The ethics of genetically modifying humans and the social impacts it can have on humanity

How are human embryos genetically modified?

Genetically modifying a human embryo is accomplished by removing and replacing genes to achieve an intended change in the genetic material (Lotz & Smulders, 2013). There are different technologies that can be used to modify DNA. Of these, CRISPR-Cas9 is the most well-known (Medline Plus, 2020). It is an efficient, site-specific (a location within a chromosome) genome engineering technology that can be used in both unicellular and multicellular organisms. CRISPR has been used in various ways, such as controlling DNA transcription (the process of creating RNA that in turn creates proteins), conducting genome-wide screenings, and imaging chromosomes (Barrangou & Doudna, 2016). In the context of modifying human embryos, CRISPR has been used to cleave and replace genes in embryos, adding the intended gene in place of the previous one (Liang et al., 2015). Other ways of obtaining desired traits are procedures such as Preimplantation Genetic Diagnosis (PGD). This can help children be born of disease by implanting the embryos that do not contain the risk of obtaining a genetic/heritable disease from their parents into the mother’s uterus, resulting in offspring that have less chances of carrying and passing on those genes (Pray, 2014).

Current debates regarding the field

The most frequently debated ethical issues regarding human genetic modification are about the sufficiency of current research and guidelines, the morality of embryo experimentation, the possible creation of human subspecies, and theorised unavoidable disease adaptation.

The majority of researchers agree that gene modifications have the potential to improve or eradicate human genetic diseases in the future, though the process of doing so requires many resources, time, accurate experiments, and careful monitoring. The beneficial or detrimental impacts this will have on how we, more specifically governments and people in positions of power, choose to use this technology (Friedmann & Roblin, 1972).

Friedmann & Roblin (1972) advocated for further research about developing techniques and working scientific ethical guidelines for researchers to follow. They oppose any further attempts of gene modifications in humans because of three main reasons: Firstly, humanity’s understanding of processes such as gene regulation and genetic recombination are insufficient. Additionally, the known relationship between molecular defects and disease states of all genetic diseases are too limited to act upon. Lastly, there is currently no information on the short and long term side effects of genetic engineering on humans. Though this source may seem less reliable due to its publication date, the overarching concerns the paper brings up is still applicable to contemporary research on gene modifications in humans. Despite the lack of information about the effects of human modification, researchers have identified some effects of genetic modification in plants, such as changing the biodiversity of ecosystems (Schmeller & Henle, 2008).

Another debate is about the morality of pursuing genetically modifying humans. For those who regard embryos as human with equivalent rights and moral status, research involving the usage of embryos is unethical and unacceptable. Following this logic, embryos aren’t able to give consent to undergo genome editing. In contrast, people who accept the usage of embryos in research usually consider embryos to “lack any form of sentience, self-awareness, and self-will” (Chan, n.d.) as they lack the neurological structure to form these characteristics.

Some also express concerns about creating a subspecies or ruling class of humans from modifying sex cells, which are heritable. One example of this debate is of the ethics and fairness of genetically modified athletes competing in events against non-modified athletes. Some individuals naturally have better fitted genes than others, such as height or rate of metabolism from natural variations in the genome. According to Sandel (2009), supporters of genetically modified humans would argue that intentional modification is no different than existing variations of the human genome and therefore not a concern. Others would argue that it is no better than steroid usage as they both modify the human body by adding foreign material (hormones or DNA). As steroid usage is banned in athletics, genetically modified humans would not be able to compete in athletics..

Although choosing the sex of a child during the embryotic stage using PGD has been done for decades, the ethics is still highly debated. Sex selection using genetic engineering technology has a controllable influence on gender ratios. Some argue that, in some countries with a preference for male children, the ability to select sex can contribute and worsen the bias. Advocates of sex selection argue that despite this, sex selection can be used for positive reasons such as balancing family gender ratios, avoiding transmitting diseases/illness linked to certain sex genes (the driving reason behind the creation of PGD), or that it protects an individual’s procreative autonomy (Liao, 2005).

The last major concern is that nature has the possibility to adapt to genetic engineering and the pursuit of human modification would not lead to a substantial difference in quality of life long term. Evolutionists may argue that, despite human interference, diseases and mutations are guaranteed to happen on the basis of Darwin’s evolutionary theory of ‘the survival of the fittest’ (Than et al., 2018). The more suited organisms such as viruses and bacteria would survive to infect humans despite DNA modification. Moreover, the diseases that humanity has become resistant to would also evolve alongside efforts to combat it. There are many cases of host plants adapting to insects or herbivores after a few generations by developing a diversity of chemicals like toxins (Rashid War et al., 2018) (Southwood, 1984), or insects adapting to resist pesticides (Mallet, 1989). Though this example does not completely mirror the hypothetical situation of modifying the DNA of humans, the possibility of diseases adapting to infect humans regardless of DNA modifications should be considered.

