Genetic Engineering: A Danger Of Using Genetic Epidemiology

The field of genetic engineering has experienced significant improvements in recent years with the development of gene-editing technologies such as CRISPR‐Cas9. These advancements are slowly changing the scene of gene editing by making the process increasingly efficient and less costly than the earlier methods of genetic modification (Otlowski & Williamson, 2003). Despite the gross exaggeration by the sensationalist media, these improvements show that the field of science and medicine is at the precipice of significant changes. Genetic engineering could unlock the potential to treat chronic illnesses: A problem whose solution has proved elusive for years. Dr. Alexander, in his article “Medicine under dictatorship,” laments how the management of chronic illnesses has overwhelmed doctors to the point that they are considered a form of a death sentence for the patient (Alexander, 1949). Furthermore, the advancement of gene-editing technologies such as CRISP-Cas9 holds the promise of revolutionizing reproductive health. Genes that causes illnesses could be edited out before a child is born and eliminate such illnesses from the family line (Koplin, Gyngell, & Savulescu, 2019). While these advances in genetic engineering paint the picture of positive medical breakthroughs, there a significant ethical and legal issues that still make it a danger to society. The technology could be used for wrong reasons that could make it a threat to society. Thus, there is a need to adopt a careful approach to genetic engineering to avoid the Hegelian effect that Dr. Alexander warns about in his article.

In his article “Medicine under dictatorship,” Dr. Leo Alexander laments at the misuse of historical abuse of medicine. Physicians have betrayed the Hippocratic Oath and instead opted to play God with the lives of their patients. In Nazi Germany, ethical, moral, and religious values were replaced by the Hegelian trend to facilitate the mass extermination of millions of people who were considered “too sick to live” or “useless” expenses to the community as a whole (Alexander, 1949). The effect was mass deaths in the hands of doctors, which was a gross betrayal of the field of science and medicine. Genetic engineering, though still in its early developmental stages, presents significant ethical and legal issues. If genetic biologists take the Hegelian route that Dr. Alexander described, the effects could be devastating.

The first ethical concern regarding genetic engineering is the making of unintended modifications to genes. The study by Koplin, Gyngnell, and Savulescu (2019) identified the possibility of making unanticipated changes to the germline through off-target mutations that may be missed in any safety checks that are performed. Undetected, these changes are likely to have adverse effects that could be detected during old age, which means that they could affect future generations. These would add a significant burden to the families and existing healthcare facilities. Besides, in light of limited knowledge about gene editing, procedures resulting in unintended editing may result in unanticipated harm that would affect generations (Koplin, Gyngell, & Savulescu, 2019). Such issues may compound health problems and result in the current phenomena described by Dr. Alexander, where chronic illnesses are considered death sentences. As such, doctors are likely to neglect the victims of genetic engineering mistakes and deny them resources that would sustain them because they are not promising candidates for medical care.

Furthermore, Dr. Alexander dedicates a large section of his analysis on the misuse of science and medicine by qualified professionals. In light of the expecting overwhelmingly positive outcomes of genetic engineering, in the wrong hands, it would prove catastrophic. According to Otlowski and Williamson (2003), genetic epidemiology is susceptible to misuse more so with the computerization and linkage of health records. Fears of confidentiality and security are likely to affect the willingness of people to undergo genetic testing (Otlowski & Williamson, 2003). Much like Nazi Germany, where the sick were exterminated under the pretext of being given medical help, evil-minded doctors are likely to edit genes and afflict otherwise healthy people with chronic illnesses. Fears of mass experimentation on humans is also a significant fear factor. Koplin, Gyngnell, and Savulescu (2019) cite an incident where CRISPR‐Cas9 was used to edit the genes of twin girls Lulu and Nana, even though gene editing is still unsafe for use on humans and is still illegal in many areas. Thus, such careless use of gene editing tools presents a significant ethical concern that should be addressed sooner rather than later.

Another critical feature in Dr. Alexander’s article is the use of science and medicine to propagate discrimination. Nazi doctors performed a lot of fatal experiments on Jews and other non-Germans to advance the German race. Similarly, there is a likelihood of bias based on genetic information. This could further exacerbate the marginalization discrimination and stigmatization of disadvantaged groups, as was the case during the Nazi regime. Technologies such as CRISPR could be used to make people with particular unwanted qualities or race sterile to eradicate their generational line (Koplin, Gyngell, & Savulescu, 2019). The sheer scope of genetics, coupled with the complex nature of genetic engineering make such issues a pressing concern. The use of genetic information to predict behavior such as criminality could further reinforce discriminatory practices. Health insurance companies and employers could also use genetic information to discriminate members of a given community (Otlowski & Williamson, 2003). Thus, there is a danger of using genetic epidemiology for other functions other than a health tool is real and needs to be addressed.

On the legal side, gene editing on humans remains illegal in many countries. Besides, the legal framework within which genetic tests can be done is still not fully developed. This oversight exposes people to risks of having their genetic information misused by service providers. Otlowski and Williamson (2003) explain that the legal framework consists primarily of anti-discriminatory and privacy legislation, which only governs the collection and use of genetic information but does not regulate gene-editing processes. As such, there is limited legal guidance on the new challenges created by the increase in the range of available genetic testing and editing procedures, which makes it easier for the Hegelian ideologies described by Dr. Alexander to take effect. Thus, there is a need for policymakers to engage medical professionals and develop laws that will guide the development and science of genetic epidemiology.

Conclusion

Overall, the advancement of genetic engineering has implications with regards to the duty of doctors to care for their patients and adhere to the Hippocratic Oath. They have to keep up with the changes in genetic epidemiology so that they provide advice on the practices that adhere to the set ethical standards. Policymakers also need to create laws that will protect people from poor medical care, discrimination, and stigmatization. The dangers of misusing genetic epidemiology are real, and doctors are at the forefront of ensuring that these developments do not result in a medical dictatorship.