Ethical Issues of Embryo Genetic Manipulation

Abstract

Introduction:  Genetic manipulation of the embryo is a field of human knowledge, where genetic engineering can provide an acceptable treatment for some disorders. Genetic engineering refers to a set of methods for isolation, purification, import and expression of a specific gene in the body of a host which ultimately creates a particular trait or gene product in the host’s body. This knowledge has earned many usages in agriculture and animal husbandry, and in recent years, has created a huge revolution in medical and social sciences by manipulation of human genes. Human genetic manipulation can be used in the treatment of genetic diseases, such as cancers, thalassemia, hemophilia, cystic fibrosis, and other systemic diseases that have genetic roots. Although this new advancement has caused significant changes in the treatment of some diseases, it has brought about numerous challenges in the field of bioethics; in the ethical and legal aspects. Thus, this narrative review aimed to evaluate the challenges and issues of the embryo genetic manipulation. The recognition and attention to these challenges will prevent errors, abuses, and future problems. Methods: The present narrative review was conducted to evaluate the challenges and issues of embryo genetic manipulation by using key words such as gene therapy or genetic manipulation or genetic engineering, and ethical and legal issues. This comprehensive search was conducted in the PubMed, SID, Magiran, Iranmedex, Scopus and Google Scholar databases in the period between 1990 and 2015. List of the titles and abstracts were evaluated and, with the exclusion of irrelevant articles, thirty articles were reviewed. The related reports of the United Nations and WHO were also examined. The selected articles have been published into Persian or English language (21 articles in English and 9 articles in Persian) and mostly had a descriptive design. Finally, the most important results of the articles were noted, and content analysis and categorization were done. Ethical considerations:  Moral rules such as honesty and integrity in the search, analysis, reporting of the searched literature and citation of the sources were taken into consideration. Results:  We identified two issues under the embryo genetic manipulation: gene therapy and eugenics. This study showed that embryo genetic manipulation increased some problems such as the occurrence of viral infections, ‘eugenics’ and ‘children order’ phenomena and also high financial costs. These problems can lead to ethical challenges such as monopoly, discrimination against persons with disabilities, aggression to fetus autonomy and the conflict between private and public interests. Aggression to fetus autonomy is the most important ethical issue recognized in the field of human genetic manipulation. In fact, we make decisions for an unborn child and expose him to injuries such as bleeding, miscarriage and even death by invasive actions, while the fetus does not have knowledge of or consent to these actions. On the other, with the changes in fetal genes passed to the future generations, not only families but also a wide range of communities will be affected. Thus, embryo genetic manipulation is introduced as an open-ended future practice. This practice will affect next generations, while their satisfaction of these changes is unclear. Another challenging matter in genetic engineering and biotechnology, which probably in the future will be a source of great evolution in the field of bioethics, is cloning or asexual reproduction cells. During cloning, a similar version of a living organism is made by the replication of the mature cells. Because genetic identity of this similar version is still unknown, international communities do not agree with the use of this technique. Another important risk in the field of bioethics is the possibility of using genetic manipulation as a weapon or in bioterrorism. During bioterrorism, pathogenic genes enter the human bodies, so that a sick and vulnerable generation will be designed for them. Today, bioterrorism is recognized as a global challenge. Conclusion: It seems that embryo genetic manipulation; despite being effective in the treatment of diseases, has many challenges especially in the field of bioethics. Some of these challenges are unavoidable. These challenges and issues seem to be one of the reasons why this technique cannot develop in countries like Iran. It should be mentioned that the limitation or exclusion of this knowledge does not seem to be a perfect solution. A ban on conducting research in this field may irreparably harm Iran in the future. Thus, it can be concluded that with respect to ethical, legal, religious, social and medical considerations, this knowledge can bring tremendous benefits in the treatment of incurable diseases. This can be achieved by informing researchers and therapists and by ongoing control on research and clinical processes. Therefore, it is required that precise the genetic manipulation of embryo be closely monitored, especially by taking ethical and legal considerations into account. Please cite this article as:  Ghafoori F, Vedadhir A, Golian Tehrani S. Ethical Issues of Embryo Genetic Manipulation. Med Ethics J 2016; 10(36): 35-45.