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TV review: The Big Questions - Should we be striving to eliminate mistakes from the genome? (BBC One, Series 12, Episode 2)

28 January 2019
Appeared in BioNews 984

This episode of 'The Big Questions' starts with just that: a big question. One with no easy answer – which usually signposts an interesting debate. Hosted by Nicky Campbell, an effusive, fair and surprisingly (to me, at least) scientifically knowledgeable presenter, the focus is on the ethics of genome editing, asking if it is 'right' to design babies.

Ah, designer babies; that term that so riles us here at BioNews, but certain other publications love. Well, here was one transgression; I hoped the rest of the debate would be constructive.

For those not familiar with the programme's format, it is remarkably straightforward for modern television: Campbell asks questions. People answer. Campbell directs people to question and answer one another. Debate is had. Things occasionally get (rather gently) heated, and Campbell attempts to calm things down (generally via the tried and true method of talking loudly over the individual in question). Picture Jeremy Kyle, but with ethics on the stage, rather than ailing relationships. And no fights.

I will say now that you, BioNews reader, should watch this while it is on iPlayer. I do have some criticisms, but for 36 minutes of your time (tip – the first half on the programme is dedicated to genome editing), it is a stimulating, well-informed, and often eye-opening debate. Many of those reading are likely to hold a positive opinion of genome editing and its potential future applications in healthcare. You may feel scornful: what can be said here that I don't already know, or haven't already heard?

But unless we want to end up in an echo chamber, we should listen to the opinions of those who do not necessarily agree with our worldview. This programme is an excellent opportunity to do just that, from the comfort of your own living room.

The debate opens by acknowledging the recent case of Dr He Jiankui (see BioNews 977). With his work widely renounced by the academic community, this context that makes it seem more important now than ever to discuss whether genome editing technology can be used in a responsible and positive manner. So I'm glad to see the BBC taking the initiative and organising mature, informed programming addressing this complex subject matter.

A number of voices are heard and opinions aired. The contributors to this episode span experts and lay people; scientists (including BioNews expert contributors, Dr Helen O'Neill and Professor Joyce Harper), advocacy group members, teachers, and students. All with their own different takes on the topic – the programme gives an insight into what genome editing means to a truly broad cross section of society.

During the debate, one individual's suggestion that modifying the genome prior to birth is 'a little too early' highlights a common issue: poor understanding of the complex science at hand.

I raise this not to scorn the individual but because it highlights one criticism I have of this episode: it does not attempt to explain the technology behind genome editing - not so much as an infographic or an introductory paragraph. I understand that this is not the remit of the programme, and is unlikely to be an issue for BioNews readers, but I am concerned it excludes those not already interested from engaging in the debate.

Campbell generally moderates well, allowing time for all sides of the debate to be heard. That said, a significant chunk of the debate is ceded to a single voice: that of 'Don't Screen Us Out', a trisomy advocacy group. Their message is an important one, and I agree with it. 

However, their mission here seems misguided: genome editing is unlikely to ever be used to avoid Down's syndrome, for reasons multiple (covered in BioNews 963 by our own chair of trustees Professor Robin Lovell-Badge). Here Campbell falls down, failing to raise that point. Likewise, there is little acknowledgement of the fact that the technology responsible for screening out already exists, is implemented, and widely used – and has nothing to do with genome editing.

Which leads into a more general criticism: often of the focus of the debate is not on genome editing at all, but instead segues into IVF and NIPT (non-invasive prenatal testing). These technologies have already been widely implemented, and have been debated at length.

Nonetheless, the debate is still valuable. Watch for the end, for a novel argument proposed by a final year medical student: genome editing with CRISPR might be a way of us stopping evolution. New to me – and not one I'm particularly convinced by, given that the potential single change induced would be overshadowed by the 100-200 random mutations introduced every time we reproduce.

And so, this debate ends, and another question is introduced for the second half of the episode: should British museums return the priceless artefacts stolen from other countries? I mean, probably, but I think that's a different review, for a different audience.

This episode of 'The Big Questions' is available for the next two weeks. Engage with the debate while it's still up.

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