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O’Leary AP, Fletcher W. Thinking about Believing: Can Metacognitive Reflection Encourage Belief Updating? J Intell 2024; 12:47. [PMID: 38786649 PMCID: PMC11122332 DOI: 10.3390/jintelligence12050047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 02/01/2024] [Accepted: 04/22/2024] [Indexed: 05/25/2024] Open
Abstract
People often cling to their beliefs even in the face of counterevidence. The current study explored metacognitive reflection as a potential driver for belief updating. In a randomized controlled experiment (n = 155), participants rated their degree of agreement with a statement regarding genetic modification in humans. Following this, participants were presented with a passage containing an argument counter to their indicated belief. Participants in the metacognition condition were asked to deeply reflect on the ways in which the passage was similar to or different from their current beliefs. Participants in the control condition were asked to engage in more shallow reflection on the composition of the passage. After reflecting on the counterevidence, participants were asked to again rate their agreement with the statement regarding human gene modification. Both groups updated their initial beliefs to be more consistent with the presented counterevidence. Although greater belief updating was observed in those who metacognitively reflected on the passage, this effect did not reach significance (p = .055). These findings suggest that reflecting on counterevidence has the potential to encourage belief updating, regardless of whether that reflection is metacognitive in nature, and provide promise for future work investigating the role of metacognition in belief updating.
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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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Waltz M, Juengst ET, Edwards T, Henderson GE, Kuczynski KJ, Conley JM, Della-Penna P, Cadigan RJ. The View from the Benches: Scientists' Perspectives on the Uses and Governance of Human Gene-Editing Research. CRISPR J 2021; 4:609-615. [PMID: 34406038 PMCID: PMC8392077 DOI: 10.1089/crispr.2021.0038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The advent of human gene editing has stimulated international interest in how best to govern this research. However, research on stakeholder views has neglected scientists themselves. We surveyed 212 scientists who use gene editing in their work. Questions captured views on oversight and use of somatic and germline human gene editing for treatment, prevention, and enhancement. More respondents were supportive of somatic than germline editing, and more supported gene editing for treatment compared to prevention. Few supported its use for enhancement. When presented with specific conditions, levels of support for somatic editing differed by type of condition. Almost all respondents said scientists and national government representatives should be involved in oversight, but only 28% said scientists are best positioned to oversee gene-editing research. These results can inform the development of sound approaches to research governance, demonstrating the importance of identifying specific gene-editing uses when considering oversight.
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Affiliation(s)
- Margaret Waltz
- Department of Social Medicine, 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
| | - Teresa Edwards
- H.W. Odum Institute for Research in Social Science, 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
| | - Kristine J. Kuczynski
- 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
| | - Paige Della-Penna
- University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
| | - R. Jean Cadigan
- Department of Social Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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Nelson JP, Selin CL, Scott CT. Toward Anticipatory Governance of Human Genome Editing: A Critical Review of Scholarly Governance Discourse. JOURNAL OF RESPONSIBLE INNOVATION 2021; 8:382-420. [PMID: 35281674 PMCID: PMC8916747 DOI: 10.1080/23299460.2021.1957579] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 07/14/2021] [Indexed: 05/04/2023]
Abstract
The rapid development of human genome editing (HGE) techniques evokes an urgent need for forward-looking deliberation regarding the aims, processes, and governance of research. The framework of anticipatory governance (AG) may serve this need. This article reviews scholarly discourse about HGE through an AG lens, aiming to identify gaps in discussion and practice and suggest how AG efforts may fill them. Discourse on HGE has insufficiently reckoned with the institutional and systemic contexts, inputs, and implications of HGE work, to the detriment of its ability to prepare for a variety of possible futures and pursue socially desirable ones. More broadly framed and inclusive efforts in foresight and public engagement, focused not only upon the in-principle permissibility of HGE activities but upon the contexts of such work, may permit improved identification of public values relevant to HGE and of actions by which researchers, funders, policymakers, and publics may promote them.
