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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Interview
Culture
Education
Justice
S&U interviews
8 min read

How justice shaped a world of rights

Historian John Coffey talks about his contribution to a new book: Justice & Rights.

Nick is the senior editor of Seen & Unseen.

A statue of a woman holding a spear in one hand a lightening bolt in the others that reads: 'Droits de  l'homme'.
A French statute celebrating Human Rights.
DDP on Unsplash.

In our networked world old problems, and new ideas to solve them, flash across our minds and screens. It can be a hectic and dis-orientating feeling that occurs when we try to make sense of it all. Whether it's the global order changing or yet another injustice occurring. 

Seeking insights on all this means crossing boundaries, and that’s what over 160 scholars do by sharing with each other. The members of the Global Faculty Initiative (GFI), drawn from all faculties usual in great universities, integrate faith and scholarship through dialogues. They examine the themes of justice, order, flourishing and beauty - mixing subject matter expertise in everything from physics to public policy. 

The GFI has just published the results of one such dialogue in a book Justice and Rights. Among the contributors is Professor John Coffey. His work explores the history of religion and the big ideas like justice and rights. Recently he talked with GFI coordinator Bethan Willis, on its Justice podcast series. Here’s an extract of the discussion that looks at the ‘genealogy of rights.’    

 

Bethan Willis  So, shifting focus now to the question of rights, particularly. So, you talk in your Brief about the genealogy of rights, and in his Theology Brief, Nicholas Wolterstorff makes a case for placing rights at the centre of our understanding of justice, but that's obviously not an uncontested move. And some people would see a focus on rights as problematic, and part of the debate about the legitimacy or the value of rights can sometimes centre around the question of where rights actually come from. So which period in history, which philosophy and vision of human life and justice gives rise to this language. So can you tell us a little bit about that kind of trajectory that you've set out in your Brief , the different points at which people might identify rights as coming to the fore and why that happens and the various interests at play in these discussions of where rights come from?  

John Coffey   So it can be very confusing if you read the scholarship on this subject because if you listen to someone like Samuel Moyne, he will argue that the human rights revolution of the 1970s really invents human rights or maybe grudgingly the 1940s and the conservative statesmen who created the UN declaration of human rights in that period. Others, of course, would root it in the enlightenment. And I guess this is a classic answer. It's the enlightenment and the French Revolution with its Declaration of Rights of Man and Citizen, which is really at the heart of the story of rights. But then early modernists and medievalists pushback, they see natural rights language, the idea of individual subjective rights that one has simply on the basis of one's humanity. These are distinct from legal rights, but they're individual natural rights that they would see this concept emerging in the Middle Ages with canon lawyers and Juris and so on, and then being embraced by various 17th, 16th, 17th century groups up to Locke.  

And I think there are different things going on here. One, of course, is that there are turf wars between historians in different periods who want to draw attention to their period as being really seminal in various ways. People have talked about the revenge of the medievalists, the early modernists and the Renaissance specialists who made so much emphasis on this being a radical break from the dark mediaeval past that mediaevalists have always been keen to push back against that and to point to the mediaeval roots of a lot of modern concepts. But I think there's also more going on here. I think in some ways it's part of a bigger argument about political and to some extent economic liberalism as well, because rights language has been so important for liberals, whether they're talking about politics or talking about economics. So, you have an example of rival genealogies being used for political purposes, if you like, to both problematize and legitimize, right?  

BW  Your work is focused on the contributions that religious groups have made to politics and ideas. And you particularly reference the Levellers in the 17th century and the abolitionists at the turn of the 18th, 19th century. Can you tell us a bit about the contribution that Christians may have made to the development of rights and particularly to the rights of freedom of conscious thought and belief in particular?  

JC  Yeah, yeah. I think it's important to emphasize this because there's also been a long tradition of suspicion of rights language among Christians, especially in the wake of the Enlightenment and the French Revolution. I mean, this has obviously been true in the Catholic church in the 19th century where there was deep suspicion of liberalism and the individualism associated with it and rights language was regarded with a great deal of suspicion by many traditionalist Catholics. But it's also true in Protestant circles as well, among some high Anglicans. But you could see it in the Dutch Calvinist tradition, they founded an anti-revolutionary party after the French Revolution, which is very critical of the political language which emerges from that event. So, it's interesting to see how historians and intellectual historians in recent decades have recovered what you might call the theological origins of rights talk. And that's true of people like Brian Tierney writing about the mediaeval era and showing the kind of seminal influence of various mediaeval theorists of natural law, but also natural rights.  

