Public Opposes Human Germline “Enhancement” by Overwhelming Majority

Biopolitical Times
Pie chart, with groups of "Yes," "No," and "Huh?" The majority of the chart is dominated by "No," which is roughly over 3/4 proportion.

The public is firmly — overwhelmingly — opposed to using gene editing for heritable “enhancement” purposes. Many people, if pressed, will support the concept of heritable “cures” that for the foreseeable future, at least, are not practical and rarely needed, if at all. It is not clear, however, how many of the public (and perhaps the pollsters) have an adequate grasp of the issues involved in heritable human genetic modification (HGM).

CGS has for a decade been collecting polling data going back to 1986: over 50 polls, some of them international, on HGM and/or human cloning are summarized here. Assessing that data, however, has always been tricky.

Polls tend to show that public sentiment about human biotechnologies is strongly ambivalent. Most people value their potential to alleviate suffering, yet are apprehensive about the social consequences of some applications. Public opinion on HGM is particularly difficult to assess because of the ambiguity of some of the questions and the terminology used. Opposition decreases with increased emphasis on cures, and increases with emphasis on non-medical or “enhancement” uses, such as  improving intelligence.

Interpreting the data is now of much more than academic interest. Many scientists and policymakers have begun looking for a “broad societal consensus” to guide decision-making about the limits that should be put in place for human genetic applications.

Prompted by this, Robert Blendon, Mary Gorski and John Benson published a survey article, "The Public and the Gene-Editing Revolution" in the New England Journal of Medicine on April 14th. It analyzes, and links, 17 U.S. polls over the last three decades. (Several of them were not previously in the CGS collection, but they are in line with the several dozen that were.) The article concludes:

Most of the public favors gene therapy for clinical use in patients with serious diseases. The majority do not support gene editing in human embryos or germline cells, but the level of opposition varies depending on its goals. Of course, public opinion could change over time as discussions of these issues continue to evolve and as more is learned about the implications and safety of gene-editing technologies.

It’s possible to draw quite a different conclusion. The opposition to using enhancement technologies in HGM has been quite consistent for decades. Moreover, the “medical” arguments in favor are much weaker than the questions asked by pollsters generally imply. Inevitably, hypothetical questions assume success, which in this case is by no means guaranteed, or even likely. How different might the responses be if those being polled fully understood the risks involved, the slim likelihood of success in the foreseeable future, and the availability of alternatives?

Eric Lander, one of the most distinguished current geneticists, addressed these points in his presentation last December at the National Academies of Science gene editing summit (15-minute video here, strongly recommended), and elsewhere. For instance, he wrote in NEJM last June:

… Some observers might propose reshaping the human gene pool by endowing all children with many naturally occurring “protective” variants. However, genetic variants that decrease risk for some diseases can increase risk for others. (For example, the CCR5 mutations that protect against HIV also elevate the risk for West Nile virus, and multiple genes have variants with opposing effects on risk for type 1 diabetes and Crohn's disease.) … It has been only about a decade since we first read the human genome. We should exercise great caution before we begin to rewrite it.

More bluntly, he told the Washington Post in April that we don’t understand the genome well enough to be confident that the changes we make will be salutary in the long run:

"We’re crummy at it," he said. "We are terrible predictors of the consequences of the changes we make."

The most recent poll included in the NEJM survey was conducted in January 2016 [pdf] by STAT and the Harvard T.H. Chan School of Public Health. Sharon Begley, for STAT, wrote an analysis that opens:

Most Americans oppose using powerful new technology to alter the genes of unborn babies, according to a new poll — even to prevent serious inherited diseases.

They expressed the strongest disapproval for editing genes to create “designer babies” with enhanced intelligence or looks.

The poll showed significant support for gene therapy, skepticism about genetic testing (shared by doctors) and the usual, solid opposition to enhancement:

Do you think that changing the genes of unborn babies to improve their intelligence or physical characteristics should be legal?

Yes: 11%, No: 83%, Don't know: 6%

(A Global Social Media Survey published on May 5th shows somewhat more support [27%] for editing embryos to change "any non-disease characteristic," but the authors recommend great caution in interpreting results that may not be representative.)

Moreover, the STAT survey revealed this remarkable finding:

Do you think the federal government should fund scientific research on changing the genes of unborn babies that aims to improve their characteristics such as intelligence or physical traits such as athletic ability or appearance?

Yes: 14%, No: 82%, Don't know: 4%

These are, or should be, devastating numbers to anyone who thinks that the public supports human heritable genetic modification.

Previously on Biopolitical Times: