Explainer
Biology
Culture
Ethics
9 min read

Ethics needs to catch-up with genetic innovation

Are we morally obliged to genetically edit?

John is Professor Emeritus of Cell and Molecular Biology at the University of Exeter.

An artistic visualisation of a DNA strand growing flowers from it.
Artist Nidia Dias visualises how AI could assist genomic studies.
Google Deepmind via Unsplash.

It makes me feel very old when I realise that Louise Brown, the first baby to be born via in vitro fertilisation (IVF), will be 47 years old on July 25th this year. Since her birth in 1978, over 10 million IVF-conceived babies have been born worldwide, of whom about 400,000 have been in the UK. Over that period, success rates have increased such that in some clinics, about 50 per cent of IVF cycles lead to a live birth. At the same time, there have also been significant advances in genetics, genomics and stem cell biology all of which, in relation to human embryos, raise interesting and sometimes challenging ethical issues. 

I start with a question: what is the ‘moral status’ of the early human embryo? Whether the embryo arises by normal fertilisation after sexual intercourse or by IVF, there is a phase of a few days during which the embryo is undergoing the earliest stages of development but has not yet implanted into the wall of the uterus; the prospective mother is not yet pregnant. In UK law, based on the Human Fertilisation and Embryology Act (1990), these early embryos are not regarded as human persons but nevertheless should be treated with some respect. Nevertheless, there are some who oppose this view and believe that from the ‘moment of conception’ (there actually isn’t such a thing – fertilisation takes several hours) embryos should be treated as persons. In ‘conventional’ IVF this debate is especially relevant to the spare embryos that are generated during each IVF cycle and which are stored, deep-frozen, in increasing numbers for possible use in the future.  

A further dimension was added to this area of debate when it became possible to test IVF embryos for the presence of genetic mutations that cause disease. This process is called pre-implantation genetic diagnosis and enables prospective parents who are at known risk of passing on a deleterious mutation to avoid having a child who possesses that mutation. But what about the embryos that are rejected? They are usually discarded or destroyed but some are used in research. However, those who hold a very conservative view of the status of the early embryo will ask what right we have to discard/destroy an embryo because it has the ‘wrong genes’. And even for the many who hold a less conservative view, there are still several questions which remain, including ‘which genetic variants we should be allowed to select against?; should we allow positive selection for genes known to promote health in some way?’; should we allow selection for non-therapeutic reasons, for example, sporting prowess?’ These questions will not go away and there are already indications that non-therapeutic selection is being offered in a small number of countries. 

Genetic modification 

This leads us on to think about altering human genes. Initially, the issue was genetic modification (GM) which in general involves adding genes. GM techniques have been used very successfully in curing several conditions, including congenital severe immune deficiency and as part of treatment programmes for certain very difficult childhood cancers. One key feature of these examples is that the genetic change is not passed on to the next generation – it just involves the body of someone who has already been born. Thus, we call them somatic genetic changes (from the Greek, sōmatikos, meaning ‘of the body’).  

Genetic modification which is passed on to the next generation is called germline GM which means that the genetic change must get into the ‘germ cells’, i.e., the sperm or egg. Currently, the only feasible way of doing this is to carry out the genetic modification on the very early embryo. At present however, with just one very specific exception, GM of human embryos is forbidden in all the countries where it would be possible to do it. There is firstly the question of deciding whether it is right to change the genetic makeup of a future human being in such a way that the change is passed to succeeding generations. Secondly, there are concerns about the long-term safety of the procedure. Although it would involve adding specific genes with known effects, the complexity of genetic regulation and gene interactions during human development means that scientist are concerned about the risks of unforeseen effects. And thirdly, germline GM emphasises dramatically the possibility of using GM for enhancement rather than for medical reasons.  

Genome editing 

This leads us to think about genome editing. In 2011, it was shown that a bacterial system which edits the genomes of invading viruses could also work in other organisms This opened up a large array of applications in research, agriculture and medicine. However, the ethical issues raised by genome editing are, in essence, the same as raised by GM and so there is still a universal prohibition of using the technique with human embryos: germline genome editing is forbidden. Despite this, a Chinese medical scientist, He Jiankui, announced in 2018 that he had edited the genomes of several embryos, making them resistant to HIV; two babies with edited genomes had already been born while several more were on the way. The announcement caused outrage across the world, including in China itself. He Jiankui was removed from his job and then, after a trial, was imprisoned for three years; his two colleagues who collaborated in this work received shorter sentences. 

