[Potential Spoilers]
The society of Gattaca not only embraced germ-line modification, it also created a caste system around genetic viability. The main character was unable to pursue his chosen field because the society decided that people in that field needed to be genetically tailored for that field.
I think our moves toward creating a more pluralized society, where people that have been historically deemed "genetically inferior" (the disabled, non-white people, trans people, women) have made slow and steady gains, are such that erasing that progress would require more changes to society than simply allowing genetic modification.
Genetic engineering an easy scapegoat, a slippery-slope argument that lets us jump too fast to the dystopic ending of our choice. A storyline that reduces societal, intra-personal progress to individual genetic choices is missing a big chunk of the puzzle.
We ethically shouldn't do this. We should not edit human embryos. I can't write 5 pages of why we shouldn't but the fact that we could make the difference between the have and have nots will only get bigger and bigger.
Doctor: So do you want the $500 edit to ensure your child won't have diabetes. How about the $2,000 Autism edit? Then the gender change edit is to late to perform. We could do artificial semination and guarantee the gender of your child.
Here is a decent general article on the pros and cons.
If we truly want to eliminate disease though it's not enough to cure disorders, sometimes you have to be able to prevent them, and sometimes they're going to be genetic. Not allowing scientists to use every tool in their arsenal is condemning a lot of people to a lot of pain. I agree that humans aren't always going to make the right calls, but us doing our best might be better than doing nothing.
Why assume it's going to lead to some dystopian future when technological progress has shown that advances like this come down in cost immensely over time. Even an insurance system would want in on subsidizing these procedures if it meant an upfront cost versus long term or lifelong expensive treatments.
Edit: Why even assume it would be an insurance subsidy -- the government has a strong motivation to reduce health care costs for >= 65 year-olds and if you could eliminate or reduce costs through early genetic engineering the argument can be made that the government itself should subsidize as a public health initiative.
Exactly. Treating chronic genetic disorders might require expensive biologics over the span of a long time to only partially treat. And since the disease is genetic, there is always the risk it comes back.
Just look at the past. Remember when doctors and scientists came up with ways to prevent polio, smallpox, measles, etc. and the result was just that rich kids enjoy immunity while the poor suffer?
Ethically we should to born humans. Absolutely do the good and the great. Unborn embryos never except what is medically to save the live of the fetus. We are not talking about medical but genetic and equality. We could no longer say "All Men are Created Equal."
> Doctor: So do you want the $500 edit to ensure your child won't have diabetes. How about the $2,000 Autism edit? Then the gender change edit is to late to perform. We could do artificial semination and guarantee the gender of your child.
That's a straight up violation of the Hippocratic oath and blackmail/racketeering combined. We should enforce it strictly, vigilantly, and put doctors who attempt to do this in jail away for a very long time.
I understand your main argument stems from affordability of the procedure and that's a valid concern, but keep in mind that current societies already ration health care, either by availability/wait times (UK?) or wealth (USA). You won't be able to prevent the wealthy from modifying their offspring anyway and the unfairness of having them do it vs 99% not being able to afford do is not enough of a reason to stop progress, not even close. The goal should be to make this procedure routine, as affordable as an ultrasound or a tooth extraction or a cancer screen.
How do you address this with policy? The same way we should be addressing inequality right now.
Let me posit this question to you: if genetic enhancement would be available to 100% of the population, would you still have ethics concerns?
> How do you address this with policy? The same way we should be addressing inequality right now.
How _will_ we address this with policy? The same way we already do: meaning that we do not, and in fact are thrall to an army of lobbyists and interest groups who would have us believe this inequality is not just necessary but in fact morally redeemable.
That just means you have bigger problems than a few genetically enhanced humans running around.
Which is, in fact, already happening without genetic enhancement: the Olympics are a pretty much a display of peak human genetic fitness, and no one loses their mind about it.
What would be a problem: genetically enhanced humans reach some critical mass and decide to purge the non-enhanced ones à la Eugenics wars in Star Trek (purely hypothetical)
I do not understand how this is a problem. Genes that are beneficial are propagated. Genes that are detrimental are eliminated. Nature divines which is which by survival of the fittest. I want future humanity to have the best genes possible. How else will we fight off the robots?
>You won't be able to prevent the wealthy from modifying their offspring anyway and the unfairness of having them do it vs 99% not being able to afford do is not enough of a reason to stop progress, not even close.
How is that not enough of a reason? The argument is the government has to step in and make it routine from the start. The alternative is to allow the wealthy to literally write superiority into their genes.
Well, we are not going to be able to stop that. Money rules the world. Furthermore, these technologies will appear, regardless of whether we want or not, be it legal or not, so why not do it from the start the right way, so that everyone can benefit from it? Reminds me of the age-reversing debate. It's going to happen, so we might as well bring it as soon as possible instead of letting people die.
> That's a straight up violation of the Hippocratic oath
So is abortion. And, so we're clear, allowing or in any way approving of abortion as a doctor is a far more direct violation of the Hippocratic oath than this is.
> How do you address this with policy? The same way we should be addressing inequality right now.
You mean not at all ?
I've realized though that doctors and pharmaceutical industries don't need to do anything other than save sick patients to make us utterly dependent on genetic modifications. Genetic treatments do not transmit from parent to child. So every parent you treat, the children will need to be treated as well. In some cases all of them, in other cases the chances are simply increased a bit of needing the treatment, which isn't much of a difference.
Even that is ignoring what happens when actual improvements over normal humans become available as genetic treatments. 1% bigger brain ? There is quite a bit of studies that give the impression that on average brain size does correspond to intelligence, even if there are no guarantees in individual cases. It should be an easy change in the DNA to make it a few percent bigger.
