Engineering the Human Germline: An Exploration of the Science and Ethics of Altering the Genes We Pass to Our Children - Hardcover

Hardcover

ISBN 10: 0195133021 ISBN 13: 9780195133028

Publisher: Oxford University Press, 2000

Synopsis

This book explores the many prospects, challenges and ethical questions that surround the engineering of our reproductive cells. It is an accessible, three-part examination, moving from focused, realistic assessments of the promise and problems for this advancing technology to a section of short essays on the implications of our technological ability. Also included is a panel discussion in which leading scientists, ethicists, and public policy workers give voice to their thoughts and concerns regarding our impending genetic technologies. Many world leaders in these fields, including Leroy Hood, French Anderson, Mario Capecchi, Daniel Koshland, Michael Rose, Lee Silver, and James Watson, have contributed to this volume, providing the essential elements of the debate over germline engineering. If you have ever pondered the question: "Would I be willing to genetically alter my own child-to-be, given a safe, reliable technology, offering a tempting possibility?", this book will be an indispensable guide.

About this title

About the Author

Gregory Stock is at UCLA Center for the Study of Evolution and the Origin of Life. John Campbell is at UCLA School of Medicine.

Reviews

Let's dispense with the suspense. This is a short, readable, thought-provoking book that discusses in nontechnical terms the future of humankind in the age of genetic engineering and should be read by anyone who wishes to participate in a public discourse that will shape the future. The central topic is the technology of genetically altering germ-line cells. Altering germ-line cells, which produce ova and spermatozoa, is considerably different from altering somatic cells. Germ-line changes will affect every cell in the body and will be passed on to future generations, whereas somatic-cell changes affect only specific cells within a given organ system and are not passed on.

It is interesting to see the shift in opinion within the scientific community, which previously discounted germ-line therapy, eugenics, and cloning as unachievable and morally suspect. With familiarity, increased understanding, and discussion, many now see these forms of technology as inevitable, and most of the contributors to this book are willing to consider them and some even to defend them.

Germ-line engineering, by providing a means for humans to control and direct the evolution of their species, is another blow to the fading credibility of supernatural explanations of human nature and purpose. Having established humans as inconsequential animals destined to exist only a brief time on a speck of a planet in a huge cosmos, science has left us with the ultimate truism that for humankind, man is the measure of all things.

The book is based on a 1998 symposium and is supplemented with short essays by 17 authors who represent a broad spectrum of expertise and opinion. The organization allows the reader to reach a relatively painless understanding of the technical and societal issues involved. The short-essay format does not allow detailed analysis of the issues or defense of the opinions expressed and may leave the reader wanting more.

The book is divided into three parts. Part 1 consists of reviews of the current state of germ-line engineering. The attempt is to be realistic and practical. Topics covered in this section include the introduction of genes into an existing chromosome and the introduction of an artificial extra chromosome into the gamete. The discussion covers numerous issues, including the need to understand gene regulation and interaction, reversibility, and prevention of generational transmission. The need to increase the interaction between genetics and information technology is emphasized. The consensus is that the technical issues can ultimately be resolved and that the only question is how long that process will take. Whereas Campbell and Stock predict applications in the next two decades, Anderson is more cautious and prefers to envision the development of somatic-gene therapy before a venture into the germ line. The problems with somatic-gene therapy include methods for introducing a fully functional gene into a cell that needs it and for keeping it functional over time. Capecchi suggests that germ-line therapy might be easier to bring to practical application since it avoids these problems. If past experience is any guide, its development may take longer than estimated. We have known the genetic sequence of the sickle cell gene for 20 years and the sequence of the cystic fibrosis gene for more than 10, yet there are no somatic-gene therapies available. These forms of technology, however, will be real and practical within the lifetimes of our children or grandchildren.

In the discussions of this technology, therefore, it is assumed that the procedure is "no more risky in humans than natural conception," and the discussants proceed to analyze what kinds of limits should be imposed on its use. However, it is clear that a few discussants are concerned not with physical risks, but with risks to society and its moral structure. They raise the usual objections to hubris and "playing God" and raise antireductionist objections as well. Most of the participants, however, set aside these objections and are concerned with the question of use.

The initial discussions are in terms of therapeutic or health-related applications, such as ways to introduce resistance to human immunodeficiency virus infection or prevent cancer. Capecchi uses the example of eliminating Huntington's disease. However, the issue of enhancement (i.e., the use of germ-line alteration to enhance desirable natural characteristics) is soon raised. This will be a clear demand as the technology is developed.

Each essayist is asked whether he or she would use an artificial chromosome to extend the life of his or her child. This is an unfortunate choice of question, since it involves the confounding "quality of life" issue. A better choice would have been a question about an intelligence-enhancing gene, which focuses on the use of this technology.

McGee argues that given safety, human germ-line modification is no different from many other efforts of parents to modify their offspring. The issues of increasing the existing inequities in society, the moral status of contingent persons and embryos, and unreasonable expectations of parents are discussed in this context. McGee finds nothing wrong, in principle, with enhancements. As with technology in general, scientific ignorance within society is the greatest threat to the intelligent and ethical application of germ-line modification. Until this problem is rectified, it will be necessary to regulate and control this new and powerful technology. The possibility of international and national regulations is addressed in the last two essays. Humans will develop this technology using their own intelligence; that same intelligence is the only means available to direct and control its use rationally for the development of a new, healthier, happier, and kinder humankind. The species that invented gods is the only one that can emulate them.

George Cunningham, M.D., M.P.H.
Copyright © 2000 Massachusetts Medical Society. All rights reserved. The New England Journal of Medicine is a registered trademark of the MMS.

Edition details

• Publisher: Oxford University Press
• Publication date: 2000
• Language: English
• ISBN 10: 0195133021
• ISBN 13: 9780195133028
• Binding: Hardcover
• Edition number: 1
• Number of pages: 169
• Editor: Stock Gregory, Campbell John