CRISPR: A democratizing technology calls for democratic dialogue

By now, you may have read stories about a gene editing technique called CRISPR/Cas9. CRISPR is poised to revolutionize the biological sciences because it’s the most advanced way to precisely change specific sequences of DNA in the cells of people, animals, and plants.

The technology has been hailed for its ease of use, precision, speed, and ability to disrupt or change multiple genes at once (so-called multiplexing). And consider the cost. First- and second-generation gene editing technologies rely on cumbersome and expensive protein engineering approaches.

CRISPR, by contrast, is way cheaper – 100 times cheaper, in some cases. This means that barriers to using CRISPR in laboratories (and perhaps in a neighborhood garage, with the right equipment and know-how) become very low.

Take this together and you have what science policy scholars call a “democratizing technology,” because it puts an advanced set of powerful scientific tools usually reserved for the fortunate, well-funded few into the hands of the interested many. As a result, the gene editing field has exploded. For example, last year STAT News reported that research publications on genome editing increased by 1,453 percent between 2011-2016.

While CRISPR will move science forward in many important ways, the end game is eliminating certain genetic diseases. The idea is to apply CRISPR to the 100 or so cells of an early human embryo carrying a deadly disease such as Huntington’s. Once free of the disease gene, the embryo would be implanted and carried to term.

Because in theory CRISPR can edit every cell in an embryo, the healthy baby – once grown – would not pass the gene on to future generations. But there is much work to be done in order to surmount technical hurdles that make such a procedure fraught with risk, including incomplete editing or inadvertently altering regions of the genome.

How do people feel about this application of CRISPR? Little is known about how the impact of CRISPR maps onto public attitudes. What we do know of public opinion about the prospects of a therapy that would induce a heritable change in a baby is limited to a handful of U.S. and international surveys.

One U.S. study reveals lower support for using CRISPR in ways that would alter the germline, higher support for using it to treat disease in an individual, and some uncertainty about whether we should use it to enhance a person (build bigger muscles, for example) rather than limit its use for medical conditions (such as Duchenne’s Muscular Dystrophy).

Survey data can only tell us so much. Importantly, the U.S. survey demonstrates a clear wish by citizens that scientists and other experts talk to them about CRISPR and other gene editing technologies before making these decisions.

This call, along with similar advice from policymakers across the world, will hopefully result in more democratic forms of dialogue about whether and how we should responsibly adopt these powerful new genetic technologies.

-By Christopher Thomas Scott, Ph.D., Dalton Tomlin Chair of Medical Ethics and Health Policy at Baylor College of Medicine

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