So really there's a number of choices we can do:
1) genetic modification is only allowed to be used to cure the sick
This results in the whole population becoming dependent and hostage to genetic modification. Slowly at first. Then, when we learn how to optimize humans, very rapidly.
2) genetic modification is available for parents to create embryos
This actually results in slower dependence: diseases get eliminated, including in the gametes, and any treatment does not need to be repeated in children. Still, improvements will create a class based society.
3) genetic modification is free, and not optional, at least for certain ailments (like vaccines)
This would rapidly eliminate dependence on genetic modification and would be much more fair towards everyone.
I am definitely not 100% on board with editing embryos, but income inequality is the weakest possible criticism. You could argue against literally anything on the grounds that it could lead to inequality: IVF, adoption, education, medical care, technology, owning a computer, being on Hacker News.
Just because something is being doled out injustly doesn't mean it shouldn't be doled out at all.
All men are created equal means that they all have equal rights, not that they all have equal ability. I have a daughter with a recessive genetic disease and two children without it. They're already genetically unequal. Your argument would prevent a potential treatment that would have removed this inequality.
There is something significant about humanity no longer being bound by the tyranny of natural selection. We a species who have the power, however limited, to shape the landscape to our will and desire. Now we can also conquer our own biology. To be this is poetic, utopian even.
>Doctor: So do you want the $500 edit to ensure your child won't have diabetes. How about the $2,000 Autism edit? Then the gender change edit is to late to perform. We could do artificial semination and guarantee the gender of your child.
And this is a premier example of improper application of popular logical fallacy.
The dichotomy isn't false. Like it or not genetic diseases are easier to fix when there's fewer cells to modify. Modifying a few thousand cells will always be easier than billions.
This will mean diseases that can't be cured in adults can be prevented from childhood. Denying this is condemning untold numbers of victims to diseases we could have cured.
So instead you're fine with saying "your child will have cystic-fibrosis; she will grow up her entire life unable to breath without pain and likely die before the age 25".
Today rich people pay for better access to care through out all stages of life. That doesn't mean we should ban heart surgery (for example) because the rich can disproportionally afford to get it and catch conditions early enough to treat.
The "natural is ethical" argument disgusts me and I think you really should consider how much we already depend on progress before you argue for going back to the stone ages.
Personally, I think we absolutely should. We know of genetic defects that cause disabilities and by leaving them there through deliberate inaction we essentially inflict a disability on a child. We also prevent potential advancement of our species.
Cost is a terrible reason to prohibit this and your argument can be applied to nearly all other medical procedures. They all cost money and sometimes that makes them inaccessible to people who need them. This is a different problem to genetic modification.
As for your article, going through the "cons" section, it mainly raises things that need to be thought about rather than reasons not to do it. My opinions on a few sections:
- "making irreversible changes [to people and] all their descendants would constitute extraordinarily risky human experimentation": The changes are only irreversible to the first generation, the same process that introduced the change can removed it in the offspring. The change being irreversible isn't alone a good reason to prevent it. Again, there's precedent for this in existing medicine. If a limb or organ has to be removed, that certainly isn't reversible. If there's a choice between my child definitely being born with a known defect and a child maybe possibly being born with an unknown one, I'd likely take the latter. However I do believe we should understand things better before we go making frivolous modifications to hair colour and such without understanding the consequences.
- "By definition, germline gene editing would not treat any existing person’s medical needs": You're going to refuse to treat someone simply because they're not born yet? Again, acting through inaction. The same benefits brought by treating infants are brought by treating them before they exist.
- "Would germline gene editing be justifiable, in spite of the risks, for parents who might transmit an inherited disease? It’s certainly not necessary. [...] They can do [PGD] too [...]": PGD and CRISPR differ in process but as I understand it, not in result, so I don't believe you can say one is okay but not the other. As for the other section here suggesting you can use third-party sperm or eggs, yes, you can. It isn't strictly necessary to use gene modification techniques if you're happy having someone else's child but it still amounts to selecting for desirable traits.
- "PGD itself raises social and ethical concerns about what kind of traits should be selected or de-selected. These questions are particularly important from a disability rights perspective (which means they’re important for all of us).": I'm not sure I quite get the disability rights perspective. I believe this only really applies to people who believe that life begins at conception, who would argue that selecting candidates that don't have a disability over ones that do amounts to some kind of genetic genocide. Personally I don't buy that. Why should we leave things to chance when we can give the parents the choice to do what they think best for their child?
- "From a policy perspective, how would we draw the distinction between a medical and enhancement purpose for germline modification? In which category would we put short stature, for example? We know that taller people tend to earn more money. So do people with paler skins. Should arranging for children with financially or socially “efficient” varieties of height and complexion be considered medical intervention?": Again, there's precedent for this in existing medicine. Treatment for things like dwarfism and albinism are covered as medical procedures while treatments for mild sunburn and not being able to reach the top shelf are not.
Ultimately the article raises a lot of things to think about but I don't believe any of them are good reasons not to pursue genetic modifications to humans at all.
"The number of children born with Down Syndrome (DS) in Denmark has fallen drastically in recent years – so much so that the disorder could be a thing of the past in 30 years.
Since 2004 all pregnant women have been offered a DS scan – called a nuchal scan – and the number of abortions involving DS children has increased dramatically. Last year, 98 percent of pregnant women who were revealed to be carrying an unborn child with DS chose to have an abortion."
