January 16, 2021

The Niche

Trusted stem cell blog & resources

Levrier guest post on CRISPR Consensus Meeting – “we all must get involved in this debate”

By Guillaume Levrier

Guillaume Levrier CRISPR Consensus Meeting
The author Guillaume Levrier.

Human germline editing has been done before. It will be done again in the future, as it is relatively easy to perform. No mechanism with the de facto ability to prevent it from being organized has yet been designed, let alone implemented. But the fact that germline editing has, can, and will happen again does not deprive anyone of their right to have an opinion on this capacity. The CRISPR Consensus symposium (see video below) set up at the Innovative Genomics Institutes in Berkeley, California, was precisely about everyone’s right to have a take on this difficult subject. How does one shape an opinion on germline editing? And in what space can those opinions be confronted to one another?

Asking those questions already implies taking a few things for granted. Sheila Jasanoff took the time to unravel some of the underlying assumptions. Why do we think “we all must get involved in this debate”? She continues: “I think that is because people sense, in some sense the whole meaning of humanness is the thing that is at stake, to what extent are we designers and engineers of ourselves and our own futures.” Some of the properties of what makes us human used to be out of our reach. With genome editing, they’re getting a lot closer to our hands.

If there ever was a CRISPR consensus, it ended right there. Benjamin Hurlbut, co-organizer of the symposium, started the first day by offering a few framing questions. “This ability to make genetic changes on the DNA of future children raises far-reaching ethical questions: should it be done? For what purposes and subjected to what limitations? But just as crucially, who should decide those questions? How should we as human community guide and govern these emerging technologies?” Some would argue that such a framing raises in itself important questions. Is there still time to ponder on whether it “should be done” when the means to either bring it to the masses or to prevent some to provide it to the very wealthy few do not exist? Furthermore, has there ever been such a thing as a “human community” that could “guide and govern” any kind of technology?

Several speakers suggest ideas to deal with that last question. Keolu Fox advocates a very local and localized management of germline: “I think what you have to do is create an infrastructure for self-governance.” He takes the example of biorepositories “where indigenous communities can store their own samples and blood. You provide people with access to server farms, and algorithm, and algorithm development”. Pr. Jasanoff also insists in the need for diversity: “The question about which publics, but I think we get a little over enthusiastic things like “citizens of the world”. If you take “citizens” seriously, you know, the world is not electing the climate president who is able to take the kinds of actions that we might be wanting to take for the good of the world, right? We are very much divided into nation-states and their archaic rules whereby in several countries I know, including the more civilized one to the north of us, minority votes elect the leader of the government.” At the end of the day infrastructures provide, governments govern, rulers rule. Not much room for a “human community” here.

CRISPR Consensus Meeting
CRISPR Consensus Meeting banner.

As a political scientist myself, those are positions I can easily get behind. A policy is only as strong as its underlying norms are legitimate throughout society and as the authority designated to enforce its features has efficient means of coercion. Yet my own work, a machine-learning filtered categorization of twitter-shared opinions on the birth of Lulu and Nana, would tend to show that the cultural embeddedness of viewpoints on this topic doesn’t erase some common streambed to be found across publics. This doesn’t mean everyone agrees on the terms of the debate. But rather that germline editing summons previous debates. How do we decide if germline editing is technically mature? And yet we kept going with IVF more than forty years ago. Is it eugenics? But PGD is provided as a treatment in many countries. It seems that what we’re currently dealing with is what remains of those previous debates times the CRISPR hype.

So how do we move on from here? How do we preserve every culture’s opportunity to have meaningful debates and at the same time build a comprehensive institutional system to effectively manage this aspect of genome editing? I argued during the symposium that there seemed to be a divide between an approach on bioethics (deciding what to do) and another one on biopolitics (how to enforce any kind of policy) as “CRISPR and the substances that make the editing possible are like drugs, and when you declare a war on drugs, the drugs usually win”. Pr. Jasanoff answered that while you can have a bioethical debate on what one should or shouldn’t do, that doesn’t mean you’ll end up with the biopolitical means to yield such a power: “It may be because by the time we declare the war on the drugs, they already have won. And one might then wonder how is that we come to recognize that there is a drug that we should be waging a war on, which is itself a very complicated question, and different societies have dealt with that in different ways.” This last sentence being a possible phrasing (and a much more stylish one) of my ongoing PhD topic, I would very much agree with that. She continues: “I think bioethics is a kind of technical discourse that comes out of particular political systems with their particular commitments to what the politics ought to look like, […] bioethics is every bit as promissory as gene editing is, right? It promises that there is a principled approach possible that will get you to the right results.” Again, I can only agree with that. But it does leave us with even fewer answers than before.

My own perspective in that context is that Agamben’s biopolitics still have some merit in the nuclease age. As Pr. Fox said during his presentation: “Because we’re not allowing everyone to participate. So there’s this inclusivity and exclusivity that is going on.” Genome edited embryos are a new kind of bare life, and sovereign powers will have to choose who gets included in the circle of those who can get it, and who is excluded from it. In some countries, it might be based on a medical condition-based list. In others, the criteria might be variants of interests, or even “acceptable” phenotype changes. Whichever those choices are, and who gets to access this technology, what I believe to be the main question remains unanswered. How does a State enforce such a choice? By establishing a monopoly on nucleases? On IVF? On sequencing? On synthetic RNA? All of the above when combined? We might have the technology for changing the DNA of humans yet to be born, but the technology of government needed to control such a feat has yet to be designed. Everything about germline editing is both already here and still a work in progress.

Disclosure: the author is a graduate student at Sciences Po Paris (CEVIPOF – Centre de recherches politiques) and is currently working on the institutional and policy challenges raised by genome editing. This post only represents his own opinion and does not engage any funding organization or any institution he is affiliated with. The perspective presented here is a personal take on public debates and should by no means be interpreted as a comprehensive summary of what was said and elaborated during the designated event.