Just Say No to Editing Human Embryos for Reproduction
BIG QUESTION OF THE MONTH: Should we use CRISPR, the new technique that enables precise DNA editing, to change the genes of human embryos to eradicate disease – or even to enhance desirable traits? LeapsMag invited three leading experts to weigh in.
Over the last few decades, the international community has issued several bioethical guidelines and legally binding documents, ranging from UN Declarations to regional charters to national legislation, about editing the human germline--the DNA that is passed down to future generations. There was a broad consensus that modifications should be prohibited. But now that CRISPR-cas9 and related methods of gene editing are taking the world by storm, that stance is softening--and so far, no thorough public discussion has emerged.
There is broad agreement in the scientific and ethics community that germline gene editing must not be clinically applied unless safety concerns are resolved. Predicting that safety issues will indeed be minimized, the National Academy of Sciences issued a report this past February that sets up several procedural norms. These may serve as guidelines for future implementation of human embryo editing, among them that there are no "reasonable alternatives," a condition that is left deliberately vague.
I regard the conditional embrace of germline gene editing as a grave mistake: It is a dramatic break with the previous idea of a ban, departing also from the moratorium that the UNESCO International Bioethics Committee had recommended in 2015. But in a startling move, the Academy already set the next post, recommending "that genome editing for purposes other than treatment or prevention of disease and disability should not proceed at this time" (my emphasis). It recommended public discussions, but without spelling out its own role in facilitating them.
"The international community should explicitly ban embryo gene editing as a method of human reproduction."
To proceed ethically, I argue that the international community, through the United Nations and in line with the ban on human reproductive cloning, should explicitly ban embryo gene editing as a method of human reproduction. Together with guidelines adjusted for non-reproductive and non-human applications, a prohibition would ensure two important results: First, that non-reproductive human embryo research could be pursued in a responsible way in those countries that allow for it, and second, that individual scientists, public research institutes, and private companies would know the moral limit of possible research.
Basic human embryo research is required, scientists argue, to better understand genetic diseases and early human development. I do not question this, and I am convinced that existing guidelines can be adjusted to meet the moral requirements in this area. Millions of people may benefit from different non-reproductive pathways of gene editing. Germline gene editing, in contrast, does not offer any resolutions to global or local health problems – and that alone raises many concerns about the current state of scientific research.
I support a ban because germline gene editing for reproductive purposes concerns more than safety. The genetic modification of a human being is irreversible and unpredictable in its epigenetic, personal, and social effects. It concerns the rights of children; it exposes persons with disabilities to social stigmatization; it contradicts the global justice agenda with respect to healthcare; and it infringes upon the rights to freedom and well-being of future persons.
"Reproductive germline gene editing directly violates the rights of individual future person."
Apart from questions of justice, reproductive germline gene editing may well increase the stigmatization of persons with disabilities. I want to emphasize here, however, that it directly violates the rights of individual future persons, namely a future child's right to genetic integrity, to freedom, and potentially to well-being, all guaranteed in different UN Declarations of Human Rights. For all these reasons, it is an unacceptable path forward.
The way the discussion has been framed so far is very different from my perspective that situates germline gene editing in the broader framework of human rights and responsibilities. In short, many others never questioned the goal but instead focused on the unintentional side-effects of an otherwise beneficial technique for human reproduction. Some scientists see germline gene editing as an alternative to embryo selection via Preimplantation Genetic Diagnosis (PGD), a procedure in which multiple embryos are tested to find out which ones carry disease-causing mutations. Others see it as the first step to human enhancement.
Some physicians argue that in the field of assisted reproduction, not every couple is comfortable with embryo selection via PGD, because potentially, unchosen embryos are discarded. Germline gene editing offers them an alternative. It is rarely mentioned, however, that germline gene editing would most likely still require PGD as a control of the procedure (though without the purpose of selection), and that prenatal genetic diagnosis would also be highly recommended. In other words, germline gene editing would not replace existing protocols but rather change their purpose, and it would also not necessarily reduce the number of embryos needed for assisted reproduction.
