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Aikyo T, Kogetsu A, Kato K. Stakeholder Involvement in the Governance of Human Genome Editing in Japan. Asian Bioeth Rev 2023; 15:431-455. [PMID: 37808450 PMCID: PMC10555970 DOI: 10.1007/s41649-023-00251-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 04/07/2023] [Accepted: 04/13/2023] [Indexed: 10/10/2023] Open
Abstract
Genome editing is a technology that can accurately and efficiently modify the genome of organisms, including the human genome. Although human genome editing (HGE) has many benefits, it also involves technical risks and ethical, legal, and social issues. Thus, the pros and cons of using this technology have been actively debated since 2015. Notably, the research community has taken an interest in the issue and has discussed it internationally. However, for the governance of HGE, the roles of government agencies and the general public are also important for an effective regulatory system. Here, we examine the roles of the research community, government, and public in the governance of HGE through an analysis of discussions in the Japanese Expert Panel on Bioethics. During the discussion of the research ethics review system, the professionalism of the research community and the pros and cons of state oversight have become issues for debate. Furthermore, through an examination of the overall policy-making process, three stakeholders are clearly involved in the governance of emerging medical technologies in the Expert Panel on Bioethics, a discussion forum established by government agencies. The contrast among these roles provides insight into the positive roles of government agencies and the research community and the conditions under which these roles are played. We also note that there are diverse actors in the public, which may have an impact on their participation. Our results may serve as a guide for countries and organizations to establish governance on emerging medical technologies.
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Affiliation(s)
- Tatsuki Aikyo
- Department of Biomedical Ethics and Public Policy, Graduate School of Medicine, Osaka University, Osaka, Japan
- Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Atsushi Kogetsu
- Department of Biomedical Ethics and Public Policy, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Kazuto Kato
- Department of Biomedical Ethics and Public Policy, Graduate School of Medicine, Osaka University, Osaka, Japan
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Thaldar D, Shozi B, Steytler M, Hendry G, Botes M, Mnyandu N, Naidoo M, Pillay S, Slabbert M, Townsend B. A deliberative public engagement study on heritable human genome editing among South Africans: Study results. PLoS One 2022; 17:e0275372. [PMID: 36441783 PMCID: PMC9704621 DOI: 10.1371/journal.pone.0275372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Accepted: 09/15/2022] [Indexed: 11/29/2022] Open
Abstract
This paper reports the results of a public engagement study on heritable human genome editing (HHGE) carried out in South Africa, which was conducted in accordance with a study protocol that was published in this journal in 2021. This study is novel as it is the first public engagement study on HHGE in Africa. It used a deliberative public engagement (DPE) methodology, entailing inter alia that measures were put in place to ensure that potential participants became informed about HHGE, and that deliberations between the participants were facilitated with the aim of seeking consensus. A diverse group of 30 persons was selected to participate in the DPE study, which took place via Zoom over three consecutive weekday evenings. The main results are: Provided that HHGE is safe and effective, an overwhelming majority of participants supported allowing the use of HHGE to prevent genetic health conditions and for immunity against TB and HIV/Aids, while significant majorities opposed allowing HHGE for enhancement. The dominant paradigm during the deliberations was balancing health benefits (and associated improvements in quality of life) with unforeseen health risks (such as loss of natural immunity). The seriousness of a health condition emerged as the determining factor for the policy choice of whether to allow an application of HHGE. More generally, equal access to HHGE qua healthcare service featured as an important value, and it was uncontested that the South African government should allocate resources to promote scientific research into HHGE. These results are aligned with the policy principles for regulating HHGE in South Africa suggested by Thaldar et al. They call for urgent revision of South African ethics guidelines that currently prohibit research on HHGE, and for dedicated HHGE legal regulations that provide a clear and comprehensive legal pathway for researchers who intend to conduct HHGE research and clinical trials.
