Abertay University - School of Health Sciences, Dundee, Tayside, UK.
Bioethics. 2020 Jan;34(1):90-104. doi: 10.1111/bioe.12691. Epub 2019 Nov 15.
Focusing on present-day possibilities raised by existing technology, I consider the normative aspects of genetically modifying the human germline from a utilitarian standpoint. With reference to a hypothetical case, I examine the probable consequences of permitting a well-conceived attempt to correct a disease-associated gene in the human germline using current CRISPR gene-editing technology. I consider inter alia the likely effects on utility of creating healthy new lives, of discouraging adoption, and of kickstarting a revolution in human germline genetic modification (HGGM). I reject various objections to HGGM, including claims that the risks of genetic harm outweigh the likely benefits. From this utilitarian analysis, I conclude that strong grounds exist to support intervening in the human germline using current technology. Delay in commencing such work will impose a utility cost, because the longer we wait until commencing the HGGM revolution and moving towards a world of increased utility, the greater will be the quantity of suffering accrued meantime through genetically influenced disease. Nevertheless, considering residual safety concerns and the negative publicity engendered by an ethically problematic recent (2018) first attempt at HGGM, it seems prudent-and ultimately generative of the greatest amount of utility-to delay implementing HGGM for a modest period of time, in the order of 1-2 years.
从现有技术所带来的当下可能性出发,我从功利主义的角度来考虑对人类生殖细胞进行基因修饰的规范性问题。通过参考一个假设案例,我考察了在当前的 CRISPR 基因编辑技术下,允许对人类生殖细胞中的一个与疾病相关的基因进行精心设计的修正尝试可能产生的后果。我特别考虑了创造健康新生命、劝阻领养以及开启人类生殖细胞遗传修饰革命(HGGM)的可能效用。我驳斥了对 HGGM 的各种反对意见,包括认为遗传危害的风险超过了可能的益处的说法。从这种功利主义分析中,我得出结论,有充分的理由支持利用当前技术干预人类生殖细胞。延迟开始此类工作将带来效用成本,因为我们等待的时间越长,启动 HGGM 革命并迈向一个效用增加的世界的时间就越长,在此期间通过遗传影响疾病而累积的痛苦就越多。然而,考虑到剩余的安全问题以及最近(2018 年)首次尝试 HGGM 所引发的负面宣传,似乎谨慎的做法——最终会产生最大的效用——是在 1 到 2 年内适度延迟实施 HGGM。