Explainer

Biology

Culture

Ethics

7 March 2025

9 min read

Ethics needs to catch-up with genetic innovation

Are we morally obliged to genetically edit?

John Bryant

John is Professor Emeritus of Cell and Molecular Biology at the University of Exeter.

An artistic visualisation of a DNA strand growing flowers from it.

Artist Nidia Dias visualises how AI could assist genomic studies.

Google Deepmind via Unsplash.

It makes me feel very old when I realise that Louise Brown, the first baby to be born via in vitro fertilisation (IVF), will be 47 years old on July 25th this year. Since her birth in 1978, over 10 million IVF-conceived babies have been born worldwide, of whom about 400,000 have been in the UK. Over that period, success rates have increased such that in some clinics, about 50 per cent of IVF cycles lead to a live birth. At the same time, there have also been significant advances in genetics, genomics and stem cell biology all of which, in relation to human embryos, raise interesting and sometimes challenging ethical issues.

I start with a question: what is the ‘moral status’ of the early human embryo? Whether the embryo arises by normal fertilisation after sexual intercourse or by IVF, there is a phase of a few days during which the embryo is undergoing the earliest stages of development but has not yet implanted into the wall of the uterus; the prospective mother is not yet pregnant. In UK law, based on the Human Fertilisation and Embryology Act (1990), these early embryos are not regarded as human persons but nevertheless should be treated with some respect. Nevertheless, there are some who oppose this view and believe that from the ‘moment of conception’ (there actually isn’t such a thing – fertilisation takes several hours) embryos should be treated as persons. In ‘conventional’ IVF this debate is especially relevant to the spare embryos that are generated during each IVF cycle and which are stored, deep-frozen, in increasing numbers for possible use in the future.

A further dimension was added to this area of debate when it became possible to test IVF embryos for the presence of genetic mutations that cause disease. This process is called pre-implantation genetic diagnosis and enables prospective parents who are at known risk of passing on a deleterious mutation to avoid having a child who possesses that mutation. But what about the embryos that are rejected? They are usually discarded or destroyed but some are used in research. However, those who hold a very conservative view of the status of the early embryo will ask what right we have to discard/destroy an embryo because it has the ‘wrong genes’. And even for the many who hold a less conservative view, there are still several questions which remain, including ‘which genetic variants we should be allowed to select against?; should we allow positive selection for genes known to promote health in some way?’; should we allow selection for non-therapeutic reasons, for example, sporting prowess?’ These questions will not go away and there are already indications that non-therapeutic selection is being offered in a small number of countries.

Genetic modification

This leads us on to think about altering human genes. Initially, the issue was genetic modification (GM) which in general involves adding genes. GM techniques have been used very successfully in curing several conditions, including congenital severe immune deficiency and as part of treatment programmes for certain very difficult childhood cancers. One key feature of these examples is that the genetic change is not passed on to the next generation – it just involves the body of someone who has already been born. Thus, we call them somatic genetic changes (from the Greek, sōmatikos, meaning ‘of the body’).

Genetic modification which is passed on to the next generation is called germline GM which means that the genetic change must get into the ‘germ cells’, i.e., the sperm or egg. Currently, the only feasible way of doing this is to carry out the genetic modification on the very early embryo. At present however, with just one very specific exception, GM of human embryos is forbidden in all the countries where it would be possible to do it. There is firstly the question of deciding whether it is right to change the genetic makeup of a future human being in such a way that the change is passed to succeeding generations. Secondly, there are concerns about the long-term safety of the procedure. Although it would involve adding specific genes with known effects, the complexity of genetic regulation and gene interactions during human development means that scientist are concerned about the risks of unforeseen effects. And thirdly, germline GM emphasises dramatically the possibility of using GM for enhancement rather than for medical reasons.

Genome editing

This leads us to think about genome editing. In 2011, it was shown that a bacterial system which edits the genomes of invading viruses could also work in other organisms This opened up a large array of applications in research, agriculture and medicine. However, the ethical issues raised by genome editing are, in essence, the same as raised by GM and so there is still a universal prohibition of using the technique with human embryos: germline genome editing is forbidden. Despite this, a Chinese medical scientist, He Jiankui, announced in 2018 that he had edited the genomes of several embryos, making them resistant to HIV; two babies with edited genomes had already been born while several more were on the way. The announcement caused outrage across the world, including in China itself. He Jiankui was removed from his job and then, after a trial, was imprisoned for three years; his two colleagues who collaborated in this work received shorter sentences.

