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Barlevy D, Juengst E, Kahn J, Moreno J, Lambert L, Charo A, Chneiweiss H, Farooque M, Guston DH, Hyun I, Knoepfler PS, Selin C, Wilbanks R, Zaghlula M, Scott CT. Governing with public engagement: an anticipatory approach to human genome editing. SCIENCE & PUBLIC POLICY 2024; 51:680-691. [PMID: 39035203 PMCID: PMC11258878 DOI: 10.1093/scipol/scae010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 02/21/2024] [Indexed: 07/23/2024]
Abstract
In response to calls for public engagement on human genome editing (HGE), which intensified after the 2018 He Jiankui scandal that resulted in the implantation of genetically modified embryos, we detail an anticipatory approach to the governance of HGE. By soliciting multidisciplinary experts' input on the drivers and uncertainties of HGE development, we developed a set of plausible future scenarios to ascertain publics values-specifically, their hopes and concerns regarding the novel technology and its applications. In turn, we gathered a subset of multidisciplinary experts to propose governance recommendations for HGE that incorporate identified publics' values. These recommendations include: (1) continued participatory public engagement; (2) international harmonization and transparency of multiple governance levers such as professional and scientific societies, funders, and regulators; and (3) development of a formal whistleblower framework.
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Affiliation(s)
- Dorit Barlevy
- Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, TX 77030, United States
| | - Eric Juengst
- Center for Bioethics, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, United States
| | - Jeffrey Kahn
- Berman Institute of Bioethics, Johns Hopkins University, Baltimore, MD 21205, United States
| | - Jonathan Moreno
- Department of Medical Ethics and Health Policy, University of Pennsylvania, Philadelphia, PA 19104, United States
| | - Lauren Lambert
- College of Global Futures, Arizona State University, Tempe, AZ 85287, United States
| | - Alta Charo
- Law School, University of Wisconsin–Madison, Madison, WI 53706, United States
| | - Hervé Chneiweiss
- Neuroscience, Institute of Biology Paris Seine, CNRS UMR8246, INSERM U1130, Sorbonne Université, Paris 75252, France
| | - Mahmud Farooque
- Consortium for Science, Policy & Outcomes, Arizona State University, Washington, DC 20006, United States
- School for the Future of Innovation in Society, Arizona State University, Tempe, AZ 85281, United States
| | - David H Guston
- School for the Future of Innovation in Society, Arizona State University, Tempe, AZ 85281, United States
- Julie Ann Wrigley Global Futures Laboratory, Arizona State University, Tempe, AZ 85287, United States
| | - Insoo Hyun
- Museum of Science, Boston, MA 02114, United States
- Center for Bioethics, Harvard Medical School, Boston, MA 02115, United States
| | - Paul S Knoepfler
- Department of Cell Biology & Human Anatomy, UC Davis School of Medicine, Davis, CA 95616, United States
| | - Cynthia Selin
- School for the Future of Innovation in Society, Arizona State University, Tempe, AZ 85281, United States
- School of Sustainability, Arizona State University, Tempe, AZ 85281, United States
| | - Rebecca Wilbanks
- University Writing Program, Johns Hopkins University, Baltimore, MD 21218, United States
| | - Manar Zaghlula
- Innovative Genomics Institute, University of California, Berkeley, CA 97404, United States
| | - Christopher Thomas Scott
- Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, TX 77030, United States
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Badea AR, Feeney O. Genome Editing Dilemma: Navigating Dual-Use Potential and Charting the Path Forward. JOURNAL OF BIOETHICAL INQUIRY 2024:10.1007/s11673-024-10358-8. [PMID: 39046699 DOI: 10.1007/s11673-024-10358-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 03/16/2024] [Indexed: 07/25/2024]
Abstract
Contemporary genome editing techniques have made genomic intervention-from microorganism to human-more accessible, easier to use, and more accurate than previous methods. We argue that, notwithstanding its merits in treating and preventing disease in humans, genome editing represents a potential threat for domestic and international security, requiring an integrated approach in regulating, detecting, preventing, and mitigating the risk of its use for malicious purposes. Despite the global regulatory ambitions of the 2021 WHO framework, we see insufficient attention given to the future prospect of dual-use genomic technology. Drawing parallels with the nuclear field, we suggest tentative practical steps for a way forward in dealing with genome editing technologies, such as: 1) adapting national (bio)security and defence strategies to include genome editing as a possible threat (with conceivable WMD potential); 2) enhancing the international dialogue on genome editing and raising the issue at the highest level; 3) working towards a global, legally binding verification mechanism; 4) tracking genome editing technologies.