Or we could socialize healthcare for all then treat gene edits like this as we do vaccination. We offer only those edits which would prevent chronic and termination disorders in life but leave anything else that's merely socially undesirable like neuroatypic "disorders." I know this suggestion isn't bullet proof, but it's better than letting crackpots do this in the shadowy corners of society creating all kinds of changes which lead to more suffering for the people that would bear these gene edits (I can imagine there being some weirdo rich couples that wouldn't mind turning their future kids into Nosferatus despite the adverse social impact that would have on them).
Is the gap between rich and poor really so important that we should refrain from curing diseases to avoid making it larger?
Making a rich child immune to diabetes or autism doesn't hurt poor people. It's strictly a net gain.
What's fundamentally different between this and, say, prenatal vitamins or good nutrition? Should we ban women from taking folic acid because it gives an advantage to people who can afford it?
Let's say an in-vitro preventive for diabetes could be developed but is blocked because of concerns about gene editing. That means thousands or millions of children will contract diabetes who wouldn't have if the preventive had been available and will die prematurely. How is that a good thing?
I can sort of buy the arguments for purely cosmetic changes like selecting sex or eye color or whatever. I can vaguely grasp the arguments against selective intelligence or physical strength enhancement. But to refuse to prevent diseases? Why?
There is a reason why the initial papers are coming out in China. Granted, China's biotech is young and getting better every year, but there is a cottage industry of trials initiated in China due to laxer review and ethical standards there; a trial like this in the US would have taken years of paperwork to clear the FDA.
Granted... the FDA and other pharmas do spend a lot of time, money and manpower to monitor clinical trials in China because eventually, the pharmas attempt to use these trials, conducted "over there" at lesser costs, to get approval for clinical use in the US through the FDA...
I would agree that this is a significant milestone - however I would have thought that there's still a large amount of randomness in protein expression meaning you would still be painting in "broad strokes" as opposed to granular detail of traits.
I don't really know what you mean. Genes encode to proteins, if a disorder is genetic it generally means one or more genes are incorrect, encoding to the wrong proteins. If genetic expression was significantly random, how would we identify genetic disorders to begin with? How would they be hereditary?
Not an expert, but there is a lot that is probabilities. E.g. many genes play a part in disease, so changing one set may get you a risk reduction but not full prevention.
The other issue is epigenetics. Gene expression is regulated by various factors and that gene expression can be passed between generations.
Well, broadly speaking, the idea is that there may be a subtle underlying mechanism in gene expression that we are unaware of.
So maybe you'll be able to remove a gene that could cause albinism in an individual, then 25 years later discover that the individual has become sterile.
It may seem otherwise but we still know very little on how a set of genes encodes information of how an organism will develop.
While I'm sure some variant of that will occur at some point, many genetic disorders are relatively simple and well understood. Even if we are still learning, there are dozens of disorders we could eliminate if we had robust genetic editing capability with pretty good odds of success.
"... many genetic disorders are relatively simple and well understood."
Are they, really?
As far as I know (and I am not a specialist, so someone more qualified may correct me), gene transcription and translation is far from well understood.
It's as if we don't have access to the source code for the compiler, only the machine code and the syntax. You can draw correlations and infer causality from your changes, but you can't really be sure.
Not an expert either: Even when we know how it happens, we don't know when it happens i.e. when certain chunks of replication is triggered and when it's not. Environmental factor, hormones, diet, mix of them all and much more etc.
We understand the compiler pretty well. You can grab a Bio textbook and find incredibly detailed diagrams of how the genetic transcription process works. It is true that we don't understand every factor, but it's likely the most significant ones are the ones we understand best.
At one end of the spectrum, Sickle Cell Anemia is caused by a single point mutation. The sixth amino acid in the hemoglobin beta chain should be glutamic acid, but it's been replaced by a valine. These have different charges, which is enough to warp the cell's shape and impair its function.
At the the other extreme, a lot of different gene variants have been associated with autism. However, these tend not to replicate very well--the genes identified in study A don't show up in study B and vice versa, and there are other possible mechanisms, like copy number variants.
CRISPR could potentially fix the former, but the latter is way beyond our current understanding.
Yep. As was in the news a couple of days ago, sickle cell disease can be effectively 'cured' by installing an updated Hemoglobin protein [1]. (Some) Breast cancer associated genes have pretty well understood issues that can be effectively remedied with gene therapies [2]. And mutations in and around the oncogene P53 have pretty well understood effects - all the way through public policy with regards to HPV vaccination [3].
Adding single proteins and flipping single genetic bits in single cell types in single organs is not the kind of thing that generally causes cascade failures. There are always exceptions, but in general biology is pretty robust to such changes. In fact, those are exactly the kinds of changes that occur from generation to generation. And these are precisely the kinds of systems that have been under deep study for the past four or five decades.
Well, it's not all one:one though [1]. If you're messing with transcription factor, who knows what the domino effects will be. Tiny changes might end up triggering phenotypes [2] already present that wouldn't have been expressed without those edits.
The idea that there is only about 2% difference between a chimp and man highlights this point.[3]
Of all the things to modify though, why a transcription factor? Of course there are things in the genome which modifications of would have problematic results. The question is if we should modify those parts we do think would lead to a better outcome, not the ones we know won't.
We are terrified, because we don't know, how to handle it yet. This should not stop us, the humanity. Our descendants will figure it out. There is no progress, if we are afraid of mistakes. The real problem is when we don't learn. Gattaca is a good example, what we should avoid.
FYI: I don't know if English is your first language but you are using commas excessively. All the commas in the first four sentences should be removed and the final comma should be 'of'.
EDIT: Also, the second sentence should be "This should not stop us (humanity)."