At present the universal prohibition of human germline genome editing remains in place. However, the discussion has been re-opened in a paper by an Anglo-Australian group. They suggest that we need to develop heritable (i.e. germline) polygenic genome editing in order to reduce significantly an individual's risk of developing degenerative diseases. These includecoronary artery disease, Alzheimer’s disease, major depressive disorder, diabetes and schizophrenia. I note in passing that one of the authors is Julian Savulescu at Oxford who is already well-known for his view that parents who are able to do so, are ‘morally obliged’ to seek to have genetically enhanced children, whether by PGD, GM or genome editing. The use of polygenic editing, which would, in all likelihood, be available only to the (wealthy) few, fits in well with his overall ethical position. Needless to say, the paper, published in the prestigious journal Nature, attracted a lot of attention in the world of medical genetics. It was not however, universally welcomed – far from it. Another international group of medical scientists and ethicists has stated that ‘Human embryo editing against disease is unsafe and unproven …’ and even go as far as to suggest that the technology is ‘… going to be taken up by people who are pushing a eugenics agenda …’ remain very pertinent.

Harder still and harder

I have no doubt that amongst different reader there will be a range of opinions about the topics discussed so far. For anyone who is Christian (or indeed an adherent of almost any religious faith), one of the difficulties is that modern science, technology and medicine have thrown up ethical questions that could not have even been dreamed of by the writers of the Bible (or of other religious texts). We just have to use our wisdom, knowledge and general moral compass (and for some, prayer) to try to reach a decision. And if what I have already written makes that difficult, some recent developments multiply that difficulty still more.

In the early years of this century, scientists developed methods of transforming a range of human cells into ‘pluripotent’ stem cells, i.e., cells capable of growing into a wide range of cell types. It also became possible to get both induced stem cells and natural stem cells to develop into functional differentiated cells corresponding to specific body tissues. This has huge potential for repairing damaged organs. However, other applications are potentially much more controversial. In 2023, Cambridge scientists reported that they had used stem cells to create synthetic mouse embryos which progressed at least as far as brain and heart formation within the normal pattern of mouse embryo development.

At about the same time, the Cambridge group used individual human embryonic stem cells (from the blastocyst stage of embryonic development), to ‘grow’ early human embryos in the lab. There is no intention to use these embryos to start a pregnancy – indeed, it would be illegal to do so – but instead to study a period of embryo development which is not permitted with ‘real’ human embryos (research must not continue past 14 days of development). But how should we regard synthetic embryos? What is their moral status? For those who hold a conservative view of the normal human embryo (see earlier), should we regard these synthetic embryos as persons? Neither does the law help us. The legal frameworks covering in vitro fertilisation and early embryos (Human Fertilisation and Embryology Acts, 1990, 2008) do not cover artificial embryos – they were unknown at the times the legislation was drawn up. Indeed, synthetic embryos/embryo models are, in law, not actually embryos, however much they look like/behave like early embryos. Earlier this month, the Human Fertilisation and Embryology Authority (HFEA) discussed these developments with a view to recommending new legislation, but this will not dispel an unease felt by some people, including the science correspondent of The Daily Telegraph, who wrote that this research is irresponsible.

But there is more. In addition to synthetic embryos, the HFEA also discussed, the possible use of gametes – eggs and sperm – grown from somatic stem cells (e.g., from skin) in the lab. Some authors have suggested that the production of gametes in vitro is the ‘Holy Grail’ of fertility research. I am not so sure about that but it is clear that a lot of effort is going into this research. Success so far is limited to the birth of several baby mice, ‘conceived’ via lab-grown eggs and normal sperm. Nevertheless, it is predicted that lab-grown human eggs and sperm will be available within a decade. Indeed, several clinicians have suggested that these ‘IVGs’ (in vitro gametes) seem destined to become “a routine part of clinical practice”.

