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The Ethics of Gene Therapy
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The Ethics of Gene Therapy
By Ariel Devlin
What is Genome Editing?
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The human genome codes for every aspect of our beings, from eye color to bone structure – even some deadly genetic diseases. Scientists are working on a slightly unconventional cure for those suffering genetic diseases, a cure that goes straight to the root of the source: genome editing. As succinctly described by the organization Centers for Genetics and Society, “Genome editing is a way of making changes to specific parts of a genome” (Center for Genetics and Society, n.d.). There are two kinds of human genome editing, one that alters somatic cells in hopes of boosting their ability to fend off illnesses (gene therapy), and one called germline editing that alters the gametes or embryo of an organism (Center for Genetics and Society, n.d.).
HISTORY
History
The idea of gene therapy came about in the 1960s, and two decades later researchers David Williams and David Nathan demonstrated that cells could receive DNA from viruses. Spurred on by the successful treatment of a young child (Ashanti De Silva) with an immunodeficiency using a gene imported from a deactivated virus, the field boomed until certain test subjects became afflicted by cancer and American patient Jesse Gelsinger died from a gene therapy procedure. It was not until 2010 that research started up again, thanks to improved technology that made the process more precise (Fliesler, 2020). In 2018, Chinese scientist Jiankui He revealed to the astonishment of all other scientists in the field that two twins had survived gene editing to prevent against HIV and had been successfully brought into the world, drawing intense criticism from fellow researchers (Wang & Yang, 2019). Today, as gene therapy continues to move forward, we must be careful to think critically about procedures and their ethical implications.
Ashanti De Silva years after her successful treatment
The Case for Genome Editing
At a somatic level, gene therapy has many supporters, citing the main benefit as the ability to prevent or cure some genetic diseases without worrying that any traits will be passed down (Mader & Windelspecht, pp. 232-233). For example, in 2017 scientists declared a boy mostly cured of sickle cell disease, a widespread condition requiring a constant supply of blood donations to flush out blockages (Coghlan, 2017). The thought is that as gene therapy gets to the root of the problem, patients for a genetically treated disease would not be dependent on an influx of pills, shots, or blood transfusions, and could live as though they had not been born with an illness at all. One other hope of gene therapy supporters is that the process could be used in place of harmful treatments – if scientists could successfully use gene therapy for cancer patients, sufferers would be spared chemotherapy (Burmester & Cross, 2006). Christian supporters may liken it to the fact that Jesus healed many people while on earth, and believe that to help find cures for illnesses is to follow in His example. Finding cures to help our fellow man can be considered loving our neighbor.
Sickle cell anemia is one of the diseases that scientists hope to eliminate with gene therapy.
Sickle Cell Anemia
The Case Against Genome Editing
The Case against Genome Editing
Aside from the fact that gene therapy has been occasionally criticized for its potential health risks, the practice is largely supported (Cleveland Clinic, 2019). However, germline editing has been met with extreme opposition, as any modification made can be passed down onto future generations (genetics and society). One issue presented by ethics philosopher Robert Sparrow is that with each and every advancement, children that have not been edited or have received an older treatment will become obsolete (Sparrow, 2019). This raises concerns for how the social structure will change against these older children – will they become subject to discrimination and fewer job opportunities? Will they be treated as equals in the doctor’s office, or will the more edited child receive an unfair advantage? More practically, however, scientists wonder about the health of genetically modified children – take, for instance, the aforementioned CRISPR twins. Leading expert in gene editing Kiran Musunuru believes that the test subjects might not be invincible to HIV as claimed, and may even be in line for “problems such as cancer and heart disease [that] could be passed on to Lulu’s and Nana’s future children” (Musunuru, 2019). There are too many ethical questions that deserve answers before we should consider implementing this treatment.
What does the Bible have to say?
