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Inquiry-Based Essay

Should gene therapy be categorized as a form of eugenics?

The world continues to progress in every direction, whether it is technology and science or politics and war. Time passes yet history loves to repeat itself. Our experiences from the past shape our decisions of the future. The history of eugenics is extensive and is still influencing our actions today. Gene therapy and modern genetics have the potential to save many lives, however, in the wrong hands, they may be abused.

The term “eugenic”, originally suggested in 1883 by Francis Galton, literally means “well-born” (Epstein, 2003). Most of what people do in life has that goal in mind- to have healthy children free of disease with the prospect of leading full and productive lives.  Eugenics, however, goes beyond well-born and introduces a notion of process as well as intention, of what we are willing to do to ensure our children are well-born. “Eugenics” is defined as “the science of improving a population by controlled breeding to increase the occurrence of desirable heritable characteristics” (Fox,2002). Thus, the emphasis on control of genetic properties of future offspring.

The early concepts of eugenics, developed in England, were derived from the belief that the upper social classes were in danger of being diluted by the lower classes. Lower classes had higher birth rates but were allegedly inferior races. Galton’s proposed solution was to encourage breeding of those among the upper class who possessed desirable traits. This quickly took a negative turn when upperclassmen began preventing the reproduction of the “unfit” population by “preventing marriages, sterilization, institutionalization, abortion, and castration” (Epstein, 2003). Quotas were placed on immigration of unfit groups in order to keep them out. This went on for years as the “stigmatization [of] and discrimination” against them continued. These practices spread to other countries around the world (Epstein, 2003).

Eugenics reached its ultimate and most dreadful application, the Holocaust. Nazi Germany lead a full-fledge extermination of the gene pool. Jew, gypsies, homosexuals, mentally ill, epileptics, and others were deemed unworthy and killed. No longer was it preventing the “unfit” from reproducing; it has become removing the undesirable trait altogether (Launis, 2002).

The Nazis’ pseudoscientific justifications were based on their genetic research. The mentally ill carried “hazardous genes” and others had defective sequencing and toxins which tainted the gene pool. For them, Jewish mentally ill patients were unique among victims in that they embodied both “hazardous genes” and “racial toxins”(Launis, 2002).  They believed that those of the Aryan race had an ideal genetic structure. Scientists began to dive into the enhancement of the genetic make-up of Aryans. Athletic performance and an “intelligence gene” were targeted by scientists in order to create an even more ideal generation.  The Nazis’ research were the first attempts at genetic alterations to humans. Today we have the technology to follow through with it, but the question remains. Should we alter our genetic makeup?

Modern gene therapy is designed to introduce genetic material into cells to compensate for abnormal genes or to make a beneficial protein. If a mutated gene causes a necessary protein to be faulty or missing, gene therapy may be able to introduce a normal copy of the gene to restore the function of the protein (Baltimore, 2015). This newly developed technology combines the processes of DNA sequencing and genetic engineering. DNA sequencing involves decoding the line of DNA in a sequence that contains the incorrect gene for a specific function you can target it. A gene that is inserted directly into a cell usually does not function. Instead, a carrier called a vector is genetically engineered to deliver the gene. Certain viruses are often used as vectors because they can deliver the new gene by infecting the cell. The viruses are modified so they can’t cause disease when used in people. Some types of viruses, such as retroviruses, integrate their genetic material (including the new gene) into a chromosome in the human cell. Other viruses, such as adenoviruses, introduce their DNA into the nucleus of the cell, but the DNA is not integrated into a chromosome (Baltimore, 2015).

Gene therapy holds promise for treating a wide range of diseases, such as cancer, cystic fibrosis, heart disease, diabetes, hemophilia, and AIDS. This would increase life expectancy for those suffering with these diseases.

Current gene therapy trials have been conducted on somatic cells. These are the body’s non-reproductive cells. The somatic cells in trials have been introduced to the genome engineering technique known as clustered regularly interspaced short palindromic repeats (CRISPR)-Cas9. This acts as a pair of ‘molecular scissors’ that can cut the two strands of DNA at a specific location in the genome so that bits of DNA can then be added or removed. This compound can be broken down into two sections (Baltimore, 2015). The CRISPR portion is made of a guide RNA. This makes sure that the Cas9 enzyme cuts at the right point in the genome. Cas9 is the actual enzyme that will cut and paste the genetic information. Methods that were tested in mice with liver-based metabolic disease have already proven successful. (Baltimore, 2015).

Some believe that the adoption of genetic alterations should extend to somatic cells only.  There has been a lot of debate on editing our germline cells (reproductive cells).  During the process of in-vitro fertilization designer babies have grown of interest to people.  The initial goal was a prenatal diagnosis to make sure that the child did not have any birth defects. It quickly took a turn for the worst. Designer babies have become a new controversy coming out of genetic modification. A designer baby is an embryo that has been genetically modified (or gene-edited) for the sake of producing a child with specific traits (Oregon, 2019). Hair color, eye color, and other traits would be chosen. There is an ongoing ethical debate about whether it’s okay to actively edit a baby’s genetic traits—and more importantly, how to do so responsibly.

