Tuesday, July 25, 2017

Grounding ethics from below: CRISPR-cas9 and genetic modification

By Anjan Chatterjee

The University of Pennsylvania Anjan Chatterjee is the Frank A. and Gwladys H. Elliott Professor and Chair of Neurology at Pennsylvania Hospital. He is a member of the Center for Cognitive Neuroscience, and the Center for Neuroscience and Society at the University of Pennsylvania. He received his BA in Philosophy from Haverford College, MD from the University of Pennsylvania and completed his neurology residency at the University of Chicago. His clinical practice focuses on patients with cognitive disorders. His research addresses questions about spatial cognition and language, attention, neuroethics, and neuroaesthetics. He wrote The Aesthetic Brain: How we evolved to desire beauty and enjoy art and co-edited: Neuroethics in Practice: Mind, medicine, and society, and The Roots of Cognitive Neuroscience: behavioral neurology and neuropsychology. He is or has been on the editorial boards of: American Journal of Bioethics: Neuroscience, Behavioural Neurology, Cognitive and Behavioral Neurology, Neuropsychology, Journal of Cognitive Neuroscience, Journal of Alzheimer’s Disease, Journal of the International Neuropsychological Society, European Neurology, Empirical Studies of the Arts, The Open Ethics Journal and Policy Studies in Ethics, Law and Technology. He was awarded the Norman Geschwind Prize in Behavioral and Cognitive Neurology by the American Academy of Neurology and the Rudolph Arnheim Prize for contribution to Psychology and the Arts by the American Psychological Association. He is a founding member of the Board of Governors of the Neuroethics Society, the past President of the International Association of Empirical Aesthetics, and the past President of the Behavioral and Cognitive Neurology Society. He serves on the Boards of Haverford College, the Associated Services for the Blind and Visually Impaired and The College of Physicians of Philadelphia. 

In 1876, Gustav Fechner (1876) introduced an “aesthetics from below.” He contrasted this approach with an aesthetics from above by which he meant that, rather than defining aesthetic experiences using first principles, one could investigate people’s responses to stimuli and use these data to ground aesthetic theory. Neuroethics could benefit with a similar grounding by an ethics from below, especially when ethical concerns affect public policy and regulation.
We are in the middle of a scientific revolution (Doudna & Charpentier, 2014) that will transform biological research by profoundly affecting agriculture, animal husbandry, and medicine. It also has profound implications for neuroethics. Genetic modification using CRISPR-Cas9 (clustered regularly interspaced short palindromic repeat–CRISPR-associated protein), a system of adaptive immunity discovered in bacteria, has become feasible and cheap. Described in 2015 as “Science’s breakthrough of the year”, CRISPR-Cas9 offers promises as well as perils. In addition to modifying somatic cells, we can now modify germline cells. We might be able to eliminate single gene neurological disorders like Huntington’s disease, among many others. At the same time, intentional selection of genes for physical and mental traits might reify social inequities and resurrect the possibility of eugenics. Specifically, genetic manipulation could become a deep tool for cognitive and mental enhancement that selects and manipulates genes that contribute to intelligence, attention, memory, and even creativity.

Image courtesy of Wikimedia Commons.
Scientists and ethicists are aware that the public should be involved in discussions about these technologies and their applications. Think tanks, bioethics groups, and scientific societies call for public engagement. For example, in December 2015, the US National Academies of Sciences, Engineering and Medicine held a summit on the regulation of CRISPR-–Cas9 gene-modifying technology (Travis, 2015). PHD physicist and Congressman Bill Foster (D-IL) opened the summit with a reminder that gaining public acceptance of what can be done with CRISPR-Cas9 is critical. The meeting opined that it would be irresponsible to proceed with germline modification without broad societal consensus about the appropriateness of possible uses. The final report from the National Academy of Sciences (National Academies of Science, 2017) walked back from their early call for broad societal consensus (Baylis, 2017), but did offer condition under which germ line genetic modification might be considered. Nonetheless, the report advocates for public involvement as stated on pages 7-8,
“Public engagement is always an important part of regulation and oversight for new technologies. As noted above, for somatic genome editing, it is essential that transparent and inclusive public policy debates precede any consideration of whether to authorize clinical trials for indications that go beyond treatment or prevention of disease or disability (e.g., for enhancement). With respect to heritable germline editing, broad participation and input by the public and ongoing reassessment of both health and societal benefits and risks are particularly critical conditions for approval of clinical trials. At present, a number of mechanisms for public communication and consultation are built into the U.S. regulatory system, including some designed specifically for gene therapy, whose purview would include human genome editing. In some cases, regulatory rules and guidance documents are issued only after extensive public comment and agency response.” 
Given CRISPR-Cas9’s technical ease, low cost, and potentially wide spread application, knowing current public opinion is crucial to ongoing engagement. The “public” is not a monolithic entity, and understanding how different groups differ in their attitudes becomes critically relevant to any outreach efforts. 

Public opinion on In Vitro Fertilization (IVF) has changed
dramatically since its introduction.
Image courtesy of Flickr user Image Editor.
With these considerations in mind, we investigated what “the public” thinks about genetic modification research by querying 2,493 Americans of diverse backgrounds (Weisberg, Badgio, & Chatterjee, 2017). Respondents were broadly supportive of conducting this research. However, demographic variables influenced the robustness of this support– conservatives, women, African Americans, and older respondents, while supportive, were more cautious than liberals, men, non African American ethnicities, and younger respondents. Support for such research was also muted when the risks, such as unanticipated mutations and possibility of eugenics, were made explicit. We also presented information about genetic modification with contrasting vignettes, using one of five frames: genetic editing, engineering, hacking, modification, or surgery. The media, it turns out, uses different framing metaphors than academics when describing this technology. Journalists, more often than scientists, use “editing” as a metaphor, perhaps not surprising in so far as they are professional writers. It would be useful to know if these metaphors affect people’s opinions. In the context of our vignettes, the contrasting frames did not influence people’s attitudes. Our data offer a current snapshot of public attitudes towards genetic modification research that can inform ongoing engagement. 

Our observations are hardly the last word on the topic. Rather, they are an initial survey of a dynamically changing landscape. Will public attitudes evolve as more people become aware of the possibilities and problems of these technologies? What do we make of demographic differences? Conservatives, women, African Americans, and older people do not group together in an obvious way. Surely the reasons for caution among these groups vary. We did not find an effect of metaphoric framing in our study. This absence of an effect is reassuring in so far as journalists and scientists typically write about genetic modification using different organizing frames. Perhaps the lack of effect was because of an insufficient “dose” of framing language. If we presented more extensive descriptions and reinforcing language, might we have found an effect of framing? The point is that the implications of our results are subject to ongoing refinement, further testing, and continuing discussion as is true of most empirical studies. 

In a rapidly changing world in which biological sciences have the potential to profoundly affect our physical and mental and cognitive lives, public opinion assessed from below may be critical to grounding policy shaped from above. 


Baylis, F. (2017). Human germline genome editing and broad societal consensus. Nature Human Behavior, 1. Retrieved from doi: doi:10.1038/s41562-017-0103

Doudna, J. A., & Charpentier, E. (2014). The new frontier of genome engineering with CRISPR-Cas9. Science, 346(6213), 1258096.

Fechner, G. (1876). Vorschule der Aesthetik. Leipzig: Breitkopf & Hartel.

National Academies of Science, E., and Medicine. (2017). Human Genome Editing: Science, Ethics, and Governance The National Academies Press Retrieved from http://go.nature.com/2ooO6jx.

Travis, J. (2015). Inside the summit on human gene editing: A reporter’s notebook. Retrieved from doi:https://doi.org/10.1126/science.aad7532

Weisberg, S. M., Badgio, D., & Chatterjee, A. (2017). A CRISPR New World: Attitudes in the Public toward Innovations in Human Genetic Modification. Frontiers in Public Health, 5, 117.

Want to cite this post?

Chatterjee, A. (2017). Grounding ethics from below: CRISPR-cas9 and genetic modification. The Neuroethics Blog. Retrieved on , from http://www.theneuroethicsblog.com/2017/07/grounding-ethics-from-below-crispr-cas9.html

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