Who’s to Blame for Human Genome Editing? (….and other questions that don’t need answering but need thinking about)

With nearly two months elapsed since the world first learned of the existence of CRISPR-edited newborns living in China, it is worth pondering the response this momentous event generated. When considering what people have said about Chinese scientist He Jiankui’s exploits, a disconcerting feature emerges. The ethics of the scientist himself have been front and center. While the critiques of He Jiankui’s research ethics may be on target, this singular focus may in the end provide an unfortunate distraction from the much bigger lessons to be learned.

In a YouTube video obviously crafted under a PR firm’s calculating eye, He Jiankui explains in layman’s terms how he carried out the first ‘gene surgery’ on a newly fertilized human egg. The ‘surgery,’ which used the CRISPR Cas9 gene editing tool, removed a gene responsible for making a person susceptible to HIV infection. Since one of the baby’s parents was HIV positive and held deep reservations about becoming a father, He Jiankui billed his work as a way to “heal a whole family” and provide “a beautiful and wholesome gift” for society.

The audience at the second International Human Genome Editing Summit in Hong Kong where the young scientist announced his breakthrough did not agree.

Starting with a statement issued at the close of the conference by the organizing committee, He Jiankiu’s work met with vociferous condemnation. The conference organizers described his actions as “irresponsible” and pointed out how he had “failed to conform with international norms.” Amongst other problems, the work suffered from “an inadequate medical indication, a poorly designed study protocol, a failure to meet ethical standards for protecting the welfare of research subjects, and a lack of transparency in the development, review, and conduct of the clinical procedures.”

synbioAn article in The Atlantic by Ed Yong a few days later explained how the CRISPR baby scandal “gets worse by the day.”  Yong listed 15 “damning details” of what He Jiankui did. These include the surgery not being medically necessary, the technique being poorly executed, fully informed consent not appearing to have been given by the parents, ethical advice being ignored, and the experiment breaking all the established research protocols.

An all-star list of experts in biotechnology took turns in calling He Jiankui’s experiment “reckless” and “unconscionable,” as well as “profoundly disturbing,” “monstrous,” and “horrifying.” His home university shut down his lab and launched an investigation. Numerous Chinese colleagues signed onto an open letter condemning the experiment, while an official in China’s Ministry of Science and Technology described He’s work as “extremely abominable.” At the same time, an essay in The Conversation suggested that some of the ethical lapses were linked to the cultural environment of “dangerous excess” in which He Jiankui operated.

It was, if you may, a ‘kitchen sink’ response. He Jiankui became a pariah overnight. In perhaps the biggest insult an early career researcher can receive, luminaries in the field lined up to dismiss the quality of his work. Jennifer Doudna, the Berkeley biochemist credited with first describing the CRISPR tool, explained in a special report in STAT that He Jiankui “wasn’t seen as a major player” in the CRISPR world. His previous conference presentations on the technology, Doudna said, “just did not stand out.” Another scientist present at a Berkeley conference of Doudna’s described He’s work as “sloppy” and “unnecessary.” At academic meetings, colleagues skipped his presentations, unconvinced that He would have much of importance to say.

The univocal reaction of his peers was an altogether sorry slap-down for a researcher lured back to China from a post-doc position at Stanford by its Thousand Talents Program, one who had set his sights, by his own admission, on a Nobel Prize. Only Harvard’s George Church came partially to He Jiankui’s defense.

From the outside, it certainly appears that He Jiankui behaved in a misguided, reckless, and somewhat narcissistic fashion. He may well be a sloppy scientist driven more by a thirst for recognition than by the standards of his discipline.

But the almost exclusive focus on He Jiankui rather than on the technique he used comes at a cost. It risks distraction from the enormity of the biological threshold on which the world now stands. Editing DNA in such a way that it can become part of an organism’s germ line means that humanity is closing in on the power to shape every subsequent individual of every species. If the CRISPR gene editing tool works as effectively as some of its advocates suggest – and not everyone is so optimistic – then geneticists will soon be able to choose particular ‘designs’ for organisms opening up a host of new ethical questions.

This power is particularly head-spinning when it is applied to the human form given the specter of eugenics and designer babies that haunts the moral conscience. But the power this technology offers over non-human forms of life is no less significant. Humans are close to having techniques at their fingertips that can fly in the face of the rules of Darwinian evolution and Mendelian inheritance.

tetsuya yamamotoInserting ourselves so deeply into life’s formative processes puts the planet on the cusp of what might be called a “synthetic age.” The line between the natural and the artificial fades in significance. What is “found” and what is “made” start to bleed over into each other.

It is obvious that many of the most immediate ethical worries are about the risks of harm that these practices create. Are there unforeseen health consequences associated with these methods? Will the technology be used for ill? Do we know enough to be confident about what we are doing?

But even if these questions can be answered reassuringly, the moral puzzles continue to magnify. Welcoming into the toolbox a technology responsible for a new period of planetary history poses its own kind of challenge. How do we prepare ourselves when rules in place since life on earth began are about to change?

The questions posed these technologies are not all answerable by the scientist who happened to open the Pandora’s box. Even the geneticists who have spoken out against He Jiankui’s work admit that it was only a matter of time before this threshold was crossed. They just wish it had been crossed in a more institutionally sanctioned way. By putting the focus on He Jiankui, scientists are excusing themselves from asking the questions that need to be asked.

The round (and perhaps justified) condemnation of He Jiankui should not blind us to how biotechnology is taking us to the brink. When everyone is done blaming He Jiankui, this is where the conversation should turn next.

Fork in the Road image by Tetsuya Yamamoto

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