Pdf logoIn the last five years, many laboratories worldwide have employed the genetic engineering technique known as CRISPR/Cas9, in the hope that it might one day be used to treat human diseases. Things seem to have accelerated in the last few days though, after the authorisation in the United Kingdom (UK) of these types of experiments in human embryos (See HERE). As always, there have been shouts of joy and shouts of alarm. Some say that this research holds out great hope, others see the germline — till now considered intangible — threatened, as well as possibilities for manipulating man.

The media have told us of edited human embryos on two occasions. Last April, they reported that in Canton (China), a team led by Junjiu Huang had used this technique to remove the gene that causes beta-thalassaemia, replacing it with a normal active gene in human triploid embryos. Huang acknowledged that the experiment was more failure than triumph, since the technique tested caused numerous errors and rarely hit the target.

He added that CRISPR/Cas9 technology needed to mature considerably before it could be applied to human embryos for therapeutic purposes. A long moratorium was imposed.

These days, the subject has again become news, after British regulators authorised researchers at the Crick Institute in London to apply the technique to a limited number (between 20 and 30) of human embryos produced ex professo, which will be modified and cultured in-vitro for seven days before being analysed. Some investigators say that the experiment would have to be extended beyond one week to be able to see what happens at the critical moments of development.

The project does not aim to cure any disease, but rather is limited to clarifying if and how an embryo evolves when the activity of an important regulatory gene is blocked, in this case OCT4. Subsequent studies will explore other genes. We must not forget, however, that we already understand the effects of these blocks in embryos of other animal species.

The famous 14 days

It is time to ask, has so much progress been made since Huang’s experiment to justify the London trial? Moreover, what ethics are behind the new experiment?

There is, in my opinion, a hard pragmatism. The following is proof. Last December, at the annual meeting of the influential Progress Educational Group, Professor Surani of the Gurdon Institute at Cambridge University called strongly for an extension of the 14-day term that British Law imposes on embryonic experimentation. He cited three reasons: a) that the proposed extension does not appreciably damage the minimal respect with which the law obliges the embryo be treated, as regards an object of experimentation; b) that that respect seems superfluous, even hypocritical, in view of the fact that in England, abortion is permitted up to week 24 of development, or beyond in certain circumstances, and c) that the minimal moral value that we attribute to embryos is extinguished when we experiment with them to expand our knowledge and seek the benefit of individuals already existing.

Reasons b) and c) scarcely need refuting. Reason b) is not acceptable for those who consider that abortion, while legal, is always ethically wrong and a lamentable human disgrace, and reason c), besides assuming an extremely utilitarian view, reeks of scientistic egoism.

Surani’s reason a) has more bioethical substance. In the first place, breaking the 14-day limit would be an earthquake that would make both the dominant bioethics and legislation in many countries tremble; it would also make a fool of many parliamentary commissions (among others, the Warnock Committee and the Palacios Commission); it would weaken the Oviedo Convention and the UNESCO Universal Declaration on the Human Genome (to which, we must remember, the United Kingdom did not subscribe). However — and this is bioethically more important — it would bring discredit to most of the bioethical and legal literature on the status of the embryo, since it would reduce to ruins the evidence in favour of the 14 days that bioethicists have so painstakingly produced. The famous arguments of the primitive streak, formation of monozygotic twins, genesis of tetragametic chimeras and others would be a laughing stock.

An unprejudiced reflection

The possible application of the CRISPR/Cas9 technique to genetic engineering of human embryos should be an occasion for all, including the investigators involved, to reflect once again and free from prejudice, on the ethical status of the human embryo. Critical reading of “The fictitious embryo” might be of some help. This is a book I that published a little over two years ago, in which I evaluated the biological basis of the arguments with which bioethicists support the famous 14 days. As the great Osler said, we all need to dust off our brains from time to time.

Gonzalo Herranz

Diario Médico (08/02/2016).