Advances in gene editing technology have opened up revolutionary possibilities for treating genetic diseases and personalized medicine, but they could also lead to the creation of personalized babies, social inequality, and ethical issues. The future of this technology depends on human choice.
Genetics, which began with Mendel’s laws of inheritance, has evolved into a discipline called genetic engineering, which involves the direct manipulation and processing of genes. The genetic information of an organism is stored in DNA in the form of sequences, which are used to make proteins, and proteins are combined to make an organism. The information stored in DNA is an important factor in determining the characteristics and functions of living things, and it is the source of the diverse characteristics of different organisms. Therefore, if we can read this sequence to identify the proteins that a particular sequence expresses and the diseases or disorders it causes, we can identify and make small “corrections” to treat the disease before it starts. This technology could be applied to genetic disorders as well as complex diseases such as cancer, greatly opening up the possibility of personalized medicine. Scientists began looking for ways to “fix” genes.
In 1970, restriction enzymes, so-called “genetic scissors” that recognize specific sequences of DNA and cut only those parts, were discovered, and this led to the development of genetic recombination. Genetic manipulation using restriction enzymes is called genetic recombination technology because it does not freely “edit” genes, but simply inserts the desired sequence from other DNA. Genetic recombination was initially limited to relatively simple organisms, but over time it has been applied to more and more complex organisms. However, restriction enzymes can only recognize sequences of less than 10 bases in length, limiting their use to fungal plasmids (the ring-shaped DNA in the cells of bacteria), which do not have long sequences.
In 2012, a powerful gene scissors, CRISPR, was developed that could overcome these limitations. CRISPR is a gene in the DNA of bacteria that is responsible for the immune system’s defense against bacteriophages, viruses that attack them. Bacteriophages insert their DNA into the bacteria, use the bacteria’s nucleus to replicate themselves, and then burst the bacteria to kill it. The bacteria have developed their own specialized immune system in response. Once the bacteriophage has inserted its DNA into the bacterium’s cell, the bacterium uses a protein called Cas9 to insert a piece of this DNA into its own crisper, which can be passed on to the next generation. If the bacterium, or its offspring, is attacked again by a bacteriophage, the bacterium transcribes the gene inserted into the crisper to make a gRNA that seeks out the phage’s DNA. This forms a complex with the Cas9 protein, where the gRNA finds and binds to the bacterial DNA, and the Cas9 protein then cuts the bacterial DNA.
Humans have taken note of this system: if we attach an RNA to the Cas9 protein that can bind complementarily to the sequence of the gene we want to cut, the complex can effectively cut the specific portion of DNA we want to cut. In addition, compared to traditional restriction enzymes or other gene scissors, CRISPR gene scissors are simple in structure and require only the RNA to be altered according to the desired target. CRISPR technology is currently at the forefront of genetic engineering, and the ease with which we can cut the parts of a gene we want has spurred the development of gene editing technologies.
If these gene editing technologies are refined and perfected, it may be possible in the future to treat genetic disorders caused by defective genes by directly editing a patient’s DNA. In addition, gene editing has the potential to be used as a radical treatment for rare and chronic diseases. Currently, diseases that are incurable or have very limited treatment options could be overcome with advances in gene editing technology. But what if we go even further and manipulate genes at the fertilized egg stage before a human being develops? The creation of a “personalized baby” that can be genetically manipulated to your liking would have a huge social impact. In fact, it’s already commercially available today. It’s called Preimplantation Genetic Diagnosis (PGD), and it allows people with genetic disorders to have healthy children. This technology uses in vitro fertilization in a test tube and then selects genetically normal embryos from the fertilized embryos and implants them in the uterus, which is technically a “selective baby” rather than a “custom baby,” as it selects embryos that are not genetically defective. Gene editing technology can directly modify these embryos to radically improve their health and abilities.
In China, where there is currently no ban on genetic modification of embryos, researchers have been working on this. Recently, researchers at Guangzhou University in China announced that they successfully used this technique to manipulate genes associated with infection with the HIV virus that causes AIDS in human fertilized eggs. However, we’re still only tinkering with the few genes we know about. The ability to freely subtract and insert genes to get the abilities and traits we want is a long way off. But will we ever get to the point where we can freely edit genes at the fertilized egg stage and have a “personalized baby”?
