7 Highlights from Nuffield Council’s Review on the Ethics of Genome Editing
Posted by Jessica Cussins, Biopolitical Times guest contributor on October 18th, 2016
The UK Nuffield Council on Bioethics’ recently released report, Genome Editing: an ethical review (full version available here) is the most substantial and thorough assessment of its kind. It delves deeply into the ethical, social, and political underpinnings and implications of genome editing, and touches on related, converging technologies including synthetic biology, gene drives, and de-extinction. A second report with ethical guidance regarding the use of genome editing for human reproduction is due in early 2017 from a Council working group chaired by Karen Yeung
This first report will be an important reference for people across disciplines for some time, and I will not do justice to its scope and breadth here. However, I want to draw attention to just seven concepts that are particularly helpful and illuminating, as much for their framing of the questions at stake as for their content. I briefly summarize each point, and select key quotes from the report.
1. On emerging technology and innovation
Contrary to frequent assumptions, innovation in science and technology is neither linear, autonomous, nor pre-destined. It is continuously co-produced in relation to a complex intersection of actors, institutions, market-drivers, and serendipity. Momentum and sunk costs can however encourage adherence to certain technological pathways, meaning the choice of paths we take should not be undertaken blindly, or lightly.
“A commonplace but now largely discredited perspective viewed science as a resource from which innovators draw, leading to new technological innovations that provide social or commercial benefits, such as increased wellbeing and productivity. The flaws in this ‘linear model’ are generally thought to stem from its failure to give due attention to the complexity of innovation processes, the importance of feedbacks, the role of markets and other actors, and the effects of uncertainty and serendipity. Science now tends to be seen less the wellspring of technological innovation than a ‘co-producer’ along with these other forces and actors.” (15)
“The factors that act to attract, secure and consolidate investment may also have the effect of confirming a course for innovation, creating both ‘lock in’ of contingent technological forms and forward momentum along a particular technological pathway. The reasons for this include factors such as sunk costs, learning effects, increasing returns to scale, high transaction costs associated with any change of direction and the mutual adaptation between technologies and associated conditions of use, including the structure, governance and practice of institutions, and not excluding social conditions, normative rules and standards, and public acceptance.” (18)
2. On the “editing” metaphor
Discussion of “genome editing” as opposed to “genetic modification” or “genetic engineering” has a re-framing effect that serves to distinguish the newer technological capabilities as more “precise,” as well as to diminish their consequences by avoiding connotation with such loaded terms as “GMO.” The “editing” metaphor instead conjures images of easily altered language or computer code.
“Whether intentionally or not, the ‘editing’ metaphor distinguishes the approach from less ‘precise’ forms of genetic ‘engineering’ and, simultaneously, distances it from their associated connotations, including the range of public responses that these terms typically excite. The editing metaphor also plays on characterisations of the genome as the ‘book of life’ containing ‘sentences’ (genes) made up of a ‘genetic alphabet’ of four ‘letters’ (A, C, G and T, the initial letters of the four chemical bases comprising DNA) that were common around the time of the Human Genome Project. The editing metaphor transfers easily to the more contemporary image of modifying computer code. The metaphor suggests not only the type but also the significance of the intervention: it is technical, is not dependent on scale (as it applies equally to changes large or small) and is seen as corrective or improving (at least in relation to the editor’s vision).
“In this way, the concept of editing has a certain thickness, whereby, while apparently descriptive, it implies a tacit evaluative judgement. It also implies an editor (the one who does the editing) and, by deeper implication, may distinguish the editor, who merely corrects and improves, from a putative, creative ‘author’. But whether authorship is assigned to a divinity or not, the implication is that the work of editing is trivial in comparison.” (19-20)
3. On the public interest
Science and technology are intimately connected with the public interest. They are forged through public funding and support, and they act upon and within the world, with impacts on the well-being and welfare of the public.
“There is a public interest in research for at least two main reasons. The first is to the extent that a great deal of research in the academic sector is publicly funded, from money collected through general taxation. This implies a public interest in the fact that this money is spent in a way that reflects public priorities and pursues them with the greatest possible efficiency. The second, more profound, reason is that products and practices, processes and tools produced by the application of knowledge gained through research may have a direct or indirect impact on the wellbeing and welfare of the public (including their moral and social welfare). The public have an interest in science, in terms of its expectation of net social benefits, and invests in science both financially and through the trust placed in scientists to contribute to the delivery of these benefits. But more profoundly than this, the public have an underlying public interest in the overall moral and ethical texture of the society in which they live. How technologies like genome editing are taken up and regulated both reflects and influences the broader moral values on which common social life is based and the social meaning of the practices in question.” (21)
And, quoting from Sheila Jasanoff’s article “Technology as a site and object of politics”:
“…technology, once seen as the preserve of dispassionate engineers committed to the unambiguous betterment of life, now has become a feverishly contested space in which human societies are waging bitter political battles over competing visions of the good and the authority to define it. In the process, the virtually automatic coupling of technology with progress, a legacy of the Enlightenment, has come undone. Uncertainty prevails, both about who governs technology and for whose benefit. No matter which way one looks, the frontiers of technology are seen to be at one and the same time, frontiers of politics.” (21)
4. On normality, moral norms and rights
Should we judge what constitutes an acceptable or unacceptable biological intervention using a concept of what is “normal?” What would that mean and who would decide? What lessons must we heed from 20th century eugenics programs about desires to direct humanity?
