Institute of Biomedical Ethics and History of Medicine, University of Zurich, Winterthurerstrasse 30, 8006, Zurich, Switzerland.
BMC Med Ethics. 2019 Nov 21;20(1):83. doi: 10.1186/s12910-019-0411-9.
Recent scientific advances in the field of gene editing have led to a renewed discussion on the moral acceptability of human germline modifications. Gene editing methods can be used on human embryos and gametes in order to change DNA sequences that are associated with diseases. Modifying the human germline, however, is currently illegal in many countries but has been suggested as a 'last resort' option in some reports. In contrast, preimplantation genetic (PGD) diagnosis is now a well-established practice within reproductive medicine. Both methods can be used to prevent children from being born with severe genetic diseases.
This paper focuses on four moral concerns raised in the debate about germline gene editing (GGE) and applies them to the practice of PGD for comparison: Violation of human dignity, disrespect of the autonomy and the physical integrity of the future child, discrimination of people living with a disability and the fear of slippery slope towards immoral usage of the technology, e.g. designing children for specific third party interests. Our analysis did not reveal any fundamental differences with regard to the four concerns.
We argue that with regard to the four arguments analyzed in this paper germline gene editing should be considered morally (at least) as acceptable as the selection of genomes on the basis of PGD. However, we also argue that any application of GGE in reproductive medicine should be put on hold until thorough and comprehensive laws have been implemented to prevent the abuse of GGE for non-medical enhancement.
基因编辑领域的最新科学进展引发了人们对人类种系基因修改的道德可接受性的重新讨论。基因编辑方法可用于人类胚胎和配子,以改变与疾病相关的 DNA 序列。然而,修改人类种系目前在许多国家是非法的,但在一些报告中被建议为“最后的手段”。相比之下,植入前遗传(PGD)诊断现在是生殖医学中的一种成熟实践。这两种方法都可用于防止儿童出生时患有严重的遗传疾病。
本文重点讨论了关于种系基因编辑(GGE)辩论中提出的四个道德问题,并将其应用于 PGD 的实践进行比较:侵犯人类尊严、不尊重未来儿童的自主权和身体完整性、对残疾人生的歧视以及对技术不道德使用的担忧,例如为特定第三方利益设计儿童。我们的分析没有发现这四个关注点有任何根本差异。
我们认为,就本文分析的四个论点而言,种系基因编辑在道德上(至少)应该像基于 PGD 的基因组选择一样可接受。然而,我们还认为,任何在生殖医学中应用 GGE 的行为都应暂停,直到制定出全面和全面的法律,以防止滥用 GGE 进行非医疗目的的增强。