FYI: I don't know about your language skills in general but https://en.wiktionary.org/wiki/commata#English. Point I want to make: Please stop correcting so many people in general on HN.
Edit: Yes, this was not a perfectly warranted criticism. Yes, I may come off as smug. It's my opinion that needing perfect english should not be a requirement to have a conversation about tech in general.
I often get the feeling that in an academic setting every native English speaker assumes that everyone needs to be perfectly conversational in his English but when asked which other languages they even tried to learn you often learn that the English native hasn't put considerable amount into learning something else. Again, did not want to offend anyone.
I personally do not get offended, I like to learn. Still, I often experience corrections by an English native which are simply not called for.
He's using commas to separate individual clauses of the sentence. Slavic languages do this, and probably some others too.
>This should not stop us, the humanity.
This doesn't seem like something a modern native speaker would say, but it's basically the same thing as in sentences like this:
Montfort was a younger son of Simon de Montfort, 5th Earl of Leicester, a French nobleman and crusader, and Alix de Montmorency.
, 5th Earl of Leicester, is inserted here to clarify meaning, the same way you might insert a group identifier after a we. Perhaps it might seem less out of place if he used it at the beginning of the sentence, like:
Gattaca is a movie filled with terrible science (there is no evidence of a simple gene change for intellectual ability, etc) and characters that are terrible people (NASA today doesn't allow people with heart conditions to go to space, no genetic dystopia required, because having astronauts die in transit is suboptimal to the mission).
I really wish that movie didn't get brought up every time gene therapy makes another advancement.
I thought in Gattaca they manipulated multiple embryos and let the couple choose the one with the most desired characteristics? I don't recall any mention of single genes doing anything, just embryonic manipulation. The main character was a natural birth, so he didn't benefit from a selection/manipulation process, and thus was born with less optimal genes.
I mean, I don't think you can call it terrible science, it's the premise. I feel it's like saying Star Wars is filled with terrible science because there is no evidence of extra-terrestrial life.
If there's one thing a species like ours needs - with our exposure to so many disease vectors and with so many ways to spread epidemics so quickly - it's definitely not less genetic diversity.
But is diseases really the type of diversity we want though? Some mutation that is generally bad does turn out to be good in some cases [1] but I am still not 100% convinced that the disease causing mutations is diversity that needs to be preserved.
Right, even if there are many, would you be able to justify keeping sickle cell? There was even a recent post on HN about it (thought I can't find the same link here's a jist [1]).
People will probably benefit from some type of cure as opposed to trying to save mutation that causes extreme discomfort (maybe death). I totally agree with importance of variety but i think it's equally important to understand and revert some of these unwanted mutations.
> Right, even if there are many, would you be able to justify keeping sickle cell?
Would you be able to justify eliminating genetic malaria resistance? It's the same allele, of course, heterozygotes get the benefit, homozygotes get the disease.
OTOH, if you can do in vivo editing with appropriate testing, maybe you only edit embryos that would otherwise have the disease, which may marginally reduce the distribution of the allele (in a first order analysis; but if it makes know carriers less unattractive as mates, it might actually increase the distribution), but doesn't eliminate it.
There are lots of issues like this, and overzealous editing could eliminate beneficial traits whose genetic origins we don't understand as side effects of targeting undesirable traits.
There are substantial ethical issues with vaccination as a general thing; there are specific cases where the facts have supporter a fairly broad (though not universal) consensus on the general best approach, but that doesn't change the fact that there are ethical issues in the area of vaccination.
The real ethical concerns are what lies beyond just removing nasty inheritable diseases, which is the possibility for designer babies. But also the possibility for weaponizing CRISPR, either to create nasty viruses, or make a gene editing weapon. But beyond all that, it's the worry that a few people get to make a decision that will impact the genes of future generations. And with a gene drive, you could guarantee that all descendants would have the desired modification.
I have to imagine that CRISPR will be weaponized regardless of what the civilian world decides to do with it. When it happens, we'll be better off if we have as much experience with it as possible.
Abortion laws have tightly given time periods on when embryos and fetuses exist in the human/non-human spectrum, and thus, this simple legal loophole will allow you to do anything you want to it during the non-human phase.
Roe vs. Wade will always win forever. There's an army of pinkhats who will kill you if you say otherwise.
And now, a short list of people refusing to undergo abortions (anti-abortionists) being killed by people who demand they have an abortion. (pro-abortionists)
> Abortion laws have tightly given time periods on when embryos and fetuses exist in the human/non-human spectrum
Untrue. While claims about where a fetus lies on the human/non-human spectrum are often central to anti-abortion arguments, the Constitutional cases starting with Roe on abortion do not address that issue or dictate a result on it. (The anti-abortion camp tends to misrepresent this because they believe that such a decision must control abortion policy, so they read the mere fact of a particular abortion policy as being a decision about the human/non-human issue, ignoring that that is factually not the basis of the Constitutional outcome in question.)
"1. A state criminal abortion statute of the current Texas type, that excepts from criminality only a life-saving procedure on behalf of the mother, without regard to pregnancy stage and without recognition of the other interests involved, is violative of the Due Process Clause of the Fourteenth Amendment.
(a) For the stage prior to approximately the end of the first trimester, the abortion decision and its effectuation must be left to the medical judgment of the pregnant woman's attending physician.
(b) For the stage subsequent to approximately the end of the first trimester, the State, in promoting its interest in the health of the mother, may, if it chooses, regulate the abortion procedure in ways that are reasonably related to maternal health.
(c) For the stage subsequent to viability, the State in promoting its interest in the potentiality of human life [410 U.S. 113, 165] may, if it chooses, regulate, and even proscribe, abortion except where it is necessary, in appropriate medical judgment, for the preservation of the life or health of the mother."
