Humanity entered a new era this past week. At the Second International Summit on Human Genome Editing held in Hong Kong (Nov. 27-29, 2018), which was organized “to try to reach a global consensus on whether, how and when it might be permissible to create children from genetically altered human embryos,” Dr. He Jiankui, a Chinese biomedical researcher, stunned the international scientific community when he claimed to have already used CRISPR-Cas9 to edit the genome (the genetic material of an organism) of at least two human embryos.
These two embryos were then implanted into a woman’s uterus and have subsequently resulted in the birth of twin girls at an unspecified date “a few weeks ago.” Questions are still swirling regarding exactly how Jiankui edited the twins’ genomes. Nonetheless, by and large, the scientific community has denounced the actions of Jiankui. This is captured well by the condemnatory statement of Dr. Francis Collins, Director of the US National Institutes of Health:
This work represents a deeply disturbing willingness by [Dr. Jiankui] and his team to flout international ethical norms. The project was largely carried out in secret, the medical necessity for inactivation of CCR5 in these infants is utterly unconvincing, the informed consent process appears highly questionable, and the possibility of damaging off-target effects has not been satisfactorily explored. It is profoundly unfortunate that the first apparent application of this powerful technique to the human germline has been carried out so irresponsibly.”
International ethical norms were indeed trampled, as Collins rightly recognizes. Criticism has mainly revolved around the “experimental” manner in which Jiankui appears to have approached the issue, creating unacceptable risks for a medical purpose that is questionable.
What is genome editing?
Genome editing (or simply “gene editing”) is the ability, through the use of advanced technology, to change an organism’s DNA. In genome editing, genetic material can be added, deleted, or altered at precise locations. One particular method for genome editing is CRISPR-Cas9, which is a relatively recent development that has generated a lot of excitement due to its lower cost, efficiency, and accuracy over other pre-existing editing technologies.
Genome editing holds a lot of promise for the prevention and treatment of human disease. Most research with CRISPR-Cas9 aims to understand diseases in cells animals, whereas the safe and effective use in humans is still being studied. It is the editing of the human genome which raises many of the ethical concerns with this technology.
Why is this of concern?
The actions of Jiankui are of concern for a number of reasons. By taking such a monumental step in a secretive manner, without precedent, and with much unease as to the morality of the procedure, Jiankui demonstrated tremendous recklessness. Two main ethical concerns relate to genome editing, and this story raises red flags for both.
First, there is the fear that embryos, which Christians would consider human beings, are simply created for the purpose of experimentation. This seems to be the case here, as there is serious doubt as to the necessity for the procedure that Dr. Jiankui conducted. The CCR5 receptor that Jiankui claims to have inactivated supposedly will prevent the children from ever contracting HIV, which the biological father is infected with.
Yet, the necessity of such an intervention is highly questionable. Alta Charo, a U.S. bioethicist who helped organize the summit, stated that Jiankui’s genome editing was “misguided, premature, unnecessary and largely useless,” and, “The children were already at virtually no risk of contracting HIV, because it was the father and not the mother who was infected.” Hence, Jiankui’s experimentation exposed two healthy, normal embryos to unnecessary risk.
A second main area of concern for gene editing is its purpose, or, why is it being done? Reasons may be preventive, therapeutic, or for enhancement. The case at hand falls under the first category of being done for preventive purposes. Yet, we still run into the same question as above about whether such an intervention was actually medically necessary, as, in the case of using genome editing to prevent HIV, there is no unmet medical need that is being addressed.
What is more, as this is new territory for science, there is no precedent for how such genome editing could affect these children. Research into human genome editing is decades from learning how such technology could impact individuals as well as future generations and the human gene pool if such technology is used on reproductive cells.
Should all genetic editing be opposed by Christians?
I believe the answer here to be “no,” though there is room to disagree. Genome editing that seeks to eradicate disease and increase human flourishing has merits and can be thought of in similar terms to other pharmaceutical and biotechnological interventions. However, the means of testing such interventions must be carefully established and only be proceeded with caution.
It seems that nongermline genome editing in adults who can provide informed consent can be done in a manner that is ethical and may bear similar risks as participating in clinical trials. In contrast, in regards to genetic editing of embryos who cannot provide informed consent and weigh the risks and benefits of procedure, we are called to love them and view as fellow image-bearers of God regardless of their utility or any infirmity they may have.
This conversation has to begin from a position that sees children as a gift from the Lord (Psa. 127:3-5), not as a project on which to run experiments with an unknown outcome under suspect motives and unnecessity. This, along with fears that such technology can easily devolve into eugenics and designer babies, should give us additional hesitation to perform such procedures on human embryos.