绘制人类可遗传基因组编辑的“伦理”争议:一种多学科方法

IF 1.3 Q3 ETHICS Asian Bioethics Review Pub Date : 2022-12-20 DOI:10.1007/s41649-022-00234-1
Richard Pougnet, Benjamin Derbez, Marie-Bérengère Troadec
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引用次数: 0

摘要

基因组编辑,例如CRISPR-Cas,是过去10年医学的一个重大进步,但对我们的实践提出了伦理问题。特别是,人类胚胎可遗传基因组编辑是一个巨大争议的来源。在2018年11月宣布“CRISPR婴儿”中国实验前后的4年时间里(2016-2020年),我们探讨了PubMed数据库的文献中如何对这个伦理问题进行辩论。我们通过对发表在这个问题上的评论的分析,评估了支持和反对这个话题的论点的分量。最重要的论点来自技术角度:安全问题和好处,对子孙后代的长期影响,以及评估这一方面的必要性。接下来,将讨论可预见的临床益处和这些方法的替代方案。还考虑了从这些技术中受益的人数。然而,社会和人类学问题的处理方式却截然不同。为人父母和对孩子的渴望有时会被忽视。很少有作者提到社会正义、污名化和平等获取。同意和信息以及代际关系问题得到了更明确的解决。最后,对人类或人类物种性质的影响远未达成共识;强化、优生学和超人类主义的风险也随之增加。我们得出的结论是,与该技术的不成熟相关的风险是关于人类胚胎可遗传基因组编辑的伦理辩论的前沿。他们的后果被认为比社会学或人类学的预测更直接、更容易处理,后者本质上更具推测性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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Mapping the ‘Ethical’ Controversy of Human Heritable Genome Editing: a Multidisciplinary Approach

Genome editing, for instance by CRISPR-Cas, is a major advancement of the last 10 years in medicine but questions ethically our practices. In particular, human embryo heritable genome editing is a source of great controversy. We explored how this ethical question was debated in the literature from PubMed database, in a period of 4 years (2016–2020) around the announcement of the ‘CRISPR babies’ Chinese experiment in November 2018. We evaluated the weight of the arguments for and against this topic, through an analysis of reviews published on this question. The most important arguments come from the technical perspective: safety issues and benefits, putative long-term effects on the future generations and the need to assess this aspect. Next, foreseeable clinical benefits and the alternatives to these methods are discussed. The number of people that would benefit from such techniques is also considered. However, social and anthropological issues are addressed in a more disparate way. Parenthood and desire for children are sometimes overlooked. Few authors mention social justice, stigmatisation and equality of access. Consent and information are more clearly addressed, as well as the question of the relationship between generations. Finally, the effects on the nature of humankind or human species are far from being consensual; the risks of enhancement, eugenics and transhumanism are raised. We conclude that the risks associated with the immaturity of the technique were at the forefront of the ethical debate on human embryo heritable genome editing. Their consequences were seen as more immediate and easier to handle than those of sociological or anthropological projections, which are more speculative in nature.

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来源期刊
CiteScore
6.20
自引率
3.40%
发文量
32
期刊介绍: Asian Bioethics Review (ABR) is an international academic journal, based in Asia, providing a forum to express and exchange original ideas on all aspects of bioethics, especially those relevant to the region. Published quarterly, the journal seeks to promote collaborative research among scholars in Asia or with an interest in Asia, as well as multi-cultural and multi-disciplinary bioethical studies more generally. It will appeal to all working on bioethical issues in biomedicine, healthcare, caregiving and patient support, genetics, law and governance, health systems and policy, science studies and research. ABR provides analyses, perspectives and insights into new approaches in bioethics, recent changes in biomedical law and policy, developments in capacity building and professional training, and voices or essays from a student’s perspective. The journal includes articles, research studies, target articles, case evaluations and commentaries. It also publishes book reviews and correspondence to the editor. ABR welcomes original papers from all countries, particularly those that relate to Asia. ABR is the flagship publication of the Centre for Biomedical Ethics, Yong Loo Lin School of Medicine, National University of Singapore. The Centre for Biomedical Ethics is a collaborating centre on bioethics of the World Health Organization.
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