> For the stage prior to approximately the end of the first trimester
The Supreme Court legislates classifications of time in an attempt to delineate what is and is not human.
> For the stage subsequent to viability, the State in promoting its interest in the potentiality of human life
The Supreme Court legislates the concept of a "non-human", with the words "viability" and "potentiality of human life" instead.
There are first of all the obvious worries about the impact of genetic engineering. But worse than that is the method described on Radiolab where the genetic changes produce more instances of CRISPR itself so it passes along from generation to generation. But worse than that is the idea of CRISPR being airborne such that it can infect and change all of our genetics. Or the genetics of only some particular targeted subset of the population.
That sort of sounds like a familial prion disease but really - I don't see that as a legit concern. The enzyme is already present in Strep pyogenes which is practically ubiquitous. A lot of us have that same bacteria colonized in our throats.
I never used CRISPR when I worked in a molecular lab, just a TOL2 system which was pretty cool in its own right. But CRISPR needs a DNA probe (probes are attached to CRISPR to target very specific sequences of DNA for editing) and a way to deliver itself into the cell. I didn't read the paper myself, but I'm guessing they just do a little microinjection of CRISPR into the embryo.
And these gene edits for various hemoglobinopathies (G6PD and thalassemia), while impressive, are very simple. These are very specific mutations that when fixed, should yield a normal/working protein and a healthy phenotype.
Thanks for replying. I'm a layman in this field, so I'm not quite sure about how to parse your response. But wanted to make sure you were aware of the existence of Gene Drive. To me it seems dangerous, but I'd love to hear thoughts from someone more educated in the topic:
This is the point where my thought process forked off into wondering about the implications if the capabilities of Gene Drive could somehow become airborne.
Gene Drive with CRISPR is pretty neat, thanks for sharing, I honestly haven't worked with molecular techniques in over 4 years now, so it's been quite a while since I've reviewed a lot of this kind of stuff. From the gene drive wiki, this is one of my favorite lines:
"Endonuclease gene drives work by cutting chromosomes that do not encode the drive at a specific site, inducing the cell to repair the damage by copying the drive sequence onto the damaged chromosome. This is derived from genome editing techniques and similarly relies on the fact that double strand breaks are most frequently repaired by homologous recombination if a template is present, and less often by non-homologous end joining. The cell then has two copies of the drive sequence."
So that is pretty sweet. The researcher just hijacked the cell's repair mechanism in order to ensure the gene is present in both chromosome copies (I'm assuming the human 2n chromosomes here). That mean's all sexual progeny (zygote) will have to inherit one of these copies - and once that happens the single copy can duplicate itself by breaking the chromosome received from the other mating partner and then replicating the gene/drive via homologous repair.
If you want to say it could be dangerous then yea, I'll agree with you. It would obviously depend on the gene you would include with the gene drive (the gene drive I'm assuming is just the homing endonuclease and RNA guide sequence used to target the drive-less chromosome). If a deleterious gene somehow managed to attach itself to the drive system - either artificially or randomly acquiring the sequence in vivo, then that person may have permanently ruined their chances for normal offspring.
As far as an "airborne" vector with the gene drive/and bad gene someone wanted to be propagated, that would be a lot harder I think. I believe you would need the vector to be a virus, so it could gain access to the host's cells and DNA. So you would need a pretty high powered lab working extensively to make an infectious but not virulent virus - with the gene drive and harmful gene it carries. Those labs would be highly regulated and controlled bio weapons facilities. So yea, it could be dangerous.
Or it could be fantastic and something like this could be used to cure all of sickle cell disease by coding for a normal beta hemoglobin gene. Sickle cell only occurs from a single amino acid change, it's not a super complicated genetic disease. It's just one amino acid change that causes red blood cell sickling shape and fragility - which leads to a lot of pain and eventual early demise. There are other genetic diseases that are very simple that could be cured as well.
Anyways, sorry for the late response. I think there is potential to do a lot of good and a lot of harm with this technology. Let's hope we keep it in the right hands.
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[ 10.6 ms ] story [ 163 ms ] threadAll the same, the fact that we're close to gene editing feels like something our of a SciFi book, and I think that's pretty cool.
I think our moves toward creating a more pluralized society, where people that have been historically deemed "genetically inferior" (the disabled, non-white people, trans people, women) have made slow and steady gains, are such that erasing that progress would require more changes to society than simply allowing genetic modification.
Genetic engineering an easy scapegoat, a slippery-slope argument that lets us jump too fast to the dystopic ending of our choice. A storyline that reduces societal, intra-personal progress to individual genetic choices is missing a big chunk of the puzzle.
Doctor: So do you want the $500 edit to ensure your child won't have diabetes. How about the $2,000 Autism edit? Then the gender change edit is to late to perform. We could do artificial semination and guarantee the gender of your child.
Here is a decent general article on the pros and cons.
http://www.nationalgeographic.com/magazine/2016/08/human-gen...
Why assume it's going to lead to some dystopian future when technological progress has shown that advances like this come down in cost immensely over time. Even an insurance system would want in on subsidizing these procedures if it meant an upfront cost versus long term or lifelong expensive treatments.
Edit: Why even assume it would be an insurance subsidy -- the government has a strong motivation to reduce health care costs for >= 65 year-olds and if you could eliminate or reduce costs through early genetic engineering the argument can be made that the government itself should subsidize as a public health initiative.
Wait a minute....
That's a straight up violation of the Hippocratic oath and blackmail/racketeering combined. We should enforce it strictly, vigilantly, and put doctors who attempt to do this in jail away for a very long time.
