In the nineteenth century, Charles Darwin famously coined the term “survival of the fittest”; a phenomenon in which species most fit biologically to live in an environment would continue to exist and reproduce. The fittest species, he described, were favored by nature for having mutable genes that could amend according to the needs of changing environmental factors, a privilege that could be passed on to further generations. The twentieth century introduced a man-made attempt of creating the fittest species through genetic modification, a process by which foreign DNA could be introduced into a species. The twenty-first century introduced an even more precise attempt for creating a fittest species, gene editing. Gene editing is the process by which the existing DNA sequence of a species is altered by editing the current sequence of DNA or removing parts of the DNA sequence, an approach closer to natural random genetic mutations that can occur in nature over time. One famous tool for gene editing that is gaining widespread attention is CRISPR. The advent of CRISPR introduces questions of affordability and access and how both factors can have serious social consequences.
Currently, the existing application of gene editing involves its use on somatic (non-reproductive cells), guaranteeing those who can afford it a better quality of life. As an example, the first wave of clinical trials on a CRISPR-based sickle cell anemia treatment introduces a procedure estimated to cost USD 2 million. This treatment will likely only be available at limited centers worldwide, limiting its geographical access. There is also a low likelihood of insurance plans covering such an expensive treatment, further restricting access to those who may be most in need but are less fortunate. A more concerning social disadvantage will occur once gene-editing technology on germline (reproductive cells) becomes legal. The ability to genetically edit reproductive cells will result in not only individuals who are more fortunate health-wise but in a whole lineage of individuals who carry a genetic privilege as the change will be heritable. We could ultimately see a more affluent class live even longer and more prosperously throughout generations due to inherent genetic advantages.
A further concern regarding gene editing is the possibility of propagating existing social norms of beauty and racial majority. Racial minorities in a country may opt to genetically edit the DNA in their reproductive cells to ensure that their children look more mainstream in their existing community. Similarly, other individuals may opt to change their germline data to have their children look attractive according to their ascribed norms. The altering of such superficial phenotypes poses an ethical concern regarding embracing physical diversity and the introduction of a possible phenotypical marker of wealth. Specific physical attributes could become known to be attributed to the wealthier genetically modified individuals posing a further social divide.
Policy regulators should deem access to somatic and germline editing for medical purposes as a necessity for maladies which have no cure and for maladies for which the cost of the genetic editing therapy is cheaper than treatment. The use of germline editing for cosmetic purposes should only be made possible after undergoing a psychiatric assessment.
Selwan Al-Eshaiwi is a science enthusiast though she wouldn’t make the best scientist. She sticks to investments instead.
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