Editor's Note: The third article of the "Gene Therapy" series by Melody Hansford, a series about the benefits, risks, and everything else concerning gene therapy's role in modern medicine. Part II here
Gene Therapy: The Slippery Slope
By: Melody Hansford
May 29, 2020
Mapping the position of genes in the cell nucleus sheds light on basic principles governing the genome. Here, a single gene called Pem (purple) has been localized using fluorescence in situ hybridization. DNA is stained blue; the cell cytoplasm is stained green.
Photo by National Cancer Institute on Unsplash
Since the dawn of time, the greatest applications of human intellect have been devoted to reducing or eliminating the ravages of genetic or infectious diseases through the development of medicines and vaccines.
Recent decades of this struggle that has stretched through the millennia has found that genetic therapy offers the possibility of bringing humanity its ultimate victory over a wide range of diseases.
Genetic therapists have found that one meticulously placed edit in the human genome has the power to change the mortal fate of an ill patient. Their discoveries have brought hope to people who are riddled with chronic illness.
However, the line between sound morality and scientific knowledge has become a gaping chasm. A debate has erupted in the scientific community over the botched genetic modification attempt of human embryos.
Three-Dimensional Landscape of Genome. HIPMap (high-throughput imaging position mapping) accurately determines the position of a gene in the three-dimensional (3D) space of the cell nucleus. In this illustration, images of genes (red, green, and blue spots within the nuclei of HeLa cells) are artificially superimposed on images of multi-well plates. Creator: Tom Misteli, Sigal Shachar, Murali Palangat.
Photo by National Cancer Institute on Unsplash
The offender was, He Jiankui, a former Chinese biophysics researcher, who intended to modify a gene present in embryos to create HIV resistance. His experiment has been condemned as ‘premature’ and a ‘misuse’ of current scientific technology by prominent scientific ethicists.
Jiankui was later charged with engaging in ‘illegal medical practices’ that consisted of forgery and providing two unwitting women with illegally edited embryos.
The edited embryos are feared to foster the potential of debilitating genetic abnormalities, with no evident resistance towards HIV.
Jiankui’s infamous work with the editing technique, known as Clustered Regularly Interspaced Short Palindromic Repeats, or CRISPR, has stained the public’s perception of genetic editing and therapy that will endure for years to come.
Jiankui’s case had brought attention to the moral boundaries that exist within the world’s modern technological capabilities.
One question that arises from bioethics is, what is moral and should we favor scientific advancement over moral conflict?
Genetic editing has long been smeared as the ‘slippery slope’ of scientific advancement. Currently, genetic therapy is only conducted through government-sponsored clinical trials, reserved for terminally ill patients who have no other options.
Genetic therapy was created with a benevolent intent in mind, aiming to treat and cure those who have been inflicted with genetically caused illnesses.
Patients diagnosed with Leukemia, Hemophilia, and cystic fibrosis are now allowed hope, in a technique that may rid them and their potential children of their disease.
Germline therapy is used by scientists and researchers to modify an ill patient’s reproductive cells to eradicate any possibility of their sickness being passed to their future lineage.
DNA Genotyping and Sequencing. A technician validates genetic variants identified through whole-exome sequencing at the Cancer Genomics Research Laboratory, part of the National Cancer Institute's Division of Cancer Epidemiology and Genetics (DCEG)
Photo by National Cancer Institute on Unsplash
The aforementioned ”slippery slope” becomes relevant with a quest to find one minor edit that could elevate humanity to perfection. Temptation for the acclaim and power that could come with that discovery may blur all moral, ethical and physical limits that have contained scientific examination.
If government leaders begin to further invest funds in hopeful genetic therapy trials, there may be an unfamiliar utopia lying ahead.
In a new world, genetic therapy and genetic editing will both have an opposing connotation as well as intention. Genetic therapy can remain altruistic in nature by treating and curing those who may be gravely ill, but genetic editing threatens to become a popularly demanded entry to the medical marketplace.
If placed in the hands of marketing professionals, genetic editing can offer parents the opportunity to procreate “perfect” children. Can prospective parents resist the temptation that their children will indeed be intelligent, beautiful, and seemingly flawless?
Will choosing a child’s eye and hair color, personality and physical traits become a parental right to be protected by law?
It is quite likely that only the elite, wealthy, and powerful would have access to the nefarious treatment at first.
Accessibility would expand to other social classes, perhaps even upper-middle to middle-class citizens would soon have ‘perfect’ children. Could the “perfect child phenomena” stigmatize children whose families cannot afford genetic manipulation?
Society’s standards for excellence will change dramatically as a result of humanity’s attempt at manufacturing perfection. As feared, humankind may eagerly trade their inherited humanity for a notion composed of materialism and vanity.
Good intentions are often a prerequisite to grave mistakes. Jiankui’s doomed experiment was likely a result of his ‘good intentions’. A benevolent purpose does not inherently require idyllic actions. Chasing the pursuit of knowledge requires refraining from injudicious idealism.
Genetic therapy and editing should remain true to their purpose, creating hope for patients who need it. Scientists, in their perilous pursuit, should be wary as they inch closer to the slippery slope.