This will seem like a bit of heavy science, possibly too much for a blog post. But we assure you that we are here to make this simplest way for you to understand the future of man. We are certain what’s briefly described here is the future because of the interest and early success of the work of this man – George Church — with genome editing technology CRISPR. Too high praise for Harvard scientist? Let’s find out.
Our prediction is that within the next few decades, what it means to be human could dramatically change. The work of George Church and others : Jennifer Doudna, Feng Zhang, and Emmanuelle Charpentier provides proof that it could be so.
Their contribution to science – the gene editing technology, CRISPR , makes it not too far fetched to propose that your grandparents and your grand children may not simply respectively be your ancestors or descendants. Rather, ‘distant relatives’, much in the way we are to apes as Darwinian constructs propose.
Health Disparities and the Drive Towards Universal Healthcare as Nudging Factors for more Extensive, or is it Daring, CRISPR Genome Editing
At the center of this new paradigm is the pioneering work of this man , George Church. Think Nobel Prize. Maybe the 21st century Galileo. Or modern day Frankenstein. That’s how much the work of George Church and company divides opinion.
Truth is, some might argue that CRISPR and the world of possibilities it promises threatens to add another split beyond Homo Sapiens in the taxonomic ranking of man. Beyond the likely avail of transplant organs, preventive and therapeutic uses, CRISPR is is of importance to health as it raises questions about health access.
As it is, social and scientific classification of man is known to have adverse effects on health outcomes. The pioneering genome editing technology , CRISPR, threatens to confound this problem of health disparities. CRISPR in essence is a more convenient way of redesigning the genetic makeup of man. Its wide spectrum of application threatens to usurp the slower, error strewn evolutionary process, thanks to its ability to change the course of Mendelian Inheritance – all in a Petr-dish.
Think about it. What will we call Homo Sapiens whose genome has been significantly altered and the new genetic information passed on to their offspring?
Designer Babies: The Propagation of Genetic Enhancement Blurring The Lines of Race & Ethnicity
Consider the following hypothetical sequence as a root answer to this rhetorical question. First, possibly – given pending unsolved ethical dilemmas of genome editing — the first generation of designer humans will be those ones who will have the genes begetting certain hereditary diseases edited or shut off.
Lets assume that the gene editing occurs at the level of the germ-line (ova and spermatozoa) and that these humans thrive and sexually multiply. Their descendants will be humans who are devoid of susceptibility to certain debilitating genetic diseases.
Multiply this happening and the obvious focus, especially in the realm of achieving universal health care, then becomes other traits. Biological attributes that predispose those who bear them being victims of health disparities. Think race, think ethnicity.
The End of Health Disparities?
Whilst the complexity of defining race has relegated it’s importance in explaining health disparities, social economic status is increasingly gaining traction as an explanation for differences in health outcomes between racial and ethnic groups. As Leonard E Egede offers in the paper Race, Ethnicity, Culture and Disparities in Health care
Effect of race/ethnicity on health outcomes tends to diminish significantly when socioeconomic position is controlled for and in some instances the race effect disappears
Thankfully, the role of discrepancies in socioeconomic status to healthcare access is way better defined than race, though not entirely problematic. The Bill Gates & Melinda Foundation continues to seek solutions to this and the jury is still out on that one. Brenton Woods institutions have had a go. Globalization was touted as the magic bullet – we all know how that went. Why not give biotechnology a chance? Particularly the genome editing flagship technology CRISPR?
The Science Policy Valley of Death
CRISPR faces challenges in it’s quest at being the healthcare equivalent of what the microchip was to information technology. First, it would be nearly impossible to gather genetic information about racial or ethnic groups with the singular aim of identifying their genetic susceptibility to disease. The risk of such information in the wrong hands capable of harm – such as groups with the desire and ability to develop biological weapons with the precision of drones — is too great.
Secondly, the diversity in genetic makeup within such groups makes generalization non ideal. While precision medicine offers hope in surmounting this challenge, we await its wide applicability. Thirdly, and most importantly, as Dr. Eldrin Lewis, a cardiologist at Harvard-affiliated Brigham and Women’s Hospital, summerises in a Harvard Health article: Race and ethnicity: Clues to your heart disease risk?
“your ZIP code is more important than your genetic code,”
An Argument for Genetic Enhancement: CRISPR as Bridge to Addressing Social-economic Differences
How segregation occurs is a function of many factors best described by the Schelling Model of Ethnic Residential Dynamics. For our purposes, we zero in on colloquial know-how of the undue influence of socioeconomic status in where people live. Understanding how one ends up belonging to a given social class could offer an insight on how to tackle health disparities in light of a touted reciprocal relationship with gene enhancing technologies like CRISPR.
Geek pop star Malcom Gladwell in the New York Times bestseller Outlier proposes that accumulated advantages determine success. He uses the findings of a Canadian psychologist to illustrate how physical attributes are a culprit. (quoting the linked article)
[the psychologist] noticed that a disproportionate number of elite hockey players in his country were born in the first half of the year, Gladwell explains what academics call the relative-age effect, by which an initial advantage attributable to age gets turned into a more profound advantage over time. Because Canada’s eligibility cutoff for junior hockey is January 1, Gladwell writes, “a boy who turns 10 on January 2, then, could be playing alongside someone who doesn’t turn 10 until the end of the year.” You can guess at that age, when the differences in physical maturity are so great, which one of those kids is going to make the league all-star team.
Physical Attributes, Socioeconomic Status & Genetic Enhancement
For this discussion, the take home message from Gladwell’s work is that physical attributes count for accumulated advantages. They are part of the body of attributes that can determine the social standing of an individual. The question then begs: Can CRISPR be used to gain desired physical attributes that bestow social advantages? Not yet but theoretically (inevitably) well in the realm of this genome editing technology.
Indeed scholars have identified the currency of genetic enhancement as its ability to give genetically enhanced individuals the power to purchase primary goods like health, vision, and rationality. This is because these primary goods influence physical capabilities like being healthy, seeing properly, and being able to reason.
CRISPR For All Then?
The new question then becomes how do we ensure that CRISPR does not serve only the already advantaged? Those less at risk of suffering form health disparities? Bioethicists continue to mull over this ethical dilemma. Early discussions have centered on distributive justice. The different forms of egalitarianism have gained the favor of ethicists as the philosophy to guide deployment of gene enhancement technology.
Egalitarianism is in a nutshell is the moral duty of benefiting the people who are worse off. Still, even such noble intentions have to be tempered by considerations. Like, what is the current situation of those worse off? What is the cost of the genetic interventions? Is there need for budgetary realignments to defund social programmes seen to entrench the privilege of the privileged? What about the interconnected nature of genetic information that make simple genome edits no so simple after all?
Moreover, other scholars disagree, arguing that the egalitarian construct of equal access to genetic enhancement technology may actually turn out to be disadvantageous to the genetically disadvantaged.
All these possibilities sound like they belong to the distant future that no human can assertively predict. But what we must recognize is the continuing work of George Church has a bearing on the future of man. Part of us may want CRISPR to work. At the same time, we can’t ignore the lingering tug that if it works out, we might miss being human.
Being human is about the flaws. At least that’s what we’ve known, that man is to err and no man is perfect. The looming threat that grandma’s breast cancer might re-emerge in your daughter Clara. That unknown might just nudge us to be better people by not to exposing her to second hand smoke; or at the very best quitting smoking altogether. In the simplest terms, CRISPR negates all that. CRISPR is about being able to predict the future by correcting nature’s mistakes.