By Eli Mahabir
In a world ridden with chronic diseases and genetic conditions, we have always longed for a solution. Enter CRISPR/Cas9: A massive technological breakthrough that utilizes a guided enzyme in order to precisely edit DNA. Editing adult cells can individually cure a patient, while editing early embryos could prevent the disease from occurring before birth. It is important to note that adult cells edited with CRISPR/Cas9 will not affect their babies. Imagine a world without Huntington’s disease, cystic fibrosis, and sickle cell disease, along with many more chronic diseases/illnesses.
In July 2019, Victoria Gray, an American mother of four from Forest, Mississippi, became the first sickle cell patient approved for CRISPR/Cas9 therapy. Sickle cell disease disproportionately affects Black Americans, a population that has historically faced socioeconomic disadvantages as well as less access to cutting-edge medical treatment, and it’s really what makes her willingness to be the first human test case even more fascinating. Her transformation culminated in 2023, as she was finally FDA-approved to undergo the therapy, and it is safe to say that the first case of CRISPR/Cas9 in adult human cells being utilized to eliminate genetic diseases was a massive success. Today, years later, Victoria is still living symptom-free, and her case is widely considered by medical experts and other technological experts to be a massive success in terms of genetic modification.
One major dilemma that may come about this, however, is gene editing from an ethical standpoint. Isn’t that simply eugenics? The comparison isn’t quite fair at face value, and historically, eugenics relied on coercion: entire groups of people ranked as “unfit,” as well as forced sterilization, just to name a few. CRISPR treatment is completely voluntary, and it is made to prevent further human suffering. However, the comparison isn’t exactly dismissible. If editing an embryo to prevent Huntington’s disease is acceptable, what about accounting for height, intelligence, or facial aesthetics? The truth is, nobody can make a clear distinction between “designing people” and “preventing suffering,” and that ethical dilemma is exactly why many ethicists and regulators are still in conflict over where to draw the line.
The stakes are also far different depending on which kind of editing is involved. Editing adult human cells, such as in Victoria Gray’s case, only affects the patient. Editing embryos changes every cell in a future person; that includes their reproductive cells, which means the gene editing that took place at the embryonic stage will actually pass down to future generations, permanently. The risks are not simply theoretical; they have been observed. CRISPR/CAS9 can make off-target edits, cutting DNA at unintended locations, or produce mosaicism, where only some cells in the embryo actually get edited. Not to mention, we don’t even quite understand every gene’s downstream effects, which means that a fix for one generation may have unforeseen consequences for the next generations to follow.
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