The Effect of Genetic Load on a Future Population: Implications for Genetic Engineering and the Future of Medical and Physical Well-Behavement
According to the study, the risk of diseases in embryos could be reduced if polygenic genome editing is done. There are other caveats too, the researchers report. Nature is publishing this work because it is important to start a conversation about what could happen if more-sophisticated gene-editing technologies become available, which could be the case within 30 years, the authors say. Societies need to consider relevant benefits and risks before that day comes.
Peter Visscher, a statistician and geneticist at the University of Queensland, Australia, and his colleagues modelled the consequences of simultaneously editing specific variants linked to a number of diseases, including Alzheimer’s disease, schizophrenia, type 2 diabetes, coronary artery disease and major depressive disorder (MDD).
In the long run, there might be a requirement to develop and pursue technologies such as HPE. Mildly deleterious Mutations that escape natural selection are predicted to accumulate in the gene pool. Previously published models suggest that the effect of this ‘genetic load’ might manifest itself as physical and mental deterioration in only a few generations62. However, this concept is controversial, and the conclusions are debated63,64,65. If we take seriously the idea of leaving future generations in a better state than the current generations, then we have reason to provide them with the preconditions for a good life. This may include access to clean water and unpolluted air as well as the use of HPE to lower the genetic risk of disease.
Biotechnology, Health and Disease: Implications for the Societal Well-being of the Welfarist Approach to Biotechnology and Human Rights
Although collectivist considerations should inform the values of governments and the goals they pursue, it is also important that these goals do not override basic human rights, such as the right to autonomy. The pursuit of collectivist goals must be compatible with basic human rights.
Collective welfarism is the basis of an alternative ethical perspective. According to this approach, the goal of biotechnology should be to provide benefits to individuals and to broader groups of individuals, including families, communities and societies4. HPE should not be implemented in ways that decrease social cohesion, increase division and weaken our communities and society. Notably, this approach requires further analysis of what constitutes flourishing societies.
Since there is no easy solution to these problems, it is vital that we begin to consider implications now while HPE is still many years away.
Social division is likely to increase because of the disparity in HPE use. In Fig. 3, we quantify the increase in inequality of the risk of diseases as a function of the proportion of the population undergoing HPE. Additional results for several hypothetical diseases are also given in Supplementary Fig. 4. According to these results, the Gini index indicates that there is an increase in inequality if a small percentage of the population carries edited genomes.
Limit the use of HPE to cases in which there is a reliable relationship between a trait and positive effects. Of course, this raises the vexed issue of which conception of well-being to use, but this is a problem for any welfarist approach to individual or societal improvement.
It is currently possible to test embryos created through in vitro fertilization for their predisposition to non-disease traits. Some countries only allow embryos to be tested for genetic diseases, or at least to be screened to prevent them. Health and disease are not blurred when considering polygenic traits. Is it possible to use HPE to reduce blood pressure, a risk factor for common diseases, in a non-medical application? The same question arises regarding vaccines and other preventative interventions. In extreme cases, polygenic editing can be used to delay normal human ageing, significantly prolonging human life.