Let’s first consider how the technology will evolve to get there. Biotechnology that involves living organisms is developed through numerous clinical trials, in which the risks and side effects of the technology are weeded out. However, these trials, especially those that manipulate the genes that make us who we are, are extremely risky and can take a life if they go wrong. Even if it is acceptable for people with genetic diseases, especially terminal diseases, to grasp at straws and participate in clinical trials using gene editing technology, what about clinical trials of personalized baby technology that manipulates the genes of fertilized eggs? The fertilized eggs are subjected to tremendous risks against their will, and if a major error or side effect during the experiment results in the death of the fertilized egg or the birth of a deformed baby, it would be unacceptable in the name of “sacrifice for the advancement of humanity.” The fact that the outcome of the experiment is a technological advancement that greatly benefits humanity does not justify the unethical nature of the process.
In the case of gene editing of fertilized eggs, let’s assume that the sacrifices mentioned above are minimized by the development of other biotechnologies and careful prior review. We would have a world where anyone could freely create a customized baby for a fee. Would such a technology be a blessing to humanity? Think about it from the perspective of a child, not a parent. The child would be designed according to the parents’ desires, regardless of their will, and the child would become a means to fulfill the parents’ desires. This can lead to conflict between parents and children. This is not the only source of conflict. Some parents will be opposed to these technologies for ethical or religious reasons. The children they give birth to naturally will inevitably be less physically capable than the customized babies created through gene editing. Those children, who will notice the inevitable difference in ability despite the same effort, may resent their parents for not supporting them.
In a society where personalized baby technology becomes commonplace, the gap between those who benefit from it and those who don’t will be very large. Relatively wealthy parents will be able to afford to equip their children with good skills, and these children will have a different starting point than those born to less affluent parents. Class mobility on a level playing field would disappear, and polarization would increase.
What if we impose partial controls on gene editing technologies? Manipulations that develop physical appearance or abilities should be strictly controlled and only allowed to prevent congenital genetic diseases, incurable diseases, and terminal diseases. This logic of regulating the enhancement of abilities and only allowing treatments for health purposes runs into the problem of what constitutes an ability and what constitutes health. Imagine that a fertilized egg test reveals that a child is at a high risk of congenital hair loss. Hair loss is a classic paternal inheritance, but it also reduces the external ability to look good. What if you were born with a high risk of ADHD, an attention deficit disorder? Treatment of ADHD can lead to health benefits, as well as improvements in outward appearance, such as better attention. Is the congenital treatment of these conditions an improvement in health or an improvement in abilities? After all, “health” and “external abilities” are different aspects of the same thing. Therefore, the partial control of gene editing technology will continue to stir up controversy about the extent to which it is an improvement in health and the extent to which it is an improvement in ability.
This partial control can lead to another problem. Once the technology exists, imposing partial controls will not prevent an underground market from forming. Many parents will want to use gene editing to give their children only the best traits. Some privileged people, especially those with wealth and power, may be willing to secretly benefit from the technology, even at great expense. If a good or service is in high demand, banning it doesn’t make it go away; it just creates an underground market. If gene editing is done illegally, there will be no guarantee of safety and consumers will not be compensated for any potential harm.
Gene editing is a technology that will undoubtedly have a profound impact on human life. However, gene editing of fertilized eggs should be controlled from an ethical and social justice perspective. Furthermore, as shown above, the argument for partial control of gene editing is not a viable one; full control is preferable. Instead, we should explore and apply gene-editing technology in a variety of areas. For example, instead of manipulating fertilized eggs, it could be used to repair the immune cells of terminally ill people. We should also explore ways to extend the use of gene editing to other animals and plants, such as developing pest-resistant, tastier, and more nutritious crops.
Furthermore, the ethical issues of gene editing technology need to be discussed in depth from a policy perspective. It is essential to analyze the impact of gene editing technology on society and establish appropriate regulations and legal frameworks based on this. This is not just an advancement in science and technology, but an important process in designing the future of humanity. How will humans use the power of this new technology? Whether gene editing becomes a tool for human progress and a better life, or whether it creates new forms of inequality and ethical dilemmas, depends on how we handle it and where we set its limits.
