The Dawning of the Era of Genetic Modification

by David Lemberg on July 5, 2010

In September 2007 I was the keynote speaker at The Molecular Convergence Conference at the University of Oklahoma, Tulsa. As I’m a lifelong lover of science fiction, I titled my talk “Science Fiction Becoming Science Fact”. Advances are now coming thick and fast. The exponential growth of information in many branches of science is at this point, iconic, and the most rapidly expanding field is genetics. A prominent researcher in the subfield of synthetic biology notes “We are surfing an exponential now with the capacity to impact the world in a fundamental way”.1

“Surfing an exponential” is a high-powered metaphor connoting the torrent of new information that now seems to be appearing monthly. Many scientists correctly point to the potentially extraordinary impact that breakthroughs in genetics may yield. An open question is the nature of the interface between social responsibility and the path of science.

Scientists engaged in basic research loathe questions related to applications for their work. A colleague of mine is a world-renowned particle physicist and best-selling author. She rebuffs such inquiries by asking whether the questioner is aware that our ubiquitous GPS devices are a direct application of Einstein’s General Theory of Relativity. “Do you think Einstein thought about GPS?” she adds, burying the hatchet a little deeper.

Science cannot be checked. To predetermine boundary conditions for a path of research is to doom that research to insignificance. The most brilliant breakthroughs have almost uniformly been serendipitous. One idea leads to another. The chain of associations cannot be predicted.

Right now, genetics is “riding giants”. One-hundred foot waves are crashing the shoreline. Wang et al are “expediting the design and evolution of organisms”.2 In E. coli they created more than 4.3 billion combinatorial genetic variants per day. Lartigue et al reported work that is equally remarkable. They transferred “a genome between branches of life”, devising a sophisticated end-around to the challenge of manipulating a bacterium’s genetic code.3 Lartigue et al moved a bacterial genome into yeast, a eukaryote containing built-in machinery to conduct genetic alterations, and then moved the altered DNA back into a bacterium. They term these processes “genome transplantation”. I hadn’t heard that phrase before and I literally sat bolt upright in my chair and unconsciously took in a very deep breath. I knew very clearly that my eyes had just scanned THE FUTURE.

Whenever such a sequence is performed the result is a novel organism, a strain that had not previously existed. They “engineered a bacterial cell by altering its genome outside of its native cellular environment”. And they’re saying all this with a straight face.

The organization BioBricks has been described as enabling “open-source biology”. That’s it, exactly. Linux is robust because of constant improvements. Wikipedia has achieved world domination by being an open platform. The open-source approach enabled a team of students to build a murine vaccine for H. pylori from scratch.

More complex artificial life forms will arise with only a few more exponential turns of the development cycle. The next step is to create a novel bacterium that can reproduce. Such an event will mark the beginning of post-human society for human genetic manipulation will not be far behind.

As I’ve consistently noted, bioethics cannot play catch-up. Society needs to be prepared for revolutionary — not evolutionary — changes in our most basic comprehension of what it is to be a human being. Complex issues need to be addressed, investigated, and debated in public forums across the country. As a nation, if we don’t start to think right away, now, we will be lost. Other nations not encumbered by our Puritanism, such as China and India, will rapidly embrace the new genetics and eventually America will be no more than a memory.

1Specter M: Where will synthetic biology lead us? The New Yorker, September 28, 2009
2Wang HH, et al: Programming cells by multiplex genome engineering and accelerated evolution. Nature 460:894-898, 2009
3Lartigue C, et al: Creating bacterial strains from genomes that have been cloned and engineered in yeast. Science 325(5948):1693-1696, 2009

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Genetic Enhancement, Autonomy, and Society

by David Lemberg on July 5, 2010

Prenatal and postnatal genetic enhancement may ultimately result in a post-human society. These techniques remain in the science fiction realm for the foreseeable future, but a consideration of their implications is critically important for our ability to successfully manage their impact.

What might be good concerning genetic enhancement and what might be not so good? In the early going there would be questions of distributive justice. As the procedures would be costly in the initial period of availability, the rich would get richer. One solution could involve government subsidies for those who are economically disadvantaged.

As a taxpayer, I’d resist such use of my contributions to federal coffers. Possibly the government could subsidize a select number of procedures for the entire population, and a lottery would determine the lucky families. At least, this would be a more equitable use of these new technologies.

