CRISPR babies

One of my problems with resolving ethical questions is that I so often have a hard time deciding the difference between moral, ethical, reasonable, and justifiable, and figuring out where an issue lies on the spectrum thereof.

I've always had this problem.  There are things that in my view are always wrong -- harming or endangering a child comes to mind -- but the vast majority of issues lie in that immense field of gray areas.

Which is why I'm having a hard time deciding what to make of the bombshell announcement last week that a Chinese geneticist, He Jiankui, claims to have genetically altered a pair of human embryos -- and it resulted in the birth of twin girls who, if the gene editing was successful, will be resistant to HIV.

The technique involved was CRISPR-Cas9, a protein complex that allows for what amounts to cut-and-paste for your DNA.  What He did was to use CRISPR-Cas9 to selectively delete a gene for a  receptor called CCR5 that allows HIV to attach to cells.  Without that receptor -- He hopes -- the children will be genetically immune.

[Image is in the Public Domain]

When He made his announcement, the scientific community had a collective meltdown.  "The underlying purpose of doing the experiment was obviously to show that they could do gene editing on an embryo, but the purpose for the party involved does not make any sense," said Anthony Fauci, an HIV/AIDS researcher and head of the U.S. National Institute of Allergy and Infectious Diseases in Bethesda, Maryland.  "There are so many ways to adequately, efficiently, and definitively protect yourself against HIV that the thought of editing the genes of an embryo to get to an effect that you could easily do in so many other ways in my mind is unethical."

Okay, I'm not defending He.  The real issue here, in my opinion, is risk.  "Gene editing itself is experimental and is still associated with off-target mutations, capable of causing genetic problems early and later in life, including the development of cancer," said Julian Savulescu, an ethicist at the Oxford University.  "This experiment exposes healthy normal children to risks of gene editing for no real necessary benefit."

But the problem is that at some point, scientists were going to have to take the leap and do something like this.  Ever since Jennifer Doudna of UC-Berkeley developed CRISPR-Cas9 as a gene editing protocol in 2012, it's only been a matter of time.  Once a technique like this becomes possible, it becomes inevitable.

So sooner or later, someone was going to have to accept the risk of trying it on human embryos.  Animal models only get you so far.  The potential for eradicating genetic diseases is nothing short of astonishing; think of a world without cystic fibrosis, Huntington's disease, Tay-Sachs disease, sickle-cell anemia, hemophilia.  All of that is well within the realm of possibility now.

But.  Once you've started down that road, what's to stop people from altering other traits?  Appearance, personality, behavior... for me, this gets out onto some very thin ice.  When this Pandora's box is opened, there's no telling what dubiously ethical practices will escape.

There's also the problem that if such a technique really becomes capable of (relatively) risk-free editing out of deleterious genes, it's almost certain that it would be available only to the rich, further widening the gap between the privileged and the non-privileged.  The brilliant (and prescient) 1997 film Gattaca dealt with this very issue -- how genetic engineering of children could result in a new lower class, people conceived the old-fashioned way who didn't have the same opportunities for jobs, education, health care, and health insurance as the smarter, stronger, healthier "Valids."

So I'm of two, or more, minds about all of this.  First, the potential of the therapy is mind-boggling.  And the idea that once developed, researchers were going to hold off trying it out on human embryos, is naively optimistic about human nature.

But it comes back once again to the quote from scientist Alan Grant in Jurassic Park -- "You were so busy trying to figure out if you could, you never gave any thought to whether you should."  The thorny ethical issues this technique brings up go way beyond the potential risk to two baby girls in China.

All of which makes me glad that I'm not on the scientific regulatory boards who are wrestling with how to respond to He's announcement.

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Ever wonder why we evolved to have muscles that can only pull, not push?  How about why the proportions of an animals' legs change as you look at progressively larger and larger species -- why, in other words, insects can get by with skinny little legs, while elephants need the equivalent of Grecian marble columns?  Why there are dozens of different takes on locomotion in the animal world, but no animal has ever evolved wheels?

If so, you need to read Steven Vogel's brilliant book Cats' Paws and Catapults.  Vogel is a bioengineer -- he looks at the mechanical engineering of animals, analyzing how things move, support their weight, and resist such catastrophes as cracking, buckling, crumbling, or breaking.  It's a delightful read, only skirting some of the more technical details (almost no math needed to understand his main points), and will give you a new perspective on the various solutions that natural selection has happened upon in the 4-billion-odd years life's been around on planet Earth.

[If you purchase the book from Amazon using the image/link below, part of the proceeds goes to supporting Skeptophilia!]