Another form of gene alteration that researchers can do stem cell. Stem cells can self-renew, which means that they need to provide repeated administrations of gene therapy can be reduced or possibly even eliminated. Stem cells can be acquired from adults in small numbers from the bone marrow or fat. David Scadden, Professor of Medicine and Director of the Centre for Regenerative Medicine at Massachusetts General Hospital discussed in an interview that we must establish a cell line with indicators that tell us when specific molecular events occur as well as identifying the stem cell population in adult tissue. The epigenetic memory of stem cells and their specialization gives leeway to programing those specific corrections into them. So far both in-vitro fertilization and stem cell research were theoretical until recently.

Last year China revealed the first-ever gene-edited babies. Following some backlash from the scientific community, Dr. Shoukhrat Mitalipov, Dr. Don Wolf, and Paul Mitalipov co-wrote an editorial discussing why germline gene editing shouldn’t be temporarily prohibited. The Chinese experiment was very premature, and some believe it was ethically irresponsible. More than 30 countries, including China, have regulations and laws put in place prohibiting germline modifications. It is not an issue of banning genetic modification all together; it is concern about how existing regulations should be enforced. Germline gene therapy holds promise in preventing inherited disease and the authors laid down a path for safely bringing this therapy to patients and families through in vitro fertilization (IVF) (Germline, 2019). Governments are placing limitations on research because of public fear.

An article out of Science Daily lists the emerging ethical dilemmas and policy issues regarding science and technology. Gene therapy so far seems like it has benefits that would impact medicine and research globally. However, there are worries that people have when it comes to using these technologies. The science daily article mentions that this information is “sensitive knowledge” and precautions must be taken when discussing how gene editing takes place (University of Notre Dame, 2012). There are also so many unknown variables that risk the patients’ lives. Nature can change and react to anything that we can throw its way. By doing these genetic alterations we could potentially create something worse than the disease we are trying to treat. If the new genes get inserted in the wrong spot in your DNA, there is a chance that the insertion might lead to tumor formation. The knowledge of genetic manipulation creates division amongst people. A leading group of scientists are receiving backlash after reporting that genetic research into athletic ability should be encouraged in both sport and public health. Ethical concerns emerge when differentiating between which genetic makeup has greater athletic ability. The scientists stood by their statements saying that scientists “need to engage in public debates about the potential benefits of their research” (University of Bath, 2007).

One of the main fears that factor into the divide on this topic is that genetic modifications will unlock unethical forms of science. Most people believe that the Nazi eugenics were on the extreme end of the moral spectrum, however, it somewhat parallels with what is happening today. The designer babies contain the “desirable heritable characteristics” which defines eugenics (Fox, 2002). Stem cells can be acquired in very small amounts from the bone however some scientists would take the umbilical cord or placenta of the baby for the stem cells. We should not be “exploit[ing] the whole rest of the created order for [our] own needs” (Reiss, 2001).

Genetic modification seems promising in theory, however, there is too much of a gray area to be sure that this will be an effective form of treatment for patients suffering from diseases. Eugenics is still a fear that is influencing both the people and governments’ decisions. The different ways that genetic modification appears all have the potential of helping others. The issue that arises is the abuse of power. So, should gene therapy be categorized as eugenics? No, it isn’t necessarily eugenics, however, the ability to genetically modify humans should not falls into the wrong hands. Genetic modification needs an ethical guideline agreed upon by researches across the country in order to regulate what is allowed and what isn’t.

Bibliography

  1. Baltimore, David, et al. “A prudent path forward for genomic engineering and germline gene modification.” Science (2015): aab1028. https://science.sciencemag.org/content/sci/early/2015/03/18/science.aab1028.full.pdf?casa_token=xsqkwIc7_PAAAAAA:k0Gz-fQFPKDMSdn_v9YAt6SsS3Yjr9Re-OJKVraLjqwQMXT5Z4t49qS0icp_9ht7TqCYkHPuJY3zO54
  2. Chapman, Anne. “Genetic engineering: the unnatural argument.” Techné: Research in Philosophy and Technology 9.2 (2005): 81-93. https://scholar.lib.vt.edu/ejournals/SPT/v9n2/pdf/chapman.pdf
  3. Epstein, Charles J. “Is modern genetics the new eugenics?” Genetics in Medicine 5.6 (2003): 469. https://www.nature.com/articles/gim2003376.pdf
  4. Fox, Jeffrey L. “Eugenics concerns rekindle with application of gene therapy and genetic counseling.” Nature Biotechnology, vol. 20, no. 6, 2002, p. 531+. Gale OneFile: Health and Medicine, https://link-gale-com.ccny-proxy1.libr.ccny.cuny.edu/apps/doc/A190114551/HRCA?u=cuny_ccny&sid=HRCA&xid=9af53de8. Accessed 10 Oct. 2019.
  5. Launis, Veikko. “Human gene therapy and the slippery slope argument.” Medicine, Health Care and Philosophy 5.2 (2002): 169-179. https://link.springer.com/content/pdf/10.1023/A:1016052122403.pdf
  6. Oregon Health & Science University. “Germline gene therapy: Safety.” ScienceDaily. ScienceDaily, 3 June 2019.

www.sciencedaily.com/releases/2019/06/190603151709.htm.