“While nature contains many prodigies, the normal can serve to orientate moral action (for example, in terms of whether that action tends to support what is regarded as normal functioning or produce divergence from it). What counts as normal is therefore a legitimate question but often one that is highly contested with regard to the extent to which norms are related to natural states or socially constructed, particularly in relation to issues of disability, medical intervention and enhancement. Disability justice and rights scholars have made a range of moral arguments against selective technologies, from individual rights based arguments such as the right to life of people with disabilities, to arguments for the social and emotional value (e.g. vulnerability to contingency) of biological difference, to the value to humankind of conserving disability cultures, and the importance of the visibility of disability in establishing social attitudes, behaviour, and structures.” (28)
“A particular concern that has been raised is that genome editing combined with social liberalism may facilitate the ‘consumerisation’ of human biology, and the spread of ‘consumer’ or ‘liberal’ eugenics, driven by the choices of parents rather than by state policy, but with possibly similar, socially divisive results. Objections here concern the practice as well as the consequences: that the biological conditions of human existence should not be the subject of choice since they allegedly interfere with identity of the person in morally significant ways.” (52)
5. On social justice and a just society
The advantages and opportunities of science and technology in general, and of genome editing in particular, may not be fairly distributed among different groups, different nations, or across generations. Developments cannot therefore be seen outside of the context of social, intergenerational and global justice.
“Such concerns require us to attend to the need to ensure that measures (such as the introduction of a new biotechnology) that affect welfare do so without discriminating unfairly among people. Although people may be equal in dignity and the enjoyment of rights, they are not equally situated with regard to the benefits and harms of biomedicine and biotechnology. Certain people may be disproportionately affected, may find themselves (perhaps involuntarily) in circumstances that render them particularly vulnerable, or be excluded from access to decision making or to benefits that are available to others. As a result, they may experience unfair discrimination and systematic disadvantage. It is argued by many that dignity and rights discourse is, in fact, insufficient to ground socially just action and that a specifically social justice perspective is called for: they consider it to be essential to put in place means for tracking social justice outcomes over time, and social justice goals in regulation of genome editing technologies.” (29-30)
6. On public policy
Public policy initiatives around genome editing are high-stakes, representing a collective vision of a desirable future, and determining those actions deemed unacceptable to the public interest. Public policy is both reflective of and impactful upon the society in which it functions, and in the world at large.
“As well as forestalling or redressing unjust treatment of individuals, public policy measures both reflect and affect the kind of society in which they are implemented, including the relationship between public and private, how and to what extent different groups and members participate in social life, how different priorities, preferences and values are resolved or tolerated, how equal or unequal in power, status and wealth its members are, and how open or closed the society may be. The features of any society are complex, interdependent and dynamic, but public policy measures often imply and express consistent common values and may be articulated around a collective vision of the desirable future state that they are expected to contribute to bringing about. These, in turn, influence the behaviours, institutions and culture of the society, for example whether it is welcoming or hostile to difference in terms of ethnicity, belief, appearance or ability.” (30)
7. On looking forward
Genome editing is a new development that has garnered enormous excitement. It is important to discuss the impacts of this disruptive new technology, but it will also be useful to avoid inevitability arguments, sky-high expectations, and to remember that it is just one element of a number of larger converging technologies. Future discussions would benefit from beginning with real human challenges or problems, rather than with a technology for its own sake.
“It should be remembered that most prospective technologies fail, and that some lead to undesirable consequences, a fact often obscured by ‘whig’ histories that reconstruct the history of successful technologies and their beneficial social consequences. Scientific discovery and technological innovation is important but not inevitable. Most important among the factors shaping technological development is human agency. It is human agency, in terms of decisions that are made about directions of research, funding and investment, the setting of legal limits and regulatory principles, the design of institutions and programmes, and the desire for or acceptance of different possible states of affairs, that will determine whether, and which, prospective technologies emerge and, ultimately, their historical significance.” (112)
“We are convinced that it makes little sense to treat the questions raised by genome editing as if they belonged to a single field (a hypothetical discipline of ‘genome editing studies’). Rather, they should be addressed as part of different technology convergences (e.g. with ART, with gene drives, with agricultural technologies, etc.), which also includes political technologies (regulation, legislation, etc.). But, more than that, we conclude that it is not the scale at which questions are posed but also their orientation that is important. Beginning with questions about what can be achieved at the genome level risks reducing all questions to ‘ELSI’ questions (questions about the ethical, legal and social implications of genome editing, as if that were the only or most obvious pathway available to address a complex set of real world challenges) and leaving questions about the appropriateness of genome technologies in any given case unaddressed. This is why the next, normative, phase of our work should begin with problems or challenges (and the potential diverse framings of those challenges), rather than technologies, and adopt a comparative methodology.” (115)
Previously on Biopolitical Times:
Image via Nuffield Council on Bioethics
Posted in Assisted Reproduction
, Biopolitics, Parties & Pundits
, Human Rights
, Inheritable Genetic Modification
, Jessica Cussins's Blog Posts
, Synthetic Biology
, The United Kingdom
| 1 comments
CRISPR Embryos at Karolinska: Controversies Demand Oversight
Posted by Elliot Hosman on October 7th, 2016
Rumors have been circulating since 2014 about various research teams around the world applying the genetic engineering tool CRISPR-Cas9 in human embryos. Surprisingly, only two experiments have been officially reported in scientific journals—both of them in nonviable embryos incapable of being used for reproduction, and both out of Guangzhou, China.
CRISPR in viable human embryos
On September 22, NPR’s Rob Stein reported an exclusive look inside the Karolinska Institute in Sweden at ongoing but previously undisclosed work using CRISPR in viable human embryos. Stein had traveled to Stockholm to interview researcher Fredrik Lanner and his colleagues about their program of injecting CRISPR into viable human embryos to “knock out” genes potentially linked to early development. NPR quoted CGS executive director Marcy Darnovsky who cautioned:
It's a step toward attempts to produce genetically modified human beings. This would be reason for grave concern. … If we're going to be producing genetically modified babies, we are all too likely to find ourselves in a world where those babies are perceived to be biologically superior. And then we're in a world of genetic haves and have-nots...
