Should Genome Editing Be Used on Embryos to Prevent Disease?

Editing genes in human embryos, even for research, has always been controversial. Although the scientific community has grappled over the ethics of gene modification, the technology for it has exploded with the invention of CRISPR, a genetic engineering tool that makes gene editing easier and more precise.

Ethics Debate: Bespoke Babies—Genome Editing in Cystic Fibrosis Embryos

Sunday

1:00 p.m. – 2:00 p.m.

Room 33

This advance in technology has placed genome editing on the threshold of clinical use, but there still are many unsettled questions as to its proper utilization and the underlying ethics. For example, should it be used to manipulate DNA in embryos and replace mutated genes that cause genetic diseases?

This is the question that experts will address during the Ethics Debate on Sunday afternoon, when they consider a patient who has cystic fibrosis and wants to have children who are free of the disease.

Thomas A. D’Amico, MD

Thomas A. D’Amico, MD

“This case focuses on cystic fibrosis, but I think that the discussion will go beyond just the specific disease component,” said Thomas A. D’Amico, MD, of Duke University Medical Center in Durham, NC, who will moderate the debate. “The technology of gene editing, with CRISPR becoming available, revolutionizes the management of diseases that have many components, several of which have relevancy to cardiothoracic surgeons.”

Kyle Brothers, MD, of the University of Louisville in Kentucky, will argue that cystic fibrosis genes should be replaced with normal genes in affected embryos, while Mary Devereaux, PhD, of the University of California, San Diego, will argue that cystic fibrosis genes should not be manipulated.

“Often, the Ethics Debate participants are cardiothoracic surgeons, but in this case, we were lucky enough to draw in experts from outside the field who are outstanding scientists and have strong track records on this topic,” said Dr. D’Amico.

The relevant benefits of gene editing include the ability to edit somatic cell mutations, so that if you had a specific disease with a specific mutation, it could potentially be changed with this technology. The debate will revolve around the ethics of how far to go and whether to perform germline editing, as well.

“The drawback, ethically, would be that we shouldn’t genetically manufacture human beings. That’s on ethically shaky ground. But most people would agree that gene editing will play a role in controlling diseases and improving health. The questions are: How far do we take it, and what are the ethical boundaries?” asked Dr. D’Amico.

This is the type of debate that cardiothoracic surgeons won’t hear in any other forum, Dr. D’Amico added.

“This is totally unique. No other courses will cover this in terms of the medical education that is involved. It’s an important CME opportunity about a topic that is cutting-edge and state-of-the-art,” he said. “I think it’s going to be one of the best debates we’ve ever had.”  

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