04 July 2016
ByAppeared in BioNews 858
TEDx, Tuesday 1 December 2015
Presented by Dr Paul Knoepfler
In the world of genetics and assisted reproduction, the fear of 'designer babies' is one that constantly bubbles under the surface. Paul Knoepfler's TEDx talk 'What if my neighbor's kid was genetically modified?' covers familiar ground as he develops this theme. He sets up a future scenario, set in 2030, in which there is widespread genetic modification (GM) of children to improve their physical and intellectual capabilities.
His set-up is strongly reminiscent of the 1997 sci-fi classic 'Gattaca' - segregation between 'natural' and GM children, unintended side effects, playing god, and eugenics all feature in Knoepfler's talk as he appeals for a moratorium on human genetic modification.
The talk is inspired by two recent developments in genetic technology and assisted reproduction that, according to Knoepfler, could make this dystopian fiction become a reality. The first of these developments is the widespread success of the genome-editing technique, CRISPR/Cas9, that allows for cheap, precise and comparatively simple modifications to the genome.
The second is the recent legal approval given to trials of mitochondrial replacement therapy in the UK. This is a technique that involves replacing the mitochondria from a human egg that would otherwise lead to a child with mitochondrial disease, with healthy mitochondria from a second donor egg.
The combination of these technologies and policies is prompting serious discussion about the legal and ethical implications of allowing modifications to human embryos. These debates revolve around the as-yet-unknown safety of these techniques, the fact that modifications could be passed onto future generations, and the question of what is natural or desirable.
I was struck by the lack of subtlety in Knoepfler's principal argument. He asserts that unless there is a moratorium there will inevitably be widespread uptake of genetic modification to create people with extraordinary intellectual and physical capabilities. He goes on to suggest that GM people will have a number of unwanted traits, such as narcissism and aggressiveness. Finally, he alludes to the eugenics programme of Nazi Germany, and issues a warning that using these technologies risks a return to the divided societies of the 1930s and 40s.
These are strong words but not, in my opinion, strong arguments. Many of the traits that Knoepfler suggests could be added to people at will would require a huge leap forward in our knowledge of genetics to even become possible.
For example, genome-wide association studies have failed to find a single genetic variant that accounts for even one IQ point. This means that to be able to deliberately genetically engineer someone to be more intelligent you would have to alter several thousand as-yet-unidentified genes, with a knowledge of all of the genetic interactions that are affected by the changes so that you don't make any mistakes that harm the child. That would be an enormous leap forward in just 14 years.
His scenario also invokes a strong form of genetic determinism, ignoring the huge impact of a person's environment on such complex behavioural traits. If you wanted to improve your child's chances of having a high IQ, it would make far more sense to do this the traditional way and make sure that they received a high-quality education.
It also assumes that people would want to use this technology for anything other than medical interventions to prevent children from inheriting a genetic disease. There is nothing to suggest that this would ever be legal, or even widely desirable. One of the reasons that IVF is popular is that it allows people to have children that are as genetically related to them as possible. Genetic modification for 'desirable traits' would work against this sense of relatedness, and it's why I doubt that people would choose to use technology in this way.
Should we permit the genetic modification of humans to prevent children from being born with serious medical conditions? On that question I am still undecided. The safety of these techniques is a big unknown, and there's also the question of which diseases and conditions could be targeted. Assuming it is possible, would it only be used for diseases that are fatal, or could there also be modifications to remove predispositions to cancer, for example? Producing a list of conditions that would be permitted for treatment would be challenging and controversial. Finally, there are serious concerns about the cost of these treatments, which could make them unusable within the most healthcare systems.
It is essential that people debate and discuss the moral and ethical implications of new technologies, in particular those that directly affect human health. But lazy arguments about narcissistic, aggressive designer babies simply obscure the real issues, and don't advance that important debate.