The next day, Hank Greely, director of the Center for Law and the Biosciences at Stanford University, told Eric Niiler in Seeker that there is “good valid medical use” for basic scientific research using CRISPR in embryos, but followed that with a warning:
Still, Greely acknowledges that some scientists or the public might say that the Swedish experiment could be an ethical "slippery slope" toward a gene-edited human. “Even if you don't intend to, it makes it easier for someone else to do it,” Greely said.
Rogue actors: “Bioethics, get out of the way”
While many scientists, scholars, legal experts, and public interest advocates oppose using human gene editing for reproductive purposes, others question why anyone would dare stand in the way. There are longer and shorter answers. Our knowledge of both CRISPR and genetics/genomics is poor—not just on its own terms, but also in relation to other spheres of knowledge, particularly the ways in which they each interact with evolution, environments, public health, and social justice. For the foreseeable future, it would be reckless for a scientist to implant CRISPR-injected embryos for pregnancy not only because of serious safety concerns, but also in terms of democratic governance—especially given the select echelons to which most of the debate is currently restricted, and the range of social and political threats that genome editing poses to the human species.
In Seeker, legal scholar Rosario Isasi of the University of Miami voiced concern about edited human embryos being misused to produce genetically modified humans.
What are the oversight and controls to prevent this technology from being misused and go to a stage that, for now, the scientific community has agreed is a no-go?
In the italics (added) above, Isasi refers to the concluding statement from the International Summit on Human Gene Editing in D.C. in December 2015, in which the organizing committee argued:
It would be irresponsible to proceed with any clinical use of germline editing unless and until (i) the relevant safety and efficacy issues have been resolved…and (ii) there is broad societal consensus about the appropriateness of the proposed application.…any clinical use should proceed only under appropriate regulatory oversight.
Ensuring that researchers work within the bounds of existing national and international prohibitions against heritable genetic modifications in early human cells can be difficult when: (1) commercial and reputational incentives interfere, and (2) rogue scientists exploit basic research for socially and scientifically unsafe ends. Isasi noted in Seeker that the Karolinska Institute has been the venue of an ongoing controversy involving Paolo Macchiarini, a stem cell researcher whose implants of artificial trachea into people led to deaths between 2012 and 2014. Isasi asked:
How did they supervise that [artificial trachea] research, which makes me wonder, what mechanisms were in place to oversee this (gene-editing) proposal [?]
Concerns about end runs or misbehavior by individual scientists have recently grown. On September 27, the news heard ‘round the world was that a fertility doctor based in New York City went to Mexico to use scientifically controversial mitochondrial manipulation techniques to produce a child from an embryo engineered from the DNA of three people. New Hope Fertility Clinic’s John Zhang will take the stage and present the methods used to produce this “three-parent baby” at the upcoming conference of the American Society for Reproductive Medicine, the trade organization for fertility practitioners. The scientific portion of the annual meeting this year is aptly titled: "Scaling New Heights in Reproductive Medicine". It will be instructive to see whether Zhang is met with applause for his “disruptive” and “innovative” foray, or whether his colleagues will criticize the ways he short-circuited public policy and democratic discussions of emerging biotechnology regulations.
Clear boundaries - for some
In an interview with Paul Knoepfler, Lanner noted the existing Swedish policy against using modified embryos for pregnancy:
Swedish law is clear that genome editing is only allowed within the first 14 day[s] as long as the embryo is not transferred back for a continued pregnancy. This means that heritable genome editing for clinical purposes would not be allowed in Sweden. The clear legislation has been key in us moving ahead with these plans…. I’m actually pretty skeptical that the technology will be used for genome editing in the early embryo anytime soon.
The situation in China is different. While that country has regulations that would technically ban gene-edited embryos being used for pregnancy, it is unclear whether these regulations are enforced. On September 24, news emerged out of China that a CRISPR testing facility for genetically modified animals was under scrutiny for “faking inspection records and using students instead of certified technicians to conduct tests.” The testing center was established by the Chinese Academy of Agricultural Science, whose website lists partners including the Gates Foundation and UC Davis. It is a subsidiary of the Chinese Academy of Science which co-sponsored last December’s International Summit on Human Gene Editing with the U.S. National Academies and the UK’s Royal Society. Chief researcher Huang Dafang noted:
The incident has exposed management problems of some similar institutes, and serves as a warning…
Where does that leave the U.S.?
Many across the spectrum of opinion have noted the alarming speed with which CRISPR is being applied in research labs, including to human embryos, outside public scrutiny. Absent consistent laws or guidelines, many are concerned that rogue researchers may conclude that it is “safe enough” to implant edited embryos for pregnancy.
Given the competitive pressures in the world of science, the commercial incentives to be “first to market,” and the forum-shopping inherent to today’s biomedical enterprise, the “three-person IVF” child born in Mexico is a cautionary tale. Someone, somewhere could soon decide to try for a CRISPR baby. We should aim to protect future children from being born stripped of their privacy and guaranteed a life of medical display and tracking that was justified on their behalf to service goals like parental genetic connection.
We need a federal ban on any private or publically funded research aimed at clinical tests of human germline interventions and specifically against the use of gene-edited human germ cells in assisted reproduction. We also need an international conversation on how to pressure the biomedical sector in a range of political contexts to stay away from the human germline.