In some (rare) cases, PGD is not an option, because in the couples' condition, all embryos will be affected. One current option to avoid transmitting genetic traits is to use a donor sperm or egg, though the resulting child would not be genetically related to one parent. If these parents had an obligation, as some proponents argue, to secure the health of their offspring (an argument that I do not follow), then procreation with sperm or egg donation would even be morally required, as this is the safest procedure to erase a given genetic trait.
There are no therapeutic scenarios that exclusively require reproductive gene editing even if one accepts the right to reproductive autonomy. The fact is that couples who rightly wish to secure and protect the health of their future children can be offered medical alternatives in all cases. However, this requires considering sperm or egg donation as the safest and most reasonable option – the condition the NAS Report has set.
Scientists in favor of germline gene editing argue against this: the desire for genetic kinship, they say, is a legitimate expression of a couple's reproductive freedom, and germline gene editing offers them an alternative to have a healthy child. In the future, proponents say, these (very few) couples who wish for genetically related offspring will be faced with the dilemma of either accepting the transmission of a genetic health risk to their children or weighing the benefits and risks of gene editing.
But here is a blind spot in the whole discussion.
Many scientists and some bioethicists think that reproductive freedom includes the right to a genetically related child. But even if we were to presuppose such a right, it is not absolute in the context of assisted reproduction. Although sperm or egg donation may be undesirable for some couples, the moral question of responsibility does not disappear with their reproductive rights. At a minimum, the future child's rights must be considered, and these rights go further than their health rights.
It is puzzling that in claiming their own reproductive freedom, couples would need to ignore their children's and possibly grandchildren's future freedom – including the constraints resulting from being monitored over the course of their lives and the indirect constraints of the children's own right to reproductive freedom. From a medical standpoint, it would be highly recommended for them, too, to have children through assisted reproduction. This distinguishes germline gene editing from any other procedure of assisted reproduction: we need the data from the second and third generations to see whether the method is safe and efficacious. Whose reproductive freedom should count, the parents' or the future children's?
But for now, the question of parental rights may well divert the discussion from the question of responsible gene editing research; its conditions and structures require urgent evaluation and adjustment to guide international research groups. I am concerned that we are in the process of developing a new technology that has tremendous potential and ramifications – but without having considered the ethical framework for a responsible path forward.
Editor's Note: Check out the viewpoints expressing enthusiastic support and mild curiosity.
The Friday Five covers five stories in research that you may have missed this week. There are plenty of controversies and troubling ethical issues in science – and we get into many of them in our online magazine – but this news roundup focuses on new scientific theories and progress to give you a therapeutic dose of inspiration headed into the weekend.
This episode includes an interview with Dr. Helen Keyes, Head of the School of Psychology and Sports Science at Anglia Ruskin University.
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As a graduate student in observational astronomy at the University of Arizona during the 1970s, Diane Turnshek remembers the starry skies above the Kitt Peak National Observatory on the Tucson outskirts. Back then, she could observe faint objects like nebulae, galaxies, and star clusters on most nights.
When Turnshek moved to Pittsburgh in 1981, she found it almost impossible to see a clear night sky because the city’s countless lights created a bright dome of light called skyglow. Over the next two decades, Turnshek almost forgot what a dark sky looked like. She witnessed pristine dark skies in their full glory again during a visit to the Mars Desert Research Station in Utah in early 2000s.
“I was shocked at how beautiful the dark skies were in the West. That is when I realized that most parts of the world have lost access to starry skies because of light pollution,” says Turnshek, an astronomer and lecturer at Carnegie Mellon University. In 2015, she became a dark sky advocate.
Light pollution is defined as the excessive or wasteful use of artificial light.
Light-emitting diodes (LEDs) -- which became commercially available in 2002 and rapidly gained popularity in offices, schools, and hospitals when their price dropped six years later — inadvertently fueled the surge in light pollution. As traditional light sources like halogen, fluorescent, mercury, and sodium vapor lamps have been phased out or banned, LEDs became the main source of lighting globally in 2019. Switching to LEDs has been lauded as a win-win decision. Not only are they cheap but they also consume a fraction of electricity compared to their traditional counterparts.
