This may seem a shocking statement, however science is making huge advancements lately and we often forget to consider the impact on humanity. Life is always balanced, and nature will always evolve to remedy and maintain this. Gene editing in particular, is an area of great interest to scientists, but few seem to considering the wider effects.
In recent decades Science has produced many medical advances. These have included organ transplantation, prosthetic engineering, birth control, X-rays and penicillin. Now Science is exploring the cellular source code that makes us function. The new medical frontier is human genetics. The focus for study is DNA, a double-helix polymer responsible for instructing the body to grow, reproduce and essentially instructing every part of us to function. We inherit DNA from our parents, and scientists have for a long time wanted to be able to manipulate the genes that make up our DNA molecules.
There have been gene-editing tools before, but CRISPR-Cas9 is one of immense interest to scientists.. CRISPR is a specialised sequence of DNA with repeating nucleotides and spacers. Imagine a railway train, but like one you’ve never seen before, that literally surpasses the creative imagination. The nucleotides would be the carriages; the spacers the couplings that keep the train together. In fact spacers do far more, they store vital knowledge about viruses, preventing future attacks. Cas9 is the locomotive, but this is no ordinary train, remember. Cas9 is an enzyme which, when combined with certain RNA, scissors up any foreign DNA strands it encounters. These chopped up bits of DNA can be spliced into other, more complex DNA strands, altering their encoded messages and instructions. Now, this is what we would call a super train!
CRISPR technology enables scientists to create DNA editing tools of a precise 20 nucleotide length. In order to cut the DNA strand at the precise point needed, the CRISPR tool needs to deploy guide-RNA which is unique to the DNA being edited. Once the double helix cut is made, the target DNA attempts to repair itself by inserting a short sequence of nucleotides to bridge the gap. By inserting their own DNA templates scientists can trick cell repair mechanisms into altering the original DNA. When this happens, the DNA’s genetic instructions are altered too. This causes the cell to reproduce in a different manner and the organism’s physical characteristics to be modified.
Essentially CRISPR-Cas9 allows Science to edit the source code of any gene. Genes are specific sequences of nucleotides found inside DNA. Thus it can be used to correct pre-existing cell mutations or vanquish genetic diseases. Scientists have already been tinkering with plant DNA to create genetically-modified crops with superior characteristics.
CRISPR-Cas9 editing is unfortunately not 100% accurate. The process depends on the Cas-9 enzyme binding with an RNA molecule which is unique to the target DNA sequence. This ensures the cutting of the DNA strand is precise.
But in large genomes there may be many DNA sequences which are identical or near-identical to the target DNA sequence. So-called off-target mutations can result with potentially disastrous implications for future generations. These off-target mutations will continue to repeat in the organism if produced by a gene drive. This is a technique that encourages inheritance of a particular gene to increase its prevalence. There is also a risk that negatively modified sequences may cross species, unbalancing the ecosystem.
The risk is large enough when CRISPR-Cas9 is performed on non-reproductive cells. But when it is used on germ cells, such as found in sperm and eggs, or on embryos, the risks are magnified. So-called germline editing modifies all cells, transferring any adverse effects to future generations.
Releasing genetically-modified organisms into the environment could cause hitherto unknown plagues to arise. Care needs to be taken in the laboratory, with safety measures applied at all times. There are indeed real dangers facing our world now, as we march rapidly forward with these amazing technologies, which can have darker, more dangerous implications for humanity.
CRISPR-Cas9 editing can be used to eradicate disease and harmful genetic defects. It can also be used to boost economic returns in many ways. The pharmaceutical industry can use it as a weapon against disease, and thus medical companies can profit from CRISPR-Cas9. The spread of malaria can be controlled by sterilising female mosquitoes using CRISPR-Cas9. Also, in agriculture, CRISPR-Cas9 can be used to increase crop yield, as well as improve the nutritional qualities of the crop itself.
Doctors are taught the phrase 'First do no harm', as derived from the Hippocratic Oath. The general idea is that a doctor's intervention should never risk harming the patient. Yet by dabbling with genetic engineering, medical science is contradicting this ancient premise. Not only is a single patient at risk from genetic editing, but if reproductive cells are involved the whole of humanity could be threatened.
Genetic engineering deals with the physical cellular matter that makes up humans. Everything is coded into our DNA, from how we reproduce, to the colour of our eyes, to our defence against disease. There is no question of doubt that geneticists are playing God here; an accusation which neatly brings us to consider our spiritual side. Humans are not just clay, or even solely matter. We have a spirituality that reveals itself in many ways, including intellectual creativity. Whether we own a soul or not, we function as creative, thinking individuals with motivation.
We are more than the sum of our cellular parts. We cannot yet predict how tampering with our genes might affect our spiritual being in the future. However, even organ transplants have sometimes resulted in subtle character changes. Some organs seem more susceptible to cellular memory than others, and although not 100% confirmed by scientists, some are reporting significant 'changes of heart' in their patients especially after heart transplants.