Previously on Biopolitical Times:
Composite image via Pixabay (lungs), Pixabay (baby silhouette), and Flickr/Lisa Camper (DNA)
Posted in Assisted Reproduction
, Biopolitics, Parties & Pundits
, Biotech & Pharma
, Elliot Hosman's Blog Posts
, Genetic Selection
, Global Governance
, Inheritable Genetic Modification
, Media Coverage
, Medical Gene Transfer
, Other Countries
, Sequencing & Genomics
, US Federal
| 1 comments
Collaborative Science on Historically Burdened Concepts: Intelligence, Genetics, Race & Socio-economic Status
Posted by Daphne Martschenko, Biopolitical Times guest contributor on October 6th, 2016
|Image via Wikimedia: "Lithograph of a North American skull from Samuel Morton's Crania Americana, 1839. Morton believed that intelligence was correlated with brain size and varied between racial groups".|
Intelligence is a highly charged word with ties to racist, classist, and eugenic narratives. In the United States, it has been used historically to assert and establish racial and class hierarchies, especially those between Blacks and Whites, and has long been linked to notions of biological difference.
In the early twentieth century, these notions were frequently explicit. As one example among many, Princeton psychologist Carl Campbell Brigham, creator of the SAT and member of the Advisory Council of the American Eugenics Society, wrote in 1922:
According to all evidence available…American intelligence is declining, and will proceed with an accelerating rate as the racial admixture becomes more and more extensive…There is no reason why legal steps should not be taken which would insure a continuously progressive upward evolution… The steps that should be taken to preserve or increase our present intellectual capacity must of course be dictated by science. (Brigham, 1922: 210)
Even in the years following World War Two, when overt claims of racial differences in intelligence were often muted, Nobel Laureate (in physics) William Shockley could openly argue:
I sincerely and thoughtfully believe that attempts to demonstrate that American Negro shortcomings are preponderantly hereditary is the action most likely to reduce Negro agony in the future… I propose a serious scientific effort to establish by how much the distribution of hereditary potential for intelligence of our black citizens falls below whites…If those Negroes with the fewest Caucasian genes are in fact the most prolific and also the least intelligent, then genetic enslavement will be the destiny of their next generation. (Shockley, 1971: 244)
In June 2000, when the completion of a preliminary sequence of the human genome was announced at the White House, President Bill Clinton famously said,
One of the great truths to emerge from this triumphant expedition inside the human genome is that in genetic terms, all human beings, regardless of race, are more than 99.9 percent the same. (GenomeTV, 2012)
But this did not end debate about race, genes, and intelligence. In fact, many observers have noted that the years following this announcement saw an uptick in claims that race is a biologically meaningful system of classification. In 2005, Francis Collins himself suggested that “we now need to study how genetic variation and disease risk are correlated with self-identified race” (Krimsky, 2011: 25).
Among those who study genetics and intelligence today, the discourse about race is couched in more subtle and humanitarian terms than it was in the twentieth century. Take for example G is for Genes, published in 2013 by behavioral psychologist Kathryn Asbury and behavioral geneticist Robert Plomin. The book advocates for “genetically sensitive” schools that use genetic information to maximize a child’s abilities through a system of personalized learning. In a chapter titled “Mind the Gap: Social Status and School Quality,” the authors discuss the impacts of low-income status, poor parenting, and teacher quality on a child’s success in the classroom. Race is remarkably absent from the picture.
Of course, conscious and unconscious assumptions about links between race and cognitive ability haven’t simply disappeared. Although race is not valid as a biological system of categorization (Cooper et al, 2003), it remains an important causal social factor. Any research that has a history of marginalizing certain groups needs to address race explicitly—both as an inherited colonial system of classification and as a form of social inequality.
Recognizing the detrimental impact of race on an individual’s life circumstances is important for creating meaningful and effective improvements and change. Talking about race as a social factor that shapes an individual’s everyday experiences is a way of challenging vast and recurring misapprehensions that locate race in notions of the biological. Failing to talk about it makes that challenge far less likely to succeed.
Both in the social sciences and hard sciences, discomfort, confusion, and even denial often accompany conversations about intelligence. Each side habitually questions the rigor, benefit, and legitimacy of the other’s work. My own research as a PhD candidate sits between these fields, where the tensions between the two are inescapably clear.
My work focuses on four terms with burdened histories: intelligence, genetics, race, and socio-economic status. I examine how genetics research into intelligence and educational attainment affects the United States education system, where documented racial and socioeconomic disparities prevail and where teacher perceptions of student ability are known to affect student performance and referrals for gifted education programs (Elhoweris et al, 2005; Gillborn et al, 2012; Grissom, 2016; Slate et al, 1990).
On the one hand this means that I’m reading Genome-Wide Association Studies on educational attainment or intelligence, and engaging with geneticists who produce a form of scientific knowledge (Davies et al, 2011; Plomin et al, 2013; Rietveld et al, 2013; Selzam et al, 2016). On the other hand, I’m working with teachers in the classroom who are trying to make sense of why some bodies are less visible in gifted education programs than others (though gaining access in schools has been remarkably difficult, highlighting the charged and controversial nature of this project).
This is terrain on which it should be possible to connect the social sciences to hard sciences. But it is a landscape fraught with competing and underlying political debate. Two of the key questions: Are hard scientists socially responsible for how their work is interpreted and disseminated? Are social scientists truly informed about the science behind the work they often critique?
As an anthropologist, I am aware of the murky origins of my field as a whole—its expansion to legitimize Western colonialism, its use of scientific language and eugenics to validate social hierarchy as naturally occurring and biologically based. Anthropology, like other disciplines, has mobilized the concept of intelligence to maintain racialized matrices of power and hierarchies of inequality.
Scientists, on the other hand, often see their work as separate from social structures and narratives, rather than embedded in them. But insisting on the inherent objectivity of science is dangerous. In the case of genetics research on intelligence, its social impact on the US education system is potentially vast. Those who choose to research the biological basis for intelligence or educational attainment have a special responsibility to recognize this, and to understand its historical and foreseeable pitfalls. Collaborating with social scientists can help to make social implications more clear. While socially neutral research might not exist, socially responsible research certainly should.
