NIH Record - National Institutes of Health

‘Double-Edged Sword’

JHU’s Comfort Discusses Ethics of Gene Editing

Dr. Nathaniel Comfort
Dr. Nathaniel Comfort

In 2015, a new cutting-edge gene editing technology was brought to the world’s attention. CRISPR (clustered regularly interspaced short palindromic repeats) has enormous potential as a therapeutic tool, but also awakened fears of “editing humanity” and creating “designer babies.” Critics feared it could lead to a new era of eugenics.

Eugenics is a term coined by Francis Galton, who wanted to create a “galaxy of genius” by allowing only humanity’s brightest and best individuals to reproduce and create his version of an ideal society. This concept has been utilized to justify horrific events and practices, such as the Holocaust and forced sterilizations. In light of new therapies such as CRISPR, though, the debate around eugenics is being revived.

Is it simply a bad idea? Or one that is not necessarily bad, but has just been done badly and for the wrong reasons? 

Dr. Nathaniel Comfort of Johns Hopkins University School of Medicine explored this debate and the history of the eugenics movement in a lecture titled “A Galaxy of Genius? The Enduring Dream of Controlling Human Heredity.” The talk was sponsored by the Office of NIH History and Stetten Museum.

Comfort is a professor of the history of medicine, with focus on heredity and human health in the 20th century. He is the author of several books, including 2012’s The Science of Human Perfection: How Genes Became the Heart of American Medicine.

Eugenics has a complicated and controversial history. The desire to produce better offspring is ancient; philosophers such as Plato (through his teacher Socrates) reasoned that, if we used selective breeding to produce the best livestock, then the same principle could be applied to humans. 

Screenshot of Comfort giving lecture with insets of two other participants at bottom
Discussing eugenics, Comfort (top) gives a virtual lecture, “A Galaxy of Genius? The Enduring Dream of Controlling Human Heredity.”

Galton was inspired by his cousin Charles Darwin’s work on the theory of natural selection—so-called “survival of the fittest”—in which the organisms that best adapt to their environment survive, reproduce and pass on their traits to their offspring.

“Social Darwinism,” a term coined by Herbert Spencer, argued that the path to human improvement was through natural selection. Spencer took the concept further, though. His theory was used to justify imperialism, colonialism and racism, and to discourage social reform. 

Eugenics caught on quickly in Progressive-era America, supported by a flurry of advances that led Americans to believe that science could solve any problem–including social issues. Eugenic sterilization and marriage laws were passed, supposedly in the interest of bettering humanity. 

The Holocaust was perhaps the most extreme example of eugenics put into practice. Comfort has noticed that as the last survivors pass away and the event grows further from collective memory, interest in human selection is starting to creep back in.

Comfort said speculation about molecular eugenics arose in the 1960s, which posed a new question: what does the “ideal” genome look like? 

In 1969, researchers James Shapiro and Jon Beckwith announced that they had isolated and cloned a bacterial gene. They feared the return of government-run eugenics programs (reminiscent of Nazi policies) and called a press conference to discuss the implications of their research. However, it turned out that free enterprise, rather than government, would further “heredity control.”

Gene therapy began to be used to treat genetic conditions, but NIH placed a moratorium on it after several patients died in the late ’90s and early 2000s. Around the same time, new fears of “designer babies” surfaced when the world’s first cloned sheep, Dolly, was announced.

The explosion of scientific discovery in the last century has shown that our knowledge of genetics and gene editing will continue to advance, Comfort noted. Some can undoubtedly be used for good–such as treating rare genetic diseases–but where is the line between gene therapy and eugenics?

Heredity in Relation to Eugenics, a 1911 book by Charles Davenport, was re-issued in 2008. The original argued for selective breeding to improve the human race, and the re-issue featured commentary from genomics researchers. The general consensus, Comfort said, was that 21st century knowledge could now fill in the holes in Davenport’s dream. This knowledge was the “raw material for a real science of human perfection … [and we] now have materials to do it right.”

Today, personal genome sequencing and precision medicine generate interest in improving our own genomes. The emphasis on personal health over an arbitrary idea of perfecting the human species makes the idea of a new eugenics more palatable. Comfort said there are still some who believe we have a duty to better our offspring, but there is a lot of debate about where therapeutics end and unnecessary selection begins.

Ideally, Comfort said, a partnership between public and private industry, as well as the general public, is the best way to keep everyone accountable. 

Coincidentally, the Bespoke Gene Therapy Consortium was announced at about the same time as Comfort’s talk. BGTC is a partnership between NIH, FDA, 10 pharmaceutical companies, several nonprofit organizations and the Foundation for the National Institutes of Health. The collaboration “aims to develop platforms and standards that will speed the development and delivery of customized or ‘bespoke’ gene therapies that could treat the millions of people affected by rare diseases.”

Comfort called gene editing a “double-edged sword.” There do seem to be benefits to editing genes in the event of harmful genetic conditions, but everyone involved must be held accountable. 

His goal, he said, is “to help steer the science in positive directions.” He believes that it’s possible to “do this right and we need to have conversations to avoid the back side of the double-edged sword.

“Dull the back end while sharpening the front,” he concluded.

View the archived lecture at https://videocast.nih.gov/watch=44029

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