Tag Archives: Crispr

Ethics and eugenics

Nature has an piece highlighting the history of the ethics profession along side the history of eugenics: Ethical research — the long and bumpy road from shirked to shared. Connecting these dots is only possible by partial omissions of the text

Eugenics […] is particularly associated with the mass-sterilization campaigns that began after Indiana’s 1907 act, and with the Nazi racial-hygiene programme that reached its nadir in the Holocaust. Another legacy of the eugenics movement is the management of populations using techniques such as demography, racial classification and statistical modelling. These, combined with family planning, became synonymous with modernity and progress. From Latin America and Scandinavia to India, China and the Soviet Union, eugenics took root in projects to ‘improve the population’ throughout the twentieth century. […] The stereotype of bureaucratic, box-ticking ethical compliance is no longer fit for purpose in a world of CRISPR twins […]

An open letter to Dr. Hurlbut

Dear Dr Hurlbut,

given your previous involvement in the experiment of He Jiankui, I would like to make a proposal to you.

As a genetic epidemiologist, I have looked into the technical details of  Dr. He’s presentation in Hong Kong. I am deeply concerned about the two girls and and what the international community could do for the “CCR5 twins” but also for the “PCSK9 baby” that will be born in about 10 weeks.

As the official Chinese investigation report leaves a lot of open question, I suggest that an international commission including also scientists and medical doctors from abroad should examine these children. Very much in accordance to the International Atomic Energy Agency there should a multidisciplinary group be built that is allowed to do on-site visits. While I agree with many other ethicists and geneticists that the children and their parents should not be exposed to the public, I think a group of experts need to examine the children and resequence their genomes to offer them the best care available.

We are not sure if the twins are still alive as a Chinese magazine already wrote last December

Eugenics is a word many associate with America’s historical bans on interracial marriage, Nazi Germany’s quest for Aryan supremacy, and stolen Australian Aboriginal children. Its connection to China’s one-child policy is less obvious, but no less potent. Children were seen as valuable resources, and when only one child was permitted per family, there was tremendous pressure to secure the optimal outcome … “Deformed fetuses” are encouraged to be terminated in China because people who require extra care and function outside conventional norms are largely viewed as burdens on society and the family. In lower tier cities, disabled children are often hidden from view and afforded little dignity or opportunities for upward mobility. When people with disabilities are not being pitied as subhuman, those who manage to overcome societal judgment and obstacles are then trotted out as inspiration porn for able-bodied people. Many Chinese people struggle to see beyond someone’s disability. The Chinese word for “disabled” is made of up characters that mean “incomplete/broken” and “disease/suffering,” leaving little room for a fulfilling existence.

As a genetic community we owe something to these children as we collected all those genomic data and developed also the tools to modify a genome but we did not clearly voice our concerns of a germline based therapy. Based on a previous analysis I am sure that the two girls will have many more deficits than are currently known.

Knowing more about the details would be a further warning sign of doing such experiments.

Kind regards
MW

Fundamental and non fundamental objections of genome editing in humans

Braun, Schickl and Dabrock try to “map the underlying ethical arguments” (p6ff in “Moral Hazard” 2018) against human genome editing.

The various objections against germline genome editing can basically be divided into (1) fundamental (i.e. against the context of research and application) and (2) non fundamental (i.e. only against the context of application) arguments. The most prevalent fundamental arguments are (a) arguments of human dignity (b) arguments of naturalness and (c) slippery slope… The most common argument within the ethical (as well legal) debate on the use of genome editing techniques, like CRISPR technologies, is the safety argument as a non fundamental objection.

While I think the differentiation of fundamental vs non-fundamental is important for discriminating relevant from irrelevant arguments, the definitions are not fully clear. What is “context of research” – subject, object or objective? And what is “context of application” – the procedural conditions?

“Fundamental” may not be the best label as “fundamental” in German usually claims to be the  only right doctrine. Anyway, a fundamental argument will be an argument that cannot be easily overcome by a counter-argument as it is it is deeply grounded, heavy-weighted and basis for other conclusions.  A non-fundamental is just a non fundamental argument that can be rebutted immediately or in the foreseeable future.

The classification of fundamental by Braun, Schickl and Dabrock is even problematic as well. “Naturalness” is not a fundamental argument as it is nearly impossible to define a “natural” human genome. IMHO “slippery slope” is also not a logical argument at all – having more fear mongering elements than a  strict consequentialist logic.

I would therefore like to split any fundamental objections by the disciplines where they originate: (a)  philosophical/theological anthropology (b) biology and (c) sociology.

FUNDAMENTAL OBJECTION
-- anthropology
  .. human dignity
  .. missing embryonal consent
  .. genetic heteronomy
-- biology
  .. off target risks / safety
  .. unknown genetic background effects
  .. unknown next generation effects
  .. dissolution of species boundaries
-- sociology
  .. missing societal consensus
  .. new naturalism
  .. new eugenics
  .. new racism
NON FUNDAMENTAL OBJECTION
  .. medical necessity
  .. ethics vote
  .. no pre-tests
  .. no trial exit strategy
  .. conflicts of interest
  .. consent without alternatives
  .. and all Krimsky rules

Safety could of course could be a fundamental argument as set out by Nüsslein Vollhard: we can not 100% predict from one cell the fate from another cell.

Maybe this very first classification of arguments could be a further step into a more rational ethical discussion.

Braun, Schickl and Dabrock write on the same page that “the potentiality argument … which is considered to be the strongest argument for absolute embryo protection, is increasingly criticized by ethicists” citing Schöne-Seifert et al 2013 and  themselves as Schickl et al 2014. Their argument: we can reprogram now adult cells, the potentiality is therefore not a unique property of the human embryo, the embryo therefore has not any unique value, the embryo does not need protection.
I ask – instead of REVOKING potentiality of the human embryo why not EXPANDING potentiality to reprogrammed stem cells?
I have also doubts that a “reprogrammed” stem cell will ever have the unique potentiality of an embryo in situ for 3 reasons:
1. a stem cell is not a de novo creation but just a replication.
2. a stem cell will never replicate the complicated epigenetic pattern of an embryonic cell (which is a unique part of the embryonic identity, putting the Schickl argument in a row of genetic exceptionalism arguments).
3. lastly there is never ever maternal support of a stem cell, ignoring the complex biological support chain of human embryos.

And of course potentiality cannot be denied from a biological standpoint. It can be even exactly quantified: One of three fertilized eggs will develop into a human.

(TBC)