Ethics Society of Hilton Head Island
Wednesday, Nov. 3, 2021
USCB Hilton Head
Ethics of Genome Editing
Gerry Schroeter introduced the topic by listing several disabling genetic conditions that can be relieved by surgery that revises an individual’s gene makeup: cystic fibrosis, Down’s syndrome, sickle cell anemia, muscular dystrophy, inherited blindness. Is it right to perform these kinds of operations? What are their side effects? Does the benefit accrue to the individual only or to society’s greater good?
Neil Funnell posed the question of whether genetic intervention is justified to correct an abnormality in the fetus, in the uterus of a married woman with two children, undergoing an unexpected third pregnancy?
Gerry then introduced Dr. Colin Moseley, formerly the chief surgeon at the Shriners Hospital for Children in Los Angeles and a clinical professor at UCLA.
Colin began by saying that one hundred years ago we knew almost nothing about genetics. We knew, of course, that characteristics were inherited and often this inheritance was in recognizable patterns. But how it happened was a mystery. Since then, mostly in our lifetimes, we have observed the unfolding of awesome discoveries: that genetic information is carried by a chemical called DNA, that the structure of DNA is a code for these characteristics; that DNA can replicate exact copies of itself in concert with the division of cells; and that the two cells that merge to form a new being can share and re-distribute the genetic information from both parents. Once we discussed genetics at the level of the organism; today we discuss it at the level of molecules.
In spite of these exciting advances, our understanding still faces some huge challenges:
In the last decade we have learned how to design and create DNA for example to produce more effective vaccines more rapidly. In addition CRISPR - CasX technology enables the editing of existing DNA. It consists of two parts - CAS - X, which can explore DNA to locate a specific gene or code sequence and CRISPR, which can cut the DNA at that location to allow the removal of a gene, perhaps with a substitution of a new gene. It seems that we are now capable of tinkering with the essence of humanity, which raises important and difficult ethical questions:
For the first example:
An unaltered tomato will deteriorate to the point of being inedible if picked and left unattended or a few days but a gene-edited tomato can be left unattended except for transporting and displaying, with a much longer shelf life. Considering how such action affects consumers, food producers and food merchants, is it smart or ethical to do that?
The consensus of the audience members who responded was that there is no significant downside.
The single-gene disorders listed above can be corrected by gene editing, in some cases by doing the surgery in the uterus.
Comments and questions from the audience:
Modifying reproductive gene cells causes changes in the offspring of the patients and those changes affect future generations. Should we take the chance that we have impacts on generations not yet born?
Fourth example of ethical dilemmas:
Should genes be edited to modify healthy, normal people to enhance some ability, either mental or physical? For instance, tall people tend to get more attention and in some cases more respect than short people. Should physicians modify genes to produce taller people?
One audience member raised the question of what counts as “normal”?
Colin explained that doctors once were taught to use the Golden Rule, “Do unto others as you would have them do unto you,” as the basis of their decision-making in such cases. They now are taught to do what the patient wants; in other words, if a procedure is legal and a doctor can perform it and sees it as ethical in his or her own mind and a patient wants it, then the doctor should do it.
The fifth and last example:
Is it right to produce populations with characteristics that we need, in order to supply society with nurses, musicians, soldiers, or honest politicians?
From the audience:
Suppose climate change sets the world on fire and humans need to find another planet, should we modify genes to produce people who can conduct such a mission?
Thanks to Dr. Moseley for his outstanding presentation and clarification of the Ethics of Genome Editing. The wonderful slides, spaced with five breaks for audience participation, were both unique and well received by our audience. Thanks also to Betsy Doughtie for both Zooming and recording our session, Andrea Sisino for correlating the audio visual and securing our venue, and to Fran Bollin for her note-taking and always excellent, comprehensive summary of Dr. Moseley’s presentation.