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Affiliation(s)
- John P. Nelson
- School for the Future of Innovation in Society, Arizona State University, 1120 South Cady Mall, Tempe, Arizona 85287-5603
| | - Cynthia L. Selin
- School for the Future of Innovation in Society/Consortium for Science, Policy & Outcomes, Arizona State University, 1120 South Cady Mall, Tempe, Arizona 85287-5603
| | - Christopher T. Scott
- Center for Medical Ethics and Health Policy, Baylor College of Medicine, One Baylor Plaza, Houston, Texas 77030-3411
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Germani F, Wäscher S, Biller-Andorno N. A CRISPR response to pandemics?: Exploring the ethics of genetically engineering the human immune system. EMBO Rep 2021; 22:e52319. [PMID: 33615649 PMCID: PMC7926207 DOI: 10.15252/embr.202052319] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 01/17/2021] [Accepted: 02/02/2021] [Indexed: 12/26/2022] Open
Abstract
Ethical challenges should be addressed before gene editing is made available to improve the immune response against emerging viruses.
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Affiliation(s)
- Federico Germani
- Institute of Biomedical Ethics and History of Medicine (IBME), University of Zurich, Zurich, Switzerland
| | - Sebastian Wäscher
- Institute of Biomedical Ethics and History of Medicine (IBME), University of Zurich, Zurich, Switzerland
| | - Nikola Biller-Andorno
- Institute of Biomedical Ethics and History of Medicine (IBME), University of Zurich, Zurich, Switzerland
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van Dijke I, van Wely M, Berkman BE, Bredenoord AL, Henneman L, Vliegenthart R, Repping S, Hendriks S. Should germline genome editing be allowed? The effect of treatment characteristics on public acceptability. Hum Reprod 2021; 36:465-478. [PMID: 33242333 PMCID: PMC8453417 DOI: 10.1093/humrep/deaa212] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Revised: 06/25/2020] [Indexed: 01/25/2023] Open
Abstract
STUDY QUESTION To what extent do characteristics of germline genome editing (GGE) determine whether the general public supports permitting the clinical use of GGE? SUMMARY ANSWER The risk that GGE would cause congenital abnormalities had the largest effect on support for allowing GGE, followed by effectiveness of GGE, while costs, the type of application (disease or enhancement) and the effect on child well-being had moderate effects. WHAT IS KNOWN ALREADY Scientific progress on GGE has increased the urgency of resolving whether and when clinical application of GGE may be ethically acceptable. Various expert bodies have suggested that the treatment characteristics will be key in determining whether GGE is acceptable. For example, GGE with substantial risks (e.g. 15% chance of a major congenital abnormality) may be acceptable to prevent a severe disease but not to enhance non-medical characteristics or traits of an otherwise healthy embryo (e.g. eye colour or perhaps in the future more complex traits, such as intelligence). While experts have called for public engagement, it is unclear whether and how much the public acceptability of GGE is affected by the treatment characteristics proposed by experts. STUDY DESIGN, SIZE, DURATION The vignette-based survey was disseminated in 2018 among 1857 members of the Dutch general public. An online research panel was used to recruit a sample representing the adult Dutch general public. PARTICIPANTS/MATERIALS, SETTING, METHODS A literature review identified the key treatment characteristics of GGE: the effect on the well-being of the future child, use for disease or enhancement, risks for the future child, effectiveness (here defined as the chance of a live birth, assuming that if the GGE was not successful, the embryo would not be transferred), cost and availability of alternative treatments/procedures to prevent the genetic disease or provide enhancement (i.e. preimplantation genetic testing (PGT)), respectively. For each treatment characteristic, 2-3 levels were defined to realistically represent GGE and its current alternatives, donor gametes and ICSI with PGT. Twelve vignettes were created by fractional factorial design. A multinominal logit model assessed how much each treatment characteristic affected participants' choices. MAIN RESULTS AND THE ROLE OF CHANCE The 1136 respondents (response rate 61%) were representative of the Dutch adult population in several demographics. Respondents were between 18 and 89 years of age. When no alternative treatment/procedure is available, the risk that GGE would cause (other) congenital abnormalities had the largest effect on whether the Dutch public supported allowing GGE (coefficient = -3.07), followed by effectiveness (coefficient = 2.03). Costs (covered by national insurance, coefficient = -1.14), the type of application (disease or enhancement; coefficient = -1.07), and the effect on child well-being (coefficient = 0.97) had similar effects on whether GGE should be allowed. If an alternative treatment/procedure (e.g. PGT) was available, participants were not categorically opposed to GGE, however, they were strongly opposed