Scientific biotechnology banned by the church and ethics

2024 Author: Seth Attwood | [email protected]. Last modified: 2023-12-16 15:55

In 2016, the first child of three parents was born in Mexico: his mother's mitochondrial DNA was replaced with a donor one so that a serious hereditary disease would not be passed on to the child. Using CRISPR, you can edit the genome of an unborn child and cut out harmful mutations from it - a scheme already tested in the case of cardiomyopathy. Women may not have to give birth soon: the baby can be carried in an artificial uterus.

There are no special obstacles to cloning a person other than ethical ones. Aging has been announced as another disease that can and should be treated. The potential for biotechnology applications may turn out to be broader than many science fiction writers imagined - but new solutions present humanity with completely new questions that we are not ready for.

How new technologies should be applied is not only a question of those who develop them. Biology and medicine are changing the way we think about life and death; about what is natural and what is amenable to intervention and conscious control. With the help of CRISPR technology, you can not only prevent serious genetic diseases, but also, for example, get rid of the smell of sweat from under the armpits. But can parents be allowed to determine the future genetic fate of their child? It is unlikely that a child would prefer to be born with Leigh's syndrome and die within the first five years of life. But otherwise, genetic modeling of embryos looks controversial. After all, you cannot ask an embryo for informed consent.

The right to euthanasia and abortion, the ethical consequences of cloning, surrogacy and other technological changes have been actively discussed in Europe and the United States for the past half century. How deeply can we interfere with natural processes and what can be considered "natural" in general?

The moral dilemmas that arise at the intersection of ethics, medicine and technology are addressed by bioethics, a discipline that originated in the United States in the 1970s. And it began with the right to die.

How to die properly

In 1975, 21-year-old New Jersey resident Karen Quinlan returned home from a party, fell to the floor and stopped breathing. Her brain was not receiving oxygen and was shut down; for several months she lay in a deep coma under an artificial respiration apparatus. In early 1976, her mother asked the doctors to disconnect Karen from the machine. She referred to Karen's own request, which she made after two of her friends painfully died of cancer.

Attending physician Karen responded to the mother's request with a categorical refusal. The case was transferred to the state supreme court, and already in December 1976, Karen's request was granted - despite the hysteria in the media and even the intervention of Pope Pius XII himself.

From that moment on, the "right to death" officially appeared in the United States: patients in the terminal stage could be disconnected from the life support system if their consent was directly or indirectly evidenced.

After this incident, bioethics began to change medical practice: bioethics committees began to be created in hospitals, where patients and their relatives can turn in case of conflicts with the medical administration. The opinion of "ordinary" people is increasingly taken into account in making medical decisions. But the debate over passive versus active euthanasia, of course, did not end there.

This year, 2-year-old British boy Alfie Evans found himself at the center of a high-profile medical scandal. In December 2016, as a result of an unidentified neurodegenerative disease, he fell into a coma. A year later, doctors saw no hope for his recovery and went to court to get the necessary permission and turn off the artificial life support system. Despite the protests of the parents, the court gave this permission.

Alfie's mother and father began to fight for the right to save the child's life and independently determine his fate. Pope Francis and Donald Trump expressed their support for the parents. The Italian authorities agreed to grant Alfie citizenship and the possibility of free treatment in one of the Vatican clinics. But a British court banned the boy from being transported abroad. On April 23, Holly was disconnected from the ventilator, and died about a week later.

In controversial issues, British law requires the doctor to be guided by the interests of the patient, even if this only means his right to die and get rid of suffering. On the basis of this law, the will of the next of kin can be legally ignored.

The debate about the right to die could only have arisen after technological devices such as a ventilator appeared. Prior to that, it was impossible to maintain the life of a patient who fell into a coma for a long time. But today the right to die has become no less important than the right to life. In some cases, dying is much more difficult than living, so it is not surprising that the right to euthanasia in some countries has received legislation.

Cloning people, editing children

In Don Herzfeld's animated film Future World, people upload their consciousness to their own clones and in this way achieve some form of immortality. But for some reason, over time, their world becomes increasingly poor in emotions. To enjoy the experience, they have to go to their own past - at a time when cloning and digitalization of consciousness did not yet exist.

Human cloning is no longer a serious technical problem today. This year it became known about the birth of the first cloned monkeys; there is no reason to believe that cloning a human will be much more difficult. It is much more difficult to answer ethical questions. The clone, of course, will not be a passive puppet, but an independent person - just like identical twins, who are technically clones of each other. But in what kind of relationship will he be with the "original"?

Do we need a human cloning procedure at all? Clones may be ideal donors, but it would be much easier and more ethical to grow organs for transplantation from their own stem cells.

