Tuesday, September 3, 2019

Designer Babies: Technological progress vs Ethical Dilemma



The unravelling of the human genes viz. human genome project and the potential it provides has accentuated the likelihood of human genomic editing. This has allowed scientists to look into possible ways for restructuring the genes. Previously this modification – even in humans – had been tried through selective breeding, radiation, and DNA interpolation agent. These were methods of wholescale editing and more so than often resulted in unwanted diseased traits and even death. Recent advances in genomic editing techniques allow for precision and possibilities.

Are evidences supporting Positive outlook ??

Zinc Finger Nucleases (ZFNs), Transcription activators like effector nucleases (TALENs) and the gene that has scientists most enthused Clustered regularly interspaced short palindromic repeats (CRISPR) are some of the methods in and around which lays the promise for future. CRISPR a family bacterial DNA along with enzyme Cas9 acts like scissors and glue for cutting DNA at a specific point and replacing it with a new sequence. This allows for treatment of mutations in genes that cause disease. CRISPR-Cas technology has shown potential in the treatment of cancer, hemophilia, cystic fibrosis, beta-thalassemia, infections, and heart disease.
In 2016 FDA has approved a clinical trial in which CRISPR would be used to alter T cells and after engineering specific genes would be administered back into those same people. Similarly, a trial that began in 2019 utilizes CCR5-modified CD4+ T cells (using ZFN) for treatment of HIV infection. These trails are bound to make an impact on what the future holds for human genetic engineering. But an even bigger impact came in late 2018 when Lulu and Nana, Chinese twin girls, became the first germline genetically engineered babies (Designer babies). The CCR5 genes of parental DNA had been modified such that these babies were resistant to HIV infection.

Contradiction of Opinion and Ethical Dilemma

The scientific world emblazoned with this advancement has searched for what the future might hold for these babies. Was the genetic modification too early for these babies? CCR5 modification in these twins might result in cancer due to off-target effect and reduced lifespan. Also, research in mice with germline modified CCR5 shows that it may result in increased cognition and better recovery from stroke. And speculations have been flying that this might be the case in these babies as well. And the answer to this will come with time. Similarly, the scientific community has raised concerns over whether or not there was even CCR5 modification. Some pointing to only one gene modification in Lulu, thus not acquiring HIV resistance and Nana being a genetically mosaic.
CRISPR-cas9 besides being used in a clinical scenario offers myriad of possibilities especially when combined with preimplantation genetic diagnosis (PGD) allows for selection of traits best suited for the baby or in an ethically inconsiderate view – the parent. Promises of babies who are intelligent on par with adults, who are beautiful and stay beautiful in adulthood by societal standards, and who live on to be 150 without any disease or deformity bothering them are some of the promises shown by this technology. Thus these babies are colloquially termed as “designer babies”.
However, the ethics surrounding “production” of these babies befuddles the ethics surrounding human experimentation. The tenets of pricipalism - autonomy, beneficence, non-maleficence, and justice – have to be ignored for these experimentations. The possible instrumentalization of these babies is always of concern. A concern in and around Kantian ethics which states that “a human being can never be used as a means only and must be treated and end in itself”. Similarly, with any experimentation, the issue of informed consent will always be of concern. Also, the risk vs. benefits of such human experimentations without prior knowledge of what these testing might result in is of concern. Lulu and Nana if they knew they would have a shorter life span with the only benefit of having resistance against acquiring HIV, probably would not have opted for these experiments upon them.

lastly, 

These ethical concerns should and need to be answered before any human experiments are carried out. The only possibility comes out of mapping phenotypic changes with changing genotypes (reverse genetics). Similarly, this idea of having a child with heightened phenotypic changes might also be a cauldron for heightened societal disparity and social turmoil with the technology being availed to certain influential and economically advantaged people.
                                                        Thank You !!!
                                                    Dr. Samyam Aryal



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