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Ramos PD, Almeida MS, Olsson IAS. What do people think about genetic engineering? A systematic review of questionnaire surveys before and after the introduction of CRISPR. Front Genome Ed 2023; 5:1284547. [PMID: 38192431 PMCID: PMC10773783 DOI: 10.3389/fgeed.2023.1284547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 10/27/2023] [Indexed: 01/10/2024] Open
Abstract
The advent of CRISPR-Cas9 in 2012 started revolutionizing the field of genetics by broadening the access to a method for precise modification of the human genome. It also brought renewed attention to the ethical issues of genetic modification and the societal acceptance of technology for this purpose. So far, many surveys assessing public attitudes toward genetic modification have been conducted worldwide. Here, we present the results of a systematic review of primary publications of surveys addressing public attitudes toward genetic modification as well as the awareness and knowledge about the technology required for genetic modification. A total of 53 primary publications (1987-2020) focusing on applications in humans and non-human animals were identified, covering countries in four continents. Of the 53 studies, 30 studies from until and including 2012 (pre-CRISPR) address gene therapy in humans and genetic modification of animals for food production and biomedical research. The remaining 23 studies from after 2013 (CRISPR) address gene editing in humans and animals. Across countries, respondents see gene therapy for disease treatment or prevention in humans as desirable and highly acceptable, whereas enhancement is generally met with opposition. When the study distinguishes between somatic and germline applications, somatic gene editing is generally accepted, whereas germline applications are met with ambivalence. The purpose of the application is also important for assessing attitudes toward genetically modified animals: modification in food production is much less accepted than for biomedical application in pre-CRISPR studies. A relationship between knowledge/awareness and attitude toward genetic modification is often present. A critical appraisal of methodology quality in the primary publications with regards to sampling and questionnaire design, development, and administration shows that there is considerable scope for improvement in the reporting of methodological detail. Lack of information is more common in earlier studies, which probably reflects the changing practice in the field.
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Affiliation(s)
- Pedro Dias Ramos
- i3S–Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal
- ICBAS–Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal
| | - Maria Strecht Almeida
- ICBAS–Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal
| | - Ingrid Anna Sofia Olsson
- i3S–Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal
- ICBAS–Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal
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Segers S. Heritable genome editing: ethical aspects of a developing domain. Hum Reprod 2023; 38:2055-2061. [PMID: 37581898 DOI: 10.1093/humrep/dead167] [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] [Received: 03/09/2023] [Revised: 08/05/2023] [Indexed: 08/16/2023] Open
Abstract
In the past decade, scientific developments in human germline genome editing (GGE) have reinvigorated questions about research ethics, responsible innovation, and what it means to do good in the field of reproductive biology and medicine. In recent years, it has become part of the ethical debate on GGE whether categorical objections about (un)naturalness, dignity, respect for the gene pool as common heritage, are and should be supplemented by more pragmatic questions about safety, utility, efficacy, and potential 'misuse', which seem to become more dominant in the moral discussion. This mini-review summarizes the morally relevant aspects of the rapidly developing domain of GGE, focusing on reproductive applications and with special attention to the ethical questions pertaining to how this technology may affect the interests of those that come to be by means of it. While vital, this encompasses more than safety considerations. Taking this perspective, it will be crucial to engage with normative questions about how GGE maps on the importance of accommodating future parents' preference to have genetically related children, and how far we should go to facilitate this. Similarly, a comprehensive ethical debate about 'appropriate application' of GGE cannot shake off the more fundamental question about how notions like 'normalcy', 'quality of life', and 'disability' can be conceptualized. This is crucial in view of respecting persons whichever traits they have and in view of acceptable boundaries to parental responsibilities.
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Affiliation(s)
- Seppe Segers
- Department of Philosophy and Moral Sciences, Bioethics Institute Ghent, Ghent University, Ghent, Belgium
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de Miguel Beriain I, Payán Ellacuria E, Sanz B. Germline Gene Editing: The Gender Issues. Camb Q Healthc Ethics 2023; 32:1-7. [PMID: 36847191 DOI: 10.1017/s0963180122000639] [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: 03/01/2023]
Abstract
Human germline gene editing constitutes an extremely promising technology; at the same time, however, it raises remarkable ethical, legal, and social issues. Although many of these issues have been largely explored by the academic literature, there are gender issues embedded in the process that have not received the attention they deserve. This paper examines ways in which this new tool necessarily affects males and females differently-both in rewards and perils. The authors conclude that there is an urgent need to include these gender issues in the current debate, before giving a green light to this new technology.
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Affiliation(s)
| | - Ekain Payán Ellacuria
- Department of Public Law, University of the Basque Country-Bizkaia Campus, Leioa, Spain
| | - Begoña Sanz
- Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country, Leioa, Spain
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Abstract
Human gene editing, particularly using the new CRISPR/Cas9 technology, will greatly increase the capability to make precise changes to human genomes. Human gene editing can be broken into four major categories: somatic therapy, heritable gene editing, genetic enhancement, and basic and applied research. Somatic therapy is generally well governed by national regulatory systems, so the need for global governance is less urgent. All nations are in agreement that heritable gene editing should not proceed at this time, but there is likely to be divergence if and when such procedures are shown to be safe and effective. Gene editing for enhancement purposes is not feasible today but is more controversial with the public, and many nations do not have well-developed regulatory systems for addressing genetic enhancement. Finally, different nations treat research with human embryos very differently based on deeply embedded social, cultural, ethical, and legal traditions. Several international governance mechanisms are currently in operation for human gene editing, and several other governance mechanisms have been proposed. It is unlikely that any single mechanism will alone be effective for governing human gene editing; rather, a polycentric or ecosystem approach that includes several overlapping and interacting components is likely to be necessary.
