Re-Design of the human being – What are we: Molecular genetic machines or autonomous individuals?

Considering the groundbreaking developments in genetic engineering in recent years, it is all too surprising that the new opportunities to bioengineers have not yet provoked a broader public debate. In concrete terms, as humanity we are facing what is probably the most important crossroads of the last 2’000 years: the appropriation of nature by man, which has distinguished our cultural and technological history for thousands of years and which has dramatically accelerated and expanded over the last 300 years through science and the technologies that have emerged from it, is now joined by a second grand project: the genetic, biological, medical, neurological and consciousness-technological transformation and redesign of man himself and his physical and mental faculties and abilities.

Nowhere is this clearer than in the field of genetic engineering. Although biologists have been manipulating the DNA of various organisms since the 1970s, their approach has so far resembled the principle of trial and error rather than the targeted alteration of individual genes or gene segments. In 2012, however, genetic researchers found a completely new powerful technology that allows them to do just that: access individual genes and modify them. Its name has by now reached some fame: CRISPR (more precisely: „CRISPR/Cas9“, which stands for „Clustered Regularly Interspaced Short Palindromic Repeats“ and initially describes sections of repeating DNA in the genome of bacteria). CRISPR enables extremely precise, rapid and cost-effective intervention in the genome of living organisms. This technology has already being used to modify the genetic makeup of plants, while applications to animals and humans are still at an early stage. But genetic engineers are already working at full speed on radically new applications. The potential of CRISPR is immense. And among those some are very threatening: Once the technology is applied to human embryonic cells, egg cells or sperm cells, not only is the individual human being manipulated, but also all of his or her offspring. Thus, on the one hand, CRISPR provides enormous opportunities in the treatment and prevention of hereditary diseases, on the other hand it gives genetic engineers the opportunity to modify specific human characteristics, not least possibly intelligence or visual attractiveness. In a nutshell: CRISP enables human breeding! Could genetically optimized humans soon be cognitively and physically superior to „normal humans“?

No wonder that philosophers, theologians and ethicists in various formations are already discussing the power of the new method. The most influential group of this kind in Germany is the German Ethics Council. Entitled “Interventions in the human germ line“ it has now published a comprehensive guideline on the new possibilities of genetic engineering. In particular, its aim is to contribute to a broader public discussion. Only three weeks later the Ethics Council of the Max Planck Society formulated its own discussion paper on gene editing. The scientists formulated the same goal as their philosophy, theology and ethics colleagues. Thereby they go beyond the question of the legitimacy of editing the humangenome and also discuss issues such as the benefits and risks of genome-edited plant and animal organisms and the new gene drive method, which deals with the efficient dissemination of genetically modified variants in entire species’ populations. „The report is intended to stimulate discussion on a number of research-relevant topics. The Max Planck Society would like to provide its expertise to the public discourse so that politics can make informed decisions in a socially important but also very complex area,“ said Martin Stratmann, President of the Max Planck Society.

It is regrettable that both have hardly achieved their goal so far. In fact, their statements offer plenty of material and suggestions for reflection and discussion. But already the federal press conference on the paper of the German Ethics Council was poorly visited. The subsequent coverage in the news organs was accordingly sparse. This is a pity, as the report of the Ethics Council has quite some content: While the ethicists state that at this point interventions in the human germ line are irresponsible, they clearly see that the techniques will inevitably develop further. And then, so the report, an intervention in the human germ for the purpose of treating serious diseases could possibly not only be permitted, but would be deemed ethically indispensable.

The report first summarizes the state of research in a way that is comprehensible even to laypersons. First of all, it is made clear that the process of the modified strands of genetic material joining back together is still very much prone to errors. DNA sections can be lost or incorrectly linked. The clinical consequences of such unintended modifications are difficult to predict, especially in the genome editing of germ line cells (it is now strongly suspected that the Chinese babies born in fall 2018 after having been made immune against AIDS by CRISPR have far greater susceptibility to other diseases). Therefore, unwanted side effects have to be largely excluded and at the same time the desired genetic changes to be precisely achieved before germ line interventions in humans with the help of such a technology can even be considered. Thus, the German Ethics Council explicitly calls for an international moratorium on the clinical use of human emaciation interventions.Once these problems have been solved and the technique of gene editing in humans has matured, ethicists have identified three different objectives for an intervention in the human germ line: Avoiding genetic diseases, reducing the risk of disease, and, last but not least, optimizing certain characteristics or abilities, such as athletic performance or intelligence.

