Targeted modifications of the human epigenome, epigenome editing (EE), are around the corner. For EE, techniques similar to genome editing (GE) techniques are used. While in GE the genetic information is changed by directly modifying DNA, intervening in the epigenome requires modifying the configuration of DNA, for example, how it is folded. This does not come with alterations in the base sequence (‘genetic code’). To date, there is almost no ethical debate about EE, whereas the discussions about GE are voluminous. (...) Our article introduces EE into bioethics by translating knowledge from science to ethics and by comparing the risks of EE with those of GE. We, first (I), make the case that a broader ethical debate on EE is due, provide scientific background on EE, compile potential use-cases and recap previous debates. We then (II) compare EE and GE and suggest that the severity of risks of novel gene technologies depends on three factors: (i) the choice of an ex vivo versus an in vivo editing approach, (ii) the time of intervention and intervention windows and (iii) the targeted diseases. Moreover, we show why germline EE is not effective and reject the position of strong epigenetic determinism. We conclude that EE is not always ethically preferable to GE in terms of risks, and end with suggestions for next steps in the current ethical debate on EE by briefly introducing ethical challenges of new areas of preventive applications of EE (III). (shrink)

Targeted modifications of the human epigenome, epigenome editing (EE), are around the corner. For EE, techniques similar to genome editing (GE) techniques are used. While in GE the genetic information is changed by directly modifying DNA, intervening in the epigenome requires modifying the configuration of DNA, for example, how it is folded. This does not come with alterations in the base sequence (‘genetic code’). To date, there is almost no ethical debate about EE, whereas the discussions about GE are voluminous. (...) Our article introduces EE into bioethics by translating knowledge from science to ethics and by comparing the risks of EE with those of GE. We, first (I), make the case that a broader ethical debate on EE is due, provide scientific background on EE, compile potential use-cases and recap previous debates. We then (II) compare EE and GE and suggest that the severity of risks of novel gene technologies depends on three factors: (i) the choice of an ex vivo versus an in vivo editing approach, (ii) the time of intervention and intervention windows and (iii) the targeted diseases. Moreover, we show why germline EE is not effective and reject the position of strong epigenetic determinism. We conclude that EE is not always ethically preferable to GE in terms of risks, and end with suggestions for next steps in the current ethical debate on EE by briefly introducing ethical challenges of new areas of preventive applications of EE (III). (shrink)

BackgroundClustered Regularly Interspaced Short Palindromic Repeats-associated technology may allow for efficient and highly targeted gene editing in single-cell embryos. This possibility brings human germline editing into the focus of ethical and legal debates again.Main bodyAgainst this background, we explore essential ethical and legal questions of interventions into the human germline by means of CRISPR-Cas: How should issues of risk and uncertainty be handled? What responsibilities arise regarding future generations? Under which conditions can germline editing measures be therapeutically legitimized? For this (...) purpose, we refer to a scenario anticipating potential further development in CRISPR-Cas technology implying improved accuracy and exclusion of germline transmission to future generations. We show that, if certain concepts regarding germline editing are clarified, under such conditions a categorical prohibition of one-generation germline editing of single-cell embryos appears not to be ethically or legally justifiable.ConclusionThese findings are important prerequisites for the international debate on the ethical and legal justification of germline interventions in the human embryo as well as for the harmonization of international legal standards. (shrink)

Volume 19, Issue 7, July 2019, Page 49-50.

In der ethischen und rechtlichen Debatte um den möglichen Einsatz neuer Techniken zur Genomeditierung spielt der Begriff der genetischen Veränderung eine zentrale Rolle. Während im Bereich der grünen Gentechnik intensive Debatten um seine Bedeutung geführt werden, wird dieser Umstand im Kontext gentechnischer Interventionen am Menschen weitgehend ausgeblendet. Der Aufsatz expliziert drei mögliche Bedeutungen genetischer Veränderung, namentlich: ein prozessuales, ein diachrones sowie ein klassenbezogenes Verständnis. Anhand zweier Szenarien zukünftig erwartbarer Keimbahninterventionen wird anschließend exemplarisch gezeigt, welche Konsequenzen die Begriffe für die Kennzeichnung (...) humaner Embryonen als genetisch veränderte Entitäten haben und was dies jeweils für eine ethische und rechtliche Bewertung von Keimbahninterventionen bedeuten würde. Dabei ergeben sich jedoch für jeden der Begriffe logische, konzeptionelle sowie Anwendungsprobleme, die es problematisch erscheinen lassen, Maßnahmen der Genomeditierung überhaupt unter Verweis auf einen Begriff der genetischen Veränderung rechtlich oder ethisch zu bewerten. Soll dieser Bezugspunkt dennoch aufrechterhalten werden, ist unter pragmatischen Gesichtspunkten letztlich nur ein prozessuales Verständnis genetischer Veränderung plausibel. (shrink)

The aim of the present paper is to reinforce some of the affirmations made by Vera Lucia Raposo in a recent paper published by the Journal of Bioethical Inquiry. According to her, germline gene editing does not violate human dignity at all. This article offers some complementary ideas supporting her statement. In particular, four main arguments are stressed. Firstly, not only is the idea of human dignity unclear, but the idea of the human genome suffers from a general lack of (...) concreteness, which has dramatic consequences for the debate. Secondly, it is highlighted that if we believe that the immutability of the human genome underpins human dignity, then it should be our duty to use the tools of genetic modification to reverse any accidental changes that occur in nature. Thirdly, it is showed that if the alteration of germline constitutes an attack on human dignity, then we should also refrain from performing medical practices such as chemotherapy, which cause precisely this effect. Finally, we argue that modification of germline is not contrary to human dignity but an excellent expression of our autonomy. (shrink)