Social scientists also have a responsibility. They can understand the methods and techniques of scientific research. And they can engage with geneticists in an open and inquiring manner. Intelligence researchers see legitimate benefits for individuals and society in their work. The social sciences can understand what the argued benefits are and why they are deemed valuable. Having a background in basic genetics and understanding the methodological practices at work in the field can strengthen critiques of the risky assumptions built into the methods and techniques of genetics research or highlight weaknesses in findings.
Scholars working in the hard sciences have faulted the media for misinterpretation, oversimplification, or sensationalism of their work (Asbury and Plomin, 2013: 96). Those in both social and hard sciences have noted that misleading hype often emerges in university press releases associated with the research (Evans, 2016: 11-13). Understanding the conditions and constraints of research, and what published academic journal findings can actually demonstrate, might test whether this is, in fact, the case and keep researchers and public media in check.
Prospects for Reconciliation
So how do we collaborate across the social and hard sciences? And how do we as researchers make our ways through our work detached from personal lived experiences, appearances, and backgrounds that might inform how we look at another discipline? How might we try and set apart our work from the history that precedes it? Is it too dangerous to even try? Would doing so perpetuate systems that marginalize or make peripheral certain groups? I know my experiences as an ethnic minority and my work in the education system with underrepresented groups certainly inform my approach to research; denying this would ignore potential biases I carry.
Whatever collaboration might look like, finding a common language for discussion is paramount. Part of the disconnect between the soft and hard sciences stems from different academic vocabularies and expressions, making one field at times seem like a foreign language to the other. I think, for instance, that hard scientists might have trouble reading this piece, filled as it is with an anthropologist’s lexicon. Creating a shared language centered on the pursuit of knowledge could be one good starting point, since both sides already seem invested in this area in their own way. Shared language that acknowledges the social consequences and historical context of knowledge production would also be enormously beneficial. Together, these sets of common concepts and vocabulary might help bridge the existing divide between the social and hard scientists.
Intelligence. Genetics. Race. Socio-economic status. Using these four words in the same sentence has closed doors for me as a researcher. Each is difficult to talk about on its own—and they’re almost explosive when joined together. Despite this, I strongly believe in combining these concepts through a full range of biological and social science methodologies—and in the value of picking up some diplomacy skills along the way.
Image via Wikimedia
Asbury, K., & Plomin, R. (2013). G is for genes : the impact of genetics on education and achievement, xii, 197 pages.
Brigham, C. C. (1922). A study of American intelligence. Princeton: Princeton university Press.
Cooper, R. S., Kaufman J. S., & Ward, R. (2003). Race and Genomics. New England Journal of Medicine, 348(12), 1166-1170. http://doi.org/10.1056/NEJMsb022863
Davies, G., Tenesa, A., Payton, A., Yang, J., Harris, S. E., Liewald, D.(2011).
Genome-wide association studies establish that human intelligence is highly heritable and polygenic. Molecular Psychiatry, 16(10), 996–1005.
Elhoweris, H., Mutua, K., Alsheikh, N., & Holloway, P. (2005). Effect of Children’s Ethnicity on Teachers’ Referral and Recommendation Decisions in Gifted and Talented Programs. Remedial and Special Education, 26(1), 25–31. http://doi.org/10.1177/07419325050260010401
Evans, J. P. (2016). (Mis)understanding Science: The Problem with Scientific Breakthroughs. Hastings Center Report, 46(5), 11–13. https://doi.org/10.1002/hast.611
GenomeTV. (2012). Human Genome Announcement at the White House (2000). Retrieved from https://www.youtube.com/watch?v=slRyGLmt3qc
Gillborn, D., Rollock, N., Vincent, C., & Ball, S. J. (2012). “You got a pass, so what more do you want?”: race, class and gender intersections in the educational experiences of the Black middle class. Race Ethnicity and Education, 15(1), 121–139. http://doi.org/10.1080/13613324.2012.638869
Grissom, J. A., & Redding, C. (2016). Discretion and Disproportionality: Explaining the Underrepresentation of High-Achieving Students of Color in Gifted Programs. AERA Open, 2(1). http://doi.org/10.1177/2332858415622175
Krimsky, S., Sloan, K., & Council for Responsible Genetics (Eds.). (2011). Race and the genetic revolution: science, myth, and culture. New York: Columbia University Press.
Plomin, R., Haworth, C. M. A., Meaburn, E. L., Price, T. S., & Davis, O. S. P. (2013).
Common DNA Markers Can Account for More Than Half of the Genetic Influence on Cognitive Abilities. Psychological Science, 24(4), 562–568.
Rietveld, C. A., Medland, S. E., Derringer, J., Yang, J., Esko, T., Martin, N. W., Koellinger, P. D. (2013). GWAS of 126,559 Individuals Identifies Genetic Variants Associated with Educational Attainment. Science, 340(6139), 1467–1471. http://doi.org/10.1126/science.123
Selzam, S., Krapohl, E., von Stumm, S., O’Reilly, P. F., Rimfeld, K., Kovas, Y., Plomin, R. (2016). Predicting educational achievement from DNA. Molecular Psychiatry. http://doi.org/10.1038/mp.2016.1075488
Shockley, W. (1971). Negro IQ Deficit: Failure of a “Malicious Coincidence” Model Warrants New Research Proposals. Review of Educational Research, 41(3), 227–248. http://doi.org/10.2307/1169529
Slate, J. R., Jones, C. H., & Charlesworth, J. R. (1990).Relationship of Conceptions of Intelligence to Preferred Teaching Behaviors. Action in Teacher Education, 12(1), 25–30. http://doi.org/10.1080/01626620.1990.10734385
5 Reasons Why We Need People with Disabilities in the CRISPR Debates
Posted by Emily Beitiks, Biopolitical Times guest contributor on September 8th, 2016
This article was cross-posted on Disability Remix, the blog of the Paul K. Longmore Institute on Disability at San Francisco State University.
