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Leigh Babineaux Project 107 UNIV 100 21 November, 2017 Genetic Leigh Babineaux Project 107 UNIV 100 21 November, 2017 Genetic Editing ABSTRACT This paper explores the medical ethics of the manipulation of the human genome in fetuses with CRISPR-Cas 9, more commonly know to the public as designer babies. Now there are several factors that must be looked at to determine the efficacy of genetic editing. The major factors this essay explores are: how is it done, what are the side effects, what are its uses, and what are its alternatives. Through scientific inquiries, and not science fiction based fear, this paper explores the ethical standpoints on the alteration of the human genome. Babineaux1 What if there was a way to change the one thing that truly made us physically human? To manipulate the very genes that separate the human species from any other living organism? To alter DNA and eradicate certain genetic disease forever? Imagine a world where not only could a parent ensure that their child was free from the burden of any genetic abnormalities but have the ability to theoretically determine any and every traits of their offspring. Within this decade this idea, once only believed to be science fiction, is being developed and utilized through the gene selection process formally known as CRISPR-Cas 9 1. For now this groundbreaking tool is being used in laboratory settings but as capitalism pushes its ever present head into the scientific community, one must be prepared to argue the ethics of genetic manipulation for non-medical purposes. Commercialization of such a powerful and historic innovation raises several questions. Should something that could very well alter the fate of the human species as we know it, be determined by the same species that brought the world such horrific inventions like as Sandwich in a Can? For many science fiction enthusiasts the term “designer babies” would evoke terrifying and hair raising images from such movies as Gattaca 2 or Splice 3. While the very idea of mere humans having the ability to manipulate genetic code seems completely outlandish, technological innovations dating back to the late 1990s have been leading up to this very moment. For the first time in human history, the question is no longer could we manipulate the human genome, but should we and to what extent. Is this scientific development the answers to the ill or is it an illusion made of wax and feathers much like the wings of Icarus 4 from Greek mythology? Babineaux2 The true ethical dilemma comes into play when assessing whether or not it would be helpful or harmful to manipulate a child’s genetic makeup. According to Dr Daryl F. Sas and Hannah Martin Lawrenz in their paper "CRISPR-Cas9: The Latest Fashion in Designer Babies.", “[as] long as the benefits of the technology appear to outweigh the risks—a strictly consequentialist view—it is ethical to use” (86). But what are the technological benefits and risks and when does one decide when one risk outweighs the other? In the case of genetic manipulation, there seems to be a general consensus that any child is better off without any biological deficits but what about in the case of any other trait? Is a child better off with blue eyes instead of brown? Or blond hair instead of red? Although the desire to continue one’s genetic lineage is personal, the refashioning any genetic aspect of a living creature would qualify the creature as a Genetically Modified organism 5, or GMO; therefore alteration of the human genome should be regulated by the Inter- Ministerial Commission For Safety of Genetically Modified Organisms (CIBIOGEM)6. In 2005, the commission outlined their function with the Law on Biosafety of Genetically Modified Organisms that was “created in order to manage potential risks associated with GMOs and promote the ethical development of this area of biotechnology” (Chan 431). However, the Inter- Ministerial Commission For Safety of Genetically Modified Organisms (CIBIOGEM) denies responsibility for determining the efficacy of designer babies. They claim that the law is “essentially symbolic” in the case of genetic modifications within the human genome because of the “[stipulation] that ‘human beings’ are not considered ‘organisms’ for the purposes of the law” (Chan 431). This left various group to come to their own conclusions and further impede a unified opinion on its efficacy. Babineaux3 Until recently there has been no true overseer regulating this procedure because it seemed to fall between the cracks of each regulator agency’s responsibilities. While this flux of power was going on, the only unified response from the biomedical community as a whole was that “gene editing to create children [is] impermissible at the present time” (Chan 428 ). Finally after years of an ethical standstill, the U.S. Food and Drug Administration (FDA) has taken over this responsibility (Kozubek). They are classifying CRISPR-Cas 9 as a drug because of its ability to chemically modify a cell (Kozubek). While exploring the efficacy of gene selection, first one must look at the processes in which DNA is altered. In a breakthrough drug Exondys 51, improperly placed stop codons are altered by the replacement of a single base pair (Babineaux 1). This drug is given intravenous on a bi weekly basis to sufferers of Duchenne Muscular Dystrophy 7 (Babineaux 1). This treatment is the first of its kind to go into an adolescent's DNA and inhibit the reading of the stop codon in the next DNA replication (Babineaux 1). With Exondys there is little concern about the alteration of the germline 8 and its affects future offspring, because those afflicted with Duchenne Muscular Dystrophy that live to see their reproductive years are in no physical condition to procreate (Babineaux 3).Unlike Exondys that is used long after the primary stages of DNA formation and cell development, any genetic modifications in vitro could eliminate the chance of a trait being passed down to future offspring. For this reason, many scientist fear that if these two types of DNA alterations are not distinctly separated that “gene editing research would be ‘tarred with the same brush’, impeding valuable science” (Chan 428 ). Babineaux4 One concern on genetic alteration is the chance of any genetic abnormalities altered in one generation would still be passed down to the next; however, new scientific developments proves that this would not be the case. Ironically it is the exact opposite occurrence; any change to the parent DNA will affect their offspring. Not only is this a side effect of genetic modification, but one of the results for which it strives. As Dr Stephen L Baird, Director of Pathology and Laboratory Medicine at UC San Diego states, “Germline engineering seeks to affect the genes that are carried in the ova and sperm, thus eliminating the disease or disorder from all future generations, making it no longer inheritable”(14). Many advocacy groups argue that the use of germline manipulation be used only for “clinical reproductive use and calling for measures to ‘[s]trongly discourage, even in those countries with lax jurisdictions where it might be permitted, any attempts at germline genome modification for clinical application in humans’” (Chan 428). Of course, there are limitations on how traits are selected at this point in time; natural conception and genetic manipulation can not currently be used hand in hand. Any gene manipulation must take place in a laboratory. According to Dr Baird: “Germline modification would begin by using [In Vitro Fertilization] to create a single- cell embryo or zygote. This embryo would develop for about five days to the blastocyst stage (very early embryo consisting of approximately 150 ceils. It contains the inner cell mass, from which embryonic stem cells are derived, and an outer layer of cells called the trophoblast that forms the placenta. (It is approximately 1/10 the size of the head of a pin.) At this point embryonic stem cells would be removed. (Figure 2) These stem cells Babineaux5 would be altered by adding genes using viral vectors. Colonies of altered stem cells would be grown and tested for successful incorporation of the new genes. Cloning techniques would be used to transfer a successfully modified stem cell nucleus into an enucleated egg cell. This "constructed embryo" would then be implanted into a woman's uterus and brought to term. The child born would be a genetically modified human {Inheritable, 2003)” (14). Since this procedure is fairly new, there are several problems associated with it. The two major risks would be the chance that if the procedure takes place after a certain time stamp the fetus could develop mosaicism 9. In even worse circumstances, the wrong gene has been accidentally cut on or misplaced(Sas 86). This mishap begins when the CRISPR molecule sends an enzyme, commonly Cas 9, to “chop the code like tiny molecule scissors” as Jim Kozubek from the New York Times states in his article “How Gene Editing Could Ruin Human Evolution.”, Cas 9 is not known for its precision, so during the “jerry-rigged repair” in which the enzyme “[incorporates] small bits of available DNA or a repair template of other genetic material that scientists might add” misplacements are known to occur (Kozubek). According to Tuhus-Dubrow, it is likely that the court cases Connecticut v. Griswald 10(1965) and Roe v. Wade 11 (1973) will have inadvertently set the legal groundwork in the future case of selecting traits. The case of Griswald v Connecticut ensures a couple “right to privacy in marital relations” and, therefore, if a child were to be conceived and their DNA edited for any reason, it could be argued that the choice to alter their child’s DNA is a form of marital relation (Griswald v Connecticut).
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