The potential change in perceptions & behaviours towards health issues

The elimination or lessened severity of health issues is a major reasoning behind the pursuit of genetically modifying humans. Research about identifying genes that make people predispositioned to experiencing certain health issues has been done. Researchers are also improving or creating new technology to eliminate or deactivate those genes in humans. With this research, humanity’s ability to solve these health issues seems guaranteed. Despite this promising technology, societies should consider the changes that may happen on perceptions, perspectives, and behaviours towards health issues and the consequent impacts it has for those who are affected by them and their community. For example, there may be less efforts and resources used to support those currently affected by health issues under the impression that in the future, little to no people would be impacted by those health issues and therefore spending resources on this would be less beneficial.

With efficient and accurate genetic engineering technology to achieve this, many lives can be saved. The UN found that respiratory system diseases accounted for 7.5 % of all deaths in the EU in 2016 (Eurostat, 2021). There have been many animal experiments and human clinical trials that target genetic lung diseases such as asthma, allergies, and lung cancer with promising - though not completely conclusive - results. Like many other studies, the researchers conclude that further research is vital before making genetic modification widespread (Sondhi et al., 2017). This recurring expert opinion makes it evident that researchers and researchers believe that the current knowledge of genetic engineering for humans is not yet a viable option for humanity.

Genetically modified embryos are not the only kinds of cells that have the potential to prevent diseases and disorders. Stem cells from bone marrow can be used to regenerate and repair tissue. Stem cells are also often collected from embryos, making their usage ethically debatable. Their effectiveness has been tested on bone disorders, neurological disorders, cancer, cardiovascular injuries, and kidney failure with positive results. However, stem cell therapy involves many risks such as 80% survival rate 5 years after therapy (Martin et al., 2010), chances of engraftment - a process that occurs when stem cells enter the bloodstream, embed themselves in bone marrow, and make new blood cells of their kind (Lee, 2016) - and can result in insufficient development of fully functional tissues. To potentially solve these issues, researchers have tried genetically modifying stem cells to improve survival rates and effectiveness of stem cell therapy (Hodgkinson et al., 2010). The potential of a reliable new treatment for health issues seems promising.

An implication of genetically modifying humans to eradicate diseases is that governments will not need to spend as much money on healthcare, especially for the diseases that have been cured or alleviated by genetic engineering. For some countries with limited finances, this would allow the redistribution of funds to benefit them as they can use their finances on other aspects such as education or conservation. This would subsequently result in a higher quality of living for societies. On the other hand, this may lead to underfunded healthcare systems and an inability to respond to medical-related crises in times of need such as a pandemic (Iacobucci, 2021). With higher life expectancy, countries will also have to provide more healthcare services and accomodations for the elderly which can be costly. Even with the possibility of spending less money and resources on healthcare long term, governments would have to first fund the research. This would take time and resources that may ultimately be more costly than not pursuing this endeavour. Even then, it is possible that this theoretical benefit would not happen.

Another concern is the political, social, and economic effect caused by countries gaining the usage of genetic engineering. Depending on the accessibility of the technology, this may cause isolation of certain ethnicities, religious groups/affiliations, or income levels. This power imbalance can have a positive impact on certain groups at the expense of others. For example, a country with access to successful human gene editing technology can gain more connections with other countries, exclude certain social groups based on their existing relationships, and/or improve their national economy. Though there is no current research on this aspect, it is a significant aspect to keep in mind.

As mentioned in the debate portion, regulating genetic engineering technology and its usage can be difficult, especially if the policies and laws do not exist or are not effective. Not only should regulations of conducting genetic research be carefully considered, but implementing new regulations specific to regulating genetically modifying humans is crucial for a better future for humanity, such as the prior example about competitive sports. Many countries such as Norway and China have been working on improving their regulations and laws on the genetic modification of organisms (Lester & Hutchens, 2001)(Myhr & Traavik, 2003). However, in 2018 an experiment on genetically modified embryos that resulted in the birth of two genetically modified babies was done in China against national and international regulations. After this scandal, China’s genetic modification regulations have been more strict (Normile, 2019).

Conclusion

The prospect of genetically modified humans and its ethics has become an important topic to discuss as ongoing research is making it more feasible and accessible. If the social impacts of genetically modifying humans were not considered, the negative consequences would be more prominent and have no existing countermeasures. Careless and unconsidered genetic engineering of humans would be a massive, likely negative, change for humanity. Although the ethics and feasibility of genetically modifying humans has been extensively debated about, experts and researchers in the field of bioethics have acknowledged the current barriers that hinder researcher’s abilities to safely and ethically genetically modify humans.

Genetically modifying humans does not only impact perceptions and behaviours towards health issues caused by the genetic modification of humans; it is very likely to have other social impacts as well. It may affect the future of accessibility for people with disabilities or create discrimination for or against modified human beings. Further exploration of these areas should be considered to gain a more informed view on genetically engineering humans and the consequent ability to make the most ideal and beneficial decisions.