Why Human Germline Editing is More Problematic than Selecting Between Embryos: Ethically Considering Intergenerational Relationships

Abstract

Do we have a moral obligation to genetically cure embryos rather than selecting between them? Such an obligation would be an ethical argument for human germline gene editing (hGGE) to avoid the inheritance of genetic conditions instead of using pre-implantation genetic diagnosis (PGD). In this article, the intuition that we do have such a moral obligation is critically evaluated. The article first develops a theoretical framework for discussing the ethical questions of hGGE. This framework is based on an exploration of the phenomenology of the germline, from both biological and philosophical points of view. It interprets the germline as an embodied intergenerational relationship that carries meanings for the parents and for the children-to-be. It relates them to previous family generations, and to their own children. Hence, the germline is a phenomenologically much richer concept than just the line of cells that carry the inheritable genetic information. Against this background, selection is compared with editing and a key moral difference is identified: editing is in effect an act of co-constructing the genome, which necessarily assumes a wider range of responsibilities that include those parts that are left unedited. Introducing hGGE into societies would hence significantly affect and change the moral structure of the intergenerational relationships. Selective implantation, on the other hand (in the context of PGD), is based on a moral choice in favour of the embryo which is to be unaffected by a disease or disability that causes suffering, rather than selecting knowingly the affected one. The claim that hGGE is in the best interests of the child-to-be counterfactually assumes the presence of a patient who has an interest in being cured. The embryo (a potential future patient) is, however, brought into existence by the same act that is also the treatment. The future children who would result from treatment by hGGE may rather have an interest in not having been treated by hGGE, since it makes the intergenerational relationships more complicated and burdensome. The question ‘Is hGGE justified, or even an obligation?’ is answered with a No.

Keywords:

• germline
• gene therapy
• germline gene editing
• phenomenology of reproductive genetics
• intergenerational relationships

Acknowledgments

I thank Hannes Foth, Anika König, Christina Schües and Jackie Leach Scully for critical suggestions on an earlier draft. Monica Buckland revised the English.

Notes on contributor

Christoph Rehmann-Sutter is Professor for Theory and Ethics in the Biosciences at the Institute for History of Medicine and Science Studies at the University of Lübeck in Germany. His work focuses on elements for a new methodological framework for bioethics, drawing on resources of phenomenology, philosophical hermeneutics, relationship ethics and social theory.

Notes

1 See the related criticism on essentialist interpretations of genes and the genome in the context of developmental systems in Neumann-Held and Rehmann-Sutter (2006), Oyama (2000) and Griffiths and Stotz (2013).

2 The intrusion argument was put forward by Nancy King at the Human Genome Editing conference in Belgrade, August 2017.

3 The symbolized genders of the two mes on the two sides of the graph are arbitrary.

4 On prenatal diagnosis Gregg (1995), Rapp (1999), Haidar et al. (2016); on PGD Rehmann-Sutter (2017).

5 I have suggested this point already in an earlier article about the ethics of germline therapy (Rehmann-Sutter, 1991), anticipating a situation as we see it now with the CRISPR systems.

6 This is not a classical slippery slope argument but a realistic projection.

7 On enhancement and disability see Eilers et al. (2014).

Additional information

Funding

This research was funded by the Deutsche Forschungsgemeinschaft DFG through grant number RE 2951/3-1.