The lab-grown gametes would be used in otherwise normal IVF procedures, the only novelty being the ‘history’ of the eggs and/or sperm. Clinicians have suggested that this could help couples in which one or both were unable to produce the relevant gamete, but who still wanted to have children. In this application, the use of IVGs poses no new ethical questions although we may be concerned about the possibility of the gametes carrying new genetic mutations. However, some of the more wide-ranging scenarios do at the least make us to stop and think. For example, it would be possible for a same-sex couple to have a child with both of them being a genetic parent (obviously for males, this would also involve a surrogate mother). More extremely, a person could have a child of which he or she was actually, in strictly genetic terms, both the ‘father’ and the ‘mother’. What are we to make of this? Where are our limits?

Dr Christopher Wild, former director of International Agency for Research on Cancer, explores in depth many of the developments and issue I outlined above. His article on why a theology of embryos is needed, is clear, well-written, helpful and thought-provoking.

This article is based on a longer blog post with full footnotes.

John Bryant's Blog

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Article

Books

Culture

Sustainability

Wildness

5 December 2024

7 min read

Wild writers for those who wish to wonder

A wilderness reader for wintertime and beyond

Elizabeth Wainwright

Elizabeth Wainwright is a writer, coach and walking guide. She's a former district councillor and has a background in international development.

Sheep around a frozen pond in a snowy landscape, a ruined cottage sits beyond.

Winter near Brno, Czechia.

Tomas Tuma on Unsplash.

We live in a time of decreasing biodiversity, reduced access to wilderness, and worsening mental health, and these things are, I think, linked. I wrote a bit about this recently. We are intimately tied to wilderness. We evolved on a diverse, living planet – not separate to it, but in it, dependent on it. It can be easy to forget this in part because we manipulate the world with lights and schedules and ideas of progress; we seal ourselves away in the walls of home, of work, of shops. Some of us live within the walls of church, too – disconnecting us from a wild God who increasingly to me seems most at home under the loud silence of the stars, and in the way the setting sun points to beauty before darkness, and in the way two people can bask in each other’s hearts. When I encounter love, and the loveliness of the world, I also encounter God.

We are good at taking for granted the strange beauty of the planet. We are good at forgetting how to sit with wonder, how to even access it. The poetry of the Psalms tells us that “…they forgot what he had done, the wonders he had shown them...” We must restore not only the living breathing wilderness of the planet we live in and on, but also our own ability to feel wonder, because this can be a first step towards feeling, caring, and acting.

There are writers I turn to when I need to remember the diverse wildness and unlikeliness of our planet that is, as far as we so far know, an island of life in a cold and vast universe. When I read them, I wonder at our shared earth, at our hearts, and at the mysterious holiness of it all. Here then, some of those wild writers:

Wendell Berry has influenced the way I interact with my locality, my faith, my responsibility to the earth I stand on. He is the author of essays, poetry, non-fiction and novels, but he is also a farmer in Kentucky. His preferred tools are a pencil and a team of work horses. For decades, his tending of both words and soil have each strengthened the other. His writing is rooted in the particularity of place, and through that, he speaks to the universality of our shared existence. His voice is incisive and honest, clear-eyed but full of a well-worn love. His call to a more localised and rooted way of life is not a call to escape, but to encounter – with beauty, with neighbour, with a spirit that breathes life through it all. In recent years, his writings have found new audiences. A good place to start, is The World Ending Fire: The Essential Wendell Berry. It contains a selection of his essays written over decades – essays that call out ideas of endless progress and the unthinkingness that feeds it. From here, you might turn to other collections like The Unsettling of America, or The Art of the Commonplace. His poems are earthy and beautiful – look at The Peace of Wild Things And Other Poems. For fiction, his best-known works are Jayber Crow and Hannah Coulter, rooted in the complexity of people and their community. At a time in which our planet burns faster than ever, his writing is prophetic and honest, yet braided with grace and love.