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Affiliation(s)
- Gary E Marchant
- Center for Law, Science, and Innovation, Sandra Day O'Connor College of Law, Arizona State University, Phoenix, Arizona 85004, USA;
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Abstract
PURPOSE OF REVIEW Continued development of gene editing techniques has raised the real possibility of clinical application of germline gene editing. These results, as well as reports of an unethical experiment which resulted in the birth of at least two children from edited embryos in 2018, have highlighted the urgency and importance of ethical issues about translational pathways for editing of human germline cells. Charting responsible translational pathways for germline gene editing requires tackling some significant and complex ethical issues. RECENT FINDINGS A literature on development of clinical applications of germline gene editing is emerging, and several key ethical issues are coming into focus as major challenges for responsible translational pathways. SUMMARY Potential clinical utility, clinical justification, and human subjects research for germline gene editing raise outstanding ethical questions. Work on these questions will help provide guidance to researchers and clinicians and direct translational projects toward justifiable applications.
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Affiliation(s)
- Bryan Cwik
- Philosophy and University Studies, Portland State University, Fourth Ave Building Suite 175, 1900 SW 4th Ave, Portland, OR 97201 USA
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Knoppers BM, Kleiderman E. Heritable Genome Editing: Who Speaks for "Future" Children? CRISPR J 2020; 2:285-292. [PMID: 31599679 DOI: 10.1089/crispr.2019.0019] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Approximately 80% of rare and often incurable and serious conditions affect newborns and children, and roughly half of all rare diseases are considered to have an onset in childhood. Somatic gene therapies are already in clinical trials for spinal muscular atrophy, beta thalassemia, and macular degeneration. If proven to be safe and effective, could heritable genome editing be seen as a form of preventive personalized medicine and as fostering the right to health of the child? The latest calls for global moratoria on clinical applications of heritable genome editing are troubling in that they may create an illusion of control over rogue science and stifle the necessary international debate surrounding an ethically responsible translational path forward. Children are people with distinct rights and interests. An arbitrary moratorium neither fosters their best interests or health nor respects their right to benefit from the advancements of science.
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Affiliation(s)
| | - Erika Kleiderman
- Centre of Genomics and Policy, McGill University, Montreal, Canada
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Ranisch R, Rudolph T, Cremer HJ, Knoepffler N. Ordo-Responsibility for Germline Gene Editing. CRISPR J 2020; 3:37-43. [PMID: 32091257 DOI: 10.1089/crispr.2019.0040] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The case of twins born with genes modified by He Jiankui highlights the need for international governance of germline gene editing (GGE). This article proposes a global framework that utilizes "ordo-responsibilities." This is a pragmatic ethical approach open to pluralism and grounded in principles of human dignity and human rights. Ordo-responsibility is pragmatic in (1) accepting generally available values on a global level (e.g., human dignity, human rights) and (2) seeking achievable implementation. Genetic science is practiced globally in ways that transcend borders. As such, its practice must take account of the vast complexity of cultural, ethical, legal, and anthropological convictions. Here, we explain the basic structure of an appropriate rule-finding process, outline a possible pathway toward an international framework, and discuss minimal requirements that are needed in that endeavor. We thereby contribute to the debate on how to govern genome-editing technologies and GGE globally.
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Affiliation(s)
- Robert Ranisch
- Institute of Ethics and History of Medicine, University of Tübingen, Tübingen, Germany.,Ethics Center, University of Jena, Jena, Germany
| | - Tina Rudolph
- Ethics Center, University of Jena, Jena, Germany
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Parent B, Turi A. Nature beyond control: how expectations should inform decisions about human germline engineering. J Assist Reprod Genet 2019; 36:1771-1777. [PMID: 31313011 PMCID: PMC6730720 DOI: 10.1007/s10815-019-01528-4] [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] [Received: 06/30/2019] [Accepted: 07/08/2019] [Indexed: 12/01/2022] Open
Abstract
In the ongoing discussion about the risks of reproductive human germline modification, scant attention has been paid to whether it could be reconciled with theories of psychological well-being. Even if safety and feasibility challenges could be overcome and germline engineering technology could be implemented in ways that avoid exacerbating social inequality, we would still have to question whether germline modification would promote circumstances that lead to better psychological experiences for parents, society, and the genetically edited person. This paper posits that germline engineering would produce expectations of being able to control the manifestation of an individual's characteristics, which will inevitably be upset by our limited understanding of how genes interact with each other and with the environment. Drawing on self-discrepancy and relative deprivation theories, it is suggested that both editing and being edited could lead to unmet expectations and thus negative emotional states that would offset benefits of successful intended genetic changes.
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Affiliation(s)
- Brendan Parent
- Division of Medical Ethics, NYU School of Medicine, 227 East 30th Street, Rm 721, New York, NY, 10016, USA.
- Center for Genetics and Society, Berkeley, CA, USA.
| | - Angela Turi
- Division of Medical Ethics, NYU School of Medicine, 227 East 30th Street, Rm 721, New York, NY, 10016, USA
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