miércoles, 9 de agosto de 2017

One small step for medicine, one giant leap for eugenics | August 9, 2017 | MercatorNet |

One small step for medicine, one giant leap for eugenics

| August 9, 2017 | MercatorNet |

One small step for medicine, one giant leap for eugenics

The first US human gene-editing experiment involves a number of serious ethical issues
David Albert Jones | Aug 9 2017 | comment 

On August 2 scientists published the results of the first experiments conducted on human embryos using the gene editing tool CRISPR/Cas9 in the United States [1]. These experiments have shown greater efficacy in editing embryos than previous attempts.
At first glance, it might seem like efforts to prevent the inheritance of genetic disease, or treat it at an early stage, are a good thing to pursue. Nonetheless, some elements of these experiments – including both methodology and intentions – raise serious ethical concern.
Reproductive exploitation of women
In order to conceive human embryos for these experiments, the scientists needed human eggs. They therefore recruited healthy women who were paid to undergo ovarian stimulation to produce eggs for the research. Ostensibly these women did not “sell” their eggs but were “compensated” for their “time, effort, and discomfort” and presumably also for risks associated with the process.
The ethical concern here is not just whether this practice constitutes buying and selling of body parts and whether such trade fails to respect the dignity of the human body. The greater concern is that women are being encouraged by financial inducements to part with their reproductive potential. The short term risks of ovarian stimulation are well known [2], and in this case the risks were incurred not in the hope that a baby would be born but purely to produce human embryos for scientific research.
Embryonic research subjects
In the present study, embryonic human beings were conceived purely for their use as experimental subjects. They did not exist prior to the research and they were never given any chance of being born or of growing up. From conception, they were appreciated only for their potential usefulness.
The control embryos and the genetically-modified embryos were then disassembled so that their constituent cells could be examined to see whether all their cells were identical or whether they were mosaics. In the process, these human embryos were destroyed and their short lives came to an end.
Eugenic purposes
Part of the purpose of the research was to determine the most effective time to modify the embryo. Hence, in some, the tool that modified these embryos, CRISPR/Cas9, was injected into the egg together with their father’s sperm. In others, the CRISPR/Cas9 was injected into the newly formed zygote, after the mother’s egg had been fertilised by the father’s sperm, but before the cell had begun to divide.
In the first case, which proved more effective, the modifying of the gene was part of the process of conception. The embryo never existed in an unmodified state and so the modification cannot be said to be therapy. It is simply the production of an individual with a desired characteristic or, rather, without an undesired characteristic.
In the second case the embryo exists and is subsequently modified. It might seem, therefore, that injecting the CRISPR/Cas9 is therapeutic for that embryo. It is gene therapy on an individual who just happens to be very young.
However, a key difference between this process and somatic gene therapy is that, here, the very existence of the individual is linked to his or her modification. The two processes, of in vitro fertilisation and genetic modification, are coordinated and are parts of the same plan of action. The embryo is conceived with the intention that it will be modified.
Hence, whichever method is used the aim is the same: to produce a modified embryo.
This aim is the essence of eugenics: not to make people better but to make “better” people. Currently it would be illegal in the United Kingdom to use this technique to produce a genetically modified baby, and the scientists acknowledge that the technique is too risky for clinical use, and that existing techniques for eugenic selection (screening out embryos using preimplantation genetic diagnosis) would have the same effect without the added risks. However, the whole rationale for this experiment is to take a step towards genetic modification as an assisted reproductive technology.
O brave new world
In short, the destruction of dozens of embryonic human beings and the subjecting of women to risks in the selling of their eggs to produce these embryos were not even done for an unambiguously good cause.
Instead of treating existing human beings in ways that respect their rights and do not pose excessive risks to them or to future generations, we are manufacturing new human beings for manipulation and quality control, and experimenting on them with the aim of forging greater eugenic control over human reproduction.
This is not a case of using bad means for a good end, but of bad means to a worse end. Historic examples, not only in Germany but in Sweden and in the United States show vividly how easily programmes for the eradication of defects in the human stock can undermine principles of equality, solidarity and respect for people with heritable conditions. Eugenics involves not only scientific experimentation but social experimentation and we have seen the results of such experiments. They do not end well.
Professor David Albert Jones is the director of the Anscombe Bioethics Centre, in the UK.
[1] Hong Ma et al. ‘Correction of a pathogenic gene mutation in human embryos’. Nature, 2017; doi:10.1038/nature23305.
[2] See, for example, the Royal College of Obstetricians and Gynaecologists’ patient information leaflet on ‘Ovarian hyperstimulation syndrome’, 2016: https://www.rcog.org.uk/globalassets/documents/patients/patient-information-leaflets/gynaecology/pi_ohss.pdf. 33% of women develop mild ovarian hyperstimulation syndrome as a result of ovarian stimulation, while 1% develop it in its moderate or severe form.


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One small step for medicine, one giant leap for eugenics

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