The World Ending Fire is curated and has an introduction by Paul Kingsnorth: a writer I increasingly turn to. His story travels a path from environmental activism via explorations of various beliefs (including Wicca, Paganism, and Buddhism) to a recent – and unexpected to both him and many of his readers – conversion to Christianity. His journey is recounted in his essay, The Cross and the Machine. In his popular newsletter, The Abbey of Misrule, he writes essays that explore deep ecology, and ideas of a wild God, and of early Christian mystics who seemed much closer to the earth than many modern Christians do. His background in environmental activism still echoes – he cares for the world deeply, but his writing now, like his contemporary Dougald Hine, faces what might come when modern life as we know it becomes untenable. Like Berry, Kingsnorth brings an honesty to his writing that is often challenging to sit with. His collection of essays and talks, Confessions of a Recovering Environmentalist, was key in my own journey. He also writes fiction, set in a strange, old England. And his short book Savage Gods, in his words, “…marks a break in my writing, my style and my worldview. This slim semi-memoir is one long question about the value of writing itself, and about what it means to belong, or not to.”

Another writer of honesty and clarity is Marylinne Robinson. She is a social critic and novelist, perhaps Gilead being her most well-known book. Her latest book, Reading Genesis, is an interpretation of the book of Genesis. She takes words that are often interpreted in two-dimensional ways and makes them come alive. She speaks not just to the complexities of faith, but of what it is to be human in this world. Throughout her work more broadly, nature is a recurring theme, symbolising beauty but also fragility, and pointing to wonder and to our own inner state.

The late and beloved Mary Oliver points to the luminosity of the world. Whether small creature or vast landscape, she invites us to slow down and really look. She insists again and again that we “Pay attention. Be astonished. Tell about it.” Often, her writing helps me to touch the interconnectedness of the living world, and of our humanity. Each fragment she shows us feels part of a larger whole she is also pointing to, and for which she regularly expresses gratitude, inviting the readers to consider “what is it you plan to do with your one wild and precious life?” A good place to start is with Devotions, a collection of her most loved poems, or with Upstream, a mix of poetry and essays. Here, in the details of her daily walks and reflections, Oliver manages to conjure awe and a sense of the sacred.

Another author who is extraordinarily attentive to the natural world is Annie Dillard. Her rapturous wonderings and explorations of world and place and self, link to deeper reflections, and often to the divine. Like Oliver, Dillard values specifics: “The sheer fringe and network of detail assumes primary importance. That there are so many details seems to be the most important and visible fact about creation.” Dillard weaves her senses with her reading, and often her humour, zooming out and reminding us that “the universe has continued to deal exclusively in extravagances, flinging intricacies and colossi down aeons of emptiness.” Her 1975 Pulitzer prizewinning Pilgrim at Tinker Creek is perhaps her best-known work, but a good place to start is Teaching a Stone to Talk; a slim collection of essays that begin with her observations of natural phenomena but end up encompassing the wilds of her mind and of its “ultimate concerns.”

Poet, author, musician and playwright Joy Harjo was the first Native American to hold the position of Poet Laureate. She is a member of the Mvskoke Nation, and often explores themes of identity, history and social justice. Harjo weaves together past, present and future, linking our innate holiness with the natural world. A good place to start is the personal collection Conflict Resolution for Holy Beings, or for an insight into her life, try Poet Warrior which brings together memoir, poetry and song, singing often of regeneration in the face of darkness.

A few others you might naturally turn to from these authors include the late essayist Barry Lopez (his last remarkable collection published in 2022 is Embrace Fearlessly the Burning World), novelist and essayist Ursula K Le Guin (her Earthsea trilogy is fantasy but offers I think a profound reflection on who we are), and Robert Macfarlane, who writes thoughtfully of nature and myth, inner and outer landscape. And the old Psalmists tell of beauty and wonder: Psalm 104, in the New King James version, contains leviathans and rock badgers, lions and moons, trees and humans, all of it singing together the great song of life – a life that is precious, earthy and holy; a life woven by a God who we hear in Genesis say, “let us make mankind in our image, according to our likeness.” God is plural, as diverse as his creation. I am grateful for the writers, just a few of whom I’ve shared here, who help me to pay attention to the diverse and strange beauty of the world, and through that, help me see its luminous holiness. That holiness – wholeness – depends on all of us, all of creation, being able to be itself. As Mary Oliver says:

“…Whoever you are, no matter how lonely,
the world offers itself to your imagination,
calls to you like the wild geese, harsh and exciting –
over and over announcing your place
in the family of things.”