Text Amelia Abraham

For years we’ve been able to eradicate illnesses, but in the near future it looks like gene selection is moving towards enhancement – potentially creating a generation of extremely athletic, super-intelligent humans

Sci-fi has always loved the fantasy of a superior race of genetically engineered humans. Aldous Huxley’s Brave New World is the 1931 dystopian novel set in 2540, imagining a society of people who are grown in a hatchery, their intelligence augmented by the chemical treating of their embryos. Gattaca is the 1997 film about a society created through genetic selection, with Ethan Hawke playing a natural human who is genetically discriminated against. Kazuo Ishiguro’s 2005 book Never Let Me Go is about children who are genetically reared to be organ donors. But these ideas are no longer just the stuff of science fiction; they are swiftly becoming a scientific reality. Now, we are able to ‘design’ babies, filtering out illnesses, and selecting things like eye colour, hair colour, and even intelligence. And the possibilities will only continue to grow in the near future. At the moment, there are two main ways that you can scientifically intervene in what a baby looks like before conception. To start with, there’s selection: Pre-implantation Genetic Diagnosis, (PGD), a procedure that involves taking cells from embryos at a very early stage, looking at their genomes and then choosing which ones to use. It’s basically a gene testing and selection process used for screening out genetic defects. In the UK, this technology can be used, but only by parents who have one of the rare genetic diseases on the Human Fertilisation and Embryology Authority’s list. Laws in the US are more slack, however, and the first American company claiming to offer PGD testing for low IQ on embryos was announced in November 2018. Within 10 years, the same company claims that it will be able to screen for the embryo with the highest IQ. The second method is gene editing. Also known as CRISPR-Cas9, the technology was created in 2012 to edit genes using enzymes with precision accuracy. In 2018, it was used in China to create the first genetically engineered babies. The experiment, conducted by a scientist called Dr He Jiankui was met with controversy, and has been condemned by the Chinese government, his methods considered unsafe and unethical. The babies’ genes were edited to remove HIV, but the long term risks around other genetic mutations that could occur are unknown. The babies are under medical watch, and Jiankui could face criminal charges. In most of Europe and the US, using a genetically engineered embryo to create a pregnancy is illegal.

According to Professor Ronald Green, a bioethicist and author of Babies by Design: The Ethics of Genetic Choice, gene selection is much safer than gene editing. “If you have two or three embryos and one has the mutation for cystic-fibrosis say, you could just put that one aside and give people a child that doesn’t, so that’s pretty safe,” he says. “But the biggest problem with CRISPR is called ‘off-target insertions’, which might cause a different disease condition. We are developing ways of checking the quality of the insertion and I think we’ll reach the point – we’ve reached it for certain conditions – where people are confident that it’s safe enough to use in practice.” Once the practice becomes safer, Ron believes that it will become commonplace. But some genes are easier to identify and engineer than others, things like eye colour and hair colour, say (which we can already identify), because those are well-known gene patterns. “Height and skin colour are harder because they’re what we call polygenic,” says Ron. “A polygenic trait is one whose phenotype is influenced by more than one gene.” Smithsonian futurist Jamie Metzl explains why genetic selection for polygenic traits will become easier: “In 10 years, because more people will have been (genetically) sequenced then, we’ll be able to use big data analytics to compare their genetic sequence to their phenotypic information, how those genes are expressed over the course of their lifetimes,” he explains. “We’re going to know a lot more about complex genetic disorders and diseases, like the genetic predisposition for heart disease or early-onset familial Alzheimer’s. But we’re also going to know more about traits that have nothing to do with health status, like height or the genetic component of IQ.” Ron supports the use of both gene selection and gene editing to erase genetic diseases, but not for gene enhancement. This is apparently most people’s opinion: “In general,” found a survey on 6000 people conducted by The Johns Hopkins Genetics and Public Policy Center, “Americans approve of using reproductive genetic tests to prevent fatal childhood disease, but do not approve of using the same tests to identify or select for traits like intelligence or strength.” Ron gives an example of how enhancement might work in practice: “Say you have an embryo that your calculations tell you will be 5’6 inches tall and the father would like a child who could play basketball, 6’2 inches tall, you could (hypothetically, in future) edit the height gene. You couldn’t do this via selection because the parents would probably not be able to produce an embryo much larger than themselves. But with editing, you could go to the point in the gene that determines height – and unfortunately there’s not just one point but many that work together (because it’s polygenic) – and do those changes to produce a basketball player on demand.”

There could also be positive health applications to these kinds of physical enhancements, he says: “In the future, it will be possible to edit the skin colour of an embryo from two white parents, either through editing or the insertion of a black-skinned gene. This is not necessarily a cosmetic matter; for instance, we might see millions of Australians requesting darker-skinned children because one of the scourges of Australia is high incidences of skin cancer caused by the presence of a light-skinned population in a high solar environment. It might become fashionable and healthy for Australians to tweak their children to have a more melanin-saturated skin type.” While there are positives and negatives around genetic engineering, many critics are dubious about the ethics of it, beyond simply health risks around gene mutations. “When you get to the point where you can say that person is actually intellectually or physically superior to another person because you have removed certain possibilities for that person getting ill… or because they’re enhanced in other ways, that has enormous implications for very basic values that we have,” Kazuo Ishiguro has said. Just like in the film Gattaca, people who do not meet the criteria of ‘good genes’ or have ‘desirable’ features could be further discriminated against. Ron agrees. As he reported in his book, augmenting height, for example, gives some people an advantage over others: each additional inch of height has been found to lead to a 1.8 per cent increase in lifetime wages for white males in America. He also points out to America’s booming sperm and egg donor industry where traits like athleticism and intelligence are found to be highly desirable, and worth a higher price tag. By editing babies’ genes to have more desirable characteristics, says Ron, “you get kind of an arms race going on.” He explains: “if everyone’s child is going to be three inches taller, people think: ‘Mine had better be!’ That’s a problem. We see that in sports doping and other places where people do dangerous things in order to excel.” Ron calls this idea of a class of people with ‘perfect genes’ “genobility” – but adds that it will only be available to those who can afford it. As dystopian as that might sound, he says, society is already rife with divisions along privilege lines when it comes to access to medicine and cosmetic procedures, so perhaps it won’t seem as sci-fi as we might think. Plus, the cost of gene selection is falling: “Thanks to technological advances, the cost of human whole-genome sequencing has plummeted,” reports The Guardian. “In 2009 it cost around $50,000; today it is most like $1,500, which is why several private companies can now offer this service. In a few decades, it could cost just a few dollars per genome.” Over time, the same could be true for gene editing. By reducing instances of genetic diseases, some argue that gene editing could save governments “billions of dollars” on healthcare. Others, like Ron, worry there will be pressure on people to undergo gene editing; “For example, a couple likely to pass on cystic fibrosis might be pressured by their insurer or, in the UK, the government to make sure that none of their children have that gene,” says Ron. He also wonders whether cost – coupled with legal jurisdictions and licensing – might end up leading to medical tourism. Strict licensing in places like the UK or the US might mean that clinicians won’t do certain edits. “This might lead to small jurisdictions in the South Seas offering cognitive enhancements, with people flying there to start their pregnancies,” predicts Ron. “We already screen for Down’s Syndrome in kids in Britain, promote vaccines to eliminate illnesses, and now we have embryo testing for eradicating genetic conditions. By tampering with genes to remove other illnesses or to manipulate visual traits, we could change the way that society looks forever”