But as cheap LED installations became omnipresent, they increased light pollution. “People have been installing LEDs thinking they are making a positive change for the environment. But LEDs are a lot brighter than traditional light sources,” explains Ashley Wilson, director of conservation at the International Dark-Sky Association (IDA). “Despite being energy-efficient, they are increasing our energy consumption. No one expected this kind of backlash from switching to LEDs.”
Light pollution impacts the circadian rhythms of all living beings — the natural internal process that regulates the sleep–wake cycle.
Currently, more than 80 percent of the world lives under light-polluted skies. In the U.S. and Europe, that figure is above 99 percent.
According to the IDA, $3 billion worth of electricity is lost to skyglow every year in the U.S. alone — thanks to unnecessary and poorly designed outdoor lighting installations. Worse, the resulting light pollution has insidious impacts on humans and wildlife — in more ways than one.
Disrupting the brain’s clock
Light pollution impacts the circadian rhythms of all living beings—the natural internal process that regulates the sleep–wake cycle. Humans and other mammals have neurons in their retina called intrinsically photosensitive retinal ganglion cells (ipRGCs). These cells collect information about the visual world and directly influence the brain’s biological clock in the hypothalamus.
The ipRGCs are particularly sensitive to the blue light that LEDs emit at high levels, resulting in suppression of melatonin, a hormone that helps us sleep. A 2020 JAMA Psychiatry study detailed how teenagers who lived in areas with bright outdoor lighting at night went to bed late and slept less, which made them more prone to mood disorders and anxiety.
“Many people are skeptical when they are told something as ubiquitous as lights could have such profound impacts on public health,” says Gena Glickman, director of the Chronobiology, Light and Sleep Lab at Uniformed Services University. “But when the clock in our brains gets exposed to blue light at nighttime, it could result in a lot of negative consequences like impaired cognitive function and neuro-endocrine disturbances.”
In the last 12 years, several studies indicated that light pollution exposure is associated with obesity and diabetes in humans and animals alike. While researchers are still trying to understand the exact underlying mechanisms, they found that even one night of too much light exposure could negatively affect the metabolic system. Studies have linked light pollution to a higher risk of hormone-sensitive cancers like breast and prostate cancer. A 2017 study found that female nurses exposed to light pollution have a 14 percent higher risk of breast cancer. The World Health Organization (WHO) identified long-term night shiftwork as a probable cause of cancer.
“We ignore our biological need for a natural light and dark cycle. Our patterns of light exposure have consequently become different from what nature intended,” explains Glickman.
Circadian lighting systems, designed to match individuals’ circadian rhythms, might help. The Lighting Research Center at Rensselaer Polytechnic Institute developed LED light systems that mimic natural lighting fluxes, required for better sleep. In the morning the lights shine brightly as does the sun. After sunset, the system dims, once again mimicking nature, which boosts melatonin production. It can even be programmed to increase blue light indoors when clouds block sunlight’s path through windows. Studies have shown that such systems might help reduce sleep fragmentation and cognitive decline. People who spend most of their day indoors can benefit from such circadian mimics.
When Diane Turnshek moved to Pittsburgh, she found it almost impossible to see a clear night sky because the city’s countless lights created a bright dome of light called skyglow.
Diane Turnshek
Leading to better LEDs
Light pollution disrupts the travels of millions of migratory birds that begin their long-distance journeys after sunset but end up entrapped within the sky glow of cities, becoming disoriented. A 2017 study in Nature found that nocturnal pollinators like bees, moths, fireflies and bats visit 62 percent fewer plants in areas with artificial lights compared to dark areas.
“On an evolutionary timescale, LEDs have triggered huge changes in the Earth’s environment within a relative blink of an eye,” says Wilson, the director of IDA. “Plants and animals cannot adapt so fast. They have to fight to survive with their existing traits and abilities.”
But not all types of LEDs are inherently bad -- it all comes down to how much blue light they emit. During the day, the sun emits blue light waves. By sunset, red and orange light waves become predominant, stimulating melatonin production. LED’s artificial blue light, when shining at night, disrupts that. For some unknown reason, there are more bluer color LEDs made and sold.