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Affiliation(s)
- Ana Ruxandra Badea
- University of Bucharest, Faculty of Philosophy, Splaiul Independentei 204, 060024, Bucharest, Romania.
| | - Oliver Feeney
- University of Tübingen, Ethics of Genome Editing Research Unit, Institute of Ethics and History of Medicine, Gartenstr. 47, 72074, Tübingen, Germany
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Kolanu ND. CRISPR-Cas9 Gene Editing: Curing Genetic Diseases by Inherited Epigenetic Modifications. Glob Med Genet 2024; 11:113-122. [PMID: 38560484 PMCID: PMC10980556 DOI: 10.1055/s-0044-1785234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024] Open
Abstract
Introduction CRISPR-Cas9 gene editing, leveraging bacterial defense mechanisms, offers precise DNA modifications, holding promise in curing genetic diseases. This review critically assesses its potential, analyzing evidence on therapeutic applications, challenges, and future prospects. Examining diverse genetic disorders, it evaluates efficacy, safety, and limitations, emphasizing the need for a thorough understanding among medical professionals and researchers. Acknowledging its transformative impact, a systematic review is crucial for informed decision-making, responsible utilization, and guiding future research to unlock CRISPR-Cas9's full potential in realizing the cure for genetic diseases. Methods A comprehensive literature search across PubMed, Scopus, and the Web of Science identified studies applying CRISPR-Cas9 gene editing for genetic diseases, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Inclusion criteria covered in vitro and in vivo models targeting various genetic diseases with reported outcomes on disease modification or potential cure. Quality assessment revealed a generally moderate to high risk of bias. Heterogeneity prevented quantitative meta-analysis, prompting a narrative synthesis of findings. Discussion CRISPR-Cas9 enables precise gene editing, correcting disease-causing mutations and offering hope for previously incurable genetic conditions. Leveraging inherited epigenetic modifications, it not only fixes mutations but also restores normal gene function and controls gene expression. The transformative potential of CRISPR-Cas9 holds promise for personalized treatments, improving therapeutic outcomes, but ethical considerations and safety concerns must be rigorously addressed to ensure responsible and safe application, especially in germline editing with potential long-term implications.
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Subica AM. CRISPR in Public Health: The Health Equity Implications and Role of Community in Gene-Editing Research and Applications. Am J Public Health 2023; 113:874-882. [PMID: 37200601 PMCID: PMC10323846 DOI: 10.2105/ajph.2023.307315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/06/2023] [Indexed: 05/20/2023]
Abstract
CRISPR (clustered regularly interspaced short palindromic repeats) is a Nobel Prize-winning technology that holds significant promise for revolutionizing the prevention and treatment of human disease through gene editing. However, CRISPR's public health implications remain relatively uncertain and underdiscussed because (1) targeting genetic factors alone will have limited influence on population health, and (2) minority populations (racial/ethnic, sexual and gender)-who bear the nation's greatest health burdens-historically suffer unequal benefits from emerging health care innovations and tools. This article introduces CRISPR and its potential public health benefits (e.g., improving virus surveillance, curing genetic diseases that pose public health problems such as sickle cell anemia) while outlining several major ethical and practical threats to health equity. This includes minorities' grave underrepresentation in genomics research, which may lead to less effective and accepted CRISPR tools and therapies for these groups, and their anticipated unequal access to these tools and therapies in health care. Informed by the principles of fairness, justice, and equitable access, ensuring gene editing promotes rather than diminishes health equity will require the meaningful centering and engagement of minority patients and populations in gene-editing research using community-based participatory research approaches. (Am J Public Health. 2023;113(8):874-882. https://doi.org/10.2105/AJPH.2023.307315).
