Editing the Genome: Prospects, Progress, Implications, and Cautions

Abstract

Clinicians, clinical researchers, and the general public all need to consider the implications of rapid advances in gene editing technology, which have given rise not only to new hope for the development of corrective interventions for genetic defects and many other diseases and conditions but also to many ethical, social, and policy concerns. Gene editing tools are potentially both more precise and more accurate than current gene transfer interventions; in addition, the discovery and development of the CRISPR/Cas9 system has made gene editing research considerably easier, faster, and cheaper. As a result, long-standing debates about the safety, efficacy, affordability, ethical and social acceptability, oversight, and control of efforts to pursue human germline alteration and enhancement have been rekindled. Added to these debates are controversies about newly discovered capacities to use gene editing to reshape the environment by altering or eliminating non-human species (insects in particular) that pose threats to humans. This review examines the science of the new gene editing boom in its social and historical context and discusses both past and current policy debates and future prospects for ethical consensus on whether, where, when, and how to move forward with clinical research and medical applications.