Maybe you haven’t heard of CRISPR-Cas9. To be honest, if I hadn’t previously worked at the Center for Genetics and Society, I probably wouldn’t have heard of it either. It’s a new genetic technology that brings modification of the human germline closer in reach than ever before.
Driven by the promise of allowing parents to avoid passing on incurable genetic diseases to their offspring, the use of CRISPR to engineer human embryos presents serious risks with particularly strong implications for people with disabilities—in the present and future. It’s been getting plenty of press. And yet, as someone who tries to stay up to date constantly with what’s trending in the disability social media scene, it has seemed to me that CRISPR has been more or less absent.
Why aren’t people in the disability community talking more about this?
Why should people with disabilities have to keep spending their time justifying their existence rather than just enjoying it at present?
I recall a conference I organized with the Longmore Institute in 2013, “Future Past: Disability, Eugenics, and Brave New Worlds.” Disability studies scholar and activist Marsha Saxton began her panel by sharing a memory of talking with a genetics counselor while contemplating getting pregnant. The counselor exclaimed, “Gee, if I’d have known Spina Bifadas turned out as well as you, I would not have recommended selective abortion as much as I’ve done!”
Similarly, a conversation comes to mind that I had with another disability activist, who previously focused on the neo-eugenic uses of genetic technologies but left because she was burnt out. As a person with a disability, she didn’t want to continue spending her life’s work validating her own existence, and moved into the arts instead to celebrate the beauty that disability brings.
Despite the disability rights movement’s progress, both of these stories help illustrate why people with disabilities might not want to waste their time thinking about these issues. Indeed it suggests that my own lack of understanding of why people with disabilities aren’t more interested in following this comes from a place of privilege as a nondisabled ally. It seems that for many, engaging in the debate is just too hurtful. Why should people with disabilities have to keep spending their time justifying their existence rather than just enjoying it at present?
Yet when it comes to CRISPR for human reproduction, disability is at the center of it all. Whether or not CRISPR takes hold in the fertility clinic, the scientific and philosophical debate is constantly centered on disability. So here are five reasons why CRISPR and disability are dangerously intertwined, exemplifying why we need the perspectives of people with disabilities weighing in on this debate, as unappealing as diving in may be:
- Modern-day eugenics. For me, it’s pretty much that simple… and that scary. Advocates of using CRISPR for heritable genetic modification argue that we can distinguish to ensure this is only used for deselecting genetic diseases (“germline therapy”), rather than using the technology to select for more desired traits (“enhancement”). But even this binary presumes we can draw clean lines to eliminate diseases that don’t also suggest preventing disabilities. It brings up questions of what we should and shouldn’t value in future generations. Knowing that these choices are being made in a deeply ableist culture—where people like Marsha Saxton would likely not have been born because of fear of the “spina bifidas”—illustrates how hard it would be to draw lines about what genetic diseases “we” agree to engineer out of the gene pool and which are allowed to stay.
- We are moving backwards. Even as opponents of CRISPR germline modification make their case, it often hinges on the idea that we don’t need CRISPR because we already have preimplantation genetic diagnosis (PGD) to allow parents to have children free from genetic abnormalities. However, disability advocates still contest PGD as socially harmful genetic selection and disability prevention. The Center for Genetics and Society’s Executive Director Marcy Darnovsky recently shared with me that when she points out this tension to the press, they rarely if ever include it.
- It’s selling disability as tragic. This isn’t new. It’s how preimplantation genetic diagnosis was sold. It’s how stem cell therapy was sold. Before we even develop the technology, we develop the story: people with disabilities are living a sad, tragic existence, and only through progress in the genetic sciences can we spare their suffering in future people. This tragedy gets retold and retold, creating urgency for the technology in question: Forget the vibrant disability community. Forget the changes in technology, art, and culture that people with disabilities bring to our world from the insights of living with a disability. We don’t have time to worry about ethics or risks! Selling the need for the cutting edge technology comes on the backs of people with disabilities, so science policy and debates become one more place where the tired trope of disability as “the worst” thrives.
- Nondisabled people won’t get it unless people with disabilities are part of the debate. Nondisabled proponents are arguing we need to use CRISPR to prevent disabilities. Nondisabled opponents suggest we should be wary of CRISPR for its threat to disability justice. Both sides are talking about disability, but the conversation would carry more weight if disability activists were involved.
This is why the work of disability activist and writer Harriet McBryde Johnson was so powerful. In a series of conversations with philosopher Peter Singer, one of the most outspoken advocates of preventing children with disabilities from being born, McBryde Johnson put a face to his theoretical exercises and argued that they had life or death consequences for people like her. (Still image via Vimeo)
When I share my interests in these sorts of debates, I often get this wave of enthusiasm from other nondisabled people who seem to find it fun to sit around and discuss how much better the world would be if we could prevent or cure all disabilities. They want to talk it out through thought experiments and philosophical exercises. I mean no disrespect to those who think that way. After all, I’m married to someone with a philosophy degree, and some philosophers with disabilities have made important contributions to the way disability is theorized in ethical debates (e.g. Adrienne Asch and Anita Silvers). However, I think the debate needs more perspectives and personal stories coming from people with disabilities who help us to attach faces and lives to the debate and to remind us what a loss it would be to live in a world with less disability.
(At the 2015 National Academies' International Summit on Human Gene Editing, the conversation did not include any featured speaker open about being a person with a disability. There were efforts to invite one or two, and Ruha Benjamin did give a wonderful presentation which you can view here, but the omission was startling.)