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Affiliation(s)
- Andrew M Subica
- Andrew M. Subica is with the Department of Social Medicine, Population, and Public Health, University of California, Riverside School of Medicine
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Cadigan RJ, Waltz M, Henderson GE, Conley JM, Davis AM, Major R, Juengst ET. Scientists' Views on Scientific Self-Governance for Human Genome Editing Research. Hum Gene Ther 2022; 33:1157-1163. [PMID: 35850532 PMCID: PMC9700337 DOI: 10.1089/hum.2022.087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 07/16/2022] [Indexed: 01/06/2023] Open
Abstract
As research on human gene editing has grown, a variety of prominent international organizations are considering how best to govern such research. But what role do scientists engaged in genome editing think they should have in developing research governance? In this study, we present results from a survey of 212 U.S.-based scientists regarding views on human genome editing governance. Most did not believe that scientists should be allowed to self-govern human genome editing research. Open-ended responses revealed four main reasons: conflicts of interest, the inevitability of rare "bad apples," historical evidence to the contrary, and the limitations of scientific expertise. Analyses of open-ended responses also revealed scientists' views on how human gene editing research should be governed. These views emphasize interdisciplinary professional and public input. The study results illustrate a noteworthy shift in the scientific community's traditional vision of professional autonomy and can inform ongoing efforts to develop research governance approaches.
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Affiliation(s)
- R. Jean Cadigan
- Department of Social Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Margaret Waltz
- Department of Social Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Gail E. Henderson
- Department of Social Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - John M. Conley
- University of North Carolina School of Law, Chapel Hill, North Carolina, USA
| | - Arlene M. Davis
- Department of Social Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Rami Major
- Curriculum in Genetics and Molecular Biology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Eric T. Juengst
- Department of Social Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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Liscum M, Garcia ML. You can't keep a bad idea down: Dark history, death, and potential rebirth of eugenics. Anat Rec (Hoboken) 2021; 305:902-937. [PMID: 34919789 DOI: 10.1002/ar.24849] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 11/20/2021] [Accepted: 11/23/2021] [Indexed: 12/11/2022]
Abstract
"Be careful what you wish for": This adage guides both how this project came to life, and how the topic covered in this review continues to unfold. What began as talks between two friends on shared interests in military history led to a 4-year discussion about how our science curriculum does little to introduce our students to societal and ethical impacts of the science they are taught. What emerged was a curricular idea centered on how "good intentions" of some were developed and twisted by others to result in disastrous consequences of state-sanctioned eugenics. In this article, we take the reader (as we did our students) through the long and soiled history of eugenic thought, from its genesis to the present. Though our focus is on European and American eugenics, we will show how the interfaces and interactions between science and society have evolved over time but have remained ever constant. Four critical 'case studies' will also be employed here for deep, thoughtful exploration on a particular eugenic issue. The goal of the review, as it is with our course, is not to paint humanity with a single evil brush. Instead, our ambition is to introduce our students/readers to the potential for harm through the misapplication and misappropriation of science and scientific technology, and to provide them with the tools to ask the appropriate questions of their scientists, physicians, and politicians.
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Affiliation(s)
- Mannie Liscum
- Division of Biological Sciences, University of Missouri, Columbia, Missouri, USA
| | - Michael L Garcia
- Division of Biological Sciences, University of Missouri, Columbia, Missouri, USA
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