At present the universal prohibition of human germline genome editing remains in place. However, the discussion has been re-opened in a paper by an Anglo-Australian group.  They suggest that we need to develop heritable (i.e. germline) polygenic genome editing in order to reduce significantly an individual's risk of developing degenerative diseases. These includecoronary artery disease, Alzheimer’s disease, major depressive disorder, diabetes and schizophrenia. I note in passing that one of the authors is Julian Savulescu at Oxford who is already well-known for his view that parents who are able to do so, are ‘morally obliged’ to seek to have genetically enhanced children, whether by PGD, GM or genome editing. The use of polygenic editing, which would, in all likelihood, be available only to the (wealthy) few, fits in well with his overall ethical position. Needless to say, the paper, published in the prestigious journal Nature, attracted a lot of attention in the world of medical genetics. It was not however, universally welcomed – far from it. Another international group of medical scientists and ethicists has stated that ‘Human embryo editing against disease is unsafe and unproven …’ and even go as far as to suggest that the technology is ‘… going to be taken up by people who are pushing a eugenics agenda …’ remain very pertinent. 

Harder still and harder 

I have no doubt that amongst different reader there will be a range of opinions about the topics discussed so far. For anyone who is Christian (or indeed an adherent of almost any religious faith), one of the difficulties is that modern science, technology and medicine have thrown up ethical questions that could not have even been dreamed of by the writers of the Bible (or of other religious texts). We just have to use our wisdom, knowledge and general moral compass (and for some, prayer) to try to reach a decision. And if what I have already written makes that difficult, some recent developments multiply that difficulty still more.  

In the early years of this century, scientists developed methods of transforming a range of human cells into ‘pluripotent’ stem cells, i.e., cells capable of growing into a wide range of cell types. It also became possible to get both induced stem cells and natural stem cells to develop into functional differentiated cells corresponding to specific body tissues. This has huge potential for repairing damaged organs. However, other applications are potentially much more controversial. In 2023, Cambridge scientists reported that they had used stem cells to create synthetic mouse embryos which progressed at least as far as brain and heart formation within the normal pattern of mouse embryo development. 

At about the same time, the Cambridge group used individual human embryonic stem cells (from the blastocyst stage of embryonic development), to ‘grow’ early human embryos in the lab. There is no intention to use these embryos to start a pregnancy – indeed, it would be illegal to do so – but instead to study a period of embryo development which is not permitted with ‘real’ human embryos (research must not continue past 14 days of development). But how should we regard synthetic embryos? What is their moral status? For those who hold a conservative view of the normal human embryo (see earlier), should we regard these synthetic embryos as persons? Neither does the law help us. The legal frameworks covering in vitro fertilisation and early embryos (Human Fertilisation and Embryology Acts, 1990, 2008) do not cover artificial embryos – they were unknown at the times the legislation was drawn up. Indeed, synthetic embryos/embryo models are, in law, not actually embryos, however much they look like/behave like early embryos. Earlier this month, the Human Fertilisation and Embryology Authority (HFEA) discussed these developments with a view to recommending new legislation, but this will not dispel an unease felt by some people, including the science correspondent of The Daily Telegraph, who wrote that this research is irresponsible.  

But there is more. In addition to synthetic embryos, the HFEA also discussed, the possible use of gametes – eggs and sperm – grown from somatic stem cells (e.g., from skin) in the lab. Some authors have suggested that the production of gametes in vitro is the ‘Holy Grail’ of fertility research. I am not so sure about that but it is clear that a lot of effort is going into this research. Success so far is limited to the birth of several baby mice, ‘conceived’ via lab-grown eggs and normal sperm. Nevertheless, it is predicted that lab-grown human eggs and sperm will be available within a decade. Indeed, several clinicians have suggested that these ‘IVGs’ (in vitro gametes) seem destined to become “a routine part of clinical practice”.  

The lab-grown gametes would be used in otherwise normal IVF procedures, the only novelty being the ‘history’ of the eggs and/or sperm. Clinicians have suggested that this could help couples in which one or both were unable to produce the relevant gamete, but who still wanted to have children. In this application, the use of IVGs poses no new ethical questions although we may be concerned about the possibility of the gametes carrying new genetic mutations. However, some of the more wide-ranging scenarios do at the least make us to stop and think. For example, it would be possible for a same-sex couple to have a child with both of them being a genetic parent (obviously for males, this would also involve a surrogate mother). More extremely, a person could have a child of which he or she was actually, in strictly genetic terms, both the ‘father’ and the ‘mother’. What are we to make of this? Where are our limits?  

Dr Christopher Wild, former director of International Agency for Research on Cancer, explores in depth many of the developments and issue I outlined above. His article on why a theology of embryos is needed, is clear, well-written, helpful and thought-provoking. 

 

This article is based on a longer blog post with full footnotes.  

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Article
AI
Attention
Culture
5 min read

Will AI’s attentions amplify or suffocate us?

Keeping attention on the right things has always been a problem.

Mark is a research mathematician who writes on ethics, human identity and the nature of intelligence.