to using GGE for enhancement (coefficient = -3.37). The general acceptability of GGE was higher than participants' willingness to personally use it (P < 0.001). When participants considered whether they would personally use GGE, the type of application (disease or enhancement) was more important, whereas effectiveness and costs (covered by national insurance) were less important than when they considered whether GGE should be allowed. Participants who were male, younger and had lower incomes were more likely to allow GGE when no alternative treatment/procedure is available. LIMITATIONS, REASONS FOR CAUTION Some (e.g. ethnic, religious) minorities were not well represented. To limit complexity, not all characteristics of GGE could be included (e.g. out-of-pocket costs), therefore, the views gathered from the vignettes reflect only the choices presented to the respondents. The non-included characteristics could be connected to and alter the importance of the studied characteristics. This would affect how closely the reported coefficients reflect 'real-life' importance. WIDER IMPLICATIONS OF THE FINDINGS This study is the first to quantify the substantial impact of GGE's effectiveness, costs (covered by national insurance), and effect on child well-being on whether the public considered GGE acceptable. In general, the participants were strikingly risk-averse, in that they weighed the risks of GGE more heavily than its benefits. Furthermore, although only a single study in one country, the results suggests that-if sufficiently safe and effective-the public may approve of using GGE (presumably combined with PGT) instead of solely PGT to prevent passing on a disease. The reported public views can serve as input for future consideration of the ethics and governance of GGE. STUDY FUNDING/COMPETING INTEREST(S) Young Academy of the Royal Dutch Academy of Sciences (UPS/RB/745), Alliance Grant of the Amsterdam Reproduction and Development Research Institute (2017-170116) and National Institutes of Health Intramural Research Programme. No competing interests. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- I van Dijke
- Department of Obstetrics and Gynecology, Center for Reproductive Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam 1105 AZ, The Netherlands
- Department of Clinical Genetics, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam 1081 HV, The Netherlands
| | - M van Wely
- Department of Obstetrics and Gynecology, Center for Reproductive Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam 1105 AZ, The Netherlands
| | - B E Berkman
- Department of Bioethics, Clinical Center, National Institutes of Health, Bethesda, MD 20814, USA
| | - A L Bredenoord
- Department of Medical Humanities, Julius Center, University Medical Center Utrecht, Utrecht 3584 CG, The Netherlands
| | - L Henneman
- Department of Clinical Genetics, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam 1081 HV, The Netherlands
| | - R Vliegenthart
- Amsterdam School of Communications Research, University of Amsterdam, Amsterdam 1018 WV, The Netherlands
| | - S Repping
- Department of Obstetrics and Gynecology, Center for Reproductive Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam 1105 AZ, The Netherlands
| | - S Hendriks
- Department of Bioethics, Clinical Center, National Institutes of Health, Bethesda, MD 20814, USA
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Genetics experience impacts attitudes towards germline gene editing: a survey of over 1500 members of the public. J Hum Genet 2020; 65:1055-1065. [PMID: 32737393 DOI: 10.1038/s10038-020-0810-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 07/14/2020] [Indexed: 11/08/2022]
Abstract
CRISPR-Cas9 has revolutionised genome engineering and has the potential to radically change our approach to genetic disease. However, the potential for genetic modification of embryos has raised significant and complex ethical and social concerns. The scientific community have called for ongoing stakeholder consultation about Germline Gene Editing (GGE), in particular lay publics, to help guide policy, education, research and regulatory priorities. In response, we conducted a survey to gauge public support for GGE and describe the demographic, experiential and contextual factors that influence individual attitudes. Respondent support was measured across nine hypothetical medical and enhancement GGE applications. We received responses from 1537 participants across 67 countries. Respondents were generally supportive of GGE, particularly for medical applications. While the most opposition observed was among religious respondents, those with work experience in genetics or genomics also reported greater resistance to GGE. Personal or family-related experience with genetics or genomics, identifying as female and tertiary education were also associated with less support for GGE. Further research needs to explore a diverse range of community and group attitudes towards GGE; the reasons underlying demographic and experiential differences; and to determine where the public and genetics professionals draw the line on ethical implementation respectively.
