Wednesday, December 5, 2018

Homo sapiens 2.0 (pre-Alpha)

Like it or not, Homo sapiens 2.0 is here.

Last week, it came out that a scientist by the name of He Jiankui has made the first human CRISPR-edited babies. He did it in secrecy, without properly informing the parents, without any scientific review, with no animal tests, with substandard laboratory methods, and with no clear idea about what the effects of the editing would be. An excellent breakdown of the fiasco, written by Ed Yong, was published in the Atlantic. The response by most of the scientific community has been shock and disgust, although the inimitable George Church advocated restraint (and a rather odd take on the ethics involved) in an interview on the subject. It is important to note that the community is reacting to how and possibly why He did the work, not whether we should edit human genomes in the first place.

To be clear, I personally think gene editing babies is someday going to be routine and am not against the idea in principle. First off, genetic diseases like Cystic Fibrosis or Huntington's disease, could not only be prevented, but could even be (eventually) eradicated from the gene pool entirely. There is a fairly strong consensus, at least among scientists and policy makers, that such gene editing would be acceptable if the technology were developed carefully. Second, one can imagine enhancing the human genome by mixing and matching performance related traits, such as muscular build, IQ, or longevity (assuming the genetic determinants for such traits were some day carefully elucidated).

Most people are more hesitant about this latter application. At issue is nothing less than the very real risk that the human species literally bifurcates into Homo sapiens 1.0 and Homo sapiens 2.0, with the latter species arising from those who have access to and can afford the technology. I personally neither embrace or reject this eventuality, as much as I see it as a very likely and unavoidable outcome of humanity's co-evolution with the world of ideas and technology. Humanity is not and never was a static phenomenon. However, it is important to acknowledge that every human on the planet is a stakeholder in the development and use of such technology. We're not just hacking genomes, we're hacking what it means to be human.

The problem with He Jiankui's work is the reckless way in it was performed. He seems to have put about as much thought into this project as a high school student does when putting the gene for green fluorescent protein into a lab strain of E. coli. He seems to have thought: well, it will probably work so I'll give it a try and see what happens. Furthermore, He seems to be angling for recognition and personal gain. Modern science and engineering is filled with such temptations, especially as easy to use dual-use technologies like CRISPR seem to be developed almost daily. Finally, by focusing on HIV, instead of some devastating genetic disease that would have otherwise resulted in a nonviable embryo, He has blurred line between prevention and enhancement.

Unfortunately, neither society nor the scientific community have yet agreed upon any kind of process for approving a particular gene edit, other than that we should slow down. The closest rules we have are fairly rigorous processes for developing new pharmaceuticals, which (should and usually do) include years of development, animal testing, and clinical trials. But the ethical questions surrounding drug development are mainly regarding patients one at a time, and not the potential for the development of new species, and so once again, a much broader set of stakeholders are involved. And regardless or the subtle and not so subtle ethical issues, scientists like He, and probably many others, are forging ahead with the technology like it is some kind of gold rush, which to some extent it is.

He is not unique. It is likely that as with most exciting new technologies, human gene editing entrepreneurs will ask for forgiveness and not permission. It seems to be part of our culture. They will take their cues from Facebook and Uber (how exciting) instead of the Genetics Public Policy Center (how boring), and work in secret or in countries with no rules or scruples about designer babies.

I support efforts to lay out ethical frameworks and encourage discussion. I am also preparing myself for the inevitable emergence of Homo sapiens 2.0. During the rollout, there will be successes, possibly gruesome failures, public outcry, legislation, secrecy, inequality exponentially worse than it is now, and ultimately the emergence of very powerful and very precise human genome engineering. Especially given how humanity is also intertwined with technologies like AI and robotics, the effects of widespread gene editing are harder to predict than is any technology heretofore invented. I hope we manage the transition well.