that the new techniques may have on humanity, author and philosopher Francis Fukuyama observes that: “The moment when we will be able to alter characteristics that will be handed down to all future generations of human beings is upon us”. He warns that rather than becoming over excited about the possibilities, we as a society need to think very carefully before we proceed, because, “this type of activity potentially strikes at the core of what it means to be human.” [Ref: New York Daily News] Likewise, bioethicist Dr Calum MacKellar is similarly cautious about the ethics of genome editing. He notes that whilst we may be some way from being able to genetically engineer humans in the way that Aldous Huxley depicts in his dystopian classic ‘Brave New World’, he worries that the research is moving at such a pace that, “technologies like Crispr have brought (that) future a whole lot closer.” [Ref: Scotsman] For other critics, the possibilities that gene editing presents means it can be used for both good and bad, which is ethically problematic because: “This could mean eliminating harmful genetic conditions, or enhancing traits deemed advantageous, such as resistance to diseases”, and it “may also open up the door to eugenics” [Ref: The Conversation]. Aside from the ethics, there are also practical concerns about the safety and efficacy of current gene editing procedures. The results of the resent Chinese experiment to genetically edit non-viable embryos were poor – with just 4 of the 86 eggs tested being successfully modified [Ref: New Scientist]. Moreover, some worry that our understanding of DNA is not advanced enough for scientists to accurately predict the full consequences of editing genes with any confidence. One writer argues that this uncertainty might result in a scenario where a cure for a condition through gene editing, could end up causing other severe genetic defects [Ref: Huffington Post].

A Brave New World?
Advocates of gene editing focus on the potential applications for treating debilitating illnesses, with trials into finding a “functional cure” for HIV and Sickle Cell disease for example, currently underway [Ref: New Scientist]. Moreover, genome editing could “allow physicians to fix…some types of blindness, the blood disorder Beta Thalassaemia and the neurodegenerative disorder Tay-Sachs disease. It could also mean new approaches to treating cancers and viral infections”, according to scientist Professor George Church [Ref: New Scientist]. Supporters dismiss claims that the technology could pave the way for a slippery slope towards designer babies, with columnist Matt Ridley suggesting that moral panics about scientific discoveries in the recent past have proved to be wrong. He cites examples such as IVF and sequencing the human genome, which were at the time seen by some as the beginning of a dangerous slippery slope, but concludes that ultimately: “People want to use these techniques to cure diseases, not to do eugenics. Genetic knowledge has not undermined morality or respect for human life.” [Ref: The Times] And even if there were a desire to create ‘designer babies’ with the new technology, some argue this is not within the possibilities of genome editing anyway [Ref: H-Plus Magazine]. Although we are not yet at the stage where embryos can be successfully edited – thus potentially eradicating certain genetic illnesses, Professor John Harris is bullish about the ethics of genome editing in this controversial sphere, arguing that: “If there is a discernible duty here it is surely to create the best possible child.” [Ref: Guardian] He concludes that we should, “keep open the possibility of using gene editing to protect embryos from susceptibility to major diseases, and prevent other debilitating genetic conditions from being passed on through them to future generations.” [Ref: Guardian] In support of this, Huntingtons disease carrier Charles Sabine, claims that we should welcome genome editing in embryos when it is safe to do so, because it, “offers a glimmer of light for families suffering from genetic diseases. For generations to come this could be priceless.” [Ref: BBC News] With all of the arguments considered, should we welcome a much heralded scientific breakthrough with the potential to change many lives? Or instead, should we be asking if it is right that “society should use technologies like CRISPR, just because it can” [Ref: Scotsman]?

ESSENTIAL READING

It is crucial for debaters to have read the articles in this section, which provide essential information and arguments for and against the debate motion. Students will be expected to have additional evidence and examples derived from independent research, but they can expect to be criticised if they lack a basic familiarity with the issues raised in the essential reading.

The gene hackers

Michael Specter New Yorker 16 November 2015

FOR

Why human gene editing must not be stopped

John Harris Guardian 2 December 2015

Gene editing: Bring it on

Jessica Griggs New Scientist 26 September 2015

Smile! Genetic engineering is here to help

Matt Ridley The Times 7 September 2015

AGAINST

Concerns over the ability to edit a human life

Callum MacKeller Scotsman 11 November 2015

Once we start editing our genes, where do we stop?

Michael Hanlon Telegraph 2 September 2015

Genome editing poses ethical problems that we cannot ignore

Anthony Wrigley & Ainsley Newson The Conversation 31 March 2015

IN DEPTH

The Crispr quandary

Jennifer Kahn New York Times 9 November 2015

KEY TERMS

Definitions of key concepts that are crucial for understanding the topic. Students should be familiar with these terms and the different ways in which they are used and interpreted and should be prepared to explain their significance.

BACKGROUNDERS

Useful websites and materials that provide a good starting point for research.

Why treat gene editing differently in two types of human cells?

G Owen Schaefer The Conversation 7 December 2015

Excitement rises over gene editing tool, but ethical doubts remain

Clive Cookson Financial Times 6 December 2015

Gene editing: is the era of designer humans getting closer?

Fergus Walsh BBC News 3 December 2015

The promise of gene editing

Fergus Walsh BBC News 1 December 2015

Can Crispr avoid the Monsanto problem?

Michael Specter New Yorker 12 November 2015

Gene editing beat a baby’s leukaemia. Are other cancers next?

Michael Le Page New Scientist 11 November 2015

Why there is an urgent need for a moratorium on gene editing

Vivek Wadha Huffington Post 9 September 2015

The age of the red pen

Economist 22 August 2015

CRISPR: is it a good idea to upgrade our DNA

Zoe Corbyn Guardian 10 May 2015

Human gene editing has arrived – here’s why it matters

Penny Sarchet New Scientist 29 April 2015

Chinese scientists genetically modify human embryos

David Cyranoski & Sara Reardon Nature 22 April 2015

Don’t edit the human germline

Edward Lanphier et al Nature 12 March 2015

ORGANISATIONS

Links to organisations, campaign groups and official bodies who are referenced within the Topic Guide or which will be of use in providing additional research information.

IN THE NEWS

Relevant recent news stories from a variety of sources, which ensure students have an up to date awareness of the state of the debate.

AUDIO/VISUAL

Editing the human genome

BBC 28 November 2015

Science and morality

Moral Maze BBC Radio 4 22 February 2014

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