Gene Editing and CRISPR technologies

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A Few Ethical Questions…

– Should the distribution of genetically modifying technologies be based upon need or equality? 
– Should parents be able to genetically modify their children if the disease is non-emergent? 
– What should the limits of genome editing/gene editing be?

What should the limits of genome editing/gene editing be?

First of all, what is gene therapy:

Gene therapies aim to treat/cure conditions by correcting problems in the persons DNA. DNA contains special instructions for making proteins which are essential for good health. Mutations or changes in the DNA can lead to proteins that do not work properly or that are missing altogether. These changes can cause genetic disorders such as cystic fibrosis, thalassemia, hemophilia, sickle cell disease, and much more. Genetic therapies are approaches that treat genetic disorders by providing new DNA to certain cells or correcting the DNA. Gene transfer approaches, also known as gene addition, restore the missing function of a faulty or missing gene by adding a new gene to the affected cells.

Gene Editing Diagram

The Types of Gene Therapy:

In general, there are two main types of gene therapies… somatic therapy and germline therapy.

Somatic TherapyGermline Therapy
A human gene is placed in a somatic cell (any cell other than a sperm or an egg)A human gene is placed/inserted in a non-somatic cell (either a sperm or egg cell)
Only targeted towards the patient… not their offspringThe corrections made to the disease causing genes are passed on to future generations.

Somatic vs. Germline

Somatic Vs. Germline

Overview: What is CRISPR? How does it work?

Step By Step: A virus invades the bacterial cell, where a new spacer is derived from the virus and integrated into the CRISPR sequence. From there, a CRISPR RNA is formed. Then, the CRISPR RNA guides molecular machinery to target and destroy the virus that entered the cell initially. The initial stages are known as adaptation in which the CRISPR technology is adapting and learning the virus’s special patterns in case the virus comes again. Then, there is the production of CRISPR RNA. RNA is important because it is helps the molecular machines to destroy the virus. Finally, the last steps are the CRISPR RNA that guides the molecular machinery to target and destroy the viral genome. Overall, this is a very advanced type of technology which has the potential to benefit millions of people who suffer from serious illnesses.

How can CRISPR benefit people?

In the Industry:

The functions of the CRISPR system help the industrial processes that utilize bacterial cultures.

In the Lab:

Scientists have learned how to harness CRISPR technology in the lab to make changes in the genes of organisms as diverse as fruit flies, fish, mice, plants, and human cells.

In Medicine:

Due to the many successes in the lab, many people are looking toward medical applications of CRISPR technology. Specifically, many people are looking forward to the time when scientists and medical professionals are able to use CRISPR as a tool for the treatment of genetic diseases.

The ETHICS

Above is a diagram showing countries where gene editing laws are restrictive, intermediate, or permissive. Although legislation and law ethics are very different from bioethical ones, This is a very helpful tool to get an idea about what some countries generally think about gene therapy in general.

Take a look at where you are from and your countries’ view on gene therapy… Do you agree? Let me know in the comments!

“Before genome editing is used in humans, animals, or plants, it is essential that we understand the technical and ethical issues associated with its use.”

Wellcome Sanger Institute

Dr. Sarion Bowers
Policy Lead

4 bioethical principles

Autonomy: To be independent, free, and self-directing.

Non-maleficence: Avoiding and preventing harm to all persons

Beneficence: To provide benefit and advantage.

Justice: Fairness and equity to all; all have access to resources

The key bioethical principles that play a role in this issue are the issue of beneficence and justice. Beneficence is an issue because as these research technologies are still in the preliminary stages, so many of the patients initially will be part of the research as well. Therefore, I believe that it is of the utmost importance that the researchers and scientists who specialize in this area of gene editing ensure that the patients are at least guaranteed to benefit somewhat from the gene therapy. For example, I do not think it is enough to just give them a placebo… If they have a condition that they are hoping to have cured they should be given at least some type of treatment for it. In short, no patient should lose more than they win. Also, it is important especially with the distribution of gene therapy technologies, that the companies and scientists which are distributing and performing these technologies and surgeries are looking out to ensure there are patients who actually will benefit from the technology… Not just that they have the money to afford it. Meanwhile, Justice is also very important in regards to this topic. Maintaining justice especially in the principle of need and equity is a significant part of the discussion as to the methods of distribution for the genetic technologies. I believe that it is pertinent that the distribution is fair and the people who actually need the genetic technologies are receiving them.

Here is a really cool TED talk which discusses whether or not we should continue with gene editing. What do you think?

DISTRIBUTION… is distribution ethical?

The distribution of gene therapy and gene editing technologies is still being discussed today. Many are worried that the issues of equity as it relates to distribution will be overlooked as opportunities for a higher benefit arise.

note: equity is considering how access to knowledge, technology, and resources influence human interactions and understandings of a situation, event, issue, or phenomenon.

This is an important idea especially as it relates to gene therapy. To what extent do you think equity relates to gene editing?

What I think: I think that you could easily relate the concerns of the distribution of gene therapy to the concerns of distribution of the COVID-19 vaccine. For example, there are several countries that have already come forward with concerns that they will not be able to receive the vaccine as soon as more developed countries may be able to. This is a also a concern with gene therapy as there are obviously people in under-developed countries that also need access to theses helpful technologies. This also relates back to the bioethical principle of justice as it is important to make sure that everyone is able to fairly access the technologies. What do you guys think?

COMING TOGETHER…

Now that you all know a little more about the ethical issues behind gene therapies, what do you think? 

Here are a few questions you could answer in the comments below: 

  1. Do you think the pros of gene editing/therapy outweigh the cons? 
  2. To what extent do you think equity relates to gene editing? 
  3. Which ethical principles is the most important when talking about gene therapy? 
  4. What are you most concerned about regarding gene therapy? 
  5. What are you most excited for regarding gene therapy? 

Works Cited: https://docs.google.com/document/d/1YxwD6fMpqwijMtJnT8LMQScpIQhV9z-DTBTATSG_bHc/edit?usp=sharing 

1 Comments

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    Hi Ella! You have a really thorough analysis of the complexities of gene editing and CRISPR. I also agree with your analysis of equity in the context of gene editing. I like how you were able to tie it all back to the general bioethical theory of justice. Good work!

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