Book Review: The Promise and Peril of CRISPR

The Promise and Peril of CRISPR
By Dr Neal Baer
Published by ‎Johns Hopkins University Press
ISBN-10: 1421449307, ISBN-13: 978-1421449302
Buy this book from Amazon UK

Life-altering treatments, 'designer babies', and powerful bioweaponry – The Promise and Peril of CRISPR sets out to explore the double-edged sword of genome editing. The CRISPR approach to genome editing has transformed the scientific landscape, enabling unprecedented control over genetic material. This revolutionary tool allows for the precise editing of DNA sequences, potentially eradicating inherited diseases and reshaping medical treatments.

Further advances, such as base editing (see BioNews 1175, 1119 and 924) and prime editing (see BioNews 1243, 1093 and 1021), have made these techniques even more accurate and versatile, further expanding the horizons of what we can achieve.

CRISPR has, quite fairly, been met with both fascination and fear. Both of which the editor, Dr Neal Baer explores in this book. On the one hand, it offers a future where we could eliminate genetic disorders, enhance human capabilities, and even tackle issues like climate change. On the other, Dr Baer raises ethical dilemmas, from the potential creation of 'designer babies' to the weaponisation of genome editing as a tool.

Personally, I position myself in the camp of cautious optimism. The advantages of genome editing are undeniable: eradicating diseases and improving the quality of life for countless people. However, I cannot ignore the daunting risks that lurk behind these scientific breakthroughs.

The Promise and Peril of CRISPR is formed of essays from a wide variety of authors discussing this genome editing approach from many angles, providing a vast catalogue of voices and opinions. In one essay, bioethicist Alta Charo discusses the fear surrounding heritable genome editing asking whether this technology should be embraced or shunned. This essay also serves to remind the reader that while CRISPR technology is still in its infancy, these ethical and moral debates are not. Specifically, the controversies surrounding the use of IVF and the preimplantation genetic screening of gametes echos similar concerns about the use of CRISPR genome editing.

Personally, I think that this viewpoint, reinforced throughout the book, helps to put the current fear surrounding CRISPR into context. Past advancements were initially met with similar scepticism and fear, yet many have been embraced as transformative tools in medicine and science. The fear that accompanies CRISPR's rise might well diminish as we learn more about its applications and safeguards. By looking to history, Dr Baer shows a pattern of technology initially being viewed with suspicion before it becomes a normal part of medical practice.

Dr Baer explores the profound implications of CRISPR genome editing, focusing mainly on the tension between its transformative potential and the ethical challenges it presents. A key theme is the question of responsibility, both moral and legal. For example, Dr Baer asks who should be given the power to decide which characteristics are undesirable.

My main praise of this work is that the book is highly accessible, making complex topics understandable for a broad audience. While this might leave scientifically inclined readers craving more technical detail, I believe that Dr Baer successfully achieves his goal, highlighting CRISPR as not just a scientific advancement, but a societal issue with far-reaching implications. He emphasises that the CRISPR debate is one that must engage all of society, perhaps even more urgently than it engages the scientific community. By ditching the jargon Dr Baer allows the general public to understand the arguments and begin forming their opinions on a topic which will impact us all. I can see this book becoming a first point of call for those of us hoping to understand this debate.

By compiling a wide range of essays from ethicists, scientists, and individuals directly impacted by genetic conditions, Dr Baer presents a diverse spectrum of opinions and viewpoints. One perspective I found particularly compelling was that of individuals currently living with conditions CRISPR may one day eradicate. What struck me most was how these narratives shed light on a stance I hadn't fully considered: some people living with these disorders may not want to be 'cured' (see BioNews 1212).

In particular, one essay by Dr Sandra Suffian discusses the implication of using CRISPR to cure cystic fibrosis. She draws on her own experience as an individual with cystic fibrosis to raise some intriguing questions. Stating that she finds it difficult to unlink her disorder from her identity and sharing her concerns over the loss of cystic fibrosis communities with the use of CRISPR genome editing. Statements about life with cystic fibrosis provided much-needed context for the scientific debate, offering a humanising lens on the potential consequences of genome editing.

By challenging the assumption that eradicating these conditions is inherently desirable, Dr Baer offers a profound counterpoint, urging readers to reconsider the ethics of genome editing from the vantage point of those who experience these conditions firsthand.

Personally, I found that the book leans a little too heavily into the potential dangers of CRISPR, often focusing on worst-case scenarios. While the concerns are definitely valid, the emphasis on the 'perils' might overshadow a balanced discussion of its promising applications.

Additionally, while the book raises important ethical and societal questions, it falls short of offering concrete solutions or a clear path forward for how CRISPR genome editing could be responsibly introduced into society. I think that readers like me, who are interested in the clinical applications of CRISPR in modern medicine, may come away with more questions than answers.

Overall, while I don't believe that this book provides any novel arguments either for or against CRISPR, I do believe that Dr Baer has curated a valuable resource for people seeking to understand the controversies surrounding CRISPR genome editing. By compiling a wide range of voices and opinions, this book is ideal for someone hoping to educate themselves on the debate before coming to their own conclusion.

Buy The Promise and Peril of CRISPR from Amazon UK.