Eric Dahl

English 3307
Prof. Thomas Akbari
Unit 3 Final Draft
June 16 2017
The Ethics of CRISPR Technology: Playing God?
Abstract
The CRISPR genome editing mechanism is the most promising breakthrough in human
medicine since the discovery of vaccines. The potential with the CRISPR mechanism is
tremendous, as it may one day lead to medicine for diseases that are considered incurable by
todays standards: cancer, HIV/aids, and other genetic disorders such as autism. However, the
applications of CRISPR stretch much further than cures for disease. CRISPR has the theoretical
potential to edit any aspect of an individuals DNA, including height and eye color, which worry
scientists who envision a world of designer babies. With these new applications of CRISPR
technology come other ethical dilemmas. Accessibility to CRISPR technology based on income
is called in to question. The large gap between rich and poor in capitalistic economies proves that
society is currently unprepared for the revolution in genetics, as differential accessibility to
CRISPR can lead to instability of the world economy. Lastly, some scientists argue to leave
CRISPR research and application limitless, but the most sensible approach remains to prohibit
genomic germline editing for the safety of human evolution. With too much artificial editing of
the human germlines, variability of the human species can decline drastically, leaving the human
race vulnerable to catastrophic disease. This paper will review the potential of CRISPR
technology, explain the danger of germline editing, and assess the ethics behind utilization of
CRISPR.
Keywords
CRISPR: A genetic engineering tool used to artificially edit the base pairs found in DNA.
Acronym for clustered regularly interspaced short palindromic repeats.
Phenotype: The set of observable characteristics of an individual that results from the interaction
of its genotype with the environment.
Palindromic (genetics): A DNA sequence that reads the same backward as forward. Example:
CAGATTAGAC
Somatic cells: Any cell found in a living organism, other than reproductive cells. Also known as
body cells.
Germline cells: Reproductive cells, or gametes. Eggs for females, sperm for males.
Designer baby: A baby whose genetic makeup has been artificially predetermined, especially in
order to eradicate a particular defect or to ensure a particular gene is present.
Gene Pool: The collection of genes in an interbreeding population.
Introduction
Historically, medicine has relied on the modification of secondary systems in the human
body. Vaccines, for example, utilize the memory of immune systems to enable it to destroy more
dangerous pathogens. Until recently, medicine has never successfully modified the inherent
determinant of health: the human genome, or DNA. The CRISPR mechanism is a recently
discovered biological pathway that can be hijacked to edit the DNA artificially and integrate
these edits into a human phenotype. The applications of the CRISPR mechanism is incredible; it
can theoretically be used to cure cancer, HIV/aids, and other genetic diseases. Further, CRISPR
can be used to unlock the true potential of the human genome. It can theoretically allow humans
to retroactively edit genetic information such as height, eye color, metabolism, and more.
However, the incredible potential of CRISPR has led to a wealth of ethical concerns from
scientists all over the world. Debates are ongoing about the purposes for which CRISPR should
be used, and also about who should have access to the benefits of the technology. As CRISPR
becomes more developed and closer to utilization in humans, it is important to consider the
societal impacts of its arrival. This paper will explain the current state of CRISPR technology,
express the consequences of germline editing, and discuss the ethics of using CRISPR in society.
Discovery of CRISPR
In 1993, a researcher named Francisco Mojica set out to describe some DNA fragments
that were altered based on the salt concentration that they were incubated in1. Mojica observed a
very interesting structure one that consisted of palindromic DNA base sequences placed
between DNA spacers. The characteristic palindromic repeats is what led to the mysterious
fragments name: clustered regularly interspaced short palindromic repeats, or CRISPR. Over the
next two decades, Mojica and other researchers around the world vehemently investigated
CRISPR by discovering it in more organisms, describing it genetically, and exploring its
purpose. It would not be until 2012 that the true potential of the mechanism would be uncovered.
Feng Zhang, a researcher for the Broad Institute at MIT, found that CRISPR could be used to
directly edit the DNA of mammalian cells2. Soon after, CRISPR became viral as scientists
around the world began to realize its potential to cure genetic disease. Today, research on
CRISPR continues, as scientists attempt to isolate and excise DNA retroactively.
As CRISPR develops, its potential to cure genetic diseases in mammals is becoming a
reality. HIV-1/AIDS is a sexually transmitted, genome editing disease that has long eluded a
permanent cure. However, in early May 2017, researchers from the Temple University School of
Medicine used CRISPR to cure mice infected with the HIV-1 provirus, an in vivo experiment3.
Duchenne Muscular Dystrophy (DMD) is another genetic disease. Effective from birth, DMD
severely limits muscle growth. DMD affects 200,000 in the US annually, and those affected have
a life expectancy of only 26. In another in vivo experiment with DMD mice, the problematic
DNA was isolated and excised, leading to an effective cure similar to the HIV-1/AIDS
experiment.
Although this research is a huge leap forward in the fight against genetic disease, the
researchers acknowledged that corresponding human cures are still a ways off. The in vivo
efficacy is still a large obstacle; a CRISPR injection with the chosen DNA has only a small
chance of resulting in the desired outcome, as it may unintentionally target healthy areas of DNA
to create dangerous mutations. Due to the lack of precision in outcome, more research is
certainly required before CRISPR can be utilized with high success in human trials. However,
the HIV-1/AIDS and DMD cures demonstrated in mammalian mice prove the potential of
CRISPR technology, and it is a necessity that society start preparing for its future impact.
