If you’re a 90’s kid, you probably grew up playing MASH. The game lets you pick your future house, car, spouse, job and any other life decision you might imagine. Medical technology is now approaching the ability to play MASH with our bodies. A gene-editing tool called CRISPR/Cas9 allows scientists to remove, add and edit parts of DNA.
The National Academy of Sciences and the National Academy of Medicine published their recommendations on reproductive gene editing this month. The report is a collaborative effort by 22 experts in genetics and medical technology. It gives a cautious green light to gene editing for the prevention of disease, but explicitly rejects gene editing for non-essential enhancement.
Until now, the use of CRISPR/Cas9 has gone largely unquestioned. The system has allowed scientists to study the process of DNA repair, genetic links to disease, and cancer progression, among other topics. Scientists have already manipulated human genes in isolated cells. They are now on the brink of altering DNA human embryos.
Medical ethicists are concerned about the reproductive possibilities of CRISPR. Manipulating embryo DNA would create a cascade of mutations as cells multiply, passing the mutation to every subsequent cell. Proponents tout the technology’s ability to protect newborns against disease, while critics caution against the temptation to create ‘designer babies.’
One of the first major successes of CRISPR was its prevention of HIV infection in human cells, according to a study published in the 2014 Proceedings of the National Academy of Sciences. With unprecedented precision, CRISPR allows scientists to directly link specific genes to certain disorders. The new technology may be able to target a disease-causing or a mutated gene, and remove it.
The flipside of such genetic control is abuse of that power. It could be a slippery slope from disease prevention to customizing physical and mental traits. CRISPR may have the potential to pursue cosmetic enhancement, such as muscular or neural development. For example, CRISPR can target muscle development genes to treat people with muscular dystrophy, but the same technique could be used on a patient without that illness to make him or her stronger by increasing muscle mass. Currently, the process of developing human trials for cosmetic CRISPR experiments is illegal.
We already know that a single gene mutation can have profound effects, causing such devastating ailments as Huntington’s Disease, sickle cell anemia, and cystic fibrosis. The risk of debilitating or deadly outcomes is currently too unpredictable to justify CRISPR experiments on human embryos.
As a childhood MASH enthusiast now in her 20s, I would theoretically love to cherry pick my genes. But I have to side with the critics urging caution on CRISPR/Cas9. I don’t trust society with the power to manipulate genes for enhancement.
Imagine the intensified social pressure for superhuman ‘perfection,’ and the deepened chasm between the haves and have-nots of healthcare. Wealthy fathers and mothers could select genes for intelligence or physical fitness, much like selecting car features. Those who could afford it could create their ideal ‘designer’ baby. Meanwhile, poorer children whose parents could not afford such enhancements would be born at a greater disadvantage.
Human embryo trials for CRISPR enhancements are too risky for nonessential changes, given the degree of uncertainty for the outcome of the embryo once it fully develops. However, the potential for treating and preventing genetic disorders is too great to ignore. With the almost endless possibilities of CRISPR technology to improve our lives, it is sure to be on the forefront of medical research for years to come. Ethicists, lawmakers and medical experts will have to navigate this issue cautiously while allowing for future exploration.