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Affiliation(s)
- Donrich Thaldar
- School of Law, University of KwaZulu-Natal, Durban, South Africa
- * E-mail:
| | - Bonginkosi Shozi
- School of Law, University of KwaZulu-Natal, Durban, South Africa
- Institute for Practical Ethics, University of California San Diego, San Diego, California, United States of America
| | | | | | - Marietjie Botes
- School of Law, University of KwaZulu-Natal, Durban, South Africa
- Interdisciplinary Centre for Security, Reliability and Trust, Université du Luxembourg, Luxembourg, Luxembourg
| | - Ntokozo Mnyandu
- School of Law, University of KwaZulu-Natal, Durban, South Africa
| | | | - Siddharthiya Pillay
- School of Management, Information Technology & Governance, University of KwaZulu-Natal, Durban, South Africa
| | - Magda Slabbert
- College of Law, University of South Africa, Pretoria, South Africa
| | - Beverley Townsend
- School of Law, University of KwaZulu-Natal, Durban, South Africa
- York Law School, University of York, York, United Kingdom
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De Melo-MartíN I. Reproductive Embryo Editing: Attending to Justice. Hastings Cent Rep 2022; 52:26-33. [PMID: 35993107 DOI: 10.1002/hast.1406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
The use of embryonic genome editing tools is often touted as a way to ensure the birth of healthy and genetically related children. Many would agree that this is a worthy goal. Yet the purpose of this article is to argue that, if we are concerned with justice, accepting such a goal as morally appropriate commits one to rejecting the use of social resources for further development of embryo editing for reproductive purposes. This is so because there are safer and more effective means that can allow many more prospective parents to achieve the same valued goal and that can offer additional benefits.
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Shozi B, Kamwendo T, Kinderlerer J, Thaldar DW, Townsend B, Botes M. Future of global regulation of human genome editing: a South African perspective on the WHO Draft Governance Framework on Human Genome Editing. JOURNAL OF MEDICAL ETHICS 2022; 48:165-168. [PMID: 33762299 PMCID: PMC8899489 DOI: 10.1136/medethics-2020-106863] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 01/28/2021] [Accepted: 02/05/2021] [Indexed: 06/12/2023]
Abstract
WHO in 2019 established the Advisory Committee on Developing Global Standards for Governance and Oversight of Human Genome Editing, which has recently published a Draft Governance Framework on Human Genome Editing. Although the Draft Framework is a good point of departure, there are four areas of concern: first, it does not sufficiently address issues related to establishing safety and efficacy. Second, issues that are a source of tension between global standard setting and state sovereignty need to be addressed in a more nuanced fashion. Third, it fails to meaningfully engage with the extent to which the conceptualisation of human dignity may justifiably vary between jurisdictions. Fourth, the meaning of harm to the interests of a future person requires clarity. Provided these four areas of concern can be addressed, the future of the global governance of human genome editing may hold promise.
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Affiliation(s)
- Bonginkosi Shozi
- School of Law, University of KwaZulu-Natal, Durban, KwaZulu-Natal, South Africa
| | - Tamanda Kamwendo
- School of Law, University of KwaZulu-Natal, Durban, KwaZulu-Natal, South Africa
| | - Julian Kinderlerer
- School of Law, University of KwaZulu-Natal, Durban, KwaZulu-Natal, South Africa
| | - Donrich W Thaldar
- School of Law, University of KwaZulu-Natal, Durban, KwaZulu-Natal, South Africa
| | - Beverley Townsend
- School of Law, University of KwaZulu-Natal, Durban, KwaZulu-Natal, South Africa
| | - Marietjie Botes
- School of Law, University of KwaZulu-Natal, Durban, KwaZulu-Natal, South Africa
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Genome Editing among Bioethics and Regulatory Practices. Biomolecules 2021; 12:biom12010013. [PMID: 35053161 PMCID: PMC8774098 DOI: 10.3390/biom12010013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 12/10/2021] [Accepted: 12/20/2021] [Indexed: 12/26/2022] Open
Abstract
In the last decade, genome editing technologies became very effective and several clinical trials have been started in order to use them for treating some genetic diseases. Interestingly, despite more than 50 years of discussion about the frontiers of genetics in human health and evolution, the debate about the bioethics and the regulatory practices of genome editing is still far from satisfactory answers. This delay results from an excessive emphasis on the effectiveness of the genome editing technologies that is relevant for the regulatory practices, but not at a bioethical level. Indeed, other factors (such as accessibility and acceptability) could make these techniques not accepted at the bioethical level, even in the presence of their 100% effectiveness.
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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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