A Slippery Slope Indeed

    Ever since I was a kid, it’s been one incredible scientific breakthrough after another. What made it even more exciting was that popular entertainment made it seem all that more believable, or at the very least, hopeful. Science fiction shows became more than a little smarter, and regular television shows sometimes gave us story lines that pushed the boundaries of what was then, current scientific knowledge. The next thing you know we’ve got Arnold and his endless Terminator franchise with its never-a-happy-ending A.I. storylines. Next up to bat has been the various comic book to movie takes, like The X-Men, with its on-again, off-again subplots about gene-editing. 

    Now, gene editing, for me anyway, is one of the scarier things in todays’ science news. But not all gene editing is the same. It matters whether researchers edit “somatic” cells or “germline” cells. Germline cells are the ones that propagate into an entire organism – either cells that make sperm and eggs (known as germ cells), or the cells in an early embryo that will later differentiate into different functions. What is critical about those particular cells is that a change or mutation in one will go on to affect every cell in the body of a baby that grows from them. That’s why scientists are calling for a moratorium on editing the genes of germ cells or germline cells.

    Somatic cells are everything else – cells in particular organs or tissues that perform a specific function. Skin cells, liver cells, eye cells and heart cells are all somatic. Changes in somatic cells are much less significant than changes in germline cells. If you get a mutation in a liver cell, you may end up with more mutant liver cells as the mutated cell divides and grows, but it will never affect your kidney or your brain.

    Our bodies accumulate mutations in somatic tissues throughout our lives. Most of the time humans never know it or suffer any harm. The exception is when one of those somatic mutations grows out of control leading to cancer. 

    I have read pieces by numerous geneticists who study the genetic and environmental causes of a number of different disorders, from birth defects – cleft lip and palate – to diseases of old age like Alzheimer’s. Studying the genome always entails thinking about how the knowledge you generate will be used, and whether those likely uses are ethical. So geneticists have been following the gene editing news with great interest, as well as great concern.

    In gene editing, it matters enormously whether you are messing with a germline cell, and thus an entire future human being and all its future descendants, or a somatic cell that deals with just one particular organ. Gene therapy – fixing faulty genes in individual organs – has been one of the great hopes of medical science for decades. There have been a few successes, but a lot more failures. Gene editing may make gene therapy more effective, potentially curing important diseases in adults. The National Institute of Health runs a well-respected and highly ethical research program to develop tools for safe and effective gene editing to cure disease.

    But editing germline cells and creating babies whose genes have been manipulated is a very different story, with multiple ethical issues. The first set of concerns is medical – at this point society doesn’t know anything about the safety. “Fixing” the cells in the liver of someone who might otherwise die of liver disease is one thing, but “fixing” all of the cells in a baby who is otherwise healthy is a much higher-risk proposition. This is why the announcement not long ago that a Chinese scientist had done just that created such an uproar.

    But even if we knew the procedure was safe, gene editing of the germline would still catapult us straight into all of the “designer baby” controversies and the problems of creating a world where people try to micromanage their offspring’s genes. It does not take much imagination to fear that gene editing could bring us a new era of eugenics and discrimination. I mean, I get that many of you younger readers out there would like your kids to have my dimples or my advanced hand/eye coordination in order to put him or her on the path to basketball or golf greatness! Who wouldn’t? You’re an idiot. But...and there’s always a “But.” I believe there is something to be said for the beauty and sanctity of the individual. Especially in the sense of how that individual was originally genetically intended. Can an argument be made to edit, as it were, a somatic cell in order to edit or delete a certain gene that is known to bring on some life-shortening disease? Intelligent people can have that conversation. 

    However, I’m not sure I can have the conversation about editing a gene that continues down through the family tree for all time. Maybe the great-great-great grandchild doesn’t want the genetic upgrade, whether it be purely aesthetic (say, an aquiline nose), or intellect-related, or even something that is done to enhance the physical strength and prowess of the individual. It seems to me that would be a dangerous first step toward artificially enhancing the human condition, which is where all those sci-fi movies with the horrific endings...begin. 

    And then you run into the obvious questions like, who gets this type of treatment? Does everyone? Pro bono? Probably not. I understand that some people today have better access than others to certain advanced care. I have no problem with that as long as everyone has access to good, basic care. But I think we can all agree that gene-editing/enhancing is a “Brave New World.” And as I’ve typed before in this space; just because we CAN do something, doesn’t necessarily mean we SHOULD do something. 

    Look, having typed the above sentence, I know this is coming. Things like this, especially when it comes to science, tend to take on a life of their own, not unlike a locomotive barreling down the track. But does all of this still sound scary? Well, it should. However, I think it makes a huge difference whether you are manipulating individual organs or whole human beings, as well as their descendants. Stay tuned...

Write to Peter: magtour@icloud.com