The call for a moratorium capped a remarkable shift in policy statements. In 2015, the committee of the first ethics summit said germline editing would be “irresponsible” unless and until certain conditions were met. In 2017, the NASEM report concluded it “should be permitted” provided that conditions were met; and in 2018, the Hong Kong summit committee surmised that germline editing was acceptable in principle and needed a translational pathway. For Baylis, a Canadian bioethicist and author who joined Lander’s call for a moratorium, that progression was alarming. “There’s nothing that’s happened that warrants this kind of shift. What’s the hurry?”49
With JK imprisoned, China has sent a resounding message warning off any other potential genome hotshots. The government required researchers to complete a survey to catalogue gene-editing programs in the country. China belatedly established an ethics commission to plug some of the jurisdictional gaps between the health and science ministries. What effect will these actions have? “It is also almost certain someone will attempt gene editing to make stronger, smarter, more attractive babies. Pandora’s box is wide open in China,” wrote Mei Fong.50
In April 2019, Yang Hui, a young neuroscientist at the Shanghai Institute of Biological Sciences, and Wang Haoyi, a bioethicist at the Chinese Academy of Sciences, published a damning rebuke of JK’s work.51 The authors were “shocked” and “enraged” by JK’s “irresponsible conduct” that violated the medical ethics of China and the world. JK had no intention of trying to precisely introduce the Δ32 variant, they alleged, merely to break the CCR5 gene.
Despite his fierce criticism of JK, Yang Hui was advancing his own research on human embryos using base editing.52 He didn’t mention the JK controversy in the article—it was as if the CRISPR babies had never been born. But in a candid interview, Yang told a Chinese paper that gene editing, like weapons or drugs, could be used for either good or immoral purposes. If we’re allowing germline editing, then his goal was to leave no unedited embryo behind. “Even if there is just one embryo left unedited, it will create an ethical problem. An almost 100 percent efficiency is required before the technology can be used on humans,” he said.53
That day might happen sooner than we think. And while Yang said the production of “superbabies” should be permanently banned, his zeal to follow in JK’s footsteps was apparent. Indeed, you could be forgiven for seeing shades of a new Cold War. “We are ahead of the competition in the United States,” he said. “We are working with the same spirit as building the first nuclear bomb!”
But if there are groups in China or anywhere else intent on pursuing germline editing, they have an uphill task. “Chromosomal mayhem” is not a phrase widely deployed in Nature headlines, but in June 2020 it was not an exaggeration.54 A trio of bioRxiv preprints from the leading experts on genome editing in human embryos outside China—Niakan, Egli, and Mitalipov—independently reported worrisome “on target” DNA aberrations when using CRISPR to edit specific genes. Niakan’s group found that a fraction of embryos displayed unwanted deletions and rearrangements in the vicinity of the targeted gene, while Egli and Mitalipov also reported serious chromosomal damage or rearrangements in some embryos. It was a timely reminder that we still have much to learn about the raw mechanics of DNA repair processes at the earliest stages of embryogenesis before we can safely and responsibly consider genome editing in the human embryo.
I. “Illegal medical practice” has three grades in China: For an offense in which no one was harmed, the maximum sentence is three years (plus a fine). If a patient has been harmed, the maximum sentence is ten years, longer in cases with a loss of life. Whether the CRISPR babies were harmed in any way remains to be seen. JK’s sentence seems more than a slap on the wrist. Perhaps the Chinese government is sending a message of the dangers of money poisoning science.
II. Since 2016, the U.S. effectively has a ban on human germline editing. An amendment by Representative Robert Aderholt (Alabama) bars the FDA from funding clinical trial applications of gene editing of human embryos.
PART IV
“DNA is not just a genetic code. It is in some sense also a moral code.”
—Siddhartha Mukherjee
“Soon we must look deep within ourselves and decide what we wish to become. Our childhood having ended, we will hear the true voice of Mephistopheles.”
—E. O. Wilson
“We are all mutants, but some of us are more mutant than others.”
—Armand Leroi
CHAPTER 20 TO EXTINCTION AND BEYOND
You can’t write a book on genome editing without visiting George Church. Or so he tells me. So I make the pilgrimage to the Church lab, nestled in the complex of famous hospitals and institutes that make up Harvard Medical School, a David Ortiz home run from Fenway Park, the proud home of the Boston Red Sox. Church’s schedule is crammed with appointments: mine nestles between a check-in with a medical student and a visit from the founders of an Israeli tech company.
I scan the overflowing bookshelves that line an entire wall of Church’s office. There are copies of Church’s first book, Regenesis. There’s Hood, Luke Timmerman’s biography of the inventor of automated DNA sequencing; One in a Billion, the story of a landmark clinical case of genome sequencing; and Woolly,1 Ben Mezrich’s book about Church’s ambitious quest to recreate the woolly mammoth, which is being made into a film. On his desk is a stack of Walter Isaacson bestseller biographies including Steve Jobs and Leonardo Da Vinci. On top of the pile is The Innovators. It occurs to me I’m looking at one. I wonder who can carry off the trademark Church beard in the Woolly movie? I’m guessing George Clooney or Jeff Bridges, but all Church will say is that it is his wife’s favorite actor.
Church is one of the most imaginative, restless, in-demand scientists alive, despite suffering from narcolepsy. He’s warned me more than once to keep panel discussions I’m moderating with him as a guest interesting or he’s liable to nod off. In 2019, Church opened a keynote lecture at a gene therapy conference by saying he hoped to make it through his lecture fully conscious. Only he wasn’t joking: the day before, he’d fallen asleep—and fallen over—while talking to guests in his office. It’s an occupational hazard he mitigates by fasting during the day and never letting his mind let up.
He launches new fields and new biotech companies with merry abandon, pairing “radical technology and radical application” to push the envelope of genetics. He’s a pioneer of systems biology and the Personal Genome Project. One of his companies has released what Church fondly calls the “zero-dollar genome,” another is developing new gene therapy vectors, yet another is trying to reverse aging. I peek into a room where some of his students are growing brain organoids, a controversial new tool to understand diseases like Alzheimer’s and schizophrenia.
If there was a tagline for Church’s sprawling operation, it might be: “Read and write DNA without limits” or “life finds a way” from Jurassic Park. The genome has become a giant experimental playground for Church. At any given time his lab is populated by dozens of wicked smart students from all corners of the globe, inspired by a legendary scientist who not only encourages but almost demands moonshots and imaginative ideas to turn science fiction into biomedical fact.