04 Apr 2023
“It's peace and quiet that we need to go back to work again.” – Bob Dylan, Joey
In recent posts I have been following the contours of the flourishing debate on genome editing as it spills from the laboratory into the world of public opinion and public policy. Last week it was the turn of the Hinxton Group to enter the fray with a new consensus statement. To all intents and purposes the statement is about two things, a new kind of technology, on the one hand, and a morally equivocal practice, on the other: Genome Editing Technologies and Human Germline Genetic Modification. It’s presented in two main parts that reflect this distinction, along with a scene-setting prologue and an epilogue on the importance of governance and meaningful engagement.
The exigency behind the statement is the broad and rapid uptake of the CRISPR-Cas9 genome editing system (CC9) in research. Although it acknowledges that CC9 is transformative in terms of its precision, ease of use, low cost and efficiency, the statement, notes that most of the moral questions that have been raised so far in relation to genome editing have been debated before. Perhaps more importantly, then, it draws attention to the fact that the context in which they are now appear is ‘dramatically different’. (I don't know how deliberately this phrase was chosen, but it seems both apt and informative.)
The statement lists some distinctive features of this mise en scène. Against the background of progress and diffusion of science, unfolds a broad chorus of acceptance of biomedical techniques such as those of assisted conception. Waiting in the wings, however, are mavericks not socialised in orthodox scientific institutions, who might use the techniques ahead of their validation by the international scientific community. (There is an irony in this particular conjunction – I recall the late Robert Edwards recounting how the first experiments in IVF had to be carried out in secret for fear of being thought monstrous. If the irony is intentional, the intention must be chastening rather than emboldening.) But there are vulgar, political and economic forces that also have their parts to play: “there is and will be pressure to make decisions – scientifically, and for funding, publishing and governance purposes” (issues identified in our recent examination of The culture of scientific research in the UK). The staging here seems to me to be tragic, awaiting catalysis by one fatal error of judgement; but this may be averted if virtuous embryo research can be insulated from the vices of unruly technoscience.
The second part of the statement, which talks about future applications, seeks to consolidate this break between the science and innovation: let the science proceed in pastoral simplicity, untrammelled by the vicissitudes of innovation. But the break is also an ordering, an ordering of conditions: an ordering that is also a conditioning. The statement asserts that “prior to any movement toward human reproductive applications” a roadmap is needed to guide the development of standards of safety and efficacy. The proposed elements of this roadmap (assessment of the health of individuals and their descendants, for example) suggest, however, that rather than being prior to a movement towards reproductive applications it is part of such a movement, albeit one that is sublimated by the apparent discontinuity between science and innovation. (We wrote about the role of roadmapping exercises in articulating and promoting collective visions for technology development in our 2012 report on Emerging Biotechnologies.) The moral of the Hinxton statement seems to be that orderly research and innovation will lead to morally desirable progress, while acts of heroism or impetuosity may lead to unpredictable and possibly tragic consequences. So the third act, yet to be written, could play out as a pastoral idyll of scientific progress; or a tragedy of premature innovations and broken ambition; or, again, a comedy of overhyping and credulity.
The Hinxton Group is a convocation of mostly anglophone, mostly academic scientists and other researchers, funders, regulators, etc. with an interest in embryo and stem cell research. As such it offers a good indicator of how the self-consciously responsible majority of the scientific community thinks. Like the funders’ statement I discussed in my previous post, it is also significant contribution to open debate about genome editing.
Last week, as the ink was drying on the Hinxton statement, we held the initial meeting of our new Nuffield Council working group on genome editing. This did not give rise to any clear statement of position but initiated (or, rather, marked a new phase in) an extended discussion that will issue, we hope, reasoned advice in the first part of next year. What is distinctive and, we believe, valuable about our way of working is that it relies on informed, extended and dynamic deliberation. This is different from the sort of approach that seeks primarily to identify points of consensus among the existing viewpoints of a defined group of participants. It is also different from the kind of consultative approach on which a lot of public and even regulatory policy now rests, and, again, from a scholarly research-based approach more characteristic of academic institutes.
These distinctions are perhaps a little crude: in practice, most considerations involve all of these elements to a greater or lesser extent, and all of them are valuable in their own ways. I certainly do not wish to claim a priority for our approach or that we ourselves do not strive to achieve a consensus, that we do not consult a broad range of others or that our work is not supported by assiduous research. And, of course, ours is perhaps just one more group of ‘experts’. But in reasoning out our conclusions we hope to show explicitly how we have been influenced by consultation, how we have understood the research and how we have, hopefully, reached consensus through the confrontation and transformation of ideas. It is an approach that we believe is particularly apposite in relation to genome editing and its complex scenography.
We will shortly be issuing an open call for evidence and encourage anyone with an interest in genome editing or the questions on which it bears to respond. A more focussed consultation on a specific area of application will follow next year.