by Jamie Metzl
If, against all odds, we as a species succeed in creating this kind of preliminary global regulatory structure, we will still need to figure out how to balance the carrot of enticement and the stick of enforcement. As with the NPT, I can imagine the more advanced countries offering to help bring others into the genetic and biotechnology age in exchange for commitments by the less developed countries to join an international regulatory body and abide by agreed ethical principles.
Even if this happens, there will always be a market for some kinds of extra alterations and enhancements banned in most parts of the world. Perhaps aggressive parents decide to give their children dangerous predatory instincts. Perhaps a given country decides to genetically engineer a subclass of its people to be superhuman masters or docile followers or fierce killers at the behest of the state. Perhaps companies will set up extreme genetic enhancement centers in international waters. What will happen then?
At a 2005 global summit, heads of state from around the world endorsed the principle that states have a “responsibility to protect” their citizens which, when violated through human rights violations and other abuses, shifts to the international community.19 Although the “responsibility to protect” is not legally binding, it was used to justify military interventions in places like Iraq, Libya, and Yemen with mixed results at best.
For only the most egregious violations of agreed international norms on genetic engineering, the international community could conceivably fashion an escalating level of pressures, ranging from economic sanctions to military intervention, to change the ways of a given violator. Given the poor track record of many forcible “humanitarian” interventions, it may seem downright crazy to suggest that countries might someday justifiably intervene militarily to stop a country from genetically engineering its population in some monstrous way that massively violated an internationally agreed, ethical redline. From the perspective of today, it probably is crazy. But if we as a species determine that some future alterations of our fellow human are far beyond the pale of acceptability, some ultimate enforcement mechanism might someday be necessary.
Given all of these challenges, establishing and enforcing any sort of global restrictions on human genetic enhancement is a very tall order for which we collectively are not close to being ready. Today’s mismatch between what the science can and will soon be able to achieve and how poorly people understand and are prepared for it is creating an extremely dangerous public tinderbox that must be addressed, first and foremost, through public education and engagement.20*
A first, immediate step in this direction is to help every country develop its own national public-education program, bioethics commission, and regulatory framework for human genetic engineering that applies its own traditions, values, and interests.
There are many excellent models from around the world for how this can be done. The United Kingdom’s Human Fertilisation and Embryology Authority is probably the world’s best example of a government regulatory body thoughtfully overseeing advanced reproductive technologies. Different countries can have different models, but every country should have something. When they do, they’ll be better able to share engagement and regulatory models, learn from each other, and together evolve best practices. These UK government efforts have been supplemented by the excellent work of the private charities Private Education Trust, Genetic Alliance UK, and the Wellcome Trust, engaging the British public and developing language supporting a more inclusive public dialogue.21 The United Kingdom’s Nuffield Council on Bioethics in 2018 recommended the creation of an independent government-funded body to promote public understanding and engagement around issues of genome editing and human reproduction.22 Denmark also does a great job empowering citizen groups to provide input to elected representatives about genetic engineering and other technological issues.
But even the most internationally minded people among us cannot and should not wait for our countries and the international community to act. Each of us must take individual responsibility for ensuring we are educating ourselves about what’s coming and bringing as many of our fellow humans as possible into the conversation. We must each play a role in jump-starting a species-wide conversation on the future of human genetic engineering before it’s too late.
Long before the international community turned against slavery, land mines, and blood diamonds, or embraced anti-corruption, African debt relief, and environmental protection, activists lit a spark that inspired popular movements, which, in turn, pressured governments in each of these areas.
Norms are, in many ways, squishy and difficult to measure. Slavery, for example, was widely accepted in many parts of the world until the antislavery movement caught steam in nineteenth-century England. From a small spark at Cambridge University, the movement grew until British laws were changed, slavery was abolished in the United States and elsewhere, and the idea of slavery became increasingly taboo. Before the idea of antislavery was translated into law, it was a general feeling, a growing zeitgeist. Lots of individual conversations, deep thinking, research, soul searching, dialogues, coalition building, and ultimately fights and even civil wars gave the idea form, like a rolling snowball.
“Never doubt,” the cultural anthropologist Margaret Mead (allegedly) once said, “that a small group of thoughtful, committed citizens can change the world. Indeed, that is the only thing that ever has.” This type of norm-building process is required to help our species articulate and champion our best values to find the right balance on human genetic engineering. We must foster a continual series of local, national, and global conversations that can, over time, congeal into global norms and lay an informed foundation for the decisions we will collectively need to make in the future.
We’ve never conducted a species-wide conversation on our future. But how could we have organized a global dialogue in the eighteenth century at the advent of the industrial revolution when only around 10 percent of the global population was literate and the primary means of international communication was snail mail that took months to deliver? Even in 1945, at the dawn of the nuclear age, only around 30 percent of the world population was literate and landline telephones were few and far between. Today, about 85 percent of the global population is literate, two-thirds have their own cell phones, and over half have access to the internet—and the numbers are growing.