The Catastrophic Consequences of Germline Editing
The success of the CRISPR/Cas9 mechanism has raised concerns over its use. To achieve
an ethical standard that researchers are expected to adhere, the International Summit on Human
Gene Editing was held on 1-3 December 20155. As members of national scientific academies in
America, Britain, and China discussed the ethical considerations of CRISPR technology, they
agreed on certain limitations of its use6. Of most importance from the summit was the agreement
to draw a distinction between somatic cell versus germline cell genome edits. Whereas somatic
cell genome edits would affect only a single individual, germline genome edits would be
incorporated into the sex cells of an individual, and would thereby be passed down to every
successive generation of that individual.
The ability for man to control evolution with CRISPR is a scary thought, as resulting
limited variability between human genomes could leave the species vulnerable to catastrophic
diseases. For example, one of the key reasons our species survived the Black Death in the 14th
century is because of the variability of genomes from person to person7. During the Black Death,
evolution favored people who carried certain immune system genes. If CRISPR is used to edit
germlines, the variability of the human gene pool will decrease as time goes on, and everyone
may carry the same immune system genes. This opens the door for a Black Death that our
species may not survive. Due to the potential impact that germline genome edits would bring
about on human evolution, the summit agreed that CRISPR would be used in somatic cells only,
effectively limiting the spread of genetic modification to the individual level. Although a rule
that prohibits research on germline editing seems obvious, it is vehemently opposed by some.
George Daley, a stem cell biologist with Harvard Medical School, argues that germline
editing with CRISPR should be allowed as long as it is used in research applications only, not in
clinical applications8. Daley believes that with this exception, using CRISPR to edit germline
cells could answer an array of scientific questions that would increase human knowledge on sex
cells without the detrimental effects on human evolution. Daley believes this knowledge could
one day lead to medicine for sex cells that is not CRISPR based. Daley is correct that limiting
modifications in germline cells to research would preserve the sanctity of human evolution, but it
is likely that this practice will generate a snowball effect, eventually leading to clinical
applications. This is because research into germline modifications will bring legitimacy to its
clinical application, leaving ethics as the last barrier to its medicinal use. Other scientists are
more extreme, arguing that CRISPR research and clinical applications should be left completely
unrestricted due to its potential to wipe out genetic disease and suffering9. Those that advocate
for the unrestricted use of CRISPR are either ignorant to the implications on human evolution, or
are too optimistic about the probability of another Black Death pandemic.
Each argument for where the line should be drawn for germline genomic editing has its
own considerations. The most sensible approach remains to be the approach that prohibits
germline editing altogether. This is by far the safest approach for the evolution of the human
species, while still allowing for eradication of genetic disease through CRISPR edits of somatic
cells. Unanimous agreement within the scientific community is unlikely. Nonetheless, even the
specific editing of somatic cells has been called into debate.
Societal Concerns for CRISPR Utilization
While scientists that are conducting research on the CRISPR/Cas9 mechanism have
agreed to focus on genetic disease, others in society are entertaining the idea of eradicating all
genetic imperfections that could be found in the human genome. Still a facet of the future, the
idea of designer babies refers to the potential that parents could design their offspring, instead
of leaving it to the random chance of biology10. Given the full development of CRISPR
technology, parents could theoretically choose every aspect of their baby including height,
metabolism, race, eye color, hair color, and sex. Designer babies are an obvious ethical
concern. Not only can parents play God in the choosing of their childs traits, but if the
practice becomes widespread enough, designer babies could also contribute to the decrease in
variability of the human gene pool as certain traits are deemed more desirable than others by
society. Only a few countries currently have legislation in place pertaining to genetic
modification in reproduction10. Of the countries that do have legislation on the issue, all have
outright banned it. To ensure the long term success of human evolution, it is important that
legislation against designer babies becomes widespread throughout the globe. Even if used
exclusively in disease related situations, CRISPR presents its own ethical dilemma when
considering its availability.
Like all medicine, CRISPR will likely be limited to use for only patients who can afford
it. It is impossible to accurately predict what the future cost of CRISPR medicines will be, but
gene therapy currently costs an average of one million dollars, with large variability11. As
CRISPR becomes more developed, it is possible that the treatment costs decline drastically.
Whatever the cost, it is imperative that governments around the world allow for equal
accessibility to the medicine, regardless of income. Governments may need to raise taxes in
order to make such subsidies possible, however a gap in accessibility to the medicine based on
income would be detrimental to the stability of the country. Without subsidies, a tremendous life
expectancy increase may be observed for those above a certain income level, while those who
cannot afford CRISPR are left with traditional medicine. As a result, there may be vastly more
death in the lower classes of a capitalistic society. To preserve the sanctity of society as we know
it today, it will be important to establish CRISPR as a universally accessible medicine.
Conclusion
This paper assessed the potential of the CRISPR mechanism, and described the current
state of the technology. Additionally, the ethical implications of utilizing the biological discovery
in medicine were discussed. Thus far, ethical communities have justifiably agreed that CRISPR
is only to be used in somatic cell lines, specifically for cures to genetic disease. For now, this is
the safest approach to the utilization of this powerful technology, and loosening the restrictions
could have catastrophic consequences on the human species. Further, using CRISPR to create
designer babies is not a widespread effort in the scientific community, yet. As CRIPSR becomes
more developed throughout the next few years, however, it will be a problem that society must
face. Lastly, the financial availability of CRISPR as medicine for patients will need to be
considered by governments throughout the world. The ethical considerations discussed in this
paper reveal that CRISPR will require much discussion between scientists, lawmakers, and the
general public. This discussion will be of utmost importance to the implications of the gene
editing technology to the success of human society. While CRISPR presents an array of
difficulties including the possible demise of the human species, it also has the potential to
augment the human species by preventing death from genetic disease and raising the life
expectancy.
Acknowledgements
I would like to dedicate this space for my revision club partners, Eric Jacques and
Abigael Gunther, for their intelligent comments on the rough drafts of this paper. I would also
like to thank Professor Akbari for his knowledge, expertise, and guidance in writing a literature
review paper.
 References
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