August 23, 2016
As medical enhancement technology develops at an ever-increasing rate, the American public is more concerned about the future ethical implications of these new discoveries. Which medical enhancements provoke the strongest reaction, and are bioethicists prepared to respond to emerging ethical questions?

In July 2016, the Pew Research Center released a study investigating public opinion on three promising medical enhancement technologies: gene editing, implanted cognitive chips, and synthetic blood. Gene editing allows geneticists to cut and insert specific genes. Cognitive chips, or neuroprosethetics, are computer chips implanted in the brain that are currently used to overcome neurological conditions such as Parkinson’s Disease. These devices could also have the ability to boost memory and advanced learning procedures. Synthetic blood, or smart blood, is artificially created blood that could carry oxygen at an enhanced level, increasing individual’s energy and cognitive functions.

The Pew survey found that more Americans were worried than excited about the societal impact of these new technologies. The study found that Americans don’t necessarily have an aversion to medical enhancements: 31 percent of Americans have one of these medical enhancements and 58 percent of people know someone who has been enhanced. However, the study revealed the public is worried about medical enhancements that could enhance humans past their “peak capacity.” The more extreme the enhancement and the more permanent it becomes, the less people embraced it.

For example, 47 percent of Americans consider the use of synthetic blood substitutes to improve physical abilities an “appropriate use of technology” if the resulting change to people’s speed, strength, and stamina would be “equal to their own peak abilities.” But if the same enhancement results in physical abilities “far above that of any human known to date,” far fewer (28 percent) say it would be an appropriate use of technology.

Gene editing is the most controversial of the surveyed enhancement treatments, with 68 percent of respondents saying they were “very” or “somewhat” worried about gene editing. Of the four thousand people Pew surveyed, 70 percent of the respondents expressed concerns that society will not fully understand these new technologies before they become widely available. However, despite this concern, many believe they will become commonplace in the next fifty years.

Fully 81 percent of US adults expect artificially made organs to be routinely available for transplant and 66 percent of Americans say scientists will probably or definitely cure most forms of cancer within 50 years.

While none of the surveyed enhancements are widely available, that day is approaching quickly. In 2015, a British team launched the first human trial of synthetic blood, and in April 2016, a neural computer chip allowed a paralyzed man to precisely move his arm with just his thoughts. However, by far the most revolutionary and controversial medical enhancement test was the first human embryotic gene editing test. In April 2015, researchers from China carried out the first genetic test in human pre-implantation embryos. The researchers attempted to remove a potentially fatal blood disorder. The test reignited the bioethical debate surrounding gene editing and many bioethicists and geneticist expressed concerns that this technology could lead to an ethical slippery slope into eugenics. In December 2015, the world’s leading geneticists and bioethicists met to urge the genetics community to hold off on embryotic editing until further international guidelines and norms are established.

The first embryotic genetic editing test not only presents ethical dilemmas, but has caused significant concern for national security leaders. Previously, genetic editing was conducted with protein chains to manipulate single genes over several generations at significantly high costs. In 2012, a new gene editing technique known as CRISPR was developed. This new technology was simpler, more dependable, and cheaper, allowing more labs to conduct advanced genetic testing. But it also lowered the cost of creating a biological weapon. On February 9, in front of the Senate Armed Forces Committee, Director of National Intelligence James Clapper labeled gene editing a Weapon of Mass Destruction threat for increasing the potential of germline warfare, which allows the compounding of desirable traits to create more dangerous and powerful pathogens. 

The scientific community is divided over the feasibility of a biological WMD. Although CRISPR lowers the barriers to the development of bioweapons, genetic editing is still incredibly complex and requires significant technical skills and infrastructure. The high technical cost may preclude organized, non-state actors from developing bioweapons. Instead, the CRISPR technique allows those already with the necessary knowledge in genetic editing to progress farther. Others in the scientific community are concerned that CRISPR’s potential could inspire rogue scientists, who have unsafe lab practices to experiment with the CRISPR technique.

“Research in genome editing conducted by countries with different regulatory or ethical standards than those of Western countries probably increases the risk of the creation of potentially harmful biological agents or products” – James Clapper, Director of National Intelligence

CRISPR regulation is still in its infancy. There are no international regulations governing embryonic research and the lack of regulations has national security experts and bioethicists concerned. The lack of international CRISPR regulations presents two ethical issues: not only could one use CRISPR to fundamentally alter the gene pool, but also unless a universal rule is accepted, no national policy can address CRISPR regulation.

Many in the scientific community are concerned that regulation will stifle innovation and hope that industry self-regulation will prompt policy makers to enact more flexible laws. International organizations have already taken notice of the powerful CRISPR technology: in October 2015, the United Nations Educational, Scientific and Cultural Organization called for a ban on all genetic editing of human DNA. The upcoming Eighth Review Conference of the United Nations Biological Weapons Convention will be the first review conference since CRISPR’s development and it presents a significant opportunity to begin a dialogue and set a strategic agenda on the relationship between genetic editing and international national security.

Kevin Fulgham is an intern with the Strategic Foresight Initiative.