On Sunday (November 25), He Jiankui, a scientist at Southern University of Science and Technology in Shenzhen, China, announced that he was the “first” to use CRISPR to genetically edit twin babies to inactivate the gene for CCR5, a chemokine receptor that the HIV virus uses to infect human immune cells. There are many questions regarding this announcement: What were the medical motivations in using gene editing to “protect” these future twins from contracting HIV? Why weren’t embryos that carry fatal genetic mutations the targeted subjects for gene editing? How do we protect the “autonomous rights” of the unborn?
Nonetheless, the visions of how this gene-editing technology could be abused unnerved scientists, medical ethicists, and legislators. The temporary halt to gene editing on humans ordered by the Chinese government is only an appropriate step if it leads to instituting intelligent ethical guidelines related to this technology.
As a scientist and biothethicist, I believe this “first” underscores the importance of guidelines, rather than reactive prohibitions or restrictions. This philosophy may explain why the organizers of an international conference on human gene editing held this week in Hong Kong, where He defended his work, responded to He’s announcement by calling for a “translational pathway” that might eventually bring the ethically fraught technology to patients in a responsible way. They were correct in not demanding a global research moratorium on similar studies, as some scientists and bioethicists had hoped.
Prohibiting scientific research is not always the answer to ethical challenges that emerge from new biotechnologies. There are many lessons bioethicists and scientists can learn from history. One lesson is that the application of innovative and ethically challenging biotechnologies in medicine can, at times, have future positive outcomes for society and may even revolutionize healthcare.
For instance, the development of in vitro fertilization (IVF) in 1978 by Robert Edwards is an excellent example. Edwards performed the first IVF procedure to produce a baby girl named Louise Brown. At that time, this procedure had no ethics board approval and no one knew what potential health risks might occur when an egg is fertilized outside the woman’s body. Now, after Brown has celebrated her 40th birthday, we know that the medical risks associated with IVF are, luckily, minimal, and more than 8 million people owe their lives to this remarkable procedure. The positive outcome from Edwards’s unapproved clinical trial was developing a procedure that revolutionized reproductive medicine.
Conceptually, gene-editing technologies such as CRISPR have great medical potential. However, scientists need time, funds, and moral guidelines to research the brave new world of gene editing in order to identify all the risks and benefits. There is much hope that continued responsible research related to gene editing will actualize its potential to cure some of the most devastating genetic diseases affecting humankind.