CRISPR Ethics in the Real World

Every discussion of CRISPR gene editing technology seems to come with an obligatory but superficial mention of the ethical dilemmas it brings up, especially in the context of applying it to the human germ line. Everyone asks questions like Should we remove sickle cell anemia from the gene pool? Where do we draw the line between curing diseases and building designer babies? What if everyone opts for 6-foot tall blonde-haired, blue-eyed archetype? Should we allow trans-human enhancements like taking genes from the mantis shrimp to give ourselves hyperspectral 16-color vision? What if only the rich have access, and become a ruling cadre of genetic elites, passing heritable enhancements down through their segregated bloodlines? Aren’t we playing God? How can we avoid becoming a society that looks like Gattaca or Brave New World? What thoughtful, proactive regulations can we enact to ensure this technology is used only for good, and that ethical boundaries are respected?

These questions are a fine starting point, but they also seem to be where popular explorations of this technological quandary end. I listened to Ezra Klein’s interview with Walter Isaacson on the topic this morning over coffee, and big chunks of it sounded like they could have been taken verbatim from the recent documentary Human Nature.

This hypothetical ethical discussion feels like it’s taking place in relation to a hypothetical society that makes well-reasoned policy decisions based on a shared idea of what’s right and good in the best long-term interests of society at large. A society that, having made those good decisions, can actually enforce them.

How can anybody think that’s the world we live in?

We are not good at policy

Look at the systematic campaign to delay action on climate change for the last 30 years. Consider how badly even “competent” wealthy countries have handled the pandemic. People are forced to ration insulin in the US to the point of death. We seem unable to do anything about the outsized power of digital platform monopolies and their surveillance capitalism business model, or algorithmic biases that discriminate against the poor and people of color. A new crop of racially targeted voter suppression laws is sweeping the US. There’s a familiar financial crisis brewing around sub-prime car loans. A quarter century after the original crypto-wars, countries are still trying to outlaw certain kinds of math. GMO crops have been used almost entirely to enable predatory business models that lock farmers into using a particular complex of pesticides and proprietary seeds.

If you become intimate with at any Actually Existing public policy landscape — especially when it intersects with technology — it quickly becomes clear that we are really bad at this. How can we imagine that what we do with CRISPR will be the result of some thoughtful ethical deliberation that centers equity and the public interest?

Given our track record in other areas, it seems more likely that there will be an irresistible pressure to take advantage of CRISPR technology when it does work, that the benefits will be inequitably distributed, and that enforcement of any rules we come up with will be uneven. Some actors will find a way to do what they want, even if they’re unable to shape the rules to their liking, which they will certainly try to do.

We need engagement from people who already understand abusive corporate behavior and regulatory power dynamics. We need to hear from folks that actually experience and study how systemic injustices are built in to almost everything we do as a society. It’s not enough to worry in the abstract that Capitalism and selfish individual choices might do something bad with a new world-changing technology. Of course they will! We need more informed imagination to explore what specific bad things might be possible. What nightmares can people who are familiar with illicit markets, monopoly power, and interest group politics dream up? Are there proactive policies that can at least set up countervailing powerful interest groups that want different outcomes?

More particular badness

Most technological goods start out expensive and exclusive, and decline drastically in price over time. If CRISPR follows that trend, eventually it’ll be available to a wide range of users, maybe on somewhat egalitarian terms. How might that not happen? Could prices be kept artificially high to ensure that it remains an exclusive positional good, valuable only insofar as it makes you better than others? How might gene patents and other intellectual property law play into this? Will there there be opportunities to develop genetic platform monopolies? Could you lock your descendants into perpetual dependency on a particular gene vendor because of intentionally engineered compatibility issues? What if these incompatibilities mean you’re unable to safely have children with people using other vendors?

When abortion is illegal, the rich have access and the poor don’t. What if outlawing CRISPR really just means it’s preferentially available to privileged people with connections, who the law tends to ignore? This isn’t uncommon. The penalties for the same crimes are often wildly different for different classes of people. For a long time the sentencing guidelines gave you the same amount of jail time for 100 units of powdered cocaine (used by white people) as 1 unit of crack cocaine (used by black people) gave. Under three-strikes laws with minimum sentencing, petty theft can get your sent to prison for decades, while financial criminals operating banks can steal millions or billions of dollars and face far milder consequences.

Your genes aren’t private information. We drop copies of our genome everywhere we go as we shed cells. You children each get half of your genome. It’ll be very hard to hide illicit edits when everyone is routinely sequenced for medical purposes, or when an adversary with access to your space can easily collect genetic samples. Will some people be deemed genetically illegal? What happens to you as a kid, if your parents had you enhanced against the rules? There are obvious parallels here to undocumented child migrants, who had no choice in whether they migrated. What if you move from a place where it’s legal to to be enhanced to a place where it’s not? Will that kind of migration be outlawed? Will you be forcibly sterilized to prevent those illegal modifications from spreading?

If germ-line engineering becomes cost-effective and easy, how will the genetic preferences of the masses be manipulated to encourage its consumption? How will it be sold? What can we learn from the way pharmaceutical companies market drugs directly to consumers today? Or from the way that people get taken in by fad diets and alternative medicine hucksters? Or from the engineered obsolescence of so many other technological goods?

What kind of exploitative debt markets will emerge to finance genetic enhancement of your progeny? How will repossession of the assets for non-payment work? What kind of warranties and liability will be associated with these modifications? Will people accept the technology on an as-is basis? Will the genetic editors be given some kind of immunity as with vaccines? What will we do when companies run trials of new genetic modifications in poor countries where they have more power and face fewer regulations? What if they refuse to sell the enhancements to people in poor countries?

What if companies only allow you to modify your children’s genes if you agree to make your offspring unable to reproduce without technical intervention from the same company, so that the company’s intellectual property doesn’t replicate itself in the wild?

What kinds of incentives will crop up in the health insurance industry? Will they give you a discount on your premiums if you engineer out a bunch of common, costly health problems? In universal healthcare systems, will there be an incentive to require or encourage parents to adopt a basic set of edits so as to reduce the overall burden on the system, for the public good? Or will these edits be seen as a liability, because we can’t know all their long term consequences ahead of time, or how they will interact with each other in the wild?

Maybe these weirder, more detailed conversations are already happening somewhere out of sight. If so I hope they break out into public consciousness sooner rather than later. I’d love to see a round table that included a bunch of these folks:

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Zane Selvans

A former space explorer, now marooned on a beautiful, dying world.

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