I understand your main argument stems from affordability of the procedure and that's a valid concern, but keep in mind that current societies already ration health care, either by availability/wait times (UK?) or wealth (USA). You won't be able to prevent the wealthy from modifying their offspring anyway and the unfairness of having them do it vs 99% not being able to afford do is not enough of a reason to stop progress, not even close. The goal should be to make this procedure routine, as affordable as an ultrasound or a tooth extraction or a cancer screen.
How do you address this with policy? The same way we should be addressing inequality right now.
Let me posit this question to you: if genetic enhancement would be available to 100% of the population, would you still have ethics concerns?
How _will_ we address this with policy? The same way we already do: meaning that we do not, and in fact are thrall to an army of lobbyists and interest groups who would have us believe this inequality is not just necessary but in fact morally redeemable.
Which is, in fact, already happening without genetic enhancement: the Olympics are a pretty much a display of peak human genetic fitness, and no one loses their mind about it.
What would be a problem: genetically enhanced humans reach some critical mass and decide to purge the non-enhanced ones à la Eugenics wars in Star Trek (purely hypothetical)
How is that not enough of a reason? The argument is the government has to step in and make it routine from the start. The alternative is to allow the wealthy to literally write superiority into their genes.
So is abortion. And, so we're clear, allowing or in any way approving of abortion as a doctor is a far more direct violation of the Hippocratic oath than this is.
> How do you address this with policy? The same way we should be addressing inequality right now.
You mean not at all ?
I've realized though that doctors and pharmaceutical industries don't need to do anything other than save sick patients to make us utterly dependent on genetic modifications. Genetic treatments do not transmit from parent to child. So every parent you treat, the children will need to be treated as well. In some cases all of them, in other cases the chances are simply increased a bit of needing the treatment, which isn't much of a difference.
Even that is ignoring what happens when actual improvements over normal humans become available as genetic treatments. 1% bigger brain ? There is quite a bit of studies that give the impression that on average brain size does correspond to intelligence, even if there are no guarantees in individual cases. It should be an easy change in the DNA to make it a few percent bigger.
So really there's a number of choices we can do:
1) genetic modification is only allowed to be used to cure the sick
This results in the whole population becoming dependent and hostage to genetic modification. Slowly at first. Then, when we learn how to optimize humans, very rapidly.
2) genetic modification is available for parents to create embryos
This actually results in slower dependence: diseases get eliminated, including in the gametes, and any treatment does not need to be repeated in children. Still, improvements will create a class based society.
3) genetic modification is free, and not optional, at least for certain ailments (like vaccines)
This would rapidly eliminate dependence on genetic modification and would be much more fair towards everyone.
Just because something is being doled out injustly doesn't mean it shouldn't be doled out at all.
Can we say "All Men are Created Equal?" Not anymore.
I don't have a problem with any of that.
The dichotomy isn't false. Like it or not genetic diseases are easier to fix when there's fewer cells to modify. Modifying a few thousand cells will always be easier than billions.
This will mean diseases that can't be cured in adults can be prevented from childhood. Denying this is condemning untold numbers of victims to diseases we could have cured.
Today rich people pay for better access to care through out all stages of life. That doesn't mean we should ban heart surgery (for example) because the rich can disproportionally afford to get it and catch conditions early enough to treat.
The "natural is ethical" argument disgusts me and I think you really should consider how much we already depend on progress before you argue for going back to the stone ages.
Cost is a terrible reason to prohibit this and your argument can be applied to nearly all other medical procedures. They all cost money and sometimes that makes them inaccessible to people who need them. This is a different problem to genetic modification.
As for your article, going through the "cons" section, it mainly raises things that need to be thought about rather than reasons not to do it. My opinions on a few sections:
- "making irreversible changes [to people and] all their descendants would constitute extraordinarily risky human experimentation": The changes are only irreversible to the first generation, the same process that introduced the change can removed it in the offspring. The change being irreversible isn't alone a good reason to prevent it. Again, there's precedent for this in existing medicine. If a limb or organ has to be removed, that certainly isn't reversible. If there's a choice between my child definitely being born with a known defect and a child maybe possibly being born with an unknown one, I'd likely take the latter. However I do believe we should understand things better before we go making frivolous modifications to hair colour and such without understanding the consequences.
- "By definition, germline gene editing would not treat any existing person’s medical needs": You're going to refuse to treat someone simply because they're not born yet? Again, acting through inaction. The same benefits brought by treating infants are brought by treating them before they exist.
- "Would germline gene editing be justifiable, in spite of the risks, for parents who might transmit an inherited disease? It’s certainly not necessary. [...] They can do [PGD] too [...]": PGD and CRISPR differ in process but as I understand it, not in result, so I don't believe you can say one is okay but not the other. As for the other section here suggesting you can use third-party sperm or eggs, yes, you can. It isn't strictly necessary to use gene modification techniques if you're happy having someone else's child but it still amounts to selecting for desirable traits.
- "PGD itself raises social and ethical concerns about what kind of traits should be selected or de-selected. These questions are particularly important from a disability rights perspective (which means they’re important for all of us).": I'm not sure I quite get the disability rights perspective. I believe this only really applies to people who believe that life begins at conception, who would argue that selecting candidates that don't have a disability over ones that do amounts to some kind of genetic genocide. Personally I don't buy that. Why should we leave things to chance when we can give the parents the choice to do what they think best for their child?
