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Uproar. Outcry. Scientists and ethicists condemning and denouncing. Chinese researcher He Jiankui dropped a bio-bombshell this week when he announced that he had engineered history's first gene-edited babies.
Ethicist Arthur Caplan calls the experiment a "moral monstrosity" and He a "moral idiot" whose work "may well [set back] the very promising field of germline genetic engineering a decade or more."
That would be no small harm, in a field as exciting as gene editing. Already, FDA Commissioner Scott Gottlieb told BioCentury that if scientists don't police their own better, governments may respond with heavy-handed regulations.
But when talk turns to the looming advent of "designer babies," I enjoy the science-fictional frisson and the extraordinarily complex ethical questions about human enhancement — but I also shake my head.
I'm guilty myself of resorting to "designer baby" headlines. But the truth is, I don't believe there will be a big crop of CRISPRed babies for a very, very long time — if ever.
My reason is simple: parental guilt.
Which parent among us has not wondered whether a child's challenge is our fault? Whether a son is terrified by dogs because you didn't save him fast enough from that aggressive Labrador when he was 3, or a daughter developed her eating disorder because once — just once — you mentioned that her pants looked too tight?
Imagine that you CRISPR your embryo with the goal of a smarter or taller or even more disease-resistant child. Now imagine that your baby is one of the roughly 4 percent born with a birth defect.
Could you be sure, with the great complexity of the human genome, that it wasn't at least partly your fault? I know the mother of a child with medical issues who still wonders if it was the two cocktails, total, over nine months, that she had while pregnant.
Or say there's no obvious birth defect, but your child is not perfect, as none is. Gene editing pioneer Feng Zhang warns that He's experiment is so premature because it's simply too risky, given the early state of the technology and the many unknowns.
"From a technical perspective, the gene editing system is known to be able to make unwanted edits, and these are called 'off-targets'," Zhang told WBUR. "So even if we're trying to fix Gene A [...] it's possible that they may edit in locations B, C and D, and maybe even more. And because we don't know what some of these unwanted changes are — how they may affect the way the body works — there is very high risk going forward to use this in the embryo."
Zhang points out additional possible unintended consequences. For example, he warns that He's editing does decrease the risk of HIV but increases the likelihood of contracting West Nile Virus or dying from the flu. It's also possible that gene editing intended for a different purpose could affect a cancer-related gene and make tumors more likely.
Just imagine that: You not only have the heartbreak of your child dying of flu or developing cancer, but you also have the guilt of possibly having helped cause it by tinkering with their genome. Actually, don't imagine it — it's unbearable.
So at what point will it be imaginable to tinker with our children's genomes?
To some, it already makes sense to take those risks if the benefit would be salvation from serious genetic diseases — not only for that embryo but for generations to come.
David Liu of the Broad Institute told WBUR that he worries that this week's news could lead to overreactions and regulations that could prevent badly needed research.
"There are thousands and thousands of human genetic diseases, many of which are fatal, almost all of which have no known treatment," he said. "And patients urgently need better ways to cure their disease than they currently have available."
I agree with those who say eliminating the suffering and death of such dread diseases would be nothing but a boon for humanity, if it could be done safely.
But we're clearly not there. And for many, there are other ways to avoid having children with such diseases — genetic screening, pre-implantation genetic diagnosis — that don't involve the unknown risks of mucking with embryo genomes.
I admit, it's fun to think about. I get a thrill when I read historians writing that for the first time ever, humanity is becoming the conscious architect of its own evolution.
But when I've seen CRISPR pioneer George Church asked about that, he tends to puncture my awe by pointing out that the cellphones in our hands are surely altering humanity far, far more than any tinkering with our genes will for the foreseeable future.
And when I asked Dr. Isaac Kohane, chair of bioinformatics at Harvard Medical School, if he could imagine, at this stage in the technology, the CRISPRing of his future grandchildren, he responded in an email with a resounding no:
If I went to Apple and told them that I had identified a bug in iPhone software, and would they please edit their software accordingly, they would not ship any phones before thoroughly testing that their bug fix worked. We have not yet attained that corresponding safe engineering practice for CRISPR. And grandkids are a whole lot more precious than iPhones.
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