Bioethics cannot give us a clear picture but at least Uncle Bobby can give us a loving result, writes Pat Kane
At first glance, this couldn’t be a happier tale.
Yesterday’s papers reported that an amazing reunion is about to take place. Over the past 30 years, 6,000 babies have been conceived through IVF (in-vitro fertilisation) at the Nuffield Hospital in Glasgow – and they are all invited to a celebratory event this summer.
Dr Bobby Low helped to found the unit, eight years after the first IVF baby Louise Brown was born on 5 July, 1978. By all reports charismatic and committed, Dr Low couldn’t be a more reassuring front-man for the benefits of reproductive medicine, going by his avuncular pictures yesterday.
Do we still call them “test-tube babies”? We used to (even though they were, technically, petri-dish babies). Indeed, it’s worth remembering the original fearful reaction.
No less a figure than James Watson, co-discoverer of DNA with Francis Crick, warned a US Congressional committee at the time that he foresaw “all kinds of bad scenarios… All hell will break loose, politically and morally, all over the world”.
Over four million extra and entirely unique humans later, you might imagine seventies’ talk about “clone armies” and “assembly-line foetuses” has gone the way of spacehoppers and T-Rex. But with each new unlocking of the inner mechanisms of genes, cells and embryos, the storm and thunder easily returns.
And rightly so, one would have to say. Scientists may propose (from the lab), but politicians dispose (through regulation). Both are under the pressure of a popular culture that both shudders at the prospect of meddling with human biology (zombies and Terminators), and gets a bit excited about the possibilities (movies like Lucy or Limitless).
It’s a diagram of forces that can seem messy, each pole struggling for authority. However, going by the record of IVF at least, its consequence is that we advance cautiously, but richly and effectively, upon the tricky terrain of designing human biology.
One crucial element is the way that scientists have become ever better storytellers and persuaders about what they do.
The tabloid headline “three-person embryos” could rival “test-tube babies” for luridness. But there was a thumping, free-vote majority in the House of Commons a few weeks ago, allowing research on mitochondrial IVF in humans to go ahead.
Simply put, the procedure removes the inheritable diseases that can be triggered by the mitochondrial DNA in a mother’s egg, and replaces them with non-faulty DNA from a third donor. The altered egg is then implanted back into the mother.
The Newcastle professor responsible for the research, Doug Turnbull, took an early decision to be a calm and ever-available advocate – talking to media, science festivals, religious gatherings, patients, regulators and politicians.
But it’s interesting to go into the specifics of this therapy, to see why it’s evaded the Frankenstein knee-jerk response. One in 6,500 children dies before adulthood from mitochondria-triggered conditions like Leigh’s disease, progressive infantile poliodystrophy and Barth syndrome – horrors that affect the brain, muscles, heart and liver. Who wouldn’t want to delete these from the human biological condition?
The mitochondrial DNA sit outside the nucleus of a cell – and it’s the DNA in the nucleus that controls eye and hair colour, along with other specific human traits. So we’re clearly alleviating suffering, say the three-parent baby makers – we’re not providing future fascists with the tools to make blue-eyed, blonde-haired paragons.
But science, as you’d expect, immediately drives us to consider whether that’s already a possibility. As reported this May, scientists at Sun Yat-sen University in China have been the first to edit genes from the human nucleus. (They used embryos no older than the 14-days-old international limit, and of a quality unfit for further use in IVF.)
Their aim was to eliminate a rare inherited blood disease. But according to the National Institute of Health in the US, and the leading scientific journal Nature, the Chinese scientists have “crossed a line”.
If we can go into our core DNA, and identify not just diseases but attributes to precisely snip, tuck and replace (the technology is called, predictably, CRISPR), we open up “a path towards non-therapeutic genetic enhancement”, says the Nature editorial.
Halt! Bio-Nazis On Robo-Bikes up ahead! But we can do better than this, if we want to consider the impacts of “germline editing” (as it is officially called). One other major influence of how we cope with the transformations of science are the bioethicists – who bring their own brand of intellectual fireworks to the fray.
You don’t want to choose and edit what genetic mutations to pass on to your children? Well, you make that choice when you become a smoker, which mutates the DNA in your sperm. You also make that choice when you decide to become a father later rather than earlier, as age increases the level of mutations.
Except with those choices, the mutations are entirely random and uncontrolled. Wouldn’t you prefer to control them as much as possible? It is notoriously difficult to generate viable embryos under IVF. So would you prefer to discard the ones at fault? Or would you rather exert precise and loving care upon the ones you do have?
Another set of ethicists raise the prospect that a human population whose germline genes are too edited for public health reasons might fall foul of epidemics. That’s because genetic mingling and diversity is one of the best ways to build resilience against infectious disease.
But all the ethicists ask us to remind ourselves just how robust, and how globally binding, our existing procedures and protocols are. And also how necessary it is to sometimes take an experimental leap.
IVF treatment excises one quarter of the chosen embryo’s cells. Did we know what all the future consequences for the coming child would be from this bold, violatory act? But here we are, with millions born that wouldn’t have been, and incalculable parental happiness.
The future comes at different paces. While our digital revolution flashes all around us at light-speed, showering us with options to click or interact, the bio-century seems to be moving with a much slower, more deliberative rhythm.
We can silently thrill (guilty as charged) to all the sci-fi dilemmas available around bioscience. You know, genetic overclasses having privileged access to human enhancements, wearing pointed plastic shoulderpads, sneering at underlings in their RADA accents, etc.
Or we can find a moment’s calm in the idea of “Uncle Bobby” (as many of his beneficiaries know him) and his thousands of love-driven triumphs over the limitations of human biology, just a few minutes from Glasgow’s Great Western Road.
Francis Fukuyama once called this “our posthuman future”. It still seems pretty human to me.