With an increasing percentage of the world population connected to the information grid in one way or another, we now have an unprecedented opportunity to come together for a more meaningful collective process than ever before. Given the trajectory of the science and political divisiveness of the issues, the window for constructive dialogue may not stay open long.
A species-wide conversation would involve connecting individuals and communities around the world with different backgrounds and perspectives and varying degrees of education in an interconnected web of dialogue. It would link people adamantly opposed to human genetic enhancement, those who may see it as a panacea, and the vast majority of everyone else who has no idea this transformation is already underway. It would highlight the almost unimaginable positive potential of these technologies but also be honest and straightforward about the potential dangers.
One way of structuring this global dialogue would be to establish an international commission of top scientists, thinkers, religious leaders, and others tasked to come up with a discrete number of essential questions about the future of human genetic engineering. These questions might include:
1.What can be done to ensure the broadest possible access to the health and well-being benefits of genetic technologies?
2.Should there be limits on the application of genetic technologies to treat or eliminate disease? If so, what should they be?
3.Should people have full access to information about their own and their potential future children’s genetic makeup or should this access be limited? If limited, what should the restrictions be and why?
4.Should parents be allowed unlimit
ed freedom to select from among their natural embryos during in vitro fertilization? If not, on what basis should limitations be set? Should parents be allowed to select embryos based on non-disease-related traits, like height, projected IQ, personality style, etc.?
5.If it is proven safe, should precision gene editing be used to eliminate genetic diseases in adult sex cells and preimplanted embryos in a manner that would be passed to future generations?
6.Do we need a global framework to help prevent the worst abuses of human genetic engineering? If so, what standards should underpin these efforts?
7.What long-term institutions do we need to foster an inclusive global dialogue on the future of human genetic engineering that optimizes the benefits of these technologies and minimizes potential harms?
8.What more can be done to help ensure the genetic revolution helps enhance all of our humanity, and how can each of us be better engaged in this process?
After these issues are framed by the expert commission, easily understood multimedia background materials could be created for each question that could be a foundation for an extensive and ongoing series of dialogues to be held around the world.
A global coalition of partner universities, school systems, think tanks, religious organizations, and civil society groups could then organize these dialogues to be held in venues big and small all around the world. Each partner organization could organize its own forums as well as real and virtual dialogues based on the questions and report back their findings to the commission.
On an even more democratic level, motivated individuals and any other type of group could be encouraged to self-organize their own conversations based on the same central questions. These hundreds of thousands or even millions of conversations could be held in conference rooms, classrooms, place of worship, kitchens, bus stops, barber shops, town squares, nail salons, union halls, internet chat rooms, village commons, virtual worlds, social media forums, and countless other places where humans connect.
Global virtual summits could periodically be held to bring together populations from all of the various dialogues around the world, and a network of talks and content based on the TEDx model could both help make learning and participating interesting, exciting, and accessible, and raise additional core questions needing to be addressed.
When this structured and informed global dialogue on the future of human genetic engineering reaches critical mass, an ongoing dialogue mechanism—possibly a new body connected to the United Nations—could be created to help further systematize the process and take it to a next level. This organization could pull together the content from the global conversations, views of experts, and inputs from national, nongovernmental, and other communities into an ongoing series of recommendations constantly churning through the cycle of public and expert engagement.
Over time, this type of engaged process could help individuals, societies, states, and the global community writ large better understand the genetic and other scientific revolutions, become more active participants in the decision-making process about our common future, and begin to define limited redlines beyond which we collectively feel our species should not, for the moment at least, go.
A species-wide dialogue on the future of human genetic engineering may seem like a drop in the bucket compared to the magnitude of the challenge the genetics revolution will bring. Such a process could even potentially do harm by waking up slumbering neo-Luddites, who might forcibly oppose even the most benign and beneficial genetic technologies. But the alternative to getting started with this kind of broad, public engagement is worse. If a relatively small number of even well-intentioned specialists unleash a human genetic revolution that touches most everyone else and ultimately alters our species’ evolutionary trajectory without informed, meaningful, and early input from others, the backlash against the genetic revolution will overwhelm its monumental potential for good. Humans must and will embrace the genetic revolution, but we will be far better off if we do it together.
The genetics revolution will unlock one of the greatest opportunities for advancing human health and well-being in the history of our species. We will demand access to genetic technologies for ourselves and our children as a next step in our perpetual struggle with the cruelty of the natural world and to realize our greatest aspirations to transcend our limited biology and, someday, our time-limited planet.
Figuring out how to deploy genetic technologies in ways that enhance our dignity and respect for each other will require us to draw on the best of our humanist values and double down on our embrace of, respect for, and investment in our diversity, equality, and common humanity. While the genetic engineering technologies are new, the values and philosophies we will need to use them wisely are often very old.
Deploying our best values at this transitional moment for our species demands that we all understand what is happening now, what is coming, what’s at stake, and the role we each must play in building a technologically enhanced future that works for all of us.