The procedure of mitochondrial replacement therapy already now allows parents with defects in mitochondrial DNA to conceive a healthy child without hereditary diseases. Technically, the first step in this procedure is similar to cloning. You need to take an egg from a donor woman, remove the nucleus from it, insert the mother's genetic material instead, fertilize it with the father's sperm, and then transplant it into the uterus and wait for the normal fetal maturation. The first child, the embryo of which was obtained by mitochondrial replacement therapy, was born in 2016 in Mexico, the second - a year later in Ukraine. Two more conceptions using this method are likely to occur this year in the UK, the only country where mitochondrial DNA replacement is legal.

In the media, to describe the procedure, the expression “a child from three parents” is usually used. Geneticists, however, do not like this definition. The child's real mother is still one; only mitochondria are borrowed from the “second mother”. But even these arguments show how much our understanding of parenting can be changed thanks to new biotechnology.

Representatives of the Catholic and Orthodox Churches oppose this procedure, in part because of its "unnatural" and possible risks, in part because of the suffering of embryos that will die during the selection of candidates for birth. In Christianity, a person is considered a person from the very moment of conception, therefore it is considered unethical to conduct research on embryos. The American geneticist of Russian origin Shukhrat Mitalipov, who developed this technology, thinks differently: “I think that research on embryos is ethical. To develop methods for treating diseases, it is simply necessary to work with embryos. Otherwise, we will never learn anything. It would be unethical to just sit and do nothing."

It is estimated that 1 in 5,000 babies is born with an inherited condition that mitochondrial replacement therapy can prevent.

The long-term effects of this procedure are not yet known. After the first successful experiment, geneticists found that they still failed to completely remove mDNA from cells: mitochondria from some tissues still carried a harmful mutation. This means that the disease may manifest itself in the future, but to a much lesser extent.

As for the social and psychological consequences that most people worry about most, it is unlikely that children of "three parents" will be somehow different from other children. When the technology of in vitro fertilization appeared, many doubted whether people who were conceived in a test tube would be the same as others. Now there are millions of such people, and no one believes that they are somehow different from others. Some even believe that IVF will eventually become the accepted method of reproduction, and that sex will simply turn into a pleasant hobby.

Embryonic gene editing is an even more complex and controversial procedure. It is done using CRISPR and other similar technologies. This mechanism, obtained by biologists from bacteria, allows you to cut a specific section of DNA and replace it with the desired sequence.

In this way, the unborn child can be saved from many genetic diseases - from hemophilia and cystic fibrosis to certain types of cancer. Or, at the very least, reduce the chances of them occurring.

Theoretically, this technology can be used to determine other parameters of the unborn child. However, it is not so easy.

Most of the external traits - such as height, hair and eye color - are determined by complex inheritance mechanisms that are very difficult to identify and change. The level of intelligence or aggressiveness is even worse. About 50% of these characteristics are determined not by genetics, but by the environment.

Therefore, fears that parents will be able to create their own babies to order is at least premature.

Any new technology is by definition unethical. Even the introduction of the stethoscope and thermometer into medical practice initially aroused public outrage.

But first impressions are often deceiving. Probably, it would be more ethical not to disconnect small children from artificial life support devices and not to hope for a miracle. It would be more ethical to make sure in advance that they will not become victims of fatal hereditary diseases.

Many new technologies do involve complex ethical issues. But this does not mean that these problems cannot be resolved.

Aging population. If medicine can further and further postpone death and fight the diseases of old age, social relations will have to change. Generations will not be able to replace each other, as it happened before. It will affect family, politics, work and many other areas of our lives, not to mention the problems associated with overpopulation.

Genetic privacy. Today it is possible to analyze your genome for very little money, and over time this procedure will become completely trivial. But other people, such as governments or corporations, can use your genetic data. You may be denied a job on the grounds that a DNA test indicates your predisposition to aggression or a certain disease. The issue of privacy and discrimination will move into the biological realm.

Caste modes. After some time, class inequality can turn into biological inequality. New technologies aimed at improving people and getting rid of diseases will be available primarily to residents of the wealthy West. As a result, humanity can split into two new races, which will differ from each other much more than African Americans from Eskimos or even Australopithecines from Sapiens. However, the future may be much more diverse and democratic. Technology alone does not determine this.

Changing humanity. People who improve their intellectual abilities through psychopharmacology and neurointerfaces, cope with diseases through genome editing and organ replacement, will be radically different from you and me. They will have different ideas about life and death, different joys and other problems. Some welcome these changes, while others are horrified. But the future is likely to be different from both the best and worst-case scenarios.