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Snure Beckman E, Deuitch N, Michie M, Allyse MA, Riggan KA, Ormond KE. Attitudes Toward Hypothetical Uses of Gene-Editing Technologies in Parents of People with Autosomal Aneuploidies. CRISPR J 2020; 2:324-330. [PMID: 31599684 DOI: 10.1089/crispr.2019.0021] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Researchers are exploring the use of gene-editing technologies to prevent and/or treat genetic conditions in humans. Stakeholder views, including those of patient and family populations, are important in the ongoing bioethical discussion. We conducted 27 semi-structured interviews with parents of people with trisomy 21 (T21; N = 10), trisomy 18 (T18; N = 8), and trisomy 13 (T13; N = 9)-conditions not previously studied in regard to attitudes toward hypothetical gene editing. While many discussions focus on the morality of gene editing, parents in our study focused on quality of life and concerns about changing their children's identity. All participants prioritized ameliorating life-threatening health issues when those were present; many also emphasized increasing their children's communication and cognitive ability. These results suggest that patient populations with the lived experience of genetic conditions have unique concerns that may differ from broader discourse.
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Affiliation(s)
- Erika Snure Beckman
- Department of Genetics, Stanford University School of Medicine, Stanford, California
| | - Natalie Deuitch
- Department of Genetics, Stanford University School of Medicine, Stanford, California
| | - Marsha Michie
- Department of Bioethics, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Megan A Allyse
- Biomedical Ethics Program, Mayo Clinic, Rochester, Minnesota
| | | | - Kelly E Ormond
- Department of Genetics, Stanford University School of Medicine, Stanford, California.,Stanford Center for Biomedical Ethics, Stanford University School of Medicine, Stanford, California
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Armsby AJ, Bombard Y, Garrison NA, Halpern-Felsher BL, Ormond KE. Attitudes of Members of Genetics Professional Societies Toward Human Gene Editing. CRISPR J 2020; 2:331-339. [PMID: 31599688 DOI: 10.1089/crispr.2019.0020] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Gene-editing technologies have improved in ease, efficiency, and precision. Although discussions are occurring around acceptable uses of human gene editing, limited data exist on the views of genetics-trained individuals. In 2017, we distributed an anonymous online survey to assess the attitudes of members of genetics professional societies toward gene editing (N = 500). Virtually all respondents were supportive of somatic editing in basic-science (99.2%) and clinical (87.4%) research on nonreproductive human cells. Only 57.2% were supportive of germline-editing basic-science research; 31.9% supported the transfer of viable embryos to humans for clinical research. While most favored future therapeutic uses of somatic (96.6%) and germline (77.8%) editing, there was little support for enhancement in somatic (13.0%) or germline (8.6%) cells. This study describes attitudes toward gene editing from genetics professionals worldwide and contributes to ongoing discourse and policy guidance in this domain.