“Communities install blue color temperature LEDs rather than redder color temperature LEDs because more of the blue ones are made; they are the status quo on the market,” says Michelle Wooten, an assistant professor of astronomy at the University of Alabama at Birmingham.
Most artificial outdoor light produced is wasted as human eyes do not use them to navigate their surroundings.
While astronomers and the IDA have been educating LED manufacturers about these nuances, policymakers struggle to keep up with the growing industry. But there are things they can do—such as requiring LEDs to include dimmers. “Most LED installations can be dimmed down. We need to make the dimmable drivers a mandatory requirement while selling LED lighting,” says Nancy Clanton, a lighting engineer, designer, and dark sky advocate.
Some lighting companies have been developing more sophisticated LED lights that help support melatonin production. Lighting engineers at Crossroads LLC and Nichia Corporation have been working on creating LEDs that produce more light in the red range. “We live in a wonderful age of technology that has given us these new LED designs which cut out blue wavelengths entirely for dark-sky friendly lighting purposes,” says Wooten.
Dimming the lights to see better
The IDA and advocates like Turnshek propose that communities turn off unnecessary outdoor lights. According to the Department of Energy, 99 percent of artificial outdoor light produced is wasted as human eyes do not use them to navigate their surroundings.
In recent years, major cities like Chicago, Austin, and Philadelphia adopted the “Lights Out” initiative encouraging communities to turn off unnecessary lights during birds’ peak migration seasons for 10 days at a time. “This poses an important question: if people can live without some lights for 10 days, why can’t they keep them turned off all year round,” says Wilson.
Most communities globally believe that keeping bright outdoor lights on all night increases security and prevents crime. But in her studies of street lights’ brightness levels in different parts of the US — from Alaska to California to Washington — Clanton found that people felt safe and could see clearly even at low or dim lighting levels.
Clanton and colleagues installed LEDs in a Seattle suburb that provided only 25 percent of lighting levels compared to what they used previously. The residents reported far better visibility because the new LEDs did not produce glare. “Visual contrast matters a lot more than lighting levels,” Clanton says. Additionally, motion sensor LEDs for outdoor lighting can go a long way in reducing light pollution.
Flipping a switch to preserve starry nights
Clanton has helped draft laws to reduce light pollution in at least 17 U.S. states. However, poor awareness of light pollution led to inadequate enforcement of these laws. Also, getting thousands of counties and municipalities within any state to comply with these regulations is a Herculean task, Turnshek points out.
Fountain Hills, a small town near Phoenix, Arizona, has rid itself of light pollution since 2018, thanks to the community's efforts to preserve dark skies.
Until LEDs became mainstream, Fountain Hills enjoyed starry skies despite its proximity to Phoenix. A mountain surrounding the town blocks most of the skyglow from the city.
“Light pollution became an issue in Fountain Hills over the years because we were not taking new LED technologies into account. Our town’s lighting code was antiquated and out-of-date,” says Vicky Derksen, a resident who is also a part of the Fountain Hills Dark Sky Association founded in 2017. “To preserve dark skies, we had to work with the entire town to update the local lighting code and convince residents to follow responsible outdoor lighting practices.”
Derksen and her team first tackled light pollution in the town center which has a faux fountain in the middle of a lake. “The iconic centerpiece, from which Fountain Hills got its name, had the wrong types of lighting fixtures, which created a lot of glare,” adds Derksen. They then replaced several other municipal lighting fixtures with dark-sky-friendly LEDs.
The results were awe-inspiring. After a long time, residents could see the Milky Way with crystal clear clarity. Star-gazing activities made a strong comeback across the town. But keeping light pollution low requires constant work.
Derksen and other residents regularly measure artificial light levels in
Fountain Hills. Currently, the only major source of light pollution is from extremely bright, illuminated signs which local businesses had installed in different parts of the town. While Derksen says it is an uphill battle to educate local businesses about light pollution, Fountain Hills residents are determined to protect their dark skies.
“When a river gets polluted, it can take several years before clean-up efforts see any tangible results,” says Derksen. “But the effects are immediate when you work toward reducing light pollution. All it requires is flipping a switch.”