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The Daily Tar Heel

Opinion: Gene-editing is here. How should it be used?

On Feb. 14, the National Academies of Sciences and the National Academy of Medicine released a report recommending that heritable gene-editing trials in human embryos be permitted to move forward given certain conditions. 

The report is a scientific green light for humanity to start using new technology to address an intransigent subset of disease. It’s also, albeit in a much more limited sense, a go-ahead for us to intentionally alter our own genetic book. That’s a story we should care about.

Our genes play an essential role in determining our health — as well as almost everything else about who we are. They contain the DNA code that guides the development and daily function of our bodies. This code is passed down and reassorted from generation to generation. 

Unfortunately, genes don’t always encode what we would like them to encode. Genetic variants directly affecting only one gene product, as in cystic fibrosis, are enough to cause crippling illness and early death. Single-gene inheritable diseases like these affect 5 to 7 percent of the population.

Gene-editing, especially since the development of the CRISPR-Cas9 system in the last few years, holds the promise to cure such diseases. In some cases, this will not involve changing heritable genetic material. 

For genetic diseases that affect multiple different systems in the body, though, the most effective treatments may involve altering the genetic make-up of all cells (which would mean affecting the genes that are passed on in reproduction as well as those in normal body cells).

The limited applications of germ-line editing — the editing of genes that will be passed to the next generation — recommended by the NAS promise clear benefit in treating awful diseases. Once the era of germ-line gene-editing begins in earnest, though, it’s easy to imagine a rise in the availability of heritable gene-editing for other purposes. People may seek to have their embryos’ genetic material altered not only to prevent genetic disease, but also in the hopes of increasing the athleticism, intelligence or beauty of their future children.

While making changes to personal appearance or fitness is widely accepted (we don’t worry too much about the flaunting of the natural order when people dye their hair or exercise), editing heritable genetic material brings up a whole slew of questions about autonomy and social impact: Is making changes to embryos without their consent OK? What about if such changes will endure as part of the human gene pool?

Just as concerning are questions of access to gene-editing. Such access will almost certainly not be universal, and a gap — one more stark even than our socioeconomic or racial divides — might split our future society into those who have been gene-edited and those who have not been. 

Andrew Niccol’s 1997 sci-fi film, "Gattaca," envisions such a development. Does such a gap bother us? And, if so, can we avoid it while still reaping the benefits of gene-editing?

We don’t know the answers to many of the questions that accompany the coming world of gene-editing. However, we do know that now is the time to begin seeking them as a society. The contents of our genetic compendium — and of history — hang in the balance.

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