What Could Possibly Go Wrong?


#383

I think that CRISPR that is something that absolutely should be used embryonically to cure debilitating life-long diseases.

It is also something that needs to be adopted universally so that every child can recieve the life-saving care that an embryonic gene-edit could give, otherwise we live in the horror world that is Gattaca.

But, if we have the technology to stop babies from being born with Huntington’s disease, ALS, down syndrome, childhood cancers, sickle cell anemia… etc. Why wouldn’t we want to use it? We can make our children healthier, better, and reduce longterm costs of care? It is just plain better for the human race to stop preventable diseases if we can (And this could make those incurable diseases at least preventable).

How much different is the anti-vaccination argument than the anti-gene editing argument?

I also think that the end point of gene editing in children is preventing debilitating diseases, full stop, and it needs to be heavily regulated. The cat is out of the bag now, and we need to move to create controls that we all can live with.


#384

I don’t think there is a feasible way to use CRISPR after an embryo has implanted in the uterus. Which is where most embryos are when women learn they are pregnant.


#385

Fair enough, but I am sure that technology is coming.


#386

Don’t be so sure.

Research into such technology would be considered unethical for reasons I described above. And in addition to the long term risks, manipulating an embryo in the uterus carries a high risk of miscarriage. Frankly, it would be easier to just find a cure for all the diseases you listed.

You’ll be driving a flying car on Mars long before we have universal gene editing.


#387

Gengineering is the only real cure for genetic defects, by definition. Everything else is treating symptoms.

We do need to define what’s allowed. Fixing defects is an obvious gimme. But what about propensity towards substance addiction or obesity? What about psychopathy, or depression? What if we found an allele sequence that correlated strongly with suicide later in life? Wouldn’t you want to protect your child from these things?


#388

I think there’s a great near-future novel with all the stuff going on now, like Instagrammable views that have thousands of people in line waiting to take the shot, because everywhere is polluted and ruined, ect. I think this is already starting to happen.

I think the genetic engineering problem is inevitable. I always frame it this way - if every girl in your child’s school has been genetically engineered to look like a model, not doing so to your child will make her the ugliest girl in school. If not, perhaps, the ugliest girl in the city. She’s going to be miserable, and she’s going to hate you for keeping her plain.

I think Gattaca aims too high with its Silicon Valley / MIT view of tech company creators that made it and the slurry below of everyone else. Make it personal, about things like appearance and feelings rather than standardized test scores.

It’s easy to resist genetic engineering for yourself, but it’s much harder to do so for your children. Especially if the social consequences of not doing so could be disastrous. IE, you can resist not making your kid a super genius, but can you resist participating if by opting out they’re doomed to be a social outcast? This is assuming, of course, genetic engineering could become as inexpensive and widespread as using OTC medicine or whatnot (at least for narrative purposes anyway). In practice at least, this stuff would be the luxury of the great and the good.

The disease fixing thing otoh is pretty self evidently good and will probably be the vector by which more superficial editing slips into society.


#389

Not necessarily.

The cure for breast cancer is surgery, radiation, and/or chemotherapy. If you have genetic risk factors for breast cancer, gene therapy is no more “curative” than reducing alcohol consumption (also a risk factor). In both cases you can lower your risk, but not eliminate your risk.

If you want to reduce the risk of depression for your child, why not start them on Prozac in infancy? I mean, what could go wrong?

It’s easy to forget that genes are only one component of disease, and genes that elevate risk of certain diseases are genes that also have other functions. Adding Prozac to baby formula may very well be safer than a CRISPR intervention to reduce depression risk, yet I doubt anyone will line up for the former.

A little food for thought: is caffeine good for you or bad for you overall? The answer is, we’re not sure. Maybe good for you in some circumstances, but bad in others. No long term effects. Probably. That’s the best we can do for a simple compound that was isolated two hundred years ago, is already in near universal use, is easy to administer, and is rapidly cleared from the body. Imagine the challenge in a cost - benefit analysis for universal gene therapy, which has none of those advantages.


#390

Mastectomies don’t cure breast cancer. That’s an insane way to look at it. Radiation and chemo address the symptoms, not the root cause. If we could find the genes that code for susceptibility to breast cancer, we could edit them, and the person would be less likely to get it in the future.

Genes are absolutely only one component, you’re correct, and there may well be far-reaching effects to gengineering. We need to do the hard work to figure out what they may be, because gengineering isn’t going away. The technology exists, someone is going to use it.


#391

There are absolutely diseases that are generic though, like A1AD disorder for example, which my Aunt died from and of which i may be a carrier (I still haven’t gotten tested, i just keep forgetting. Father has 1 allele and Mother 0, so i can’t actually get the full disease.)


#392

If you fix all the genes that increase the risk of breast cancer, and the patient gets breast cancer anyway (which is not improbable), then what has gene therapy cured?

If surgery, chemo and radiation do not cure breast cancer, then what does?

Yes, there are diseases that are 100% genetic. And there is a good argument for selective gene therapy for known carriers.


#393

If you get the flu vaccine and catch the flu anyway, then what’s the point? Well, you were less likely to get it. And if you do catch the flu, it probably isn’t as bad.

Nothing cures cancer today. We just fumble around trying to kill the tumors and pray it doesn’t come back.


#394

The flu vaccine does not cure the flu.

And the point is to balance the risks of flu against the benefits and risks of the vaccine. Which is easy to do. Unlike gene therapy.


#395

I think this is a semantics argument over the word cure.

Cure is not the same as prevention.

But 100% prevention of a genetic disorder like Huntington’s or Progeria, is as good as a cure.


#396

Yes, the semantics argument is silly.


#397

Like I said, I think that it’s reasonable to envision selective gene therapy for carriers of 100% genetic diseases.

It’s unreasonable to envision universal gene therapy, for the same reasons it’s unreasonable to envision Prozac in public drinking water or doctors offering to inject permanent blue dye into the eyes of brown-eyed toddlers.


#398

I guess it depends on what you mean by universal. I do think it will be common for parents to edit out defects, in the near future, certainly within my lifetime. The only question is what’s ultimately considered a defect.


#399

Well, the first and only scientist to try it is now facing suspension and censure. Who do you think will be the next genius to volunteer to end their career?


#400

So your argument is that it’s possible to stuff the genie back in the bottle?


#401

My argument is that nobody actually wants to touch that particular bottle. It’s the third rail of medical research.

There is a big difference between something that sounds cool, and something that is actually developed into therapy. A lot of ideas are abandoned due to lack of interest and/or results. That’s two strikes against embryonic gene therapy.

Even high profile research with everyone on board can be set back decades after a single adverse event. Jesse Gelsinger died in 1999 after an attempt at adult gene therapy, and the field is still dealing with the consequences. The first adult gene therapy drug didn’t come to market in 2017, based on research performed in 1993. That’s 25 years from lab to pharmacy, in a field that everyone wants to see succeed. Lots of people don’t want to see embryonic gene therapy succeed and can easily block it. No, I don’t think it will happen in our lifetime.


#402

What if you could buy a CRISPR kit direct from Shenzen on Aliexpress.com for $199? What if you could download gene sequences off reddit.com/r/hackyoself?

Never bet against technology getting cheap and ubiquitous.