Chopra on AIDS

At what point does someone cross the line into giving advice so dangerous that the people involved in promoting him are morally culpable if they participate?

Look, it's not that I'm against free speech.  I also believe strongly in the caveat emptor principle -- that people have a responsibility to be well enough informed on matters of science and medicine that charlatans can gain no traction.  But influential people also have a responsibility, and that is to use that influence with care, to consider the harm their words could do, to make certain that what they're saying is scientifically correct (and making amends when they misspeak).

Of course, the most egregious example of how this can go wrong is the current measles outbreak in California, which has sickened 84 people so far and is still accelerating.  The CDC states that the outbreak is "directly attributable to the anti-vaxxer movement," and notes that even with treatment, measles "is a miserable disease" that can cause serious complications and death.  And we can lay the blame for the resurgence of this disease at the feet of such purveyors of unscientific bullshit as Andrew Wakefield and Jenny McCarthy, who despite mountains of verified, reliable research are still claiming that vaccinations are unnecessary at best and dangerous at worst.

But we've talked about the anti-vaxxers before, and they're hardly the only example of this phenomenon.  Just a couple of days ago, for example, we had none other than Deepak Chopra putting his two cents in (although that's vastly overestimating its worth), and he gave his opinion about AIDS...

... and said it wasn't caused by HIV.

The HIV virus [image courtesy of the Wikimedia Commons]

Chopra was being interviewed by Tony Robbins, and the following exchange took place:

Chopra: HIV may be a precipitating agent in a susceptible host. The material agent is never the cause of the disease. It may be the final factor in inducing the full-blown syndrome in somebody who’s already susceptible. 

Robbins: But what made them susceptible? 

Chopra: Their own interpretations of the whole reality they’re participating in. 

Robbins: Could that be translated into their thoughts, their feelings, their beliefs, their lifestyle? 

Chopra: Absolutely.

He goes on to say, "I have a lot of patients with so-called AIDS... that are healthier than most of the people who live in downtown Boston.  They haven't had a cold in ten years...  Someone's told them they have this disease, and they've bought into it.  The label is not the disease, the test is not the disease."

Robbins responds with a comment about a doctor who has stated that HIV is only capable of killing "one helper-T cell out of ten thousand," and Chopra agrees, saying that to get sick from it, we have to "facilitate the process with our own thoughts and beliefs, convictions, ideas, and interpretations."

Then they have the following discussion:

Robbins: There's a test that doesn't even test for the virus, and when they get a positive test, what happens to them? 

Chopra: Then they make it happen. 

Robbins:  Maybe they take something like AZT, a side effect of which is immune suppression...  What keeps us locked into this trap?  What keeps us locked in this trap where we keep promoting a philosophy of fear where we must depend on someone or something outside of ourselves to keep ourselves healthy? 

Chopra:  It's the collective belief system.  It's the hypnosis of social conditioning.  It's cultural, religious, social indoctrination.  

The way out, Chopra says, is realizing that "you are the field of all unbounded possibilities."

Are you mad yet?  I hope so.  Chopra is using his influence -- which is considerable -- to push people away from conventional treatment into accepting vacuous psychobabble, risking their own lives in the process.

You have to wonder how he explains the millions of deaths from AIDS in central and southern Africa.  Many of those people don't have access to medical tests and treatments; a considerable number of them don't have the scientific background to understand what the virus does to the immune system.

You also have to wonder how he'd explain the deaths of young children who contracted HIV from their mothers.  Was their disease due to their parents' lack of acceptance of "the field of unbounded possibilities?"  Or did the children themselves have problems with their "interpretation of the whole reality they were participating in?"

Chopra once was simply a laughable purveyor of woo-woo pseudoscience, of the kind that he evidenced by a statement made earlier in the interview: "You go beyond the molecules, and you find atoms.  You go beyond the atoms, and you find particles.  You go beyond the particles, and you find nothing.  You go beyond the nothing, and you find absolutely nothing."  But now he's crossed the line into endangering people's lives with his claptrap.

I'd much prefer it if people would come to recognizing how dangerous this man is through a greater understanding of science; but the unfortunate truth is that there will always be gullible, credulous, and poorly-educated people out there, and it is immoral to allow people like Chopra to prey on their lack of understanding.  I wish fervently that radio and television stations who are giving this man air time, and book publishers who are promoting his views in print, would say, "I'm sorry, sir, but you are a quack, and you're hurting people, and we're not participating."

But the sad truth is that even if what he's saying is garbage, it's lucrative garbage.  Given the profit motive that drives most of our society, I suspect that Deepak Chopra is going to continue to get richer at the expense of people who are ignorant enough or desperate enough to buy the nonsense he's selling.