Is CRISPR a medical wonder, a peril to humanity, or both?
Culminating in the creation of CRISPR, rapid gene editing has become a revolutionary reality: one with enormous potential to promote human welfare. Incurable, gene-linked diseases can be remedied; debilitating disorders healed; and our knowledge of the human genome advanced as never before. But with unprecedented progress, the risk of far-reaching mistakes becomes evermore prevalent.
CRISPR is a DNA sequence that allows single-celled organisms to fight viruses by detecting and destroying their genetic footprint. In 2012, biochemists Jennifer Doudna and Emmanuelle Charpentier showed that CRISPR could be used to target segments of DNA, effectively cutting, copying, and/or pasting their contents. Many are hopeful that, with advances in the efficiency and precision of CRISPR, genetic infirmities and life-threatening disorders can be eliminated. But intertwined with these medical advancements are a host of social dilemmas.
For one thing, gene editing may widen social gaps between economic classes. As an article published by the Harvard Gazette notes, “For those living in poverty, [gene-editing] is yet another way for the privileged to vault ahead.” The worry is that, with the development of the gene-editing industry, the gap between rich and poor will manifest not only in economic resources but also in biological makeup. As the upper and middle classes gain access to gene-based enhancements, the lower classes—especially the impoverished—may be left behind.
Further, Sufian and Garland-Thompson note that modifying genes to correct non-life-threatening disorders (e.g., deafness) may be “a threat to those who are judged by society to be biologically inferior.” It’s one thing to save someone’s life via gene-editing, it’s another to ‘cure’ illnesses one sees as inferior. This problem is highlighted by the beneficial consequences of disability. Sufian and Garland-Thompson, disabled authors, further write, “...we have benefited from learning early on how to live with the characteristics of our…genetic distinctiveness…We learned to thrive with the bodies we have…Yet stubborn beliefs about ‘good’ genes and ‘bad’ genes…persist in discriminatory attitudes…”
Finally, there’s immense worry over the implications of ‘germline gene-editing.’ While ‘somatic editing’ refers to “edit[ing] disease-causing DNA within the body’s non-reproductive cells” (per Brooks), germline editing entails “introducing heritable changes to sperm, eggs or embryos” (per a Nature article). That is, somatic editing only changes the DNA of a single person, while germline editing may induce generation-spanning alterations (and mistakes).
The future of gene editing may seem bleak. But it doesn’t have to be. Each of the above social dilemmas can be avoided if we limit the focus of gene editing to curing life-threatening diseases through somatic processes. This mode of editing is simply another way for physicians to save lives. As Tregaskis notes, it’s “cost-effective, convenient, and easy to use,” meaning it will likely be accessible to lower classes.
Furthermore, assuming gene-editing is used only as a treatment for life-threatening diseases, it won’t give the wealthy ‘biological enhancements’ or stoke stigma against the disabled. Thus, worries about economic inequality and ableism shouldn’t impede the development of somatic gene-editing as a medical treatment. As Bergman put it, “Developing safe, effective ways to use gene editing to treat people with serious diseases…has so much potential to relieve suffering that it is hard to see how anyone could be against it.”
But of course, as technology develops, the international community—scientists, policymakers, and everyday citizens—must be vigilant in constraining gene editing to its proper usage: developing laws and scientific standards that punish germline editing and prevent medicine from morphing into eugenics. Moreover, scientists should continue to make CRISPR cheap and efficient, allowing its benefits to be realized regardless of economic circumstances. If these actions are taken, we can refrain from the evils of ableism and biological discrimination while taking full advantage of the medical wonders offered by somatic gene editing.
Written with help from Benjamin Morris, who was an SE&T intern with ONC in 2021. Ben attends Harvard University as an undergraduate.
The opinions expressed in this article are those of the individual authors.
Sources
Barrangou R. (2015). The roles of CRISPR-Cas systems in adaptive immunity and beyond, Current Opinion in Immunology (32:36-41). https://pubmed.ncbi.nlm.nih.gov/25574773/
Bergman M.T. (2019). Perspectives on gene editing, The Harvard Gazette. https://news.harvard.edu/gazette/story/2019/01/perspectives-on-gene-editing/?utm_medium=social&utm_campaign=hu-twitter-general&utm_source=twitter
Brooks, P.J. Somatic cell genome editing, National Center for Advancing Translational Sciences. https://ncats.nih.gov/somatic
Editors. (2019). Germline gene-editing research needs rules, Nature. https://www.nature.com/articles/d41586-019-00788-5
Sufian S., Garland-Thompson R. (2021). The dark side of CRISPR, Scientific American. https://www.scientificamerican.com/article/the-dark-side-of-crispr/
Tregaskis, S. (2020). The future of gene editing, Columbia. https://www.cuimc.columbia.edu/news/future-gene-editing