When should scientists proceed with heritable genetic engineering?

Dr He Jiankui, of China, chose the wrong time. In 2018 he announced that he had genetically modified the genomes of three embryos to confer immunity to HIV. There was consternation in the scientific community.

Although stem cell experts believed, for the most part, that genetic modification is not wrong in principle, they criticised He’s experiment for “absence of medical purpose, badly designed protocol, failure to protect research subjects, and lack of transparency,” according to an article in the Journal of Law and the Biosciences by legal academic at Santa Clara University School of Law.

But this is a technology which can do much good, Kerry Lynn Macintosh argues. The wrong response to this controversial development is to declare a moratorium and wait for a broad social consensus.

In a 2019 issue of Nature, Eric Lander, President Biden’s former scientific adviser, proposed a five-year international moratorium. Thereafter individual nations could allow genome editing after “public notice of its intention; international discussion of pros and cons; evaluation of technical, scientific, medical, social, ethical, and moral issues; determination that the use was justified nevertheless; and lastly, conclusion that there was a broad societal consensus on the question of whether to go forward with HGE at all and in favor of the specific use.”

This initiative was never adopted. But the moratorium idea is persistent – and wrong, according to Macintosh.

She contends that “a moratorium plus consensus approach threatens medical progress and should not be adopted”. She proposes instead that government permit closely regulated clinical trials.

The interesting angle of the article is its rejection of the notion of “broad social consensus” because society is subject to cognitive bias:

First, human beings favor the status quo. We are primed to favor human reproduction and the human genome in their current forms and resist HGE. Second, human beings also dwell on negative information. Dr He Jiankui’s unethical and premature experiment encourages us to judge HGE and its offspring harshly. By reinforcing these biases, the proposed moratorium would make it difficult to achieve broad societal consensus in support of using HGE even to correct dangerous mutations. 

These psychological biases will make it difficult, if not impossible, to build a consensus. They are a threat to scientific progress. It is better to rely simply upon expert opinion and government regulation, she suggests.

Is this undemocratic? Macintosh says No. Genome editing is “already subject to democratic controls in the form of the federal statutes that mandate such regulation”. Besides, unless governments permit genome editing, with all due regard for safety and efficacy, the public will never see the benefits. The status quo bias will ensure that there will be no progress.