Medical Ethics Podcast

Gabe and James discuss the efficacy and ethical concerns surrounding CRISPR technology. They explain how CRISPR works by cutting and pasting new base pairs into an organism's DNA. They also discuss the moral concerns of using CRISPR to create designer babies and the potential for genetic perfection. They debate whether using CRISPR is playing God and the importance of balancing scientific advancements with ethical considerations. They mention the unethical actions of a Chinese doctor who used CRISPR on human embryos and the need for ethical research practices. They also discuss the potential use of CRISPR in genetically modifying fruits and vegetables and the use of CRISPR in treating diseases like leukemia and lymphoma. Hello, my name is Gabe, and today James and I will be talking on the issues surrounding the efficacy of CRISPR technology. CRISPR is a tool used in the science world in order to edit the human genome. This technology was a huge breakthrough in research that can be used to possibly cure disease from happening before someone is born. So for the science surrounding CRISPR, CRISPR was discovered in the 1990s when Japanese scientists studying bacteria noticed that there were unique ways of protecting themselves from viruses. So when interacting with a virus, the bacteria would store some of the virus's DNA into its own genome. Thus, when the virus attacked again, the bacteria would be better at defending itself from the virus. So the science behind it, CRISPR can be simplified into cutting and pasting new base pairs into an organism's DNA. It involves the use of guide RNAs to recognize the gene responsible for the diseases of disorders. It uses a Cas9 protein that specifically cuts the DNA and allows scientists to remove it or modify it in any way they deem necessary. CRISPR is also currently being used to modify non-organisms, as it is especially useful for research, but there are many who believe that it could revolutionize human medicine as well. Thus today, me and Gabe will discuss the moral and ethical concerns surrounding CRISPR technology. CRISPR can be used in a way where it could be very unethical. In some senses, people with lots of money who opt to use CRISPR in order to design babies, known as designer babies. This I believe is very unethical because when we're trying to make humans, there's only one way to do it. We think that using designer babies in a way where people are using money to pay for something that should be a natural thing that happens is very wrong. This goes against what Kenan says, and looking at someone for who they are not, not with what condition they may have. There should be unconditional love present towards anybody, no matter what, and there should be no judgment. The payment or possibility of payment for a designer baby goes against the morals of equal opportunity for all because wealthy people have a complete advantage over this technology compared to someone who may not have the monetary needs or have the monetary like necessities available for them to buy a designer baby per se. Another ethical dilemma involving CRISPR is that many see it as a potential way for humans to obtain genetic perfection and thus create a method to prevent diseases before they occur. However, I personally believe that this brings about two moral concerns, which Waters, an author that we have talked about a lot this semester, spoke about in his essay on disabilities. First, obtaining genetic perfection does not make one a better human. Being a good human is not defined by one's genetics, rather human worth is determined by one's ability to coexist peacefully with humanity through virtues, compassion, respect for others. Thus, we shouldn't be finding ways to make humans better animals, we should be working towards making humans better people. A second point that I believe Waters would also have concerns with is that CRISPR, by making efforts to try and prevent disabilities, can actually devalue the humanity of persons with disabilities. While there has been a recent surge in the last 20 years of finding medical techniques to prevent disabilities themselves, this attention can instead be focused on therapies for persons with disabilities. Thus, while it appears these efforts to find methods to prevent diseases have the right intentions, we must be careful to not overlook many of the other important factors that are at play as well. I agree with a lot of the things that you just said. However, I found one thing you said very interesting. When you spoke on we shouldn't be finding ways to make humans better animals, us humans are unique in this world. We have a consciousness and we are able to think in ways most, if not all, other organisms can. By us humans solely focusing on the human genome, we are limiting ourselves in the higher level thinking and progressing in science in a way where we can find cures for cancer or other life-threatening diseases from the outside, using what the earth has given us rather than going from within, using a fairly new technology in the science world to try and stop sickness internally using CRISPR. So as an important distinction and moral concern surrounding CRISPR is obviously monetary value and whether or not perfection is right. So for our second part, we're going to talk about the moral legitimacy of the procedure itself. One of the things that I really base my argument on here is Fulham. In his essay on the virtue of genomics, speaking