From a Biblical Perspective
While the Bible was written before the discovery of DNA, it is still applicable to this subject. One verse that comes to mind is Psalm 139:13-14: “For You formed my inmost being; You knit me together in my mother’s womb. I praise You, for I am fearfully and wonderfully made.” The Psalmist describes God’s creation of the individual as an intimate, highly-involved process. One can almost picture Him stitching every nucleotide into sequence, creating a blueprint for an individual whom He loves. God is not making any mistakes; He has an exact plan in mind, even if it does not align with human ideals. Continuing in this vein, Isaiah 29:16 mocks the fool that thinks he knows better than the One who made him: “You turn things upside down, as if the potter were thought to be like the clay! Shall what is formed say to the one who formed it, ‘You did not make me’? Can the pot say to the potter, ‘You know nothing’?” Tearing into the human genome smacks of “correcting” God’s “mistakes,” an act condemned here as supreme arrogance. We who do not even entirely understand the mysteries of the human genome should not presume to know better than the God who created it.
Conclusion
Where do we go from here?
To conclude, society’s opinion on editing of the human genome is dependent on the level of interference – if it is confined to somatic cells to treat a disease, it is often perceived as acceptable, but germline manipulation is often met with condemnation. I confess to being slightly torn on the matter myself. The Bible indicates that the human genome is God’s special project, something He crafts carefully for each one of us. I am very opposed to eugenics and consider germline manipulation too similar for comfort, but gene therapy seems more like a grey area. Diseases of the genes are like diseases of the flesh – they are brought on by the arrogance displayed in the Fall. God has given us permission to treat diseases of the body (Jesus treated many himself); perhaps He feels the same about diseases of the genes. The degeneration of the genome (Gee, 1999) is brought about by the natural degeneration that ensued from the Fall – perhaps we are being given more grace as we have more need of it.
References
References
Burmester, J. K., & Cross, D. (2006, September 4). Gene therapy for cancer treatment:
Past, present and future. PubMed Central (PMC). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1570487/
Center for Genetics and Society. (n.d.). What is human gene editing? https://
www.geneticsandsociety.org/internal-content/what-human-gene-editing
Cleveland Clinic. (2019). Gene therapy. https://my.clevelandclinic.org/health/
treatments/17984-gene-therapy#:~:text=Some%20gene%20therapy%20research%20indicates,include%20cancer%2C%20toxicity%20and%20inflammation
Coghlan, A. (2017, March 1). Gene therapy ‘cures’ boy of blood disease that affects
millions. New Scientist. https://www.newscientist.com/article/mg23331154-800-gene-therapy-breakthrough/
Fliesler, N. (2020, December 22). A short history of gene therapy. Boston Children's
Discoveries. https://discoveries.childrenshospital.org/gene-therapy-history/
Gee, H. (1999, February 4). Six million years of degradation. Nature News. https://
www.nature.com/news/1999/990204/full/news990204-2.html
Mader, S. S., & Windelspecht, M. (2018). Essentials of biology (Fifth ed., pp. 232-233). Penn
Plaza, NY: McGraw-Hill Education
Musunuru, K. (2019, December 3). Opinion: We need to know what happened to CRISPR
twins Lulu and Nana. MIT Technology Review. https://www.technologyreview.com/2019/12/03/65024/crispr-baby-twins-lulu-and-nana-what-happened/
Sparrow, R. (2019, July 1). Yesterday’s child: how gene editing for enhancement will produce
obsolescence—and why it matters. EBSCOhost. https://web.a.ebscohost.com.research-db.letu.edu/ehost/pdfviewer/pdfviewer?vid=8&sid=4e918ca0-3a71-4335-a397-49b86121ac50%40sdc-v-sessmgr02
Wang, H., & Yang, H. (2019, April 30). Gene-edited babies: What went wrong and what could
go wrong. EBSCOhost. http://web.a.ebscohost.com.research-db.letu.edu/ehost/pdfviewer/pdfviewer?vid=3&sid=4e918ca0-3a71-4335-a397-49b86121ac50%40sdc-v-sessmgr02