By / Dec 6

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.

By / Oct 12

Recently, it was announced that a controversial technique that uses the DNA from three persons has resulted in the first birth of a child.[1] The birth of the baby boy occurred five months ago, yet scientists are just now publicizing their success. For embryology, this is truly groundbreaking in the sense that it has never been done before.[2] However, for those ascribing to a Christian worldview, many questions persist.

What was done?

In this particular case, the Jordanian couple approached the U.S.-based team who performed the procedure after experiencing the death of two children. The mother is a carrier for Leigh syndrome, a disorder that affects the central nervous system and is typically fatal within the first three years of life. After consultation with the medical team, it was decided that a technique known as spindle nuclear transfer would be utilized. The physician, Dr. John Zhang, of the New Hope Fertility Center in NYC, first removed the nucleus from one of the mother’s eggs and inserted it into a donor egg that had had its own nucleus removed. This resulting egg (which had the nuclear DNA from the mother and mitochondrial DNA from a donor) was then fertilized with the father’s sperm, resulting in three unique DNA contributions for the child.

It is important to note that this technique has only been approved by the UK Parliament, which permitted the technology in early 2015.[3] The U.S.-based team had to travel to Mexico to actually perform the procedure in order to evade FDA oversight and capitalize on loose regulations south of the border.

What are the problems?

Pragmatically, such legal restrictions are in place for good reason, for there are too many unanswered ethical and medical questions. It is simply not readily known what type of adverse effects such a procedure may have on progeny. Recent research has suggested that mitochondrial DNA plays a role in some personality traits.[4] Hence, vital traits will no longer be inherited by only two parents, but rather three, which is completely novel for human beings.

During the UK debates on this technology, Dr. Trevor Stammers, programme director in Bioethics and Medical Law at St Mary's University of London, stated: “Even if these babies are born they will have to be monitored all their lives, and their children will have to be as well. We do not yet know the interaction between the mitochondria and nuclear DNA. To say that it is the same as changing a battery is facile. It’s an extremely complex thing.”

Further, Dr. Rhiannon Lloyd from the Zoological Society of London similarly cautioned that in more than 50 percent of animal studies, faulty mitochondrial DNA was transferred over during the procedure. Moreover, in March 2014, the chair of the FDA’s Cellular, Tissue and Gene Therapies Advisory Committee, looking into the issue of mitochondrial DNA transfer wrote to the Human Fertilisation and Embryology Authority (part of the UK’s Department of Health) to warn that their panel had decided the science of mitochondrial donation was not safe.[5] Hence, from a safety and public health perspective, there is simply not enough evidence to show that such procedures are safe. It is imprudent to trod down a road of uncertainty when the stakes are as high as this. As one commentator put it, this is science by press release.[6]

However, even if the safety of the procedure for the resulting children could be guaranteed, there remain many theological considerations for reproductive technologies in general, and three-genetic-parent embryos, in particular. The issue of human dignity must be at the forefront of this discussion. Human beings are not engineered creations to be tinkered with for the sake of novelty and innovation. Human beings, who bear the image of the Creator God, are good gifts to be received, rather than objects to be produced. The production of three-genetic-parent children points to a minimization of the sacredness of the human creation as unique gifts from God. As Albert Mohler has pointed out, once we see children as objects to be customized, ordered and configured to our liking and specifications, this changes the inherent relationship between a parent and child. This also has the ability of altering our thinking of what it means to be human.[7]

We must realistically note that one advance in technology inevitably leads to others. Once a technology like this becomes publicized and available, then it naturally leads to a widening of the application, and additional questionable biomedical activities and technologies are sure to follow. Once a society recognizes the moral worth of one genetic technology, then it predictably leads to the moral acceptance of other technologies. This is not so much a slippery slope argument as it is a statement based upon past history. Once this doorway is opened, further experimentation in the realm of designer children will not be far removed.

Let’s be clear: The desire for children is a good desire. There is a clear pattern throughout Scripture of God desiring for people to have children (Gen. 1:28) and for children being a blessing to their parents (Ps. 127:3-5). As churches and Christians, we must show compassion and tenderness toward those who have suffered infertility and disorders that have prevented the natural bearing of healthy children. Surely this is the result of a world gone awry by the effects of sin. However, the pursuit of children by any and every means is not something we should applaud, for it sets dangerous precedents from which it is difficult to backpedal.

By / Mar 6

Coming soon to America: Babies who have one genetic father, two genetic mothers, and dozens of discarded siblings.

Last month a government advisory committee began debating the merits of approving a new technique – already sanctioned in the U.K. – that combines DNA from three people to create embryos free of certain inherited diseases. According to the New York Times, the Food and Drug Administration panel focused on a procedure that scientists think could help women who carry DNA mutations for conditions such as blindness and epilepsy. The process would let them have children without passing on those defects.

The technology involves taking defective mitochondria from a mother’s egg and replacing them with healthy mitochondria from another woman. After being fertilized by the father’s sperm in a lab, the egg would be implanted in the mother, and the pregnancy could progress normally.

While the technical description of the process may sound unobjectionable, the result – a baby with three genetic parents and customized genes – raises serious ethical concerns. The innovation and its acceptance combine two of the most troubling bioethical issues related to IVF. The creation of three-parent embryos and “designer babies” are each troubling. But to combine them is a significant leap forward into an area of potentially dehumanizing eugenics.

Eugenics is the practice of improving the genetic composition of a population by increasing the number of people who have a more desired trait and reducing those with less desirable traits. Currently, our most common eugenics practice is to screen for children who may have Down syndrome and then kill them before they are born. It is estimated that upward of 90 percent of Down syndrome pregnancies are aborted.

Increasingly, though, IVF techniques are being created that allow certain genetic traits to be eliminated or selected from an embryo before they are implanted. This in itself is not morally problematic, so long as no embryos are being destroyed. But in bioethics the line between therapy (preventing or curing diseases) and enhancement (improving capabilities not related to disease) is often blurred.

Even when such distinctions can be made, our culture of unfettered personal choice makes it nearly impossible to say that certain “enhancements” should not be made. If we allow genetic changes to prevent mitochondrial disease, why should we not allow such changes to make sure a child is born with blue eyes, blonde hair, and a fair complexion?

Added to this concern is the problem of allowing three genetic “parents.” Since the creation of IVF in 1978 we've been able to sever sex from procreation; now we are able to sever parenthood from procreation. By mixing in some genetic material, anyone can be added to the “parental line” of a child. A polygamist family could have any number of genetic fathers and mothers. Who then would be legally entitled to be claimed as the “parents”? If current legal trends hold, the answer would be “all of them.”

Christians should attempt to do what we can to hold the line against techniques that degrade our humanity. But as long as “what can be done, must be done” is the only ethic our culture acknowledges, we may not be able to stop this immoral advance. We have entered a Brave New World that we are unprepared for—legally, political, ethically, and culturally—and from which we may not be able to turn back.