- "From a policy perspective, how would we draw the distinction between a medical and enhancement purpose for germline modification? In which category would we put short stature, for example? We know that taller people tend to earn more money. So do people with paler skins. Should arranging for children with financially or socially “efficient” varieties of height and complexion be considered medical intervention?": Again, there's precedent for this in existing medicine. Treatment for things like dwarfism and albinism are covered as medical procedures while treatments for mild sunburn and not being able to reach the top shelf are not.
Ultimately the article raises a lot of things to think about but I don't believe any of them are good reasons not to pursue genetic modifications to humans at all.
"The number of children born with Down Syndrome (DS) in Denmark has fallen drastically in recent years – so much so that the disorder could be a thing of the past in 30 years.
Since 2004 all pregnant women have been offered a DS scan – called a nuchal scan – and the number of abortions involving DS children has increased dramatically. Last year, 98 percent of pregnant women who were revealed to be carrying an unborn child with DS chose to have an abortion."
http://cphpost.dk/news/down-syndrome-heading-for-extinction-...
That ship may have sailed in a society where you can legally kill the embryo or cut 1/3 of the skin off a newborn infant's penis.
Making a rich child immune to diabetes or autism doesn't hurt poor people. It's strictly a net gain.
What's fundamentally different between this and, say, prenatal vitamins or good nutrition? Should we ban women from taking folic acid because it gives an advantage to people who can afford it?
Let's say an in-vitro preventive for diabetes could be developed but is blocked because of concerns about gene editing. That means thousands or millions of children will contract diabetes who wouldn't have if the preventive had been available and will die prematurely. How is that a good thing?
I can sort of buy the arguments for purely cosmetic changes like selecting sex or eye color or whatever. I can vaguely grasp the arguments against selective intelligence or physical strength enhancement. But to refuse to prevent diseases? Why?
Granted... the FDA and other pharmas do spend a lot of time, money and manpower to monitor clinical trials in China because eventually, the pharmas attempt to use these trials, conducted "over there" at lesser costs, to get approval for clinical use in the US through the FDA...
The other issue is epigenetics. Gene expression is regulated by various factors and that gene expression can be passed between generations.
https://en.wikipedia.org/wiki/Epigenetics
So maybe you'll be able to remove a gene that could cause albinism in an individual, then 25 years later discover that the individual has become sterile.
It may seem otherwise but we still know very little on how a set of genes encodes information of how an organism will develop.
Are they, really?
As far as I know (and I am not a specialist, so someone more qualified may correct me), gene transcription and translation is far from well understood.
It's as if we don't have access to the source code for the compiler, only the machine code and the syntax. You can draw correlations and infer causality from your changes, but you can't really be sure.
At one end of the spectrum, Sickle Cell Anemia is caused by a single point mutation. The sixth amino acid in the hemoglobin beta chain should be glutamic acid, but it's been replaced by a valine. These have different charges, which is enough to warp the cell's shape and impair its function.
At the the other extreme, a lot of different gene variants have been associated with autism. However, these tend not to replicate very well--the genes identified in study A don't show up in study B and vice versa, and there are other possible mechanisms, like copy number variants.
CRISPR could potentially fix the former, but the latter is way beyond our current understanding.
Adding single proteins and flipping single genetic bits in single cell types in single organs is not the kind of thing that generally causes cascade failures. There are always exceptions, but in general biology is pretty robust to such changes. In fact, those are exactly the kinds of changes that occur from generation to generation. And these are precisely the kinds of systems that have been under deep study for the past four or five decades.
[1] https://serotiny.bio/notes/proteins/hbb/ [2] https://serotiny.bio/notes/proteins/brca1/ [3] https://serotiny.bio/notes/proteins/p53/
The idea that there is only about 2% difference between a chimp and man highlights this point.[3]
[1] https://en.wikipedia.org/wiki/Transcription_factor [2] https://en.wikipedia.org/wiki/Phenotype [3] http://discovermagazine.com/2006/apr/chimp-genome
Disclaimer : Not arguing for or against.
EDIT: Also, the second sentence should be "This should not stop us (humanity)."
Edit: Yes, this was not a perfectly warranted criticism. Yes, I may come off as smug. It's my opinion that needing perfect english should not be a requirement to have a conversation about tech in general.
I often get the feeling that in an academic setting every native English speaker assumes that everyone needs to be perfectly conversational in his English but when asked which other languages they even tried to learn you often learn that the English native hasn't put considerable amount into learning something else. Again, did not want to offend anyone.
I personally do not get offended, I like to learn. Still, I often experience corrections by an English native which are simply not called for.
>This should not stop us, the humanity.
This doesn't seem like something a modern native speaker would say, but it's basically the same thing as in sentences like this:
Montfort was a younger son of Simon de Montfort, 5th Earl of Leicester, a French nobleman and crusader, and Alix de Montmorency.
, 5th Earl of Leicester, is inserted here to clarify meaning, the same way you might insert a group identifier after a we. Perhaps it might seem less out of place if he used it at the beginning of the sentence, like:
We, the humanity, shouldn't let this stop us.
I really wish that movie didn't get brought up every time gene therapy makes another advancement.
[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3499995/
People will probably benefit from some type of cure as opposed to trying to save mutation that causes extreme discomfort (maybe death). I totally agree with importance of variety but i think it's equally important to understand and revert some of these unwanted mutations.
[1]http://www.acsh.org/news/2017/03/07/did-gene-therapy-cure-si...
Would you be able to justify eliminating genetic malaria resistance? It's the same allele, of course, heterozygotes get the benefit, homozygotes get the disease.
OTOH, if you can do in vivo editing with appropriate testing, maybe you only edit embryos that would otherwise have the disease, which may marginally reduce the distribution of the allele (in a first order analysis; but if it makes know carriers less unattractive as mates, it might actually increase the distribution), but doesn't eliminate it.