And certainly, when you get to the period I'm most familiar with from the 17th century onwards, groups like the Levellers are not just talking about native rights or legal rights that they have as Freeborn Englishmen. They're also talking about universal natural human rights that individuals have on the basis of their humanity. And it's in that period in the 17th century that people begin really for the first time to talk about freedom of religion as a natural right. I mean, you don't see that in the Middle Ages. It's a development that emerges within particularly radical Protestantism in the 17th century. Though interestingly, it's also tied to the idea of duties. So because we have a duty to worship God according to our conscience, consciences must be left free and the individual must have a natural right to worship God according to their conscience, because otherwise they wouldn't be able to please God if they just follow the dictates of the state or the state church that they wouldn't be able to worship in a way that's pleasing to God. So, it is interesting the way the argument works. It's theistic grounded in a sense, but it applies not just to Christians, it applies to other kinds of religious worship, to Jews, to Muslims, to heathens and so on. 

And you can see more widely a theological grounding for rights in figures like Locke. And that's encapsulated, obviously famously in the Declaration of Independence, Thomas Jefferson drafted in 1776, that ‘all men are created equal and endowed by their creator with certain inalienable rights’. So, this idea that we have certain rights that we cannot transfer over to the state, that we can alienate them over to the state, they're inalienable, and we have a solemn responsibility before God to protect them. So yeah, I mean, it's certainly by the 18th century, this rights language is absolutely flourishing within Protestant circles, and you can see it being taken up quite significantly in the abolitionist movement in the 1780s, though people are also shying away from it in the 1790s because of the French Revolution and Tom Payne's rights of man and so on. But if you read 19th century American religious abolitionists, people like Frederick Douglas or William Lloyd Garrison or others, they're using the language of natural rights, pretty insistently.  

BC  And it's often to articulate the kind of victim's perspective, isn't it, to defend the weak against the mighty and to say there's a bigger kind of justice that is beyond the state or the law. Is that right? Can you tell us a bit about how that works?  

JC  Yeah, no, I think that's absolutely right, and it's one reason why we should be wary about just tossing, tossing rights language out as some kind of secular poisoning of the, well, a, it does have some deep roots in Christian thought, but it also, rights language is also designed as one of the weapons of the weak, if you like. It's a way to defend those whose claims are often ignored and to assert their human dignity. So, it's why it gets taken up so much by religious minorities, by those who are pushing for widening the vote and suffrage maybe to all men, maybe eventually to women. The anti-slavery movement is using it, and of course, by the 20th century, the Civil Rights movement.  

BC  But as you said, Wilberforce himself doesn't really use this language much, partly because the arenas he's speaking in and partly because of these associations with the French Revolution. Is that right?  

JC  Yeah, and if you look in the 1790s, it's interesting because it's from that period really the language of left and right starts to emerge, and those on the right are very much concerned about law and order. They look across at France and they see disorder and the guillotine and regicide and Civil War and the exile of Catholic priests and so on, and it's extremely alarming for them. So, the emphasis very much shown law and order, and they become extremely alarmed by the way that rights language has been used to undermine order. So, it's classically articulated at that divide between Edmund Burke on the one side and Tom Payne on the other. What's interesting in the British context, is you'll find sort of devout Protestant Christians on both sides of that. So, Wilberforce would be very much on Burke's side in this argument, but the founder of the London corresponding society in the 1790s, a man called Thomas Hardy, he's actually a devout Scottish Calvinist, and he's absolutely on board with this rights language. And so different religious groups will be divided over this. 

 

Follow the rest of John and Bethan's conversation on the GFI podcast.

Global Faculty Initiative resources

Justice & Rights is published by  Langham Publishing. See the link below to order.

The Justice series on the GFI Podcast features six episodes. Listen on Spotify.

Explore the GFI matrix of academic subjects and themes