It would seem that scientists still have much to learn about the amazing structure that is a human being, and even though science is making enormous leaps of advancement, humanity is still much more. We are not the sum of all our parts, but an eclectic mix of features and structures which creatively blend into a being which learns, remembers and develops in ways we may never comprehend even in the future. However, in the midst of this is an invisible spiritual being, which seemingly learns, remembers and develops in the same way.
Are we entering a world where medical science overrules all other aspects of society? We need to take care we don’t go down the same evil ideological path the Nazis in Germany did in the 1940s. In their drive to produce a blue-eyed, blonde-haired Aryan super race, they advocated cruelty. Sadistic scientists such as Dr Josef Mengele were given free licence to experiment on Jews, including children.
But power being granted by the political base to the medical establishment is not unknown even in modern times. Elective euthanasia is still under debate, yet doctors now have the power to decide when a terminally ill patient should die. End-of-life protocols, or death pathways, are a reality. They allow doctors to deprive terminal patients of food and fluids to relieve pressure on beds. The medics can place a patient on a death pathway if they establish they are dying, however as from the moment of birth we are all dying as life is finite and the human structure fails with certainty in correlation to life. These decisions could unless proper checks and balances are instigated, become earlier and earlier. In fact, some argue that these death pathways accelerate and precipitate death - which on a common sense level seems accurate as human beings need food and water to function, and ultimately live.
Do Not Resuscitate ("DNR") notices are another example of a doctor's power over another’s right to live, especially the elderly. However, these policy decisions are becoming much broader, to include disabled or intellectually impaired patients as well, often where DNR consultation should first take place. Such DNR policies beg the question whether stricter and more transparent criteria should be adopted. These might be akin to the ‘beyond reasonable doubt’ standard of evidence used in most legal systems to determine criminal conviction. It is clear that as we approach an era where costs are under scrutiny at every level, institutions like the National Health Service ("NHS") in the United Kingdom, may be forced to save costs over lives as the pressure mounts.
We are seeing increasing numbers of medically-driven and life over death decisions in the courts - Why? Surely, this in itself is evidence that the power of medicine is now more moral and ethical than in days past. Thankfully, we have an unwritten constitution which is capable of change and adaptation based on public opinion and the wishes of the public.
Where next will genetic engineering take us? Designer babies?
CRISPR-Cas9 has already been used on non-viable human embryos in China. But in most countries it has been rejected by the medical community, not least because of other preferred methods, such as egg harvesting.
Designing a baby is usually for rich parents, or at least those well off in our society. Clearly, as genetic editing techniques advance, it will be these people who will benefit most from this pioneering medical technology. This might lead to a health system for the rich, with the poor increasingly having to fall back on older, lesser treatments, or no treatment at all.
Such a two-tiered health system could only lead to major social divisions in the future. Social inequality would increase, especially if the trend of the rich getting richer and the poor poorer continues. It is well recognized in the world of genetics that we are close to the creation of super intelligent beings, or enhanced cognitive abilities. There is a danger that current human rights legislation will start to erode and the world become more unfair. Those privileged to have wealthy parents would benefit the most from genetics, and might ultimately feel superior to those less lucky. As with Hitler’s SS these people would consider themselves unassailable and above the law. They might feel entitled to commit crimes against their genetically-poorer brethren.
It is always important to keep your 'eyes wide open' to the society around you, as these changes may be subtly embedding into policy and legislation. Yet, this demands vigilance from all citizens to ensure a fair, equal and free society. It is after all in everyone's interests to ensure that this is the case, as we all ultimately suffer in a society full of inequalities.
Ultimately, it is for the people within any fair society to stand up for their basic human rights. Lobbying politicians to voice their concerns about genetic engineering that might affect their families’ lives is a start. Tampering with the human genome can cause inequality in society. This inequality spills over into many economic areas of life, such as employment, housing, allocation of resources, etc.
Since 1946, it has been UNESCO ("United Nations Educational, Scientific and Cultural Organisation") which has overseen peace between nations, human rights, the need for basic education and cultural diversity. It also promotes new scientific knowledge and addresses any ethical concerns arising from these.
UNESCO is well placed to be the global standard bearer for safeguarding human rights in the face of new medical technology. However, there are other organisations that can also rise to the challenge. The United Nations ("UN") came about after World War II to maintain peace between nations and protect human rights. A specialist agency of the UN is the World Health Organisation ('WHO") formed in 1948. WHO focuses on all matters relating to global public health. It can act as a honed scalpel against any ethical challenges which are created as genetic engineering develops.
All three global organisations need to be weighing the risks and benefits of genetic engineering before it becomes too late. The worry is that scientists have already gained the upper hand. It's impossible for global leaders to police all medical organisations, so others well-placed in our society must take up the mantle.
Encouraged by vast profits and power, it would only take one rogue medical company to unleash a genetic nightmare into the environment. Whether a new plague or a dangerous cross-breed, this genetic contagion would be hard to stop outside the controlled environment of a laboratory.
Ultimately, it might only take the one outbreak to signal a death knell for humanity.
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