- It impacts the fight for disability equity today. When cures and the end of disability are always cast as “just around the corner,” it continues to make it harder to fight for what we need today. We continue to invest millions of dollars on anything that might help us eliminate disability. Meanwhile people with disabilities struggle to implement things to make our society more accessible right now, as these social changes are always framed as “too costly.” This doesn’t mean that we need to be entirely anti-cure and certainly not anti-research, but again, we need people with disabilities to play a central role in this debate. A diversity of voices speaking to their experiences with disability can teach us that we don’t need CRISPR to “solve” the disability = tragedy equation. Social changes to the built environment and cultural changes to discriminatory attitudes are a safer bet with more widely shared impacts.
2017 will mark the 20th anniversary of GATTACA’s release, a film which brought to the big screen issues of genetic discrimination resulting from the effort to control human reproduction (for a great disability take on it, read here). The “not too distant future” imagined in the film grows closer with CRISPR. I wish I could just turn away from CRISPR to hope it’ll pass over—I far prefer spending my time on our disability film festival or promoting disability history. Yet disability culture and arts are more related to CRISPR than one might think. They provide a powerful illustration of how disability enriches our world. It just might be worth making time for the CRISPR debates (even though the emotional labor of doing so is huge), to help ensure a long-term future for disability as a creative and generative force.
Emily Beitiks is Associate Director of Paul K. Longmore Institute on Disability at San Francisco State University, and a former staffer at CGS. Beitiks earned her Ph.D in American Studies from the University of Minnesota with the dissertation "Building the Normal Body: Disability and the Techno-Makeover".
Previously on Biopolitical Times:
Image via Wikimedia
Posted in Assisted Reproduction
, Biopolitics, Parties & Pundits
, Civil Society
, Emily Beitiks' Blog Posts
, Genetic Selection
, Inheritable Genetic Modification
, Personal genomics
, Reproductive Justice, Health & Rights
, US Federal
| Add a comment
To Err is Biotechnological: Reflections on Pew’s Human Enhancement Survey
Posted by Gina Maranto, Biopolitical Times guest contributor on August 9th, 2016
|Deep brain stimulation, image via Wikimedia.|
Permit me a brief digression before I comment on the latest Pew Research Center survey of Americans’ attitudes toward biomedical technologies meant to “enhance” human performance.
I am married to a bioengineered man. Almost three years ago, after having been steadily eroded by Parkinson’s disease for over a decade, my husband Mark Derr braved deep brain stimulation (DBS) surgery. His incredible surgical team at Johns Hopkins implanted electrodes into his brain and a battery-driven stimulus device in his upper left pectoral, and the results seemed, at the time, nothing short of miraculous. With a mere incremental upping of the voltage during an initial adjustment session, the DBS instantaneously stilled Mark’s tremulous hand and foot, giving him relief that the standard drugs had only intermittently provided.
Much as DBS has improved his quality of life, Mark is far from cured. DBS cannot address the muscle stiffness, balance problems, and neurological pain he experiences daily. And the instrument requires constant attention. Mark’s days consist of frequent monitoring of his device; his weeks, of periodic adjustments of the voltage; his months, of consultation with his medical minders in Baltimore, where he travels every five months or so for “tweaking.” His latest technician there told him, “You are your own experiment.”
Based on direct experience, then, I would advise that heady promises regarding biotechnology should be viewed with a high degree of skepticism. DBS, for example, may eventually get better at addressing Parkinson’s symptoms, but cannot reverse the neuronal damage that lies at the base of the disease. Many other biotechnological interventions also carry with them an almost guaranteed set of deficits, inadequacies, inconveniences, and risks that are conveniently ignored in the valedictory narratives woven around them.
More profoundly, Mark both is and is not the Mark he was before DBS, and questions of how identity or even soul are altered by such technologies are only rarely addressed. (For excellent examples where they are, check out Françoise Baylis’s, “'I Am Who I Am’: On the Perceived Threats to Personal Identity from Deep Brain Stimulation” and Sherry Turkle’s edited volume, The Inner History of Devices.)
In some ways, the Pew survey, which looked at attitudes toward three hypothetical “enhancements” (although one, which would involve genetic enhancement of future children, is presented as a preventative medical measure), suggests that Americans get that biotech interventions raise profound social and ethical questions. In the chart below, more respondents said they were concerned rather than enthused about fiddling with babies’ genomes, following in the footsteps of Johnny Mnemonic, or engaging in blood doping squared. Not only did most of those surveyed expect that the cons would outweigh the pros of such interventions, a majority believed such interventions “could exacerbate the divide between the haves and have-nots in society…[and that] inequality would increase because only the wealthy could afford these enhancements.”
[Figure via Pew Research Center]
But Pew itself seems oddly disposed to undercut its own findings in the large accompanying piece probing “expert” opinion on enhancement in general. David Masci, in “Human Enhancement: The Scientific and Ethical Dimensions of Striving for Perfection,” seems to take the side of the pro-enhancement champions, giving ample play to the “sky’s the limit” point of view of self-avowed transhumanists and giving the final world to a futurist who says, “We’ll probably start by taking a human version of nirvana and creating it in some sort of virtual reality,” and then “we’ll transition to realms of bliss that we can’t conceive of at this time because we’re incapable of conceiving it.” Masci also strives to normalize enhancement, starting his piece with the claim that, “Human enhancement is at least as old as civilization.”
This claim, often advanced in pro-enhancement camps, suggests that education and exercise are equivalent to chips in the brain or performance enhancement through genetic alterations that would increase, say, fast twitch muscles. Call it argument by sleight of hand or by failure to make proper category distinctions. If we really want an accurate analogy, we should think about phase changes: water becomes colder and colder, and then becomes ice. A quantitative change leads to a qualitative change. Step by step, biotechnologists alter us; at a certain point, a qualitative change ensues. We cannot perfect the human; we can only push genes and protoplasm past a certain point—and no one quite knows where it lies, but many have agreed that the germline is certainly one clear and present possibility—and we will have crafted a new entity. But to what purpose is questionable.