A cute-looking robot with big eyes stares up at the viewer.
Robots - always cuter than AI.
Alex Knight on Unsplash.

Taking inspiration from human attention has made AI vastly more powerful. Can this focus our minds on why attention really matters? 

Artificial intelligence has been developing at a dizzying rate. Chatbots like ChatGPT and Copilot can automate everyday tasks and can effortlessly summarise information. Photorealistic images and videos can be generated from a couple of words and medical AI promises to revolutionise both drug discovery and healthcare. The technology (or at least the hype around it) gives an impression of boundless acceleration. 

So far, 2025 has been the year AI has become a real big-ticket political item. The new Trump administration has promised half a trillion dollars for AI infrastructure and UK prime minister Keir Starmer plans to ‘turbocharge’ AI in the UK. Predictions of our future with this new technology range from doom-laden apocalypse to techno-utopian superabundance. The only certainty is that it will lead to dramatic personal and social change. 

This technological impact feels even more dramatic given the relative simplicity of its components. Huge volumes of text, image and videos are converted into vast arrays of numbers. These grids are then pushed through repeated processes of addition, multiplication and comparison. As more data is fed into this process, the numbers (or weights) in the system are updated and the AI ‘learns’ from the data. With enough data, meaningful relationships between words are internalised and the model becomes capable of generating useful answers to questions. 

So why have these algorithms become so much more powerful over the past few years? One major driver has been to take inspiration from human attention. An ‘attention mechanism’ allows very distant parts of texts or images to be associated together. This means that when processing a passage of conversation in a novel, the system is able to take cues on the mood of the characters from earlier in the chapter. This ability to attend to the broader context of the text has allowed the success of the current wave of ‘large language models’ or ‘generative AI’. In fact, these models with the technical name ‘Transformer’ were developed by removing other features and concentrating only on the attention mechanisms. This was first published in the memorably named ‘Attention is All You Need’ paper written by scientists working at Google in 2017. 

If you’re wondering whether this machine replication of human attention has much to do with the real thing, you might be right to be sceptical. That said, this attention-imitating technology has profound effects on how we attend to the world. On the one hand, it has shown the ability to focus and amplify our attention, but on the other, to distract and suffocate it. 

Attention is a moral act, directed towards care for others.

A radiologist acts with professional care for her patients. Armed with a lifetime of knowledge and expertise, she diligently checks scans for evidence of malignant tumours. Using new AI tools can amplify her expertise and attention. These can automatically detect suspicious patterns in the image including very fine detail that a human eye could miss. These additional pairs of eyes can free her professional attention to other aspects of the scan or other aspects of the job. 

Meanwhile, a government acts with obligations to keep its spending down. It decides to automate welfare claim handling using a “state of the art” AI system. The system flags more claimants as being overpaid than the human employees used to. The politicians and senior bureaucrats congratulate themselves on the system’s efficiency and they resolve to extend it to other types of payments. Meanwhile, hundreds of thousands are being forced to pay non-existent debts. With echoes of the British Post Office Horizon Scandal, the 2017-2020 the Australian Robo-debt scandal was due to flaws in the algorithm used to calculate the debts. To have a properly functioning welfare safety net, there needs to be public scrutiny, and a misplaced deference to machines and algorithms suffocated the attention that was needed.   

These examples illustrate the interplay between AI and our attention, but they also show that human attention has a broader meaning than just being the efficient channelling of information. In both cases, attention is a moral act, directed towards care for others. There are many other ways algorithms interact with our attention – how social media is optimised to keep us scrolling, how chatbots are being touted as a solution to loneliness among the elderly, but also how translation apps help break language barriers. 

Algorithms are not the first thing to get in the way of our attention, and keeping our attention on the right things has always been a problem. One of the best stories about attention and noticing other people is Jesus’ parable of the Good Samaritan. A man lies badly beaten on the side of the road after a robbery. Several respectable people walk past without attending to the man. A stranger stops. His people and the injured man’s people are bitter enemies. Despite this, he generously attends to the wounded stranger. He risks the danger of stopping – perhaps the injured man will attack him? He then tends the man’s wounds and uses his money to pay for an indefinite stay in a hotel. 

This is the true model of attention. Risky, loving “noticing” which is action as much as intellect. A model of attention better than even the best neuroscientist or programmer could come up with, one modelled by God himself. In this story, the stranger, the Good Samaritan, is Jesus, and we all sit wounded and in need of attention. 

But not only this, we are born to imitate the Good Samaritan’s attention to others. Just as we can receive God’s love, we can also attend to the needs of others. This mirrors our relationship to artificial intelligence, just as our AI toys are conduits of our attention, we can be conduits of God’s perfect loving attention. This is what our attention is really for, and if we remember this while being prudent about the dangers of technology, then we might succeed in elevating our attention-inspired tools to make AI an amplifier of real attention. 

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