On Genetic Modification

On Genetic Modification 

To be able to perform prenatal diagnostics and to alter the genotype of offspring is a surging field in the world of genetics. With this new field comes, arguably, a potential for a means to greater good but such a greater good is naturally mirrored with the potential for what is not good. Good here is meant in the Aristotelian sense and, in this case, the alteration of the genotype is means by which we may promote the well-being, happiness, and an opportunity for an individual to live well. As to whether prenatal gene editing will be a force for good or not depends on the person and questions posed. In a sample population, there was a tendency to show concern about the health of the offspring receiving genetic editing; the sample also tended to not feel confident in the accuracy of prenatal genetic testing (Cécile and Cameron, 2016). However, as cultural norms and technology are likely to change and improve, we may find that the average person will find genetic editing to be normal. A different poll suggested that the American public is nearly split in half in terms of supporting the idea of genetic enhancements to improve physical and intellectual capabilities (Suter, 2007).  

The advancement in gene-editing technology will likely be developed with the intention to prevent detrimental genotypes and neurological disorders—Parkinson’s, Alzheimer’s, epilepsy, depression, Lupus, ataxia, and so on. As time progresses, there will then be a debate amongst the public, ethicists, geneticists, and others as to what the moral and ethical limits of genetic editing and enhancement are to be. Some fear that the development of gene-editing and enhancements could tempt the government into adopting another eugenics-like policy. Further development may provide a means for the government to, itself, further encroach into the daily lives of the individual by allowing the government to decide what may or may not be acceptable regarding gene-editing. Does the government have right to, say, mandate you to genetically modify your offspring in a certain way? Should government be allowed to sponsor public education that favors genetic modification—reminiscent of the classic eugenics era? These sorts of questions bring forth many answers. Some would prefer government to not interfere with the free market and matters of procreation; others would prefer that government is involved with how genetic modification is used and what the limits are so to protect the “welfare of unborn children” (Resnik and Vorhaus, 2006). There are even those who would argue that genetic modification should not be allowed on the basis that such modification violates “human freedom and dignity” which, if allowed, would bring forth “social, political, and biological disaster” (Resnik and Vorhaus, 2006). This is given some credibility depending on how strong genetic determinism may be; if for instance a fetus was genetically modified to where it carries a gene that increases the likelihood of it growing up to be a musician, then is this not violating freedom and dignity? There are also arguments that would state that this genetic modification objectifies children as a commodity, chides at authenticity, uniqueness, and such. These are questions and arguments to deal with in the approaching future.  

As of right now however, there is an international group of 11 academic genetic organizations that have come together to suggest a recommendation as to how genetic modification should proceed in the future. Given the amount of questions genetic modification raises, it would seem best to first tackle genetic diseases as it may be an issue wherein the public would support; any more than the treatment of genetic diseases may take time to be allowed for until society decides its stance. So, the 11 organizations agreed on certain statements such as the inappropriateness of performing “germline gene editing that culminates in human pregnancy” and allowing for limited in vitro genetic research (Ormond et al., 2017). The organizations and the Genetics and Public Policy Center suggested that there should be circumstances under which any future genetic modification research should operate under; both agree that discussions on genetic modification “must include the public” and experts (Lanphier E., Urnov F., Haecker S.E., Werner M., and Smolenski J., 2015; Ormand et al., 2017). I myself, Dr. H.M.B, serve as a sort of intermediary between the public and experts by the very nature of my work. I assist people in genetic counseling and so I am able to hear what ordinary people may think about genetic modification and prenatal diagnostics. From experience, I would say that most ordinary people are in favor of genetic editing for therapeutic purposes; however, most disagree with any sort of genetic enhancement. The percentage of patients I come across who support genetic editing for therapeutic and or for enhancement mirrors a poll suggesting that 65 percent of the public is in favor of therapeutic genetic editing; only about 26 percent of the public would for genetic editing that allowed for some enhancement and 51 percent were against (Hewings-Martin, 2017). Interestingly, the poll shows that who are not very religious are more likely to favor or accept both therapeutic genetic editing as well as enhancement via genetic editing (Hewings-Martin, 2017). Meanwhile, the polled professionals are mostly against genetic editing for enhancement. This could be due to the professionals worrying for an opportunity for eugenics to come about again as well as the unknown risks that may be caused by performing enhancements instead performing therapeutic genetic editing.  

So, given the input from the public and professionals in their respective fields, it seems very clear that are in favor for, at least, therapeutic genetic editing. There seems to be very little qualms about the repercussions of doing so. Genetic editing for the purpose of enhancement, however, does not seem to have enough public and professional support as of yet. Allowing for genetic enhancement would require all of society to resolve their issues and concerns about what would come of genetic enhancement. Potentially, the most feared outcome would be another socially and or government supported eugenic movement. Those with money would be able to design their children the way they want to. This again causes more issues such as objectifying the children and the carrier of the child if it is to be born in a womb. For those future children born without having been genetically edited, will there be discrimination given to them? Is there any ethical justification to allow for genetic enhancements? As of right now, there seems to be too many unanswered questions revolving around whether we should allow for enhancements. Society requires more time and more information before coming to an answer about this; a lot of the questions posed by this new technology may only be resolved democratically due to the subjective nature of what is good and right for what we do to our children.   

References 

Hewings-Martin [Internet] 2017 Oct 2017 [cited 2017 Nov 1]. Is gene editing ethical? Available from https://www.medicalnewstoday.com/articles/319817.php 

Lanphier E., Urnov F., Haecker S.E., Werner M., and Smolenski J. [Internet] 2015 March 12 [cited 2017 Oct 3]. Don’t edit the human germ line. Available from http://kcsschmidt.com/BME2016/Nature-Don'tEdit.pdf  

Ormond KE., Mortlock D., Scholes D., Bombard Y., Brody L., Faucett W., Garrison N., Hercher L., Isasi R., Middleton A., Musunuru K., Shringer D., Virani A., Young C., 2017 Aug 3 [cited 2017 Oct 3] ASHG position statement on human germline genome editing. The American Journal of Human Genetics. DOI: 10.1016/j.ajhg.2017.06.012. 

Muller, C., & Cameron, L. D., 2016. It's complicated - Factors predicting decisional conflict in prenatal diagnostic testing. Health Expectations: An International Journal Of Public Participation In Health Care And Health Policy, 19(2), 388-402. doi:10.1111/hex.12363 

Resnik, D.B, and Vorhaus D.B., 2006. Genetic modification and genetic determinism. Philosophy, Ethics, and Humanities in Medicine 1: 9. PMC. Web. 4 Oct. 2017. 

Suter, S.M., 2007. A brave new world of designer babies? Berkeley Technology Law Journal, 22(2), 897-969.