Jump-starting dialogues to develop norms that translate into international best practices and, ultimately, global regulations will be long and arduous. It all might end up being impossible. But simply trying will bring more people into the processes of determining the future of humanity. We will not be able to stop the genetic enhancement of our species, but we can influence, hopefully for the better, how this transformation plays out.
It will be a difficult, painful, and conflict-ridden process, but we have no alternative. We all need to participate. We don’t have a moment to lose in getting started.
Now that you have read this book, you are a critical catalyst of this dialogue.
Fellow humans, let us together begin the conversation.
*Global efforts to slow climate change show how difficult it will be to build norms and rules around human genetic engineering. It took decades for governments around the world to recognize that human-driven climate change threatened to wreak havoc on the environment and make large parts of the globe virtually uninhabitable for humans. But in spite of the overwhelming consensus among scientists and most world leaders that climate change is real, man-made, and an existential threat to our planet and selves, little progress has been made. Leaders at the 2017 meeting on the Paris Accord were only able to agree that each country would do its best without agreeing to any binding limits on greenhouse gas emissions. Even that wasn’t sustainable when U.S. President Donald Trump later withdrew the United States from the agreement.
*As of March 2018, 35 of the 47 Council of Europe member countries had signed the convention, but only 29 had ratified, and not all of these passed domestic implementation laws.
*Harvard biologist and naturalist E. O. Wilson made a similar point when he wrote, “We have created a Star Wars civilization, with Stone Age emotions, medieval institutions, and godlike technology.” Futurist visionary Stewart Brand makes a similar point: “We are as gods and might as well get good at it.”
Notes
INTRODUCTION
1Harvard biologist Michael Desai’s fascinating research on yeast that can reproduce both clonally and sexually has shown how sexually reproducing yeast adapt two times faster than their asexually reproducing landsmen, allowing harmful mutations to be reduced and helpful ones spread. Michael J. McDonald, Daniel P. Rice, and Michael M. Desai. “Sex Speeds Adaptation by Altering the Dynamics of Molecular Evolution.” Nature 531, no. 7593 (2016): 233–36. doi:10.1038/nature17143.
2“Genetics and Other Human Modification Technologies: Sensible International Regulation or a New Kind of Arms Race?” Hearing before the Subcommittee on Terrorism, Nonproliferation, and Trade of the Committee on Foreign Affairs, House of Representatives, One Hundred Tenth Congress, Second Session, June 19, 2008, Serial No. 110–201. https://fas.org/irp/congress/2008_hr/genetics.pdf.
CHAPTER 1
1For an incredible visual image of this, see Courtney K. Ellison, Triana N. Dalia, Alfredo Vidal Ceballos, Joseph Che-Yen Wang, N
icolas Biais, Yves V. Brun, and Ankur B. Dalia. “Retraction of DNA-Bound Type IV Competence Pili Initiates DNA Uptake during Natural Transformation in Vibrio Cholerae.” Nature Microbiology, 2018, doi:10.1038/s41564-018-0174-y.
2Priya Verma, “Reproduction and the Discovery of Sperm,” Elawoman, accessed June 25, 2018, https://elawomn.quora.com/Reproduction-and-the-Discovery-of-Sperm.
3F. Gilbert, “Structure of the Gametes,” in Developmental Biology, 6th edition. (Sunderland, MA: Sinauer Associates, 2000), https://www.ncbi.nlm.nih.gov/books/NBK10005/.
4A few anthropologists make the case that humans began domesticating crops around 23,000 years ago. See Ainit Snir, Dani Nadel, Iris Groman-Yaroslavski, Yoel Melamed, Marcelo Sternberg, Ofer Bar-Yosef, and Ehud Weiss. “The Origin of Cultivation and Proto-Weeds, Long Before Neolithic Farming,” Plos One 10, no. 7 (2015), doi:10.1371/journal.pone.0131422.
5Most of these epigenetic marks develops from scratch in a newly conceived organism, but recent research has shown that a small percentage of them are actually inherited from an organism’s parents. This has led some people to question the prior belief that the theories of Jean-Baptiste de Lamarck were entirely wrong.
6For a more technical history of DNA sequencing, see James M. Heather and Benjamin Chain, “The Sequence of Sequencers: The History of Sequencing DNA,” Genomics 107, no. 1 (2016): 1–8, doi:10.1016/j.ygeno.2015.11.003.
7John J. Kasianowicz and Sergey M. Bezrukov, “On Three Decades of Nanopore Sequencing,” Nature Biotechnology 34 (2016): 481–482.
8“OMIM Entry Statistics,” last modified July 24, 2018, http://www.omim.org/statistics/entry.
9See Jason L. Vassy et al., “The Impact of Whole-Genome Sequencing on the Primary Care and Outcomes of Healthy Adult Patients,” Annals of Internal Medicine 167, no. 3 (2017): 159, doi:10.7326/m17–0188; and P. Natarajan et al., “Aggregate Penetrance of Genomic Variants for Actionable Disorders in European and African Americans,” Science Translational Medicine 8, no. 364 (2016), doi:10.1126/scitranslmed.aag2367.