Reviews.

Pandora has many boxes

Book Book Review, Title A Crack In Creation, Author Jennifer Doudna & Samuel Sternberg, Rating 4.5,

A Crack In Creation

Jennifer Doudna & Samuel Sternberg

Book Review



The Chinese scientist He Jiankui recently claimed to have opened yet another of Pandora's seemingly endless set of boxes: Germline gene editing. He proudly announced that two babies were recently born whom he had genetically modified to provide resistance to HIV, changing their embryos, their germline, in vitro prior to their implantation in their mother's wombs by employing gene editing techniques based on the new phenomenon CRISPR-Cas9, a recently characterized bacterial immune system.

Jennifer Doudna's book A Crack in Creation: Gene Editing and the Unthinkable Power to Control Evolution warned against such a premature application of CRISPR-Cas 9 to the human germline. If you are interested in this new technology, its enormous promise and power, and the potential consequences, good and bad, this book is must read. The ability to directly and much more easily modify the genome of any living organism, via somatic or germline modification, has become a reality.

He Jiankui demonstrated that reality with a scenario right out of Huxley’s Brave New World, and received almost universal approbation by the scientific community. The Chinese government responded by saying, ‘“The genetically edited infant incident reported by media blatantly violated China’s relevant laws and regulations. It has also violated the ethical bottom line that the academic community adheres to. It is shocking and unacceptable.”

How should these these powerful new gene editing techniques be utilized, if at all? Doudna’s book addresses the complexities of this and related questions. This book provides a thorough and able discussion of the underlying molecular genetics, and describes how previous research and clinical approaches to gene therapy are being rapidly augmented or eclipsed by the new gene editing techniques based on CRISPR-Cas9 due to its generality, ease of use and significantly lower costs in both time and money. The author lays out the new kinds of research and clinical approaches to the curing of disease now possible and even already underway; the increased range of improvement of the food supply via these enhanced GM methods; the current unreliability of some of the clinical applications; and the huge potential risks and rewards, including the complete repair of many genetically based diseases, the threat of weaponization, unequal societal applications, and the possible eugenical abuse at a governmental level.

The author closes with the observation that emergent technologies, once invented, have never been subsequently suppressed, and follows this with a sober and thoughtful discussion of the political and ethical challenges that face humankind, now that it is out of the box: How do we take advantage of gene editing’s constructive possibilities while suppressing its equally potent destructive potential? He Jiankui violated laws and norms, particularly in using a technology not safe enough yet for use in humans, without the public debate and understanding necessary for such an act. Doudna calls for open discussion and careful development of this new technology to maximize its potential for good while minimizing its potential for harm.

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