A Crack In Creation: A Nobel Prize Winner's Insight into the Future of Genetic Engineering

by Jennifer A. Doudna

For instance, editing an embryo’s CCR5 gene might make the resulting human resistant to HIV but more susceptible to the West Nile virus.

The fact is that editing a particular gene will always carry the risk of unforeseen effects. But just because we don’t know what that collateral damage

might be doesn’t mean we should renounce germline editing altogether.

Countless lifesaving medical treatments were developed well before physicians completely understood them, so why would we hold CRISPR to a higher standard of safety?

2016 Pew Research poll

Religion

It turns out nature is less an engineer than a tinkerer, and a fairly sloppy one at that. Its carelessness can seem like outright cruelty for those people unlucky enough to inherit genetic mutations that turned out to be suboptimal.

the line between natural and unnatural blurs to the point of disappearing. We wouldn’t call a coral reef unnatural, but we might use the term for a megalopolis like Tokyo. Is this because one is crafted by humans and the other isn’t? In my mind the distinction between natural and unnatural is a false dichotomy, and if it prevents us from alleviating human suffering, it’s also a dangerous one.

It’s not uncommon to hear people talk about our genomes as if they were part of a precious evolutionary inheritance, something to be cherished and conserved.

“jeopardize the inherent and therefore equal dignity of all human beings and renew eugenics, disguised as the fulfilment of the wish for a better, improved life.”

germline editing changes the very nature of what it means to be human and that modifying the human gene pool would perniciously alter humanity itself.

we agree to use CRISPR in the germline to eliminate genetic diseases, we have to acknowledge that it might also be used to create genetic enhancements—changes in which DNA is altered not to correct a harmful gene variant but to provide some type of genetic advantage.

EPOR gene,

exceptional levels of endurance;

LRP5

extra-strong...

MSTN

supermu...

ABCC11

lower levels of armpit odor production

DEC2

lower requirement of da...

PCSK9,

regulates a person’s level of low-density lipoprotein cholesterol

it’s difficult to see how we’d do it

wealthy families would benefit from germline editing more than others,

costs of new technologies generally diminish over time as improvements are made, leading to a resulting increase in access.

could one day be subsidized by health insurance.

there’s a risk that it might give rise to hitherto unseen genetic inequalities, creating a new “gene gap” that would only widen over time.

just imagine it stratified along both socioeconomic and genetic lines.

As disability-rights advocates have pointed out, using gene editing to “fix” things like deafness or obesity could create a less inclusive society, one that pressures everyone to be the same—and perhaps even encourages more discrimination against differently abled people—instead of celebrating our natural differences.

diversity.

Unless we’re talking about coercive governments controlling their citizens’ procreative liberty, germline editing would remain a private decision for individual parents

the issue of choice. Above all else, we must respect people’s freedom to choose their own genetic destiny and strive for healthier, happier lives. If people are given this freedom of choice, they will do with it what they personally think is right—whatever that may be.

so long as the methods are safe and are offered in an equitable manner.

things—if we can walk the narrow line between prohibiting CRISPR to the detriment of certain individuals’ health and overusing it and subverting our society’s values—we will be able to use this new technology in a way that is unequivocally good.

(It’s interesting to note, though, that many other assisted reproductive technologies—preimplantation genetic diagnosis, intracytoplasmic sperm injection, and even the practice of in vitro fertilization itself—never underwent formal clinical trials or FDA review.)

in the United States in 1996, the Dickey-Wicker Amendment, prevents the government from funding any research that would create or destroy human embryos, an exclusion that would clearly apply to experiments with CRISPR. No laws in the United States prohibit privately funded research in this area.

The U.S. Congress has so far been unwilling or unable to even look at petitions to use CRISPR clinically in human embryos—a legislative approach that is tantamount to our elected leaders burying their heads in the sand.

overly restrictive policies in some countries will encourage what might be called CRISPR tourism in others.

nations need to maintain regulatory environments that are hospitable enough to permit research and clinical applications but strict enough to prevent the worst excesses.

It’s up to researchers and lawmakers alike to find the right balance between regulation and freedom. Scientific experts should work to create a set of standardized, agreed-upon guidelines that specify the safest methods of CRISPR delivery, prioritize disease-causing genes for research, and set quality-control standards to evaluate gene-editing interventions. And government officials—especially in the United States—need to take a more active role than they have so far, pursuing robust legislation while also soliciting the opinions of their constituents and encouraging public participation,

Once a game-changing technology is unleashed on the world, it is impossible to contain it.

But if we wait too long, we may find that the reins have slipped from our hands.

There’s simply no way to unlearn this new knowledge, so we must embrace it. But we must do so cautiously, and with the utmost respect for the unimaginable power it grants us.

we who practice science are obligated to participate actively in discussions about its uses.

This is but one example of the importance of fundamental research—the pursuit of science for the sake of understanding our natural world—and its relevance to developing new technologies. Nature, after all, has had a lot more time than humans to conduct experiments!

The story of CRISPR is a reminder that breakthroughs can come from unexpected places and that it’s important to let a desire to understand nature dictate the path forward.

For, as history makes clear, just because we are not ready for scientific progress does not mean it won’t happen. Every time we unlock one of nature’s secrets, it signals the end of one experiment—and the beginning of many others.