The biggest debate at the International Summit on Human Genome Editing is where to draw the line between "medical treatment" and "body enhancement."
Geneticists developing powerful genome editing tools are worried that transhumanists will try to use them on themselves before they're deemed safe and effective for use in humans, which could undermine the future of technologies, such as CRISPR/Cas9, that allow for specific, targeted DNA editing.
Many of the biggest names in the field are at the International Summit on Human Gene Editing, where they are trying to reach a consensus on when, how, and for what purposes humans should edit their own DNA (or the DNA of an embryo).
CRISPR holds promise in the potential eradication of diseases like HIV, Huntington's, and Alzheimer's, and could be used to prevent children from being born mentally impaired. The scientific community seems to generally agree that using CRISPR to potentially prevent disease is ethically OK as long as the technology overall is deemed safe for use in humans. Things get sticky, however, when you consider that gene editing could theoretically be used down the line to create designer babies, to prevent premature aging, or to stimulate muscle growth, among myriad other applications.
Transhumanists, many of whom believe science can be used to ultimately conquer death, look at CRISPR as an important part of the toolkit we can use to transcend our natural bodies. Since as early as 2004, transhumanist groups have opposed the idea of bans on human genetic editing research. Zoltan Istvan, who is running for president as a Transhumanist candidate (and who writes an occasional column for Motherboard), says CRISPR holds great promise for the human race.
"Despite some people saying CRISPR technology could lead to dangerous outcomes for the human race, the positive possibilities far outweigh any dangers," Istvan told me in an email. "With this type of gene editing tech we have a chance to wipe out hereditary diseases and conditions that plague humanity. And we could also modify the human being to be much stronger and functional than it is. CRISPR could be one of the most important scientific advancements of the 21st Century. We should embrace it."
George Church, a researcher at Harvard University and one of the most outspoken proponents of CRISPR, says that, considering the lack of clear regulatory frameworks for its use, we must expect those interested in genetic augmentation to use the tool.
Church noted in a speech Tuesday that athletes and others interested in body augmentation have already taken advantage of just about every technology we've developed. Those in the transhumanist movement (many of whom are seeking immortality, or at the very least a long extension of natural human lifespans) see CRISPR as a potential tool they could use to augment themselves.
"We're probably going to need new international oversight structures so that we don't realize these dystopian Brave New World examples"
"I'm thinking of it as more of a slippery slope," Church said. When it comes to people using CRISPR to augment themselves or their children, "some people say 'I can't imagine it happening' And I say, 'You have to imagine it happening.'"
Church and some others who work with CRISPR believe that it's already safe enough for additional research in humans, but, in the only known test of the technology on human embryos, CRISPR was largely ineffective in editing the desired genes. A breakthrough announced earlier this week enhances CRISPR's accuracy and may be key to future human studies. As those eventual studies are conducted and as the technology becomes more consistent, Church believes somatic gene therapies, which target adult body cells (and could in theory be used by adults to alter themselves) will inevitably come next.
"Enhancement will creep in the door," Church said. "The point is that [human enhancements] will come after very serious diseases and they will be spread by somatic gene therapies."
Church and George Daley of Boston Children's Hospital believe that we'd be naive to expect interested people to not edit themselves out of a sense of morality—or even because the science and policies around it are in their infancy.
Already, those interested in enhancement are gung-ho about experimenting on themselves. There are athletes who take stem cell injections to get over injury faster; Silicon Valley types who use nootropics and other "smart drugs" not approved by the Food and Drug Administration to potentially increase their brain function; and people who try things like transcranial direct current stimulation, which uses low electrical currents applied to the head to stimulate neuron function.
Lance Armstrong admitted to injecting himself with erythropoietin, a hormone that stimulates the production of red blood cells, to help him win the Tour de France. Daley said that it'd be possible to use CRISPR to make your stem cells naturally create more of the hormone.
"Why depend on injecting yourself with erythropoietin if you wanted to win the Tour de France?," Daley said. "Why not just modify your hematopoietic stem cells to produce more erythropoietin?"
Considering how we've used every other medical technology for the arguably less "ethical" use of human enhancement, why wouldn't transhumanists try out CRISPR—if it becomes available—to literally change their (or their unborn children's) DNA to make them stronger, faster, smarter, or less disease-prone?
"We're probably going to need new international oversight structures so that we don't realize these dystopian Brave New World examples," Daley said at the summit.
Should such uses of CRISPR be outlawed? Are they unethical? It's hard to say—but bioethicists and regulators are concerned that a mutation or unsafe gene could be put into the human germline, meaning that it would be passed from generation to generation.
"We also need to regulate the specific uses of the products because we're all concerned about off-label use," Barbara Evans, director of the Center for Bioethics and Law at the University of Houston, said Wednesday.
More conservative voices from the bioethics community are advocating for a full ban on the technology, regardless of how it's used. But just because some people want to use the technology in ways that so-called "bioconservatives" may not like, Daley says it'd be wrong for regulators dismiss CRISPR's human potential.
"There are some who are going to say, 'No we shouldn't go through that exercise at all—the technology has no real legitimate uses, therefore we don't have to worry, we just ban it,'" Daley said. "But I think we want a more nuanced argument than that. And that is, I think, what we're trying to figure out here."