One of the disconcerting features of bioethics debates is how quickly the public changes its mind on controversial issues. This is particularly evident in discussions about hereditary human genome editing (HGEH) and mitochondrial replacement therapy (MRT).
If one were to ask whether scientists should be allowed to tinker with the human genome, most people would probably say not at all. This intuition has been codified in international agreements such as UNESCO’s Universal Declaration on the Human Genome and Human Rights and the Oviedo Convention. Both statements include a prohibition on hereditary modifications.
However, in the United Kingdom and Australia, TRM is permitted, at least in some circumstances. Even more disturbing is the fact that a scientific consensus is building that supports modifying the human genome. In 2015, the International Summit on Human Gene Editing declared that it would be “irresponsible” to continue EHGEH until safety concerns were resolved. In 2018, a second summit called for a “rigorous and responsible translational path” and scientific consensus. However, in 2020, the US National Academies and the UK Royal Society stated that EHGEH “could represent an important option” for parents if there was a risk of genetic disease.
The pace of ethical change has been relatively fast. The stakes are high. Some scientists even believe that humanity needs to be reshaped and that modifying the genome is a necessity.
An excellent recent article in the Journal of Bioethical Inquiry by Shoaib Khan and Katherine Drabiak of the University of South Florida discusses the persuasive strategies that some scientists from the United Kingdom, Australia and the United States have used to shape public opinion about this often controversial biotechnology. The authors identify eight techniques.
1. They point to genes as the problem and genomic technology as the solution. “This rhetoric entrenches the belief that genetics summarizes the human body, and that, instead of our DNA being part of us, it becomes the objective to be solved… When we perceive that genes are the problem, biotechnology presents us as the solution. This framework ignores the complex nature of all diseases, including monogenic disease.”
2. Normalize dramatic propositions through the use of familiar metaphors. It is true that communicating complex scientific notions is difficult. But oversimplifying them risks becoming misleading. MRT, for example, has been described as a “microorgan transplant,” “a new form of in vitro fertilization (IVF),” or the transplantation of mere cellular energy packages (mitochondria). “These familiar metaphors portray MRT and EHGEH as acceptable, necessary and innovative medical procedures rather than risky and highly controversial experiments, which is what they really are.”
3. Exploiting therapeutic misconceptions and promising fantastic speculative benefits. New techniques are described as if they were proven therapies rather than risky, unproven procedures.
4. Rely on non-questionable main conclusions, such as “everyone wants healthy babies.” “This strategy exploits innate human compassion and sympathy as a means of generating stakeholder buy-in. It also assumes, with minimal or little evidence, that babies born after MRT or EHGEH are truly ‘healthy.’”
5. Minimize or rule out serious risks. “The risks of MRT are not simply ineffectiveness, but some research suggests that altering the interaction between mitochondrial DNA (mtDNA) and nuclear DNA (nDNA) could induce iatrogenic developmental disorders, latent deaths, accelerated aging and increase the risk of cancer”. But scientists have told lawmakers that these techniques are “safe enough” and “promising.”
6. Assume the inevitability of adopting technology. «Replacing society’s norms into questionable domains becomes the scientific frontier and is synonymous with progress, assumes that more technology is an optimal priority and dismisses ethical dissent as an ephemeral effect of society falling behind or not understanding the science».
7. Distort key terminology and presume legal exceptionalism. International agreements prohibiting germline modification are very clear. However, some scientists have simply stated outright that their techniques are completely different. For example, the UK Department of Health performed logical legerdemain to claim “that while MRT may constitute germline modification, it does not meet the definition of human germline genetic modification because there is no definition.” agreed upon genetic modification.
8. Hide the role of commercial motivations. The new IVF techniques are a marketable product. The scientists’ weak assurances “often fail to consider the financial incentives that drive the fertility industry to expand practices to more clients and for more prescriptions, entangled in the compelling desire that many people have to have a biological child.”