Ethical Considerations in Gene Therapy - Essay Example

Ethical Considerations in Gene Therapy Over the last few decades, various revolutionary discoveries in genetics have altered the of traditional medical practices. Along with other significant achievements, genetics also encompasses the discovery of an experimental technique that allowed medical practitioners to treat or prevent a disease by insertion, alteration or removal of genes called Gene Therapy. Although most of the traits inherited by people are normal and beneficial, some of the inherited mutations may be fatal or extremely harmful to the individuals. It is used to treat certain genetic anomalies or deficiencies which can cause disorders. Gene therapy technique is applied to develop efficient methods for introduction of DNA into cells after appropriate DNA sequences and cell types have been identified. Such delivery methods have several highly effective prospects including treatment of genetic and neurodegenerative diseases, combating viral infections, and inhibiting tumor growth (Verma and Somia, 1997). In general, gene therapy aims at replacement of abnormal genes that are causing the disease. However, the gene therapy technologies have also given rise to various moral and ethical concerns. While some scientists support and favor the experimentation, others are opposing it on ethical grounds. The two opposing views of scientists over the ultimate consequences of gene therapy have developed ethical debates in public worldwide. For ensuring proper application of any technology, it is critical to consider the various ethical implications it may have. This paper attempts to investigate the various unsolved ethical problems associated with gene therapy treatment techniques. History of the Ethical Issues with Gene Therapy Since the concept gene therapy cannot be considered as a novel variation or recent advance, the history of ethical issues associated with gene therapy dates back to the time when the term was first suggested (Escors and Breckpot, 2010). The field of gene therapy along with its ethical concerns was pioneered by the United States by establishing the Recombinant DNA Advisory committee. Hepatitis virus was used to treat Hodgkin disease earlier in 1949. However, it was by the late 1970s that scientists were able to declare gene therapy as a potential solution rather than alternative to genetic disorders. Figure 01: (a) The History of Gene Transfer Ethics Source: (Kimmelman, 2008) Stanfield Rogers and others employed Shope papilloma virus preparations to treat Hyperargininaemia in 1975. In 1980, Martin Cline was sanctioned as he did not get approval to transfer genes using recombinant DNA technology. A team of scientist carried out the first approved gene transfer protocol in 1988. The clinical experiment for any of the gene therapy techniques to treat disease was first published in 1990 (Verma and Somia, 1997). During 1990s, around four phase 3 protocols were forwarded to RAC for approval. However, around 10 protocols were submitted from 2004 to 2007. A brief history of gene transfer ethics is illustrated in figure 01 (a & b). All interventions in the series of events have raised several moral and ethical issues. It is for this reason that the present application of gene therapy essentially utilizes the non-reproductive or somatic cells (Verma and Somia, 1997). Figure 01: (b) The History of Gene Transfer Ethics Source: (Kimmelman, 2008) Ethical Considerations The discipline of gene therapy presents unique set of ethical challenges. There are two basic divisions in ethical debate on gene therapy. One involves the differences based on concepts of somatic and germ-line gene therapies and the other involves the differences based on concepts of therapy and enhancement (Chadwick, 2009). Almost all of the researchers have favored the insertion of genetic material into humans if it is solely aimed at treatment of genetic defects (Erwin et al., 1994). In other words, the somatic cell gene therapy affects individuals only, and is considered ethically acceptable. As the germ-line gene therapy aims to alter the reproductive cells having impacts on offspring, and thus affecting the entire gene pool. As it encompasses long exposures to transgene and vector, the safety of individuals is also set to risk. It is important to note here that stem cells derived from oocytes and embryos have raised far more ethical concerns than any of the other methods (Lo and Parham, 2009). Some of the ethical issues at different phases of stem cells research are illustrated in table 01. Source: (Lo and Parham, 2009) Although somatic gene therapy exhibits less controversy and ethical issues, the consequences and failures of the early experimentation also raised some serious ethical concerns. The most notable of these trials was the death of Jesse Gelsinger at the age of 18 in 1998. The target of this trail was to treat a liver ailment caused by genetic deficiency. However, contrary to the promises and hopes, accumulation of excessive ammonia led to the ultimate death of Gelsinger. His death renewed the ethical debate as he was at least living a tolerable life before. In the second division, the ill defined difference between therapy and enhancement raises the concerns. The term therapy is used to treat certain genetic disorders, whereas enhancement is a separate word that uses gene therapy to bring improvements or modifications to a normal and healthy individual (Chadwick, 2009). For instance, the concept of designer babies was raised as a serious ethical issue since children’s self understanding as a human being is altered by some individual’s design (Habermas, 2003). It is also evident from normal observation of plant species in which natural plant species are considered far more valuable than genetically modified