MEDPanel advocates for ethics in medicine

Partnering with the Berman Institute of Bioethics, the Hopkins MEDPanel hosted a roundtable discussion on Saturday, March 4, on the topic of genetic modification. The event opened with a presentation by Jeffrey Kahn, followed by a small group discussion between students and Berman Institute representatives and ended with a talk by Travis Rieder.

Kahn, the director of the Berman Institute, spoke about his position on a National Academy of Sciences committee in charge of assessing the ethics of genome editing. He discussed the current ethical and legal issues of human genetic modification, particularly in regard to recent developments in CRISPR technologies.

“It’s a very precise way of editing any kind of genome. It doesn’t have to be human, it can be in anything that’s got DNA,” Kahn said. “It’s so far the most precise, easy to use, cheap tool there is to edit genomes.”

Kahn’s committee is responsible for making recommendations to govern these technologies.

“We were asked... to identify some principles to guide the way this work should be overseen,” he said. “These [principles] should be the... foundation on which regulatory processes should be built.”

Kahn explained that several layers of regulatory oversight are already in place to oversee both cellular genetic modification. He noted that while gene therapy for the purpose of treating diseases is generally accepted, genetic enhancement is still somewhat of a gray area.

“The line between treatment or prevention and enhancement is not clear. And that’s been an area that many people have worked on for many years without there being an agreed consensus,” he said.

Kahn also stressed that the focus of his committee was not whether genetic enhancements are morally wrong, but whether the potential benefits of the technology outweigh the risks. He said that the question of morality can only be answered with extensive public input.

In the question and answer session following the presentation, Kahn said that gene editing to treat hereditary diseases should only be used if the disease is guaranteed to be passed down to the patient’s children.

Although Kahn’s committee does not endorse germline editing in any situation, they take it into consideration because of significant public desire for biological children.

“Humans have spoken,” Kahn said. “There’s a lot of money spent and a lot of energy spent and a lot of angst experienced for people to have genetically related children.”

Despite the recommendations made by the committee so far, Kahn noted that the conversation about genetic modification is far from over and that further recommendations will be discussed in future international summits.

“This is supposed to be an ongoing global, international, transnational discussion,” he said. “This is the beginning, not the end.”

Kahn’s presentation was followed by smaller discussions between Hopkins students and Berman Institute students and faculty. Groups reviewed Kahn’s talk and further debated the issue. Cameron Okeke, a second-year Master’s in Bioethics student at Berman, brought up the importance of ethics in the biological and health sciences.

“The mistake that people often make is they think that facts and science and research alone... can change the world, but in fact it’s actually arguments and reason, and more importantly ethics,” Okeke said. “If there doesn’t seem to be anything bad about [a technology]... then it seems like a policy we should do. But if there are significant dangers... the effect that could have, both on the environment but also socially, could be catastrophic.”

Rieder, assistant director for education initiatives at Berman, delivered the closing statements.

“There’s a bunch of conversations to be had [that aren’t] about a particular charge that the national academies might have,” Rieder said. “Those are broader philosophical questions... also broader religious or spiritual sorts of questions.”

While the National Academy of Sciences is only concerned with the risks involved in genetic modification, it will remain largely up to the general public to decide whether it is morally acceptable, which may determine regulatory policy. One aspect of this moral dilemma is the paradox of harm.

MEDPanel member Donghyun Kim expressed his satisfaction with the event and hopes of continuing to collaborate with the Berman Institute in the future.

“We were lucky enough because they actually reached out to us first last year, and we couldn’t really set up anything immediately, but we talked and threw ideas around and we thought this was a pretty good event to have,” Kim said.

Kim believes that overall the event went well and he hopes that it will help continue the conversation about ethics in medicine.

“I think a lot of people [found the talk interesting], because a lot of people stayed behind, and hopefully this got a lot of people interested in medical ethics and bioethics,” he said. “It’s a new light to have experts come in and engage with us instead of students just talking with each other.”