On human genome editing
The taboo of the new world
Authors note: I wrote this essay in 2021 for a university project. We had to consider 5 different perspectives from several speakers. Looking back to this chapter of my life. I was considerably more pessemistic about people and their intentions. However, I think that my thinking was more individualistic in nature. I guess life and its conformities of happiness got me nonetheless. I hope you will enjoy reading this little piece of writing, and to that extend my hearths desire!
Standing at the Crossroad
Should a medical professional instruct and change the people of the future? Shall he do it for the love of mankind as written in the Hippocratic oath: ‘’Into whatsoever houses I enter... I will abstain from all intentional wrong-doing and harm’’. Or out of pure curiosity? How men will answer is not relevant, but why is he still too eager to think the former from the latter? If humans from the past was giving the same dilemma, are they able to answer in the same way? The shadow of the earth is alongside us and in our Walled Garden, we have made breakthroughs in developments in medical sciences and especially in human genetic modification. Which may decide our path forever.
To understand the question of genetic modification and its taboo. We must try to develop the origin of this idea, and why we abhor it in modern times before we can make it to the inevitable crossroads on the future of men.
Ethical Dilemmas – Cautionary tales
In 2018 at the Second International Summit on Human Genome Editing. Dr. He Jiankui of the Southern University in Shenzhen, gave after an unsuspected leak of his research. A presentation on embryonical genome editing. From the clinical trials a twin sister named ‘’Lulu and Nana’’ where born with a mutation in their genome, The receptor for HIV binding on Helper T-cells, CCR5 was deleted from their genome by CRISPR/Cas9 editing. And thus, theoretically immune from HIV-infection. Dr. Jiankui was later sentenced for 3 years in prison together with 3 other colleagues and banned from researching into human reproductive technology ever again. This bring us to our first piece: Why we engage in genome editing? For Dr. Jiankui the answer was emotional. He said in reply to a question about the institutional ethics of his research that: ‘’If you see your relative or friend with a severe disease… you want to help him’’. The emotional argument is a strong but equally superfluous. Can we decide if it is a human act to provide genetic immunity to diseases? It may be a justified reason to think empathically, to help the sufferers or future sufferers. The question still arises as how we can be sure of an objective outcome and not of subjectivity.
The matter can be both simple and complex. Simple for the purpose is to heal the sick, and complex as in how we decide to intervene. The second piece: Is there a rationale in germline editing. Why do we develop medical technology? Even if we have developed CRISPR/Cas9 for the sake of science and understanding, research still bore its fruits that we don’t dare touch. Individuals who do touch, as Dr. Jiankui got the same treatment and lessons in History as any philosopher or scientist testing the upper limits of what is considered progress at the time. To deny and delay the progress we may need to accept unavoidably. The science on human genome editing brought us to what abandoning ethical consciences is, and what we currently understand on natural and scientific progression. The worthiness of wisdom we may or not obtain.
The Walled Garden
The story of humans is the story of God, to be more precise, of Godhood. Sometimes we choose to believe life is given to us by a higher power, or that we have earned our position on earth by being a good person. What make us believe in our existence, if we cannot accept our own? Dostojevski wrote in Notes from underground: ‘’Now I ask you: what can be expected of man since he is a being endowed with strange qualities? Shower upon him every earthly blessing, drown him in a sea of happiness, so that nothing but bubbles of bliss can be seen on the surface… He will launch a curse upon the world, and as only man can curse (it is his privilege, the primary distinction between him and other animals), may be by his curse alone he will attain his object--that is, convince himself that he is a man and not a piano-key!’’
Dostojevski argued that men cannot be pleased by his self, that he wants to extinguish himself from nature. That he even considers in burning his own stability and humanity in order to become more than nature intended. Likewise in Genesis 3:22 Eve is coerced by the snake in eating the fruit of wisdom, in turn she gave the fruit to Adam, and they subsequently hid from God. Sending them away from Eden before they could taste the tree of life. ‘’And the Lord God said, the man has now become like one of us, knowing good and evil. He must not be allowed to reach out his hand and take also from the tree of life and eat and live forever.” We might at first assume Eve had a chose which fruit and order she may have eaten. Wisdom or Eternal life. but why did she never choose to want them both? Or to choose the latter from the former. Identical to the snake, it was Pride that perhaps chose for her and took the path of wisdom. For wisdom or consciousness may provide us with a substitute of life? The lack of this very piece made us walk by God’s shadow. And the reason for men to stick with Wisdom.
Stopping progress - A misty path
In 1953 DNA was discovered by Watson & Crick, and for first time, the foundation of humanity was being understood. Blackburn and Gall presented in 1978 that the enzyme telomerase restores/sustains finite telomeres of chromosomes associated with natural death and cancer. The human genome project published in 2003 the whole sequence of our genome, and in 2021 the Nobel prize in chemistry was given for the discovery of genome editing with CRISPR/Cas9 (2012). Following year, the genome editing capabilities was shown in eukaryotic cells.
