Scott J. Schweikart
AMA J Ethics. 2019;21(12):E1042-1048.
CRISPR technology has made questions about how best to regulate human genome editing immediately relevant. A sound and ethical governance structure for human genome editing is necessary, as the consequences of this new technology are far-reaching and profound. Because there are currently many risks associated with genome editing technology, the extent of which are unknown, regulatory prudence is ideal. When considering how best to create a prudent governance scheme, we can look to 2 guiding examples: the Asilomar conference of 1975 and the German Ethics Council guidelines for human germline intervention. Both models offer a path towards prudent regulation in the face of unknown and significant risks.
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Beyond this key distinction, the potential risks and consequences—both to individuals and society—of human genome editing are relevant to ethical considerations of nonmaleficence, beneficence, justice, and respect for autonomy and are thus also relevant to the creation of an appropriate regulatory model. Because genome editing technology is at its beginning stages, it poses safety risks, the off-target effects of CRISPR being one example. Another issue is whether gene editing is done for therapeutic or enhancement purposes. While either purpose can prove beneficial, enhancement has potential for abuse.
Moreover, concerns exist that genome editing for enhancement can thwart social justice, as wealthy people will likely have greater ability to enhance their genome (and thus presumably certain physical and mental characteristics), furthering social and class divides. With regards to germline editing, a relevant concern is how, during the informed consent process, to respect the autonomy of persons in future generations whose genomes are modified before birth. The questions raised by genome editing are profound, and the risks—both to the individual and to society—are evident. Left without proper governance, significant harmful consequences are possible.
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