Br Med Bull. 2017 Feb 23:1-13. doi: 10.1093/bmb/ldx002. [Epub ahead of print]
- 1
- Section of Genetics, Department of Pediatrics, University of Oklahoma Health Sciences Center, Suite 12100, 1200 Children's Avenue, Oklahoma City, OK 73104, USA.
- 2
- Department of Bioethics, Dalhousie University, 5849 University Avenue, Room C-312, CRC Bldg, PO Box 15000, Halifax, Nova Scotia, Canada B3H 4R2.
- 3
- Department of Human Genetics, Centre of Genomics and Policy, McGill University, 740 Avenue Dr. Penfield, Suite 5200, Montreal (Quebec), Canada H3A 0G1.
- 4
- Centre for Biomedical Ethics, Yong Loo Lin School of Medicine, National University of Singapore, Level 2 Block MD11, Clinical Research Centre, 10 Medical Drive, Singapore 117576, Singapore.
- 5
- Faculty of Science, Department of Philosophy and Science Studies, Radboud UniversityNijmegen, P.O. Box 9010, NL-6500 GL Nijmegen, The Netherlands.
- 6
- School of Law, University of Manchester, Williamson Building-2.13, Manchester M13 9PL, UK.
Abstract
BACKGROUND:
The avalanche of commentaries on CRISPR-Cas9 technology, a bacterial immune system modified to recognize any short DNA sequence, cut it out, and insert a new one, has rekindled hopes for gene therapy and other applications and raised criticisms of engineering genes in future generations.
SOURCES OF DATA:
This discussion draws on articles that emphasize ethics, identified partly through PubMed and Google, 2014-2016.
AREAS OF AGREEMENT:
CRISPR-Cas9 has taken the pace and prospects for genetic discovery and applications to a high level, stoking anticipation for somatic gene engineering to help patients. We support a moratorium on germ line manipulation.
AREAS OF CONTROVERSY:
We place increased emphasis on the principle of solidarity and the public good. The genetic bases of some diseases are not thoroughly addressable with CRISPR-Cas9. We see no new ethical issues, compared with gene therapy and genetic engineering in general, apart from the explosive rate of findings. Other controversies include eugenics, patentability and unrealistic expectations of professionals and the public.
GROWING POINTS:
Biggest issues are the void of research on human germ cell biology, the appropriate routes for oversight and transparency, and the scientific and ethical areas of reproductive medicine.
AREAS TIMELY FOR DEVELOPING RESEARCH:
The principle of genomic solidarity and priority on public good should be a lens for bringing clarity to CRISPR debates. The valid claim of genetic exceptionalism supports restraint on experimentation in human germ cells, given the trans-generational dangers and the knowledge gap in germ cell biology.
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