When we think about the current development in the pharma business in treating various diseases and disorders, we are proud. We have the newest technology to treat many medical conditions that 100 years ago we could only dream of. Human gene editing, however, is a technology which risks we are not able to properly evaluate.
The most important question about human gene editing is ethics. Is human gene editing an ethical procedure concerning the possible transgenerational impact on the next generation?
The roots of dis-ease
Most people tend to treat a disease as a physical flaw. They consider themselves the “unlucky” ones to suffer from a depression, schizophrenia or to have a Huntington’s disease. Yet every disease, be it genetical or not, is a messenger, that is trying to say something to the person suffering from it.
Treating a disease solely on a physical level is a gross misconduct. Psychotherapists already know about the link between the psyche and the body. Our body is always governed by our thoughts, feelings, and habits. Therefore, a disease has many roots, some of them also are coming from our families. The research on inherited family trauma is of much importance here.
Gene editing and normal therapies
What is the difference between human gene-editing technology like CRISPR and other treatments like medications and psychotherapy? CRISPR technology is a tool for editing genomes, that is for manipulating the genes. It allows researchers to easily cut DNA sequences and modify gene function. Its many potential applications include correcting genetic defects that are a core of genetic diseases. Let’s first look at some statistics. What percentage of genetic diseases do we have? Medical investigators estimate that genetic defects are present in 10 percent of all adults.
Other treatments like medication, surgery or psychotherapy do not alter the genes and do not have an unassessed impact on the next generations. However, they do help in many medical conditions. Medication helps to cure the diseases with consequences (side effects) only for the person handled. Quite often, apart from medications used in psychiatry, the patients undergo a psychotherapy to alleviate their emotional pain and gain new insights on how to develop a healthier lifestyle by changing the way they think, act, and feel.
It’s worthwhile to note that standard methods take time and effort, whereas human gene editing can be done within much shorter time span. For sure you heard once that “it takes time to heal” or “it takes time to develop or understand”. Time, especially in current medicine, has an undervalued meaning. Everyone would like the disease to magically disappear with a touch of a fairy’s magical wand. But does this create assurance that the disease will never come back?
Transgenerational impact of human gene editing
It is relatively easy to foresee the impact of gene editing on a 65-year-old woman. She passed her reproductive age and even if some DNA alterations or cuts would be introduced, it still wouldn’t affect her descendants.
What if, because of gene editing, a woman would pass her altered genes to her baby? Another scenario includes modification in the germline – in the cells (sperm and egg). Eike-Henner Kluge from the University of Victoria has written that “germ line alteration would be performed without the consent of those who are most affected: namely, future generations.”
Considering that every medical procedure requires a written consent, the descendants of the persons who were “gene-edited” would have absolutely no say. We would take a conscious decision from them, cutting them off from deciding about their health by making gene editing that they, for example, would never ask for.
Should we make changes that could fundamentally affect future generations without having their consent? Who will be liable for unwanted results and side effects?
What if the use of germline human gene editing shifts from being a therapeutic tool to an enhancement tool for various human characteristics? We need to study the people born with edited genomes and their children, to understand the mental and physical health effects of this procedure for the next generations. This alone can take generation to check. “Primum non nocere” – first do no harm. This fundamental principle reminds healthcare personnel to consider the possible harm that any intervention might do. Safety should always come first. Even at the cost of science.
Human gene editing is a very powerful tool. But it comes with even greater responsibility. Not only for ourselves, but also pertaining to future generations.