I’ll level the playing field and create a scenario in which any family can afford genetic enhancement. Is the autonomy of the enhanced child affected? On one view, as this child is the one actually born, she can have no complaints regarding autonomy, at least with respect to her enhanced genetic sequence. She’s alive, and this is only a bad thing in the extremely unlikely circumstance that her life is not worth living.

Similar views have been propounded by Robertson in his discussion of early IVF techniques: “Since offspring would have had no alternative route to a healthy birth, embryo transfer . . . would not harm offspring, and therefore could not be banned on that basis.”1

The child’s autonomy would be affected by parents who attempt to limit their offspring’s choices. But a child’s autonomy is never that of an adult. A child’s choices are always limited. A proportion of parents who choose genetic enhancement will be smart parents who have upgraded their child’s opportunities and provide the space for their child to make her own choices (within the boundaries of being a child). Another group of parents will attempt to force choices upon their child. I assert this would occur regardless of the availability of genetic enhancement.

Such genetic manipulation could provide great value. I would have enjoyed being able to run faster and jump higher. What if we could be able to breathe underwater? Such an enhancement would be greatly appreciated by many. What if we could read a 400-page book in an hour? I’d like to be able to do that, too.

But considering how much progress has been achieved in the last 50 years regarding the treatment of cancer (literally zero), such genetic breakthroughs are at least 100 years away. Regardless, a forward-thinking society would have its ethical constructs in place in advance of the technology.

1Robertson JA: The new reproduction. Southern Cal Law Rev 59:987-1000, 1986

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Genome-Wide Association Studies — Do They Live Up to the Hype?

July 5, 2010

As is typical of decision-making in clinical diagnosis, choices in clinical genetics are never straightforward and always lead to subsidiary questions. Similarly in genetics itself, as in physiology or biochemistry, an answer to a question leads to other questions about that answer, and investigators and clinicians are led deeper into the maze.
One undertakes the journey [...]

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Gamete Commodification — Deal or No Deal?

July 5, 2010

What’s so special about gametes that causes us to be concerned about their commodification? Commodification itself is not a bad thing. In free societies, supply-and-demand relationships precisely determine prices. [I'm presupposing the absence of monopolistic practices. In oil production and supply, for example, monopolistic practices skew prices considerably.]
We exchange goods and services all day long, [...]

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Sports Genes – Hype, Hoopla, and Hubris

July 5, 2010

The Indian legend of The Three Blind Men and the Elephant is an apt metaphor for any random collection of three biotechnology entrepreneurs. Each is raptly focused on his personal locus, blind to the deep complexity just beyond his grasp.
Of course, “entrepreneur” in the medical field is for many of us a code word for [...]

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Prenatal Genetic Testing — Ethical Considerations

July 5, 2010

Many commentators are concerned that physicians have an agenda when they discuss results of prenatal testing with their patients. Often, physicians have preconceived values regarding what should be an exclusively patient-centered arena. For example, many physicians are predisposed to recommend abortion when prenatal testing reveals the presence of genetic or structural anomalies that would result [...]

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Epigenetics — Traffic Signals on the DNA Highway

June 23, 2010

The genetic code contains only four letters. Organisms of staggering complexity are built from the detailed information contained in this four-letter alphabet. How this code is manifested requires many added layers of complexity and interaction with a host of variable systems.
Epigenetics describes modifications to chromosomal DNA that do not alter the genetic code, but persist [...]

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Gene Patents Compromise Your Health

June 23, 2010

Genes are patented. Not Lee’s or Levi’s — not those jeans. Sequences composed of adenine, thymine, guanine, and cytosine — those genes. How absurd. How indirectly nihilistic. Camus, Beckett, Ionesco, and Vonnegut are laughing up their ghostly sleeves.
Only in America. Well not quite only here. But close. The sad part is that patenting gene sequences [...]

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Medicaid — The Canary in the Coal Mine

June 23, 2010

The New York Times reported on 2-19-10 that virtually every state is making or planning significant cuts in Medicaid benefits.1 These actions are taking place while demand for Medicaid grows. This entitlement, originally conceived as a support for those in lower socioeconomic classes and disabled persons, now is a necessary lifeline for those formerly in [...]

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The Doctor–Patient Relationship and the Media

June 23, 2010

Revising the doctorpatient relationship is a very important conversation. It is worthwhile and instructive to first look at how the media — broadcast, print, and web sources — participate in and affect this relationship. Stating the obvious, there are good media and bad media. Mostly bad. The power and necessity of the 24-hour news churn [...]

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