An incisive social commentary masquerading as innocuous entertainment, the 1997 science fiction movie “GATTACA” is alarming in the strength of its rhetoric and in the prescience of its message. It predicts and grapples with bioethical questions that have since surfaced with the invention of new gene-editing and gene-selecting technologies. The film depicts a dystopian society in which mankind has abandoned traditional means of procreation, turning instead to reproductive technologies that allow for the selection or manipulation of genes in order to achieve the most desirable genotypic outcome in offspring. The hero of the story, Vincent Freeman, is born by natural means; the character and the disadvantages he faces as a result of his unconventional birth and lack of hand-picked genetic makeup serve to highlight the flaws in the widespread implementation of such technologies. The advancements in question are depicted as futuristic in the film, but the past few years have seen tremendous progress in the fields of genetics and bioengineering that have brought these technologies to our doorsteps. Enter CRISPR/Cas9.
In layman’s terms, CRISPR/Cas9 is a gene-editing tool that allows for the targeted modification of specific genes. The acronym stands for “clustered regularly-interspaced short palindromic repeats,” and Cas9 is a protein that works in conjunction with CRISPR. The recent advancement of this technology is attributed to Jennifer Doudna of the University of California, Berkeley and to French scientist Emanuelle Charpentier. CRISPR/Cas9 functions by taking advantage of a natural, bacteriophage-fighting mechanism found in bacteria. According to an explanatory video by OriGene Technologies, Inc., CRISPR/Cas9 is an improvement upon previous, similarly oriented technologies in that it is less expensive and more accessible. Another notable characteristic is its accuracy, as it can manipulate specific genes more easily than could the other gene-editing mechanisms.
The possible uses of CRISPR/Cas9 are vast in number and implication. As one of many examples, an article published last year in the American Journal of Bioethics, “Germline Manipulation and our Future Worlds,” lists Mitochondrial Replacement Therapy (MRT) in humans as a possibility of CRISPR/Cas9 implementation. While the list of uses goes on, I wish to draw attention to the ethical implications of the proposed applications of this technology.
Although gene-editing tools have the capacity to facilitate innovations and solutions across a wide range of disciplines, the potential for misuse of CRISPR is enormous. CRISPR poses an unprecedented threat because its lower cost and increased accessibility foreshadows widespread use of the technology to select for desirable traits in children, perhaps even at a consumer level, rather than to select against unhealthy, life-threatening traits or to spur progress in biogenetic research. As the definition of “desirable” traits is relative to culture and era, modifying a germline on the basis of a tenuous definition of what is a “good” trait is a dangerous practice not only for the offspring, but for the greater gene pool. Parallel to the direct biological effects are the social consequences of implementing CRISPR at the layman’s level, as portrayed in “GATTACA.” While CRISPR is more affordable than its predecessors, it is not inexpensive; if the the technology were used on human embryos, the capacity of those with better access and financial capability to hand-pick the genetic makeup of their offspring would exacerbate and cement, at a genetic level, the gaping divide between the wealthy and the underprivileged.
Speculating about the potential for CRISPR to cause irreversible damage to our society and to the human race may seem excessive and reactionary in light of the current state of the technology and the potential it has to do good. To address questions about the status of CRISPR and its implementation, we must reference the decision made by the British HFEA (Human Fertilization and Embryo Authority) in February to allow for the use of CRISPR/Cas9 technology on human embryos for research purposes. The technology and its implementation are moving forward at blinding speed, and it is important to make awareness of the technology widespread. When I questioned him about the impact the recent HFEA decision could have on U.S. policy regarding CRISPR regulation, David Magnus, a renowned bioethicist and professor here at Stanford, notes that many people are concerned about “what this will do in an extremely unregulated environment [referencing reproductive medicine in the U.S.].” He feels that is “probably too early to worry” about the effects of the lack of regulation, but that “there are some pretty wild actors out there” with respect to a possible attempt to implement CRISPR to enhance otherwise normal reproduction; therefore, we should be moving quickly toward clear and all-encompassing regulation. As we push for firmer regulation regarding gene-editing technology, it is important that we temper our message by acknowledging that, if properly and carefully used, CRISPR/Cas9 can catalyze the discovery and invention of many previously elusive, albeit sorely needed, solutions.
Contact Alizeh Ahmad at alizeha ‘at’ stanford.edu.