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University of Basel

CRISPR/Cas9 – Opportunity or Risk, Priya Satalkar?

Text: Priya Satalkar

Discovered just a few years ago, the CRISPR/Cas9 method promises new possibilities for editing the genome of living creatures. While some see this as an opportunity, others focus on the risks of this efficient technology.

Priya Satalkar. (Illustration: Studio Nippoldt)
Priya Satalkar is a postdoc at the Institute for Biomedical Ethics at the University of Basel. Her research focuses on the intersection of new medical technology and its sociocultural context in society.

Technology shapes our lives. And each new technology that emerges prompts heated debates. Both sides take up extreme positions and often hold staunch opinions that prohibit an open and inclusive dialogue. This is particularly true if the technology in question has a direct impact on our lives. These debates might well be fascinating, but in my opinion they can be misleading. They rob us of an opportunity to reflect on and question our goals and exclude certain stakeholders, including the general public. This results in a waste of valuable resources.

To demonstrate my point, I’d like to take the example of CRISPR/Cas9, a method to edit human germline – known as «genome editing». My aim is not to debate whether this method can fulfil its potential but rather to reflect on two main points: What do we want to use this technology for? And once this question has been answered, how do we want to regulate its use?

Genome editing evokes strong hopes and expectations due to its potential impact on human life. It also provokes discussions on our responsibility to protect human genetic heritage, and causes fear and discomfort about its potential misuse in genetic or racial selection.

Although several technologies could, in principle, facilitate genome editing, CRISPR/Cas9 makes it more specific, quick, effective and affordable. The technology has not yet reached the stage of refinement required for use in humans. However, with ongoing research, the time will likely come when it can precisely and accurately edit problematic base pairs that cause single gene mutations responsible for diseases.

To make a conscious and well-informed decision on whether to continue research on non-human germlines to refine the technology, we need to clarify what it is we hope to achieve by using this technology in the upcoming decades.

The task here is not merely to define our goal but also to question and reflect on why we strive for this goal. Who benefits and who is excluded in our pursuit? Why do we choose this particular goal and not some other? Does our goal allow us to address the health needs of a large majority of our society or just those of the powerful and wealthy? Which stakeholders get to define the goal? Is the process democratic and does it take into account all perspectives including the cautious and skeptical ones? In short, the debate should not be about what a technology can do but rather about what we want to use this technology for and why.

This brings me to my next point regarding the regulation of CRISPR/ Cas9: Technology without a regulatory framework is much like an unguided missile. I believe that the regulatory framework for any technology has to be dynamic, proactive, and should evolve simultaneously with the technology. It should also be based on prudent precaution and be guided by available scientific evidence.

Regulation needs to be flexible to accommodate new evidence and should bring all stakeholders on board throughout its formulation and implementation. Importantly, it should also include those who will eventually use the technology and be affected by it.

It is extremely challenging to bring diverse stakeholders together and provide them with an open space for discussion. It is critical to ensure transparency in their exchanges, to address their fears and reservations, and to account for the differing interests and incentives of these various stakeholders.

Nonetheless, to truly exploit the potential of CRISPR/Cas9 for human health and well-being, we must accept this challenge. It is essential to engage with the general public and to help them understand the technology. Their concerns need to be addressed and open dialogue established. Without consistent efforts toward meaningful public engagement, I do not see how we can develop an effective regulatory framework for any technology – let alone CRISPR/Cas9.

More articles in the current issue of UNI NOVA.

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