that there is a presence of virtue being excellence or perfection, he brings up four parts of virtue, courage being the perfection of power and to avoid danger, temperance being the perfection of power of desiring what has been given to us by God, however, the limits bestowed to us should be respected and followed wholeheartedly, justice being the perfection of power of seeking the best outcome for all and prudence being the perfection of power of reasoning. All of these virtues play into a sense of perfection and because of this, there's a line present within virtues of courage with cowardness present versus courage with foolhardiness. I believe that as humans, we are far from perfect and that the use of CRISPR in order to reach said perfection is unethical. We are all created in God's image as brought up in Genesis and because of this, when we would use CRISPR on humans, it would seem like us humans are playing God in creating the perfect human. I like that you brought up Genesis there because Pope Francis in an article to medical scientists or researchers and scientists emphasized that there was that need to not be perfect and there was a need to balance curiosity and skepticism when you are making these scientific advancements and this is something I wholeheartedly agree with. We should absolutely continue to find new methods to cure or prevent diseases but you must be doing it for the right intentions and there's always limits to scientific research, especially research with humans. A great example of intentions and limits to research being disregarded was the Chinese doctor who roughly about five years ago, there was an announcement that he had been using CRISPR technology to create genetically edited babies. So he basically created two twin girls. So for his experiment, he obtained human embryos from couples who were using in vitro fertilization and then he edited the embryo's DNA before the embryos were implanted into the mother's womb. And specifically, the reason he was doing this, he was trying to target a gene that encodes a receptor protein which HIV uses to enter human cells. So basically this Chinese scientist, his goal was to make the embryos resistant to HIV infections. And after 2019, I believe, he, this Dr. He and two of his colleagues were charged and found guilty of illegal medical practices. A main concern was the ethics behind using human subjects for research and because he and his colleagues were so secretive about their processes, there were many concerns about whether their research was performed for the right intentions or for their own fame. According to a New York Times article that spoke briefly on this situation, they use an important quote which I liked. They said that in the pursuit of fame and profit, they deliberately violated the relevant national regulations on scientific and medical research and crossed the bottom line on scientific and medical ethics. While I personally agree that humans should not be edited, CRISPR should not be used to edit humans, especially before birth, how would you respond to this? That's a very interesting point you brought up about He. I want to take this back to Fulham and his virtue for genomics. A little nitpick that he says is the act of curiosity. Fulham says curiosity is the basic desire to seek knowledge and to understand how things work and how their workings can be manipulated. This whole research by Dr. He shows that he has an edge of curiosity towards him, however he used that curiosity in the wrong way. In my opinion, I truly don't believe that the way that he used CRISPR was very ethical. I agree that he should have gone to prison, however I did hear that he has now since been released and he is now working back in that same lab. I also have heard that CRISPR can also be used for genetically modified fruits and vegetables. I personally believe that fruits and vegetables are sacred to this earth and God gave us the earth for fruits and for vegetables to be eaten without the use of CRISPR to genetically modify them and create new organisms or better organisms in that sense. Interesting. So fruits and vegetables, I would personally, while I may not be eating those fruits and vegetables if they were genetically edited, I would not be against this process, especially because the human genome itself isn't what's affected. So for me and for Pope Francis, the main concern was limiting humans' research so that they could protect the human life. So if editing fruits and vegetables is just another way of adding nutrients, I personally would be in favor of this and I think that's one of the things where CRISPR, it has a lot of moral concerns and can be used in different ways. There are also ways of using CRISPR. In one of the classes that me and James have been taking is cellular neuroscience. In that class, we learned about this girl who had leukemia and they used CRISPR technology in order to cure her from her leukemia. I have recently seen a couple articles speaking on CRISPR being used recently in cancers such as leukemia and lymphoma to knock out and help use CRISPR to use gene therapy in order to cure them. Is this something that we believe is ethical? I'm going to ask James about that. Well, from my perspective, while I do think that CRISPR needs to be balanced, I would be in favor of using CRISPR for treating cancers and other diseases because I think the main thing is you shouldn't be preventing the disease, but it can be used as a way for