He Jiankui and the Ethics of Gene Editing
Chinese researcher He Jiankui recently used the CRISPR/Cas-9 complex to genetically alter the DNA of seven embryos in an attempt to make the embryos resistant to HIV. He was universally condemned, and with good reason: gene editing on humans is a relatively new technology and therefore untested and potentially dangerous. Furthermore, the scientific community tends to condemn any sort of human experimentation that violates the Nuremberg Code. There is a litany of ethical questions that human gene editing raises, and, as Bill Gates put it, gene editing is “the most important public debate we haven’t been having widely enough.”
But let’s table the human experimentation discussion for now. Assume, for the sake of argument, that gene editing is fully tested and has a 100% success rate in humans. Was Jiankui’s decision to edit the genes of human embryos ethically wrong? I’d argue not, with a few qualifications.
The most obvious benefit to allowing gene editing on humans is the prospect of curing any genetic disease or disorder. Diseases like Tay-Sachs and Cystic Fibrosis could cease to exist. Even non-genetic diseases like AIDS could be prevented, and this is what Jiankui was attempting to do: splice in an HIV-resistant form of the CCR5 gene to create individuals with HIV immunity. Curing one disease is amazing. Curing virtually all of them is unheard of.
The common objection to this is based in religion — an unwillingness to play God. To edit the human genome would be to overstep humanity’s hierarchical bounds in the great chain of being, taking on duties otherwise reserved for God(s). I would argue that playing God in the scientific sense is not only morally justifiable, it’s already been done.
Consider modern medicine, in which humans are able to affect life and death. According to Our World in Data, life expectancy has been steadily increasing since the 1850s, partly as a result of modern medicine. Modern medicine can be seen as an interference with a natural course of events — for instance, the anti-vax movement as a response to vaccines. It is through this technology that we are able to alter the course of death or prevent it for longer than ever. This is no longer a power reserved solely for religious figures. Our government accepts and implements these practices for the vast benefits, namely a much longer life expectancy. Do we overlook modern medicine’s “interference” simply because of these benefits?
Consider artificial selection, where we choose characteristics of plants and animals that are desirable and exaggerate them through selective breeding. We breed cows that produce more milk, chickens that have more meat, corn that has more protein. All domesticated animals are a result of artificial selection. Is this not playing God? We’ve already crossed the line of manipulating other beings. To draw the line at human gene editing while still enjoying the benefits of selective breeding would be arbitrary and hypocritical. The selection of animal and plant traits for human benefit is not seen as immoral, so why should embryonic gene editing be any different? What makes humans distinct from animals? Traits are, after all, products of genes.
Perhaps our manipulation of the animal genome is justifiable on the grounds that animals are not reasoning, rational, or capable of giving consent. But then one can also conclude that embryos are not reasoning, rational, or capable of giving consent, either. Is it morally defensible to alter the genes of an embryo? Perhaps it is permissible to influence plants or animals, but what about humans? To answer this, let’s go back to our vaccination example. We currently give infants the Hepatitis B vaccine at birth. Do the infants consent to the vaccination? Of course not. This doesn’t stop most people from vaccinating them. The parents consent on behalf of the children. We should at least consider the medical precedent of gene editing, vaccinations, when we establish the limitations of consent.
Let’s compare gene editing to implied consent, which allows a medical professional to perform CPR without explicit consent (because of an inability to communicate). A medical professional is therefore able to first make the assumption the individual wants to live and then take action to prolong their life. If this same line of reasoning holds true for gene editing, we can assume that these embryos (which will eventually become humans) want to live. We can then take action to prolong their life span — introducing disease resistant forms of genes that would allow them to do so.
He Jiankui should not have experimented on a human. That much is apparent. But it is my belief that that is all he is guilty of. Why draw the line of informed consent or playing god at gene editing? Gene editing is not unprecedented, rather it is the logical successor of modern medicine.
Dylan Tran is a first-year biological sciences major. He can be reached at firstname.lastname@example.org.