Event Review: Hacking Darwin - Genetic engineering and the future of humanity

Hacking Darwin: Genetic Engineering and the Future of Humanity, an event by London Futurists, was held online on 16 May. The event took place to explore pertinent issues surrounding genome editing and possible uses in 'hacking' our genome.

David Wood, author and chair of London Futurists, introduced the panel and reminded the viewers that the current COVID-19 pandemic has shown that human traits can be improved with the use of medicine and emerging technologies. The story of humanity is the story of us developing education, medical research, and engineering marvels – but where, he asked us, are we going next?

Dr Jamie Metzl who was first to take the virtual floor, explained that although humans may be vulnerable individually, we show incredible strength as a species. Dr Metzl is a technology futurist, member of the WHO international advisory group on genome editing, author of a number of science and non-scientific books, as well as the founder of One Shared World. His most recent book 'Hacking Darwin', focuses on the possible future of using genome editing in humans.

He discussed how rapidly humans have advanced, highlighting the incredible changes that we have seen in genetics and genomics over the past 120 years. The new technologies that we are discovering and improving make it necessary to come together and find which values we, humankind, have and how we should apply them. 

Dr Metzl then introduced genome editing and spoke on how it has the potential to fundamentally transform how we make babies. Although he believes it will be initially restricted to removing serious single gene mutations, given the lack of 'red lines' between therapies and enhancement, he believes it is likely to find a number of applications. He praised the UK's Human Fertilisation and Embryology Authority (HFEA) as a global example of a responsible regulatory system for assisted reproduction and said that this model should be exported and implemented in other countries. Dr Metzl then went on to discuss the role of geopolitics and recent events with COVID-19 to highlight the need for inclusive debate, and countries working together in collaboration to constructively find solutions to global issues. 

Dr Nessa Carey spoke next, stressing that we must not only focus on the human applications of genome editing, but that useful and impactful applications will be found elsewhere. She talked about editing crops to make them more efficient, giving us the ability to feed the world while using a smaller amount of land for agriculture, therefore also offering ecological benefits. Dr Carey is a virologist, visiting professor at Imperial College London, and author of a number of scientific books including her most recent, 'Hacking the Code of Life' on genome editing. 

Dr Carey focused on a number of ethical concerns in germline genome editing humans, including its permanence, irreversibility, and concerns about 'playing God'. She explored how possessive we are about our DNA sequence but pointed out that who we are is dependent on so much more than just our genetics, questioning why we should be so concerned with changing one tiny aspect of ourselves. 

Importantly, she suggested to the viewers that we could flip the ethical questions we are asking. At the moment we are saying, 'Do we have the right to develop this technology?' When perhaps we should be asking, 'Do we have the right to withhold this technology?' This technology could be used to help cure many serious and heritable genetic illnesses, so she posed that we may have a moral responsibility to use it. 

She finished by presenting the issue of applying the technology to conditions that are not life threatening, such as deafness. She suggested that by removing linguistic groups and identities we are moving dangerously close to a new form of 'genocide'. 

The final speaker was Joyce Harper, professor of reproductive science at University College London in the Institute of Women's Health. A clinical embryologist, an expert in assisted reproduction technologies including Preimplantation Genetic Testing (PGT), and a member of the Nuffield Council on Bioethics working group on genome editing, she has spoken and researched genetic engineering extensively. 

Professor Harper examined the possible future of reproductive genetics, asking the viewers questions such as if all women will freeze their eggs, if we will all use genome editing, or if we will be open to using artificial wombs.

Professor Harper discussed the use of PGT and pointed out that we have already had to examine the ethical issues at the interface of genetics and reproduction over the past few decades. She acknowledged that although genome editing could be used therapeutically, she discussed that the well-received 2018 Nuffield Report on 'Genome editing and human reproduction' could not dismiss that it might eventually be used for enhancement. In addition, she said that there are other options for parents seeking to avoid debilitating disease, including prenatal diagnosis and PGT. Despite these technologies, she agreed that the use of IVF and genetic technologies will increase in the future, and that the number of people having children 'naturally' is likely to decrease. Due to this, it is important to promote discussions like this event did, especially of the pertinent ethical issues such as the current lack of safety measures in genome editing. 

The participants were then given time to comment. Dr Metzl agreed with Professor Harper on the importance of having inclusive public conversations surrounding the decision-making and regulation of the technology. The permanence of the technology means that we have obligations not only to ourselves, but to future generations, therefore public conversations have to take place in an engaged and empowered way. 

Dr Carey emphasised the importance of ensuring that ethical discussion should run ahead of science but questioned whether it was realistic that most women would be accessing IVF soon. She also asked what the true difference is between selecting between embryos, or modifying embryos, given that both skew the phenotypes in a population. Dr Carey was also concerned that we will never be able to prove that the technology is completely safe, citing debates still taking place about the possible risks of IVF.  

Finally, and importantly, Professor Harper pointed out that although new innovative technologies are criticised because of social justice and equality concerns, existing technologies such as IVF are still not 'equitable' and many people in the UK are not able to receive IVF treatment because of the high costs. 

Questions from the public were then answered, with concerns about health tourism, and research 'brain drains' occurring where researchers move their laboratories to countries with more flexible regulatory frameworks.

The concluding statements of the talk summed up the discussion well. Professor Harper said that we are at a revolutionary point in genetics, and Dr Metzl added that because of this we all have to have a role to play in deciding how we use this resource of knowledge and techniques. Dr Carey then added that technology cannot be good or bad, what matters is how we use it.