Rawlsian Questions about CRISPR Gene Editing

By Kelly Dhru

We worship perfection because we can’t have it; if we had it, we would reject it. Perfection is inhuman, because humanity is imperfect. – Fernando Pessoa, The Book of Disquiet.

Pessoa may have had an “I told you so!” moment looking at the ethical debates over CRISPR-Cas9, which is the technology that has made the alteration of genomes easier. As we march towards fundamentally altering the code that governs our bodies, it is this very walk towards perfection that seems to scare us.

To start with, not enough can be said about the importance of CRISPR-Cas9, which is one of the most important scientific advances of our times. Because of this technology, we are now looking at the ability to combat some previously “incurable” genetic disorders. This technology is also opening up doors to tackle malaria, Zika and dengue fever in innovative ways and to potentially find a cure for cancer.

But what seems like a “sprint” is actually an obstacle-course  for this technology. The ethical issues that arise with it are manifold. For example, there have been moratoriums issued for the alteration of human embryos. One of the co-inventors of CRISPR-Cas9, Jennifer Doudna, famously asked for a global dialogue on the ethical challenges of CRISPR-Cas9.

In what seems like a science-fiction writer’s dream come true, ethical questions are being raised about the possibility of enhancement and the creation of “designer babies.” By altering the human genome, CRISPR-Cas9 may make it possible to be able to choose whether a baby will have a particular skin color, or higher intelligence, or perfect teeth, in addition to simply being born healthy.

One may ask: why, exactly, is it wrong to alter our future generations to be “better versions of ourselves?” Intuition tells us that choosing one trait over another sends the message that one trait is superior to the other, going against the idea of equality and human dignity. If there is indeed a selection of certain characteristics that becomes a norm in society—for example, if we stop producing babies with physical or mental disabilities, or even a long nose— it sends out a derogatory signal about the moral status of those existing within the society with those characteristics.

The notion of equality also gets triggered in another respect: no matter how much wealth one has, if his or her progeny is born with a low IQ or an unhealthy body, nothing that can be done about it. There is a sense of fairness in this human vulnerability to genetic lottery. It is this idea of a “natural lottery” that John Rawls in his magnum opus A Theory of Justice used to argue in favor of a system that would lead to a basic set of liberties and maximum benefit to the least advantaged. Rawls’ hypothetical thought experiment of a “veil of ignorance,” where the members of the society do not know their place in society, in a way represented the randomness of being who we are in this world, questioning whether we ‘deserve’ more privileges based on something that is a mere accident.

Such a thought is foundational not only to Rawls’ work, but also to a great extent to the rationalization of claims of equal rights per se. The fact that one’s birth, gender, race, and nationality (or even species?) are not matters of choice adds to the weight of the argument in favor of not discriminating on the basis of any of these considerations. But what happens when such a premise is no longer true?

With the possibility of choosing one’s genetic characteristics, such a vulnerability is diluted. If the idea of equality presupposes the lack of choice when it comes to certain basic characteristics, and if a gene-modifying technology is changing this very premise, how legitimate is it to criticize such a technology on the grounds of equality? It is the parents who make the choices and not the individual child, raising questions about the obligations of the parents: what do they owe to their future baby? What constitutes the “best interests” for the future child?

The elusive idea of “human dignity,” which has often been species-centric because of religious and other reasons (including the claims of rational agency capacity) and its juxtaposition with the claims of animal-rights is becoming even more convoluted with the creation of chimeras to produce human organs. In any case, rationality and intelligence are only a few mouse-clicks away with such a technology.

One if the biggest problem seems to be access to such a technology, especially for the poor and marginalized populations in developing countries. While regulating the technology is one answer, another answer to the problem of access may even be a “human right to have babies that are free from health hazards!”

Even when the actual use of CRISPR may itself have been curtailed by moratoriums, this technology is already beginning to change the assumptions that our ethical thoughts and intuitions rest on. It seems that in thoughts, even if not in action, the damage is already done.

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