curing it. I could argue that what's the difference between CRISPR versus using radiation to eliminate a cancer. In that way, while we aren't preventing the disease from occurring because a disability does not devalue the human, I do think humans should be doing all that is possible to try to cure the disease. I do believe CRISPR can be used as this sort of therapy. Going back to that, there's another way that there has been science linked to curing cancer and that's stem cell research. How would you compare stem cell research in terms of curing cancer or these diseases and the efficacy of that compared to that of CRISPR? Do you think that CRISPR is the better technology or do you think stem cell therapy is better? When comparing CRISPR with stem cells, I would absolutely prefer stem cells because stem cells you are using the body, especially stem cells that aren't from embryos, stem cells that aren't from human cells or many of the other cells that you can take from the body and that can be used to cure cancers and can be used to cure other disorders. When you compare, for me personally, if you compare CRISPR to stem cells, I would be in favor of using stem cells, but maybe there are patients out there where stem cells aren't an option, where stem cells cannot get rid of the cancer. For them, I do think CRISPR could be used as an option, but another thing is how do we get to that point where CRISPR can be used and where we can be comfortable to be using it in a medical setting? You would need human subjects or do you use subjects on rats or mice or other organisms and then hope that there won't be any side effects in humans compared to those other organisms? There's a big moral concern about how to research and use CRISPR for humans because you can't just incorporate it immediately and hope to see returns. You must find research that shows that it is useful. I think that's one thing that we should have to consider first, but what do you think about using human subjects for CRISPR research? I personally believe that going back to your stem cell therapy, I think there's a difference between the natural and unnatural first and foremost. I think stem cells are sort of natural in terms of we're using our own tissue, our own stem cells, and putting it back into our cells for healing compared to CRISPR where we're going in with a machine, we're editing something, and that's almost the act of playing God. We're playing God. We're trying to make something that's present, not present, and vice versa. Sorry, what was your question again? How would you, if you, are you in favor of using CRISPR at all for human subjects, and if you are, do you think there's a right way to do the research so that humans are trying, are not, are not endangered, I would say? First and foremost, I think that using human subjects is a very big controversial thing, especially in today's day and age when there's so many other animals and subjects that can be used in order to test, such as rats, mice, pigs, even larger animals like monkeys. I think humans should be the last step in testing. There's a lot of experimental procedures that can be done that humans can sign up for. However, I think that those experimental procedures should be done on the rats, the mice, the pigs, the monkeys, first and foremost, before we start testing on humans, just, especially with this new technology, there's a lot of unknowns that are present. So we don't know in 10 years, in 20 years, 30 years, however long it may be, what those side effects may be. Sure, it may help someone in the, right now, but we don't know what the effects could be in the later time. I believe that if the person's truly, truly, is the last hope they have is to have an experimental procedure and use CRISPR to knock out a disease that they may have, fine. But I don't believe that human subjects is very ethical in CRISPR whatsoever. So you would think that for terminal patients, that could be an option where they could almost be used as test subjects. And I know that's done in cancers, where you can be eligible for a new cancer medication, such like that. So you think that could be used for CRISPR, where terminal patients who don't have much time to live, they try to use CRISPR as a means for healing? Yes, I truly believe that. We believe that CRISPR has the potential to be used for good, in an ethical manner as well. Why? Because there are so many uses of CRISPR being unethical and a way to change what we think of humans today, in such a way where we're almost creating cyborgs, and that's my opinion. The editing of the human genome using CRISPR, in my opinion, is taking away a piece of the human and making us genetically modified in such a way where we're losing a piece of ourselves. In this day and age, we're living in a world where having genetically modified organisms such as food has become the norm. I believe that there will be a day and age where this norm will be related to humans. I believe that this will bring a lot of controversy because there's a possibility of good to come out of this, such as what we talked about, stopping fatal diseases such as cancers and other things. However, but on the other hand, diseases and illness is a part of human life. I truly believe that if we're sick, we're meant to be sick. It's part of life. And life's not meant to be easy at all. CRISPR and the use of gene editing software may take away the hardship of life and take away what it truly means to be human.