Replacement & Augmentation
There are two types of potential genetic therapy. Those in
which defective genes are replaced, and those in which the goal is to add
additional qualities to the individual which lie beyond the normal range of
genetic variation currently found within human populations.
Replacement therapies could, in principle, be carried out in
either germline or somatic cells methods. Somatic cell replacement therapies
have already been used with limited success since 1990, as an experimental
approach for treating several genetic diseases. Ethically such procedures are
no different from other medical technologies that utilize existing systems to
shuttle genes into the existing system. Germline therapy is a type of gene
therapy where new DNA is inserted into cells using a vector, like a virus and
affects subject’s descendants. Germ line therapy is "open-ended"
therapy. Its effects extend indefinitely into the future. It is the genetic
equivalent of the perfect participle in Greek. The new DNA replaces only faulty
DNA to cure genetic diseases but stays in the hereditary offspring. Somatic
cell gene therapy would aim to cure a disease only in the patient. The DNA is
transferred into body tissues. It specifically targets cells in the body which
are not passed on to the person's children descendants.
The ethical and safety repercussions in Germ cell
replacement therapies are much more profound and echo in perpetuity. They are
technically and legally banned and are technically hazardous at present. In
principle the therapy could involve, for example, IVF for parents who are known
carriers of lethal genes, followed by genetic surgery of a defective 4-8 cell
embryo. In practice, however, there would be little point in carrying out such
a procedure, since preimplant diagnosis would be available. In theory it might
seem more acceptable ethically to heal the defective embryo. In practice,
however, Christians who take an ‘personhood at conception’ view of life in very
early embryos (which I do) need to realize that their stance may encourage
development of the DNA technology for manipulation of human germ-line cells,
which could increase social pressure for the use of additive therapies. For
Christians it is a double-edged sword. It cuts both ways.
A futuristic alternative is the screening of sperm and eggs
for defective genes prior to fertilization, followed by IVF using only healthy
gametes. Such an advance could eventually make ethical discussions about
embryos and abortions redundant as the therapy would circumvent the need for
abortions due to genetic defects….as there wouldn’t be any.
Additive therapies, whether at the somatic cell or germ-line
cell level, are currently coming to the fore in things like CRIPSR. The aim of
such procedures would be to add to the individual specific qualities not
already encoded by their genome. Additive therapies therefore represent a very
different set of goals from those which aim to prevent or cure human disease.
Fortunately, the human genome is immensely complex, and numerous genes interact
to generate human capacities in ways that we understand only see in a mirror
dimly. Sometimes injection of these therapies resulted in nothing more than a
bad immunological response in patients. Sometimes, effects are far more
profound. In general, this therapy is hotly disputed and rightfully so.
The view on this type of augmentation/manipulation changes
almost weekly based on the new emerging and ever evolving CRISPR technology.
Not since the atomic bomb has a technology so alarmed its inventors that they
warned the world about its use. Many including the inventor of CRISPER called
for a worldwide moratorium on the use of the new gene-editing tool CRISPR —
that allows humanity to make heritable changes in human embryos. TO literally
cut-n-paste the genome. The cheapest, simplest, most effective way of
manipulating DNA ever known, CRISPR may well give us the cure to HIV, genetic
diseases, and some cancers, and will help address the world’s hunger crisis.
The caveat though is that the tiniest changes to DNA could have myriad
unforeseeable consequences — to say nothing of the ethical and societal
repercussions of intentionally mutating embryos to create “better” humans. This
will literally be a step-by-step, case-by-case ethical/theological
entanglement.
More importantly, the fact that we are now, with our current
genetic aptitude, made ‘in the image of God’ (Genesis 1:26-7) defines what we
are as human and how we are quantified. Accepting the term ‘image of God’ to
refer to all those equalities which distinguish humans from animals, in
particular our spiritual capacity for fellowship with God, the dangers of
trying to add to what God has given us become apparent. If we tinker with this
we’re in deep trouble. The builders of the tower of Babel (Genesis 11:1-9) in
rebellion against God thought that their improved technology would allow them
to reach up to heaven using their own human wisdom, but the result was
confusion (v. 9). I am beginning to see the same happening with genetics
additive therapies absent a theological guiding hand.
The biblical record makes it clear that human pretension to
self-grandeur (or self-augmentation) invariably end in disaster. It is vital
that we do not misuse God’s good gift of genetic engineering to repeat such
mistakes. When man is devoid of God in the overall scheme of things…disaster
occurs. When man contributes with their alignment totally to God…God is
glorified and blessings occurred. Great things can be done to God’s glory. But
the genetic changes should be on a case-by-case basis firmly rooted in
biblical/theological ethics not devoid of them. Just as in the time of the
Levitical priests and the medicinal effects of obedience to the Law, so too I
believe the same principle applies with genetics. If there is a failure to
adhere or stay aligned to this created ‘order’ we would enter a period of the
Judges or judgment.
The stark reality is this. Modern mankind has tried to make
science fully independent of God and therein lies our undoing in this ethical
quandary. It's why we even ask the question, “Should we? Most humanity
realizes that left to their own devices, man is not inherently good. Man needs
a chaperone. A Shepherd. Should it be
done? It could be but it needs to be under firm watchful and knowledgeable
theological principles. Otherwise, no. Otherwise we will create Nephilim,
Frankenstein...or literally…monsters. You see, that’s the main underlying
ethical repercussion of germ line / additive gene augmentation. It can no longer
be confined to an island in time and place. It will ripple outward
indefinitely. The Island of Dr Moreau will no longer be an island…it will be an
entire world.