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Book Review: GMO Sapiens - The Life-Changing Science of Designer Babies

30 August 2016
By Julian Hitchcock
Counsel, Denoon Legal
Appeared in BioNews 866

GMO Sapiens: The Life-Changing Science of Designer Babies

By Dr Paul Knoepfler

Published by World Scientific

ISBN-10: 9814678538, ISBN-13: 978-9814678537

Buy this book from Amazon UK

Birth rarely benefits those born with serious genetic diseases. PGD provides a tool to avoid the implantation of doomed embryos, but couples may be left childless. Could CRISPR/Cas9, which can correct mutation at or before the zygote stage, provide a solution? Not in the view of the biologist and blogger, Paul Knoepfler. He would prohibit all forms of human genome editing - preferably forever. The title of his book, 'GMO Sapiens - The Life-Changing Science of Designer Babies' implies that genome editing would lead to a dehumanised genus with a toxic moniker. Knoepfler warns readers of 'the possibility of GM people in coming years'; that 'non-sexual means of having children could in future become a preferred and relatively much more common choice for parents-to-be'; and that baby 'production' taking place 'entirely outside the human body' is a serious prospect. He urges readers to 'speak out and take action' to reduce these alarming possibilities.

To arm them, GMO Sapiens doubles as a primer, not only addressing genome editing science, but its historical and cultural context, with extracts from Knoepfler's blog interviews with George Church, Jennifer Doudna and others. He agrees with Julian Savulescu that it is 'important that bad arguments, empty rhetoric and personal interests do not cloud rational thinking', but upbraids him for arrogating reason while failing to appreciate things like gene drives. Knoepfler's own argument begins with the technical nitty-gritty. A chapter devoted to the practicalities of embryonic genome editing is particularly welcome. Editing errors and their effects are catalogued, technical problems (such as how to identify pre-edit sequences and assess post-edit success and mosaicking) are identified, and those genetic diseases having a single defined modification target are distinguished from those requiring simultaneous editing of numerous edit points - which carry a heightened off-target risk. Knoepfler then highlights the consequences of editing mistakes and the improbability of being able to correct them. The genome editing debate needs to consider awkward factual obstacles to clinical applications seriously, so these are helpful reflections written with commendable clarity.

Unfortunately, however, Knoepfler keeps swerving into Wellsian fantasy. He even uses SF to attack the use of CRISPR in embryo research, warning that 'GMO sapiens embryos created in the laboratory solely for experimental purposes could be at risk of intentional "release" if someone misappropriated them and implanted them into surrogate mothers', spreading 'in an insidious manner without us even being aware of it until too late'. The only solution, glooms Knoepfler, is 'reproductive quarantine', failing to mention one obvious alternative - CRISPR. This might inspire a remake of The Island of Dr Moreau, but is misleading in such a highly regulated environment.

Having suggested that embryo editing won't work, Knoepfler warns that capitalists will nevertheless turn a profit by designing, making and selling 'GM people' as if they were customised pizzas - 'toppings would mean your choice of unique traits, selected from a menu' - the inevitable destination of à la carte reproductive technologies such as PGD, 'dating and mating services' and 'baby genetic predictor tools'. Knoepfler is right to identify that genome editing could be used as an instrument of racist, sexist and political choice, and yes, we do know about the Myriads and Monsantos, but assuming the lowest regulatory standards, maligning companies in general and exaggerating the market does nothing to inform debate. Above all, imbuing normal people with the Blade Runner caste of 'GMO Sapiens' reeks of the social discrimination he warns against.

Adamant that children born following mitochondrial transfer will be GMOs, Knoepfler derides those who 'claim that combining the nucleus of a mother-to-be's egg with an entirely new repertoire of mitochondria and hence changing 37 entire mitochondrial genes, should not be called "genetic modification"'. This faux contention allows him to avoid admitting that children whose pathological mutations had been corrected to healthy 'wild' types, whether by mitochondrial replacement or genome editing, would be genetically normal people and that the collective genome of the human race would remain unchanged (except as regards gene frequencies - but should we lament the eclipse of cystic fibrosis genes?) Indeed, he sleights the therapeutic card beneath his transhumanist ace, remarking darkly, 'the collective genome of the entire human race … would be changed and there would likely be no going back'.

Knoepfler is similarly capricious about the latent harms of mitochondrial transfer, bristling that his letter to the UK Parliament, about a Chinese study in which cytoplasmic injection was used for infertility treatment, was dismissed as 'bunk'. It probably was bunk, because the study did not suggest mitochondrial transfer caused harm. Cytoplasmic injection may introduce third party mitochondria, but does not replace those already there. Five embryos were implanted; the fetuses perished in an attempt to reduce their number from three to two. Although the study subjects were older women, a group more prone to producing chromosomal abnormalities, the fetuses were all normal (1). Ignoring these well-known objections, Knoepfler declares that the Council of Europe opposed 'this class of experiments as "incompatible with human dignity and international law"' - which it didn't (see my comments on BioNews 726). Casual readers will probably be taken in, but others will ask why genome editing can't be used to secure human dignity against dehumanising disease. The need for genomic correction is inevitably limited by the impact of PGD, but it's surely a legitimate target for research and possible clinical use.

Superficially, GMO Sapiens is just the annoying grit in the machine that the genome editing debate needs, but readers deserve clearer lines between science, speculation and opinion. Yes, 'the goal of making a "better" human being is highly questionable', but corrective editing merely seeks normality. Correction balances editing risk against the absence of pathological risk, not potential shoe size or skin-glow. Knoepfler ducks the obvious question - which risk are we more willing to bear? - by obscuring therapeutic editing within a capitalist/transhumanist fantasy and demonising feasible applications for which there is clinical need on the basis that improbable applications are susceptible to sordid human instincts. With misanthropy such as this, readers may hope, for Knoepfler's sake, that GM humans really will be better.

Buy GMO Sapiens: The Life-Changing Science of Designer Babies from Amazon UK.

1) The UK does not permit cytoplasmic injection or the implantation of five embryos, because of the risks of multiple pregnancy
Hansard |  24 February 2015
7 November 2016 - by Annabel Slater 
Dr John Parrington thinks the ethics of genome editing should be shaped by scientifically informed public debate, and he hopes his book will provide a starting point...
1 August 2016 - by Anneesa Amjad 
A survey has found that a majority of adults in the USA are worried about the potential use of genome-editing technologies to give children a reduced risk of disease...
25 July 2016 - by Rachel Siden 
Chinese scientists plan to start the first-ever clinical trial of CRISPR genome-editing technology in humans – on patients with lung cancer – this August...
4 July 2016 - by Simon Hazelwood-Smith 
Paul Knoepfler's TEDx talk covers familiar ground – designer babies, segregation between 'natural' and GM children, unintended side effects, playing god, and eugenics all feature in his dystopian vision of a future involving genetically modified humans...
13 June 2016 - by Rhys Baker 
Over just 30 minutes Fergus Walsh has a lot of ground to cover here without even touching on the ethical debate. Yet, while gene editing may have 'just been made simple', how we respond to these stunning advances is anything but...
18 April 2016 - by Simon Hazelwood-Smith 
This book is clearly, if not beautifully, written, and remarkably concise. If you're looking for a 'what's hot in genetics in 2016', it isn't a bad place to start...
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