The paper of the Ethics Council provides a detailed overview of the international legal situation, „from an explicit prohibition of interventions in the genetic material of human germ cells and embryos in the Swiss Federal Constitution, to the admissibility of certain research projects on embryonic stem cells in Israel, a strict licensing procedure for research on human embryos in Great Britain, to attempts in the USA to regulate research by the allocation of research funds, and on selective state control in China“. In Germany, the relevant “Embryo Protection Act” dates from 1990. It prohibits germline alterations with the aim of reproduction, but does not explicitly stipulate intervention in the germline.

The most readable (and by far longest) part of the report, however, is the fourth section „Outline and application of ethical benchmarks for orientation“. From an ethical and philosophical point of view, eight relevant criteria are therein differentiated band discussed in a refreshingly differentiated way with a few good examples given: Human dignity, protection of life and integrity, freedom, naturalness, prevention of harm and charity, justice, solidarity and responsibility. After stating that a purely numerical risk-benefit analysis quickly reaches its ethical limits, the report immediately addresses what is probably the most fiercely debated question: the „identification of those entities that potentially possess human dignity“. Candidates are: impregnated oocytes, embryos and born human beings. Depending on how the questions is answered, one arrives at very different conclusions. The theologian Andreas Lob-Hüdepohl recently said that „the human germ line is not sacrosanct, i.e. unlike the embryo, it is not a carrier of dignity“. The vast majority of his colleagues in the Council also saw it that way. There are therefore no fundamental obstacles to interfering in the germ line with regard to the criterion of human dignity. For the other dimensions mentioned, both supportive and negative attitudes towards human germ line intervention can be derived, but under certain conditions (methodological security as mentioned above) neither can any fundamental prohibition of such an intervention be derived. Nevertheless must thy all be taken into account for a future legal framework for germ line intervention. For example, in the medium or long term all people must have the opportunity to benefit equally from research and technologies. With such an attitude of considering germ line interventions ethically acceptable under certain conditions and when technological maturity is reached, the German Ethics Council is moving away from its long-cherished and cultivated position of categorically rejecting interventions in the human germ line. According to the ethicists, „the ethical assessment of germ line interventions in monogenic hereditary diseases (provided that the technology is sufficiently safe and effective) shows that no reasons for a categorical prohibition of such interventions can be derived from the application of ethical considerations“. Rather, the protection of life and integrity can, if necessary, even demand corresponding actions – for example, to ward off diseases or disease risks and to promote health. The withholding of a possible germ line intervention „could be interpreted as a violation of the dignity status of the future child, since he or she was excluded from an important therapeutic possibility“. And once in the process of slaughtering sacred cows, nothing seems to be safe any longer. Thus, according to the Ethics Council, „the further development of technology through basic research in vitro without recourse to human embryos is to be promoted „.

The ethicists go even further inslaughtering sacred cows of German bio-politics: even for germ line interventions for the purpose of improving human beings, some members do not want to speak out a moratorium forever. The assessment is less clear on this point, however. Most members consider the concern about negative social effects of genetic enhancements such as a possible aggravation of social fairness or the emergence of antisolidarian social attitudes towards other people to be important. However, some see in those „no sufficient reason for prohibitions, but only for an obligation of the government to observe such developments“. The German Bishops‘ Conference, so far the mighty protector of the bio-political drawer in which everything disappeared that even remotely touched the German research ban in the Embryo Protection Act, will rub its eyes in light of such sentences. Will man himself now become the object of breeding fantasies in which our offspring are only seen as a product to be optimized? No, of course not. In fact, the report also offers clear limits. For example, people must not be created according to the ideas of others. The concept of human dignity and the freedom and autonomy of each individual still set clear limits, as the ethicists seem to not get tired of emphasizing. The report even offers an ethical flow chart, a kind of decision tree, with the help of which one can determine when in individual cases germ line intervention can possibly be deemed acceptable and when not.

This report shows three things all too clearly. 1) The leaps in knowledge within the biomedical sciences must not be ignored any longer by political decision-makers, who always like to hide behind the facades of bio-politics from the 1980s.2) At the latest with the first CRISPR baby born it has become clear: There is no longer a categorical inviolability of the human germ line. 3) The question of the justification of interventions in the human germ line requires a deep and above all unbiased philosophical and ethical discussion. Even if one may disagree with some of its positions, the report of the German Ethics Council contributes to such a discussion in stimulating and profound way. Not only for politicians is it worthwhile to read its more than 200 pages.