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Genomic technologies
Published in Wendy A. Rogers, Jackie Leach Scully, Stacy M. Carter, Vikki A. Entwistle, Catherine Mills, The Routledge Handbook of Feminist Bioethics, 2022
Genome editing technologies are also being used to modify sperm, eggs and embryos. These types of interventions, if used in the context of reproduction, would not only last throughout the lifetime of the modified individuals but would be transmissible to future generations (Lea and Niakan 2019). In this clinical context, genome editing technologies are used in combination with IVF. These interventions can be directed both to correct genetic mutations implicated in the development of various human diseases and also to improve particular characteristics, i.e. for genetic enhancement. CRISPR-Cas9, for instance, has been used already to create genetically modified macaque monkeys (Niu et al. 2014). Moreover, several groups in jurisdictions where these interventions are lawful have reported on the use of genome editing tools to modify the genomes of human embryos for research purposes (Ma et al. 2017). Although genome editing for reproductive purposes is not yet an accepted clinical intervention, in November 2018, a Chinese researcher named He Jiankui used it (Cyranoski and Ledford 2018). He and his team transferred human embryos edited to disable a genetic pathway that HIV uses to infect cells, and three babies have been born. He’s actions have been widely condemned by the scientific community and he was recently sentenced to three years in prison (Townsend 2020).
Good People / Moral Enhancement
Published in Jonathan Anomaly, Creating Future People, 2020
Although we can distinguish germline genetic enhancement of embryos from using drugs or hormones to enhance someone who is already born, what genetic enhancement would presumably accomplish for embryos is to change levels and ratios of hormones, and the uptake of hormones by the receptors that translate hormones into emotional states and behavioral dispositions. This is even more complicated than it might seem since different people have different baseline levels of hormones, and different tendencies for those hormones to rise or fall in response to environmental stimuli, such as stressful or competitive situations.
Prenatal diagnosis and reproductive genetics
Published in Peter S. Harper, The Evolution of Medical Genetics, 2019
A further development that needs careful consideration before it enters clinical practice is gene editing, which gives the possibility of repairing the mutational defect in a gamete resulting from a severe mendelian disorder. Here the ethical concerns focus mainly on the fact that this approach would also affect future generations; while this might be an advantage for a genetic disorder, it could be open to abuse if used for ‘genetic enhancement’. Again, a Nuffield Council report (2018) has clearly set out the facts and issues involved.
Procreative Beneficence and Genome Editing
Published in The American Journal of Bioethics, 2022
This has a surprising implication: Even under PB, couples could be morally required to make a procreative choice that will not result in the “best child” they could have. This now also seems to be the case in real instances of genome editing. Similar to the thought experiment described above, genetic modification could promote the well-being of offspring, but would arguably be too risky to be a reasonable option in the foreseeable future. As Sparrow (2021) rightly points out, the motivation for genome editing will likely be the attempt to enhance offspring (rather than therapy), because embryo selection already gives couples the chance to have healthy children (Ranisch 2020). However, the possibilities for significant and unambiguous enhancements through genetic modification are limited. Known monogenic traits would have only a moderate enhancing effect and are often associated with detrimental effects (Ranisch 2021b). Fanciful ideas of genetic enhancement are related to the modification of polygenic traits about which relatively little is known. Crucially, changing multiple genes increases the error-rate in genome editing. Even if genetic modification could allow couples to have “the best child” they could have, this option will often not be worth the risks. This is all the more true if genome editing is person affecting. Because then such interventions could not only benefit an individual but could also cause “real” harm to an individual. Consequently, “genetic child abuse,” as Sparrow calls it, could arise not so much from failure to enhance, but from risk-taking couples trying to have the best child.
Personhood, Welfare, and Enhancement
Published in The American Journal of Bioethics, 2022
That being said, genetic enhancement, as it is currently implemented, is not person-effecting. Phrases such as “knocking out a gene” are misleading in this regard, since they suggest that genetic enhancement is akin to pressing a particular switch in the internal mechanisms of a person’s body. The science is much more complicated than that, as Sparrow emphasizes. The latest genome engineering technologies (CRISPR-Cas) merely affect the probabilities of how an embryo will develop. From the perspective of philosophy of science, this is not surprising: cells are highly stochastic and the common textbook representation of them as complex machines is a significant idealization of reality (Nicholson 2019). For many epistemic challenges this idealization does the job, but for others it does not and the ethics of CRISPR-Cas seems to be one of those. Whether following the technique of editing the genome of a live embryo, or of inducing gametogenesis of gene-edited pluripotent stem cells, it is necessary to conduct several attempts and subsequently select the most desirable embryo. In other words, genetic enhancement for the foreseeable future will involve generating and selecting between multiple embryos. Instead of increasing the welfare of existing persons, genetic enhancement de facto selects which persons can come into existence.
Enriching, Rather than Revising, the Conceptual Toolbox on Germline Interventions
Published in The American Journal of Bioethics, 2020
That is not to suggest that Cwik’s proposed framework entails the permissibility of He’s experiment, since it clearly failed to meet the requirement not to be in equipoise with alternative interventions targeted at the same goal (Cwik 2020). My point in invoking He’s case is simply to illustrate the fact that not all germline enhancements need involve nuclear DNA transfer, so that some (which met the equipoise requirement) might in principle be allowed by Cwik’s framework. This need not ultimately be a problem: it may well be that some particular kinds of germline genetic enhancement are, or at least will prove ethically permissible at some point. If so, however, this seems to be a fact worth stating, for which our existing conceptual toolbox will be needed. Furthermore, while it is conceivable that only “non-transferring” forms of germline enhancement might be good candidates for meeting the threshold of permissibility, this conclusion would still need to be argued for in greater detail.