There are lots of issues like this, and overzealous editing could eliminate beneficial traits whose genetic origins we don't understand as side effects of targeting undesirable traits.
Abortion laws have tightly given time periods on when embryos and fetuses exist in the human/non-human spectrum, and thus, this simple legal loophole will allow you to do anything you want to it during the non-human phase.
Roe vs. Wade will always win forever. There's an army of pinkhats who will kill you if you say otherwise.
http://www.apnewsarchive.com/2002/Pa-Men-Gets-Life-For-Fireb...
http://www.nydailynews.com/news/crime/maine-man-accused-kill...
http://www.cbc.ca/news/canada/british-columbia/surrey-man-co...
http://www.dailymail.co.uk/news/article-2338710/Man-begged-f...
https://www.lifesitenews.com/news/parents-north-carolina-tee...
http://www.whio.com/news/local/woman-shot-man-demanding-abor...
Untrue. While claims about where a fetus lies on the human/non-human spectrum are often central to anti-abortion arguments, the Constitutional cases starting with Roe on abortion do not address that issue or dictate a result on it. (The anti-abortion camp tends to misrepresent this because they believe that such a decision must control abortion policy, so they read the mere fact of a particular abortion policy as being a decision about the human/non-human issue, ignoring that that is factually not the basis of the Constitutional outcome in question.)
"1. A state criminal abortion statute of the current Texas type, that excepts from criminality only a life-saving procedure on behalf of the mother, without regard to pregnancy stage and without recognition of the other interests involved, is violative of the Due Process Clause of the Fourteenth Amendment.
(a) For the stage prior to approximately the end of the first trimester, the abortion decision and its effectuation must be left to the medical judgment of the pregnant woman's attending physician.
(b) For the stage subsequent to approximately the end of the first trimester, the State, in promoting its interest in the health of the mother, may, if it chooses, regulate the abortion procedure in ways that are reasonably related to maternal health.
(c) For the stage subsequent to viability, the State in promoting its interest in the potentiality of human life [410 U.S. 113, 165] may, if it chooses, regulate, and even proscribe, abortion except where it is necessary, in appropriate medical judgment, for the preservation of the life or health of the mother."
> For the stage prior to approximately the end of the first trimester
The Supreme Court legislates classifications of time in an attempt to delineate what is and is not human.
> For the stage subsequent to viability, the State in promoting its interest in the potentiality of human life
The Supreme Court legislates the concept of a "non-human", with the words "viability" and "potentiality of human life" instead.
http://www.sacred-texts.com/wmn/rvw/rvw11.htm
Please don't create accounts to break HN's guidelines with.
We detached this subthread from https://news.ycombinator.com/item?id=13839925 and marked it off-topic.
Okay, anti-Trump Silicon Valley.
May the interest rates rise and your markets drain. :D
I never used CRISPR when I worked in a molecular lab, just a TOL2 system which was pretty cool in its own right. But CRISPR needs a DNA probe (probes are attached to CRISPR to target very specific sequences of DNA for editing) and a way to deliver itself into the cell. I didn't read the paper myself, but I'm guessing they just do a little microinjection of CRISPR into the embryo.
And these gene edits for various hemoglobinopathies (G6PD and thalassemia), while impressive, are very simple. These are very specific mutations that when fixed, should yield a normal/working protein and a healthy phenotype.
https://en.wikipedia.org/wiki/CRISPR#Gene_drive
This is the point where my thought process forked off into wondering about the implications if the capabilities of Gene Drive could somehow become airborne.
"Endonuclease gene drives work by cutting chromosomes that do not encode the drive at a specific site, inducing the cell to repair the damage by copying the drive sequence onto the damaged chromosome. This is derived from genome editing techniques and similarly relies on the fact that double strand breaks are most frequently repaired by homologous recombination if a template is present, and less often by non-homologous end joining. The cell then has two copies of the drive sequence."
So that is pretty sweet. The researcher just hijacked the cell's repair mechanism in order to ensure the gene is present in both chromosome copies (I'm assuming the human 2n chromosomes here). That mean's all sexual progeny (zygote) will have to inherit one of these copies - and once that happens the single copy can duplicate itself by breaking the chromosome received from the other mating partner and then replicating the gene/drive via homologous repair.
If you want to say it could be dangerous then yea, I'll agree with you. It would obviously depend on the gene you would include with the gene drive (the gene drive I'm assuming is just the homing endonuclease and RNA guide sequence used to target the drive-less chromosome). If a deleterious gene somehow managed to attach itself to the drive system - either artificially or randomly acquiring the sequence in vivo, then that person may have permanently ruined their chances for normal offspring.
As far as an "airborne" vector with the gene drive/and bad gene someone wanted to be propagated, that would be a lot harder I think. I believe you would need the vector to be a virus, so it could gain access to the host's cells and DNA. So you would need a pretty high powered lab working extensively to make an infectious but not virulent virus - with the gene drive and harmful gene it carries. Those labs would be highly regulated and controlled bio weapons facilities. So yea, it could be dangerous.
Or it could be fantastic and something like this could be used to cure all of sickle cell disease by coding for a normal beta hemoglobin gene. Sickle cell only occurs from a single amino acid change, it's not a super complicated genetic disease. It's just one amino acid change that causes red blood cell sickling shape and fragility - which leads to a lot of pain and eventual early demise. There are other genetic diseases that are very simple that could be cured as well.
Anyways, sorry for the late response. I think there is potential to do a lot of good and a lot of harm with this technology. Let's hope we keep it in the right hands.