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Affiliation(s)
- Alyssa J Armsby
- Department of Genetics, Stanford University School of Medicine, Stanford, California.,Department of Cardiology, John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom
| | - Yvonne Bombard
- Li Ka Shing Knowledge Institute of St. Michael's Hospital, University of Toronto, Institute of Health Policy, Management and Evaluation, Toronto, Canada
| | - Nanibaa' A Garrison
- Treuman Katz Center for Pediatric Bioethics, Seattle Children's Research Institute, Seattle, Washington.,Department of Pediatrics, University of Washington, Seattle, Washington
| | | | - Kelly E Ormond
- Department of Genetics, Stanford University School of Medicine, Stanford, California.,Stanford Center for Biomedical Ethics, Stanford University School of Medicine, Stanford, California
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Kleiderman E, Ravitsky V, Knoppers BM. The 'serious' factor in germline modification. JOURNAL OF MEDICAL ETHICS 2019; 45:508-513. [PMID: 31326898 PMCID: PMC6820154 DOI: 10.1136/medethics-2019-105436] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 06/12/2019] [Accepted: 06/28/2019] [Indexed: 06/10/2023]
Abstract
Current advances in assisted reproductive technologies aim to promote the health and well-being of future children. They offer the possibility to select embryos with the greatest potential of being born healthy (eg, preimplantation genetic testing) and may someday correct faulty genes responsible for heritable diseases in the embryo (eg, human germline genome modification (HGGM)). Most laws and policy statements surrounding HGGM refer to the notion of 'serious' as a core criterion in determining what genetic diseases should be targeted by these technologies. Yet, this notion remains vague and poorly defined, rendering its application challenging and decision making subjective and arbitrary. By way of background, we begin by briefly presenting two conceptual approaches to 'health' and 'disease': objectivism (ie, based on biological facts) and constructivism (ie, based on human values). The basic challenge under both is sorting out whether and to what extent social and environmental factors have a role in helping to define what qualifies as a 'serious' disease beyond the medical criteria. We then focus on how a human rights framework (eg, right to science and right to the highest attainable health) could integrate the concepts of objectivism and constructivism so as to provide guidance for a more actionable consideration of 'serious'. Ultimately, it could be argued that a human rights framework, by way of its legally binding nature and its globally accepted norms and values, provides a more universal foundation for discussions of the ethical, legal and social implications of emerging or disruptive technologies.
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Affiliation(s)
- Erika Kleiderman
- Centre of Genomics and Policy, McGill University, Montreal, Quebec, Canada
| | - Vardit Ravitsky
- Department of Social and Preventive Medicine, School of Public Health, Université de Montréal, Montreal, Quebec, Canada
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Ormond KE, Bombard Y, Bonham VL, Hoffman-Andrews L, Howard H, Isasi R, Musunuru K, Riggan KA, Michie M, Allyse M. The clinical application of gene editing: ethical and social issues. Per Med 2019; 16:337-350. [DOI: 10.2217/pme-2018-0155] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Gene-editing techniques have progressed rapidly in the past 5 years. There are already ongoing human somatic gene-editing clinical trials for multiple diseases. And there has been one purported scenario of human germline gene editing in late 2018. In this paper, we will review the current state of the technology, discuss the ethical and social issues that surround the various forms of gene editing, as well as review emerging stakeholder data from professionals, the ‘general public’ and individuals and families dealing with genetic diseases potentially treatable by gene editing.
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Affiliation(s)
- Kelly E Ormond
- Department of Genetics & Stanford Center for Biomedical Ethics, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Yvonne Bombard
- Institute of Health Policy, Management & Evaluation, University of Toronto; Li Ka Shing Knowledge Institute of St Michael’s Hospital, Toronto, ON, Canada
- Li Ka Shing Knowledge Institute of St Michael’s Hospital, Toronto, ON, Canada
| | - Vence L Bonham
- Social & Behavioral Research Branch, National Human Genome Research Institute, NIH, Bethesda, MD 20892, USA
| | - Lily Hoffman-Andrews
- Penn Center for Inherited Cardiac Disease, Penn Medicine, Philadelphia, PA 19104, USA
| | - Heidi Howard
- Centre for Research Ethics & Bioethics, Uppsala University, Uppsala, Sweden
- Society & Ethics Research, Connecting Science, Wellcome Genome Campus, Cambridge, UK
| | - Rosario Isasi
- Dr J T Macdonald Foundation Department of Human Genetics, Institute of Bioethics & Health Policy, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Kiran Musunuru
- Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, PA 19104, USA
| | - Kirsten A Riggan
- Biomedical Ethics Research Program, Mayo Clinic, Rochester, MN 55905, USA
| | - Marsha Michie
- Department of Bioethics, Case Western Reserve University School of Medicine, Cleveland, OH 44106, USA
| | - Megan Allyse
- Biomedical Ethics Research Program & Center for Individualized Medicine, Mayo Clinic, Rochester, MN 55905, USA
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