Instead of leaving a person’s physical well-being to the vagaries of nature, supporters of these technologies contend, science will allow us to take control of our species’ development, making ourselves and future generations stronger, smarter, healthier and happier.
To this I say hooey and hooey again. Even the most exquisitely engineered of artifacts—take the Large Hadron Collider for example—are prone to error and screw ups. Surprise, chance, and unpredictability are hard wired into our universe. Whether breakdowns come from passing birds or wayward weasels, breakdowns will come. Even when our biomedical and bioengineering prowess achieves its best, there will always be downsides.
Gina Maranto is a fellow at the Center for Genetics and Society. She is Professor and Director of Ecosystem Science and Policy and Coordinator of the Environmental Science and Policy program at the University of Miami's Leonard and Jayne Abess Center. Her articles, opinion pieces, and reviews have appeared in Discover, The Atlantic Monthly, Scientific American, The New York Times, and other publications. She is the author of Quest for Perfection: The Drive to Breed Better Human Beings.
Previously on Biopolitical Times:
Image via Wikimedia
Posted in A "Post-Human" Future?
, Biopolitics, Parties & Pundits
, Biotech & Pharma
, Inheritable Genetic Modification
, Media Coverage
, Public Opinion
, Synthetic Biology
, US Federal
| 4 comments
The Case Against Public Investment in Reproductive Genetic Modification
Posted by Jessica Cussins, Biopolitical Times guest contributor on August 3rd, 2016
Philosopher Tina Rulli argues that three-person IVF is not a “life-saving therapy” or even a medical treatment at all. Rulli explains why the technology does not meet a plausible social value standard that would justify public research investment, and why other germline modification techniques may not either.
UC Davis Assistant Professor of Philosophy Tina Rulli published a report titled "What is the Value of Three-Parent IVF?" in the July-August 2016 Hastings Center Report.
If you have seen any of the countless descriptions of three-parent or three-person IVF, also called mitochondrial replacement, as a “life-saving treatment,” you might find the question in the title confusing. How could any life-saving treatment not be of value?
As Rulli explains, the claim that this technology would save lives is “inaccurate and exaggerated.” Three-person IVF would not cure, treat, or save anyone. At best, it would allow women affected by a particular kind of mitochondrial disease to have an unaffected child who is mostly genetically related to her.
The experimental procedure works by genetically engineering an embryo to combine the intending mother’s nuclear DNA with another woman’s mitochondrial DNA. The choice a woman would make is not “do I save my child?” but “do I want to have a child in this way?” Rulli makes a strong argument that these are not morally equivalent, and that it is irresponsible to act as though they are.
How one thinks about this distinction between creating an unaffected genetically related child and saving lives may have implications well beyond three-person IVF. As Rulli points out, the creating-saving distinction probably holds for any form of germline genetic modification:
The argument here might provide a template for objections to other germline modifications or gene therapies that are valuable solely or primarily because they may enable prospective parents to have healthy genetically related children who would not otherwise exist.
For example, it would probably mean that the experiment carried out in April using CRISPR to introduce an HIV-resistant mutation into the DNA of embryos could also not be called a life-saving treatment, even if it worked well (it didn’t) and even if it was going to be used to generate a person with altered risk factors (it wasn’t).
Rulli further undermines the medical relevance of three-person IVF by pointing out that it isn’t the most effective way to reduce the transmission of mitochondrial disease. Only a small subset of mitochondrial disease could even hypothetically be addressed by this technology, since most cases involve mutations in nuclear DNA (instead of or in addition to mutations in mitochondrial DNA). And the procedure would only be accessible to women with far more financial resources than most have.
The alternative to three-person IVF – using an entire egg (rather than an egg that has had its nucleus removed) provided by another woman – would completely eliminate the risk of transmitting mitochondrial disease. In other words, the real value of the experimental procedure is not about health at all, but about the personal preference to have a genetic connection to one’s child. Rulli refers to this as “medicalization of a social preference” that works by “preserving the dominance of the bionormative family schema.”
Based on these points, Rulli asserts that three-person IVF lacks the social value that proponents have claimed for it, and that would be a necessary precondition of ethical clinical research, both in order to use limited health resources responsibly and to avoid human exploitation. She therefore concludes, despite the Institute of Medicine’s report endorsing the potential of “clinical trials,” that any public research investment in three-person IVF would be unethical.
Rulli reaches this conclusion even without addressing the multiple safety and efficacy concerns that have cropped up regarding three-person IVF. She takes it for granted that the technology will do what it says it will do. But she does note:
If the concerns about the safety of three-parent IVF for children and future generations are legitimate, then these considerations are not over-ridden by proponents’ claims about the great, life-saving potential of this technology. We know those claims to be fictional.
Throughout the push for legalization of these three-person IVF techniques, some advocates have painted any concern raised as anti-science or anti-technology. Rulli takes pains to point out that she is neither. Her argument is not against the technology per se, but whether to invest public resources in its development when the opportunity cost of that research includes, among other things, diminishing resources for investigating treatments for people suffering from mitochondrial diseases today.
Given the firestorm of attention to CRISPR, and the relative ease of genetically modifying an embryo versus an adult, we may well see arguments about germline gene editing as a “life-saving treatment.” Proponents are already pointing to three-person IVF as a pioneer technology that is paving the way for other forms of germline modification, so it is critical to set the record straight. Rulli’s report will be a useful framework to have on hand.
Previously on Biopolitical Times:
Image via Pixabay