species. Though Human Genome Organization Ethics Committee (2001) states gene therapy as “the correction or prevention of disease through the addition and expression of genetic material that reconstitutes or corrects missing or aberrant genetic functions or interferes with disease-causing processes”, it may be unethically used for physical enhancements targeting particular sports. This means that along with the treatment of disease, gene therapy could also be used for fulfillment of the eugenic aims. Apart from the two dissimilarities presented earlier, there is also a growing concern regarding the relationship of personal identity to gene therapy. As our identity lies in our genes and we are now capable of deciding through genetic manipulations that who our future generations will be, it is hard to discover whether those generations will be the same as the generations that would have occurred normally. Moreover, a modified person may develop certain grievances on his being modified. Here, the right of future generations to be naturally born gets severely challenged. If germ-line gene therapy application in a sense causes identity of the future generations to be fixed like industrial products, on what ethical grounds they would still remain human who according to Dworkin (1993) would have evolved through “billions of accidents of genetic coupling” ?. In this case, the grievances of a future person could be; “I should have had a nicer time” (William, 1990). “It would have been better if I had never existed.” (William1990). “I should not have had my genome altered” (Chadwick, 2009). “I should have been someone else” (Chadwick, 2009). “I should have been free of this genetic disorder” (Chadwick, 2009). “I should have been given genetic immunization” (Chadwick, 2009). Additionally, the historically evident abuse of genetics makes gene therapy controversial in social spheres. Some argue that regulatory practices should be adopted to monitor the decisions of individuals towards gene therapy, so that it will not be used wrongly. However, others warn that such practices will give the control of germ-line therapy in the hands of governments and they may abuse it for achieving eugenic aims. Furthermore, influences on individual choices towards gene therapy can led them to specific directions multiplying the combined effects. Another ethical concern arises on availability of gene therapy treatment. Limited availability can consequently trigger competition among individuals seeking the treatment making it difficult to decide who deserves to receive it (Feinberg, 2006). The ethical issues related to theology have also charged the heated controversy. Several questions arise such as what line separates humans from God? Who gave us the right to manipulate ourselves?, and how far we are allowed to manipulate ourselves?. These unsolved controversial questions have also lowered the morale of communities over the last decades. The suspected application of gene therapy in bio-defense research is one of the other major ethical issues that challenge public health concerns, dual-use applications, and security (Kimmelman, 2008). Also, similar gene therapy techniques are also being applied to animals for experimenting transgenic models against disease in humans. Despite of its significant implications in human health practices, manipulation of animals raises ethical concerns. Conclusion In summary, gene therapy potentially offers great opportunities for biotech advancements. It provides solutions to several genetic disorders that are normally not curable by traditional practices. It has proved to be beneficial to mankind in many of the conducted trials. However, the intentional use of gene therapy techniques for achieving eugenic aims such as enhancements raises serious health as well as ethical issues. It is also evident that all gene therapy approaches are not subject of controversy and ethical concern. Compared to the controversial germ-line gene therapy, somatic gene therapy exhibits fewer ethical concerns and is a beacon of hope for numerous individuals around the world suffering from severe genetic disorders. There is a dire need to appreciate the positive implications of gene therapy on ethical grounds, and strictly reject those issues that are contradictory to human values. It is believed that the day is not far when gene therapy with all ethical considerations will become a regular practice. References Chadwick, R., 2009. Gene therapy. In: H. Kuhse, P. Springer, eds. A companion to bioethics. Chichester: John Wiley, pp.207-215. Dworkin, R., 1993. Life’s dominion: An argument about abortion and euthanasia. London: HarperCollins. Escors, D. and Breckpot, K., 2010. Lentiviral vectors in gene therapy: their current status and future potential. Arch Immunol Ther Exp (Warsz). 58(2), 107–119. Erwin, E. et al., 2009. Ethical issues in scientific research: an anthology. New York: Garland Publishing. Feinberg, R. S., 2006. Ethical issues in gene therapy research, an American perspective. In: J. Niewohner. and C. Tannert, eds. Gene therapy: prospective technology assessment in its societal context. Oxford, Elsevier. pp.99-107. Habermas, J., 2003. The future of human nature. London: Polity. Human Genome Organization Ethics Committee., 2001. Statement on gene therapy research. Eubios Journal of Asian and International Bioethics, 11, 98–99. Kimmelman, J., 2008. The ethics of human gene transfer. Nat Rev Genet, 9, 239–244. Lo, B. and Parham, L., 2009. Ethical issues in stem cell research. Endocrine Reviews, 30 (3), pp. 204–213. Verma, I. M. and Somia, N., 1997. Gene therapy promises, problems and prospects. Nature, 389, pp.239–242. Williams, B., 1990. Who might I have been? In: D. Chadwick et al. eds. Human Genetic Information: Science, Law and Ethics. Chichester: John Wiley, pp. 167–73. Read More