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Ever since Crispr-Cas9 gene-editing technology emerged in the early 2010s, ethical questions around genetically altered humans, so-called designer babies, have become increasingly urgent. There is already a worldwide legal prohibition. No country currently allows human germline editing (meaning genetic changes to an embryo that could also be passed on to its children), and 70 have laws against it, including the UK. But a series of recent discoveries and a new poll suggest that scientists and the public believe gene-edited humans are likely – even desirable – in the near future.
Two new studies use base editing – a more precise next-generation Crispr tool – on human embryos to study early development or disease (this research is legal in the UK and US as long as the embryos are destroyed within 14 days). The lead author of one study, Dieter Egli, said that the technology wasn’t yet ready for the clinic, but the advances would “guide responsible research to achieve its ultimate safe and effective use”. This encapsulates the view of many scientists, who believe the regulated use of germline editing to eradicate hereditary conditions is inevitable, and the main objection is around safety.
Safety concerns, rather than any larger ethical ones, form the basis of most laws against gene editing – making them less ironclad than they initially appear. The position of the influential Nuffield Council on Bioethics is that human germline editing is not ethically unacceptable in itself, a line also held by the US National Academies of Sciences, Engineering, and Medicine. As the bioethicist R Alta Charo points out, each new technological advance chips away at objections over safety, forcing us toward more fundamental questions on whether this technology should be used at all, and if so in what situations. Any changes to the law must consider these questions and specific uses, rather than a narrow definition of safety.
The public, it seems, is running ahead of scientists on this front. New polling by Ipsos for the Progress Educational Trust found that a majority of citizens in the UK, Spain and the Netherlands supported the use of gene editing to correct life-threatening genetic conditions like cystic fibrosis, and a plurality support using it on difficult but manageable conditions like asthma (Italy returned a plurality in support on both questions). Given that IVF research was strongly opposed through the 1980s, this shows a remarkable degree of trust in science, and a newfound willingness to tinker with the very stuff of life.
But human germline editing should not be a fait accompli. There are genetic conditions that can’t be treated with existing methods like embryo selection, and if the technology is deemed safe it should be considered first only in these rare cases. Designer babies are not just a bogeyman. We already know that in jurisdictions including the UK, where donor selection is illegal in IVF, some couples will use companies abroad to screen for desirable traits. It is worrying that in the US there are already collaborations between such IVF companies and labs doing base-editing research, showing how short the leap is likely to be from medical treatment to on-demand genetic designs. Any discussion must make it clear that while regulation can limit these darker uses, it is unlikely to eliminate them entirely.
Human germline editing should remain banned for the time being – that is clear on the grounds of safety alone. But that argument may not always hold, and we can’t rely on it for ever. It’s time to have the conversation about what happens next.
