Is it ethical for scientists to edit the DNA in human embryos to correct a health disorder?
This is the question under debate by Catholic theologians, physicians and ethicists who question the morality of the work of an international team of scientists, funded by the Oregon Health and Science University, that has successfully corrected a genetic defect that causes a heart disorder.
From a Catholic moral and ethical standpoint, explains an Aug. 4 news story by the Catholic News Service, there are two key questions: The creation of human embryos for scientific experimentation and then destruction, and the still-unknown effect that changing DNA will have on future generations because the changes could become a permanent part of a family’s genetic line.
“Our knowledge of genetics is still in its infancy in terms of understanding the complex combination of genes leading to a trait,” notes Dr. Aaron Kheriaty, a Catholic psychiatrist, professor and author who has written several books about health and Catholicism. “It’s the kind of thing we can see now on the horizon. Once people come to believe they know how to introduce favorable traits, there will be a strong temptation to use these to enhance human beings.”
Dr. Kheriaty notes that in using germline gene transfer as an editing technique to edit sperm, eggs or embryos, “we are making changes that affect not just the embryo, but the offspring. The changes pass through the generations indefinitely. Even if the child is born, there are huge ethnical issues.”
According to the National Human Genome Research Institute, “germline gene transfer represents a relatively new possibility for the treatment of rare genetic disorders and common multifactorial diseases by changing the expression of a person’s genes.”
“Typically,” the institute continues, “gene transfer involves using a vector such as a virus to deliver a therapeutic gene to the appropriate target cells. The technique, which is still in its infancy and is not yet available outside clinical trials, was originally as a treatment of monogenic disorders, but the majority of trials now involve the treatment of cancer, infectious diseases and vascular disease.”
Dr. Kheriaty warns that “If the editing does not work as planned and has unintended side effects, it will be hard to put that genie back into the bottle. Many problems don’t manifest until later. Many [Catholic ethicists and physicians] are calling for moratorium on germline gene editing – it is fraught with big problems.”
Indeed, the Genome Research Institute notes, “Human gene transfer raises several important ethical issues, in particular the potential use of genetic therapies for genetic enhancement and the potential impact of germline gene transfer on future generations.”
The Diocese of Orange’s new chancellor, theologian Dr. Pia de Solenni, says that when they consider using gene editing for their health, Catholic couples should contemplate the Church’s longstanding teaching on the value of all human life.
“If gene editing is being used in a way that does not destroy or unreasonably endanger human life, then there can be a legitimate use for it,” says Dr. de Solenni. “At the same time, people have to be fully informed of the accuracy. For example, carrying a particular gene does not necessarily mean that one will develop that particular disease.”
Dr. de Solenni adds, “For that matter, there is no genetically perfect human being. Imperfection is part of the human condition and part of the human condition is learning to accept that reality.”
According to a document posted by the Eternal Word Television Network, more commonly known as EWTN, the Church teaches that “Every human life is of equal value, and all human lives are of infinite value,” and “Laws which permit the killing of prenatal human life are illicit, and no Christian may cooperate with them.”
So, is genetic testing compatible with the Catholic faith?
“It can be, depending on how it’s used,” says Dr. Kheriaty. “Gene testing can be a way of getting information from a patient if they are at risk from certain illnesses.”
For instance, he adds, genetic testing can tell women if they have a higher-than-normal risk for breast cancer, so they can take more precautions like screening, mammograms and even mastectomies.
In the case of fetal genetic testing, the mother may decide to see if her baby has a genetic abnormality to be better prepared to care for the child and anticipate medical needs for the future, Dr. Kheriaty says.
And, he adds, some medical interventions can help correct certain problems in utero, he says, which is ethically and morally justifiable.
Catholic physician Dr. Vincent Nguyen, who serves on the board of the Orange Catholic Foundation, says the question of whether genetic testing is compatible with the Catholic faith is like asking if money is compatible with the faith.
“It depends on how you use it,” Dr. Nguyen explains. “Some people use it for the wrong reasons. It is available but without understanding all the implications it can be used for good or evil.”
At the same time, he says he is excited about the use at Hoag Hospital of precision medicine involving genetics. “We know that people with different genetic makeups respond differently to medicine,” he says. “We can use precision medicine to classify the medications that can help patients [such as those with cancer] best.”
When it comes to using genetics to protect and treat children in the womb, Dr. Nguyen continues, “The Church embraces it. There are serious ethical implications – yet if we are trying to prevent or delay the onset of disease and not using this information to expedite someone’s death or to justify abortion – then it is acceptable. The Church is about life – the sacredness of life from the moment of conception to the time of natural death.”