Quandaries: A bioethics column

When gene editing comes up at the dinner table, the cynic among the group is quick to invoke a well-known extreme: people editing human embryos for desirable superficial traits, like hair color or eyebrow shape, or, even more insidiously, “superficial” traits, like race or height. They might reference GATTACA or Vonnegut and talk of a world without difference or with reinforced superiority. Any sort of gene editing, they will argue, is an inevitable step to what is tantamount to a dystopia.

In this light, it is easy to see CRISPR as the gateway to this proposed world, to believe that an attempt to reduce genetic illness incidence is the harbinger of greater reductions of difference.

Of course, biology is not so simple. Genetics is multi-factorial, dynamic, and occasionally contradictory. We continue to discover that things weren’t as straightforward as we first thought, and in reality, we often just get lucky. The transition from illness prevention to proactive trait selection is not going to happen over night. There will be years of research and mishaps and confusion before we get even close.

But it may well happen, at some point. Genetics as a field has moved incredibly quickly: the pace of DNA reading and production has followed Moore’s law, supercomputers are modeling DNA movement, and machine learning is helping us reveal patterns at unprecedented scale. It would be naive to imagine that this, human editing at whim, would be beyond our ability.

Which takes us to this column, Quandaries. A quandary is a difficult situation, coming from the Latin quando, meaning “when”. This is one of the cases where the etymology unlocks a critical meaning of the word. A situation often becomes difficult due to timing. It is a question of when that drives someone to be uncertain, to be cautious or to be brash. If you do not know when an urgent call will arrive, every decision that might make you unavailable is more costly. If you do not know when an arduous task will be due, you might find yourself anxious until it is complete.

The same is true of gene editing: what makes the situation complex (and therefore interesting) is that we do not know when (or whether) certain capabilities will become possible and then functional and then public. The cynic at the dinner table can call upon a dystopian future because it feels immediate, even tangible. Indeed, what we do right now could make such a vision inevitable.

In other words, the cynic might be right.

All the more reason to take the question of When and make it a conversation for Now.

In this column, I want to take a step back and explore some of the complexities of gene editing, specifically in the societal realm. How should we think about protected classes (e.g. race, gender) and genetics? Should we strive to enhance the population as a whole or merely allow everyone to achieve a baseline? What compromises (because we will eventually need to compromise) are we comfortable with? Are there any hard lines that we, as a society, should not cross?

Bioethics is a field of “should we” questions, and each person will have their own opinions. The structure of Quandaries will be to set up the arguments, to pick at science’s tangled histories, and to attempt to reconcile our statements and our actions. More often than not, it will not find a definite answer.

I do hope, though, that it will succeed in two things: first, showing that genetics is firmly entwined with who we think we are and how we wish to be, and second, that nothing is ever quite so simple.