Pougnet Richard, Derbez Benjamin, Troadec Marie-Bérengère
Laboratoire de Recherche et d'Etude en Sociologie (LABERS), Université de Bretagne Occidentale, Brest, France.
Département des Sciences Humaines et Sociales, Faculté de Médecine et Sciences de la Santé, Université de Bretagne Occidentale, Brest, France.
Asian Bioeth Rev. 2022 Dec 20;15(2):189-204. doi: 10.1007/s41649-022-00234-1. eCollection 2023 Apr.
Genome editing, for instance by CRISPR-Cas, is a major advancement of the last 10 years in medicine but questions ethically our practices. In particular, human embryo heritable genome editing is a source of great controversy. We explored how this ethical question was debated in the literature from PubMed database, in a period of 4 years (2016-2020) around the announcement of the 'CRISPR babies' Chinese experiment in November 2018. We evaluated the weight of the arguments for and against this topic, through an analysis of reviews published on this question. The most important arguments come from the technical perspective: safety issues and benefits, putative long-term effects on the future generations and the need to assess this aspect. Next, foreseeable clinical benefits and the alternatives to these methods are discussed. The number of people that would benefit from such techniques is also considered. However, social and anthropological issues are addressed in a more disparate way. Parenthood and desire for children are sometimes overlooked. Few authors mention social justice, stigmatisation and equality of access. Consent and information are more clearly addressed, as well as the question of the relationship between generations. Finally, the effects on the nature of humankind or human species are far from being consensual; the risks of enhancement, eugenics and transhumanism are raised. We conclude that the risks associated with the immaturity of the technique were at the forefront of the ethical debate on human embryo heritable genome editing. Their consequences were seen as more immediate and easier to handle than those of sociological or anthropological projections, which are more speculative in nature.
The online version contains supplementary material available at 10.1007/s41649-022-00234-1.
例如,通过CRISPR-Cas进行的基因组编辑是过去10年医学领域的一项重大进展,但在伦理方面对我们的实践提出了质疑。特别是,人类胚胎可遗传基因组编辑引发了巨大争议。我们探讨了在2018年11月中国“基因编辑婴儿”实验公布后的4年(2016 - 2020年)里,这个伦理问题在来自PubMed数据库的文献中是如何被讨论的。我们通过分析关于这个问题发表的综述,评估了支持和反对这一主题的论据的分量。最重要的论据来自技术层面:安全问题和益处、对后代可能的长期影响以及评估这方面的必要性。接下来,讨论了可预见的临床益处以及这些方法的替代方案。还考虑了将从这些技术中受益的人数。然而,社会和人类学问题的讨论方式更为分散。亲子关系和生育愿望有时被忽视。很少有作者提及社会正义、污名化和平等获取的问题。同意和信息问题得到了更清晰的阐述,以及代际关系问题。最后,对人类本质或人类物种的影响远未达成共识;人们提出了增强、优生学和超人类主义的风险。我们得出结论,与技术不成熟相关的风险在关于人类胚胎可遗传基因组编辑的伦理辩论中处于前沿位置。与社会学或人类学预测相比,其后果被视为更直接且更易于处理,而社会学或人类学预测本质上更具推测性。
在线版本包含可在10.1007/s41649-022-00234-1获取的补充材料。