The understanding of humanity in modern times has none the less been influenced by biology. the possibility of CRISPR/Cas9 genome editing brings us to another magnitude and it is maybe the rapid developmental progression and public obscurity in genome editing that we find taboo. In Japan a study has shown that the general public, when asked about their views on genome editing. Was of acceptance but was essentially lacking in understanding of both the risk and technology used in said germline editing In the same year David Baltimore stated at the same summit attended by Dr. Jiankui: ‘’It would be irresponsible to proceed any clinical use of germline editing unless and until the safety issues have been dealt with in this broad societal consensus, basically an open process and it would still be considered irresponsible’’. Would the dulling of this double-edged blade of [scientific] progression be worthwhile, one may think we do not want to open pandoras box? The obscurity of implications may bring us to taboo with mortality at its core. In which we simultaneously may find our reason for hope.
Taboo of the New world
Taboo (adj.) "consecrated, inviolable, forbidden, unclean or cursed,’’… ‘’a social or religious custom prohibiting or restricting a particular practice or forbidding association with a particular person, place, or thing’’ (Merriam webster, EtymOnline)
The early scientific/philosophical theory on aging, the theory of extending one’s life span by magic or mystical means is the same granting of eternal life as the immortalist of today theorize. They argued about the expandability of the body as a machine, that science can replace the defective parts to prolong as machines or stop aging all together. Life expansion is as Nick Bostrom describes in his essay: The Fable of the Dragon-Tyrant: ‘’The argument is not in favor or life-span extension per se. Adding extra years of sickness and debility at the end of life would be pointless. The argument is in favor of extending, as far as possible, the human health-span. By slowing or halting the aging process, the healthy human life span would be extended. Individuals would be able to remain healthy, vigorous, and productive at ages at which they would otherwise be dead.’’ The understanding of our biomolecular machinery brings us the knowledge to prolonging lifespan, by (supposedly) preventing certain diseases, as in the example of HIV. Still, we abhor to the idea of genomic modification being applied in embryonic stem cells. Empathically the preventing of diseases may sound helpful, but it is the means of providing the edited embryonic cell(s) that may be concerning. If we assume a genetic disease in a society as undesired, while the society is populated by relative healthy individuals. The mutation introduced (ignoring the logistics) in future generations of the same society, may not positively affect the quality of life in most cases. This quality of life can be partially explained in how we experience mortality. For if we extend our life expectancy by 5-10 years by introducing specific mutation(s) in the population, the standards of what we see as a long life may differ from former generations. The subjectivity cannot be ignored, for before the discovery of antibiotics the life expectancy was 47 years on average versus 76 years after the widespread use of the drug and advances in medical science. We simply accept that we live longer.
So why is germline editing not as widely embraced and researched as other live extending therapies. It may be in how we view our humanity. In Judeo-Christian tradition as described in Corinthians 6:19: ‘’Do you not know that your bodies are temples of the Holy Spirit, who is in you, whom you have received from God? You are not your own’’. The human body is the product of nature, we see our body connected to the natural world and in duality also with our own anthropological perspective of it. By maintaining this connection, the possibility of explaining our own mortality can be maintained. By severing or manipulating the connection, the sense of uncertainty of our humanity and mortality can be deteriorated. Contradictory to ‘’natural dysconnectivity’’ we may be able to extend the life span of humans with genomic editing, and simply adept and accept. If supposed the human condition is of denying once mortality, and the subjectivity of a long live may differ in society. Is the aspect of living an immortal life the reason of taboo?
The Future of Men
On January 1, 1972. James Bedford, upon his death was the first human to be cryogenically preserved. Trusting that medical science of the future may revive him and cure him of cancer. In society likewise, some choose the logic and rationale of science to extend once life instead of the spiritual counterpart of old.
We have seen in the germline editing of Lulu and Nana by Dr. Jiankui, in asking himself the morale question if he was doing good for the parents or if he was satisfying his own curiosity as a scientist. The impact of which may startle a more delicate exploration of human genome editing in the future. The (medical)technologies that govern our world of today may inevitably surpass the intended goals and understanding of the society that created them. Acceptance of technologies as: antibiotics, anti-cancer medication, organ transplants and gene therapy keep increasing the boundaries of our initial life span.
The relative quick ascend of genomic editing brings us the taboo and ethical dilemmas in how far science can go to manipulate humanness. The mortality of men and connectiveness to its nature may equally shun or captivate the idea of life extension in society. One may ask what society is capable of if life is two or ten times longer than its initial lifespan. Will premature death be more dreadful? Or progress be more abundant.
We simply must take a direction, for we may not see in the dark.
Dragan Bibib, The human condition, 2015
