Ethical considerations should have a priority place in science and medicine. Promoting sound bioethics promotes confidence in doctors and scientists and their work, among peers, the public and policymakers. This is certainly seen in the recent ethically-guided decisions around federal funding of research with fetal tissue from elective abortions. Ethical guardrails help focus precious research funds on projects with best chance of success and benefit for all. Even in a crisis such as the current COVID-19 pandemic, illumination of the ethical vs. unethical proposals can educate and serve to focus attention and resources on the paths that will benefit all.

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Should ethical considerations have a place in science and medicine? Should ethics reviews be a standard part of science proposal reviews? Some scientists have said one reason they don’t consult ethicists or think about the ethical implications of their research is because ethicists usually say “no” to new technologies or because ethics is arbitrary. But what they are really avoiding is the necessity of setting rational limits on science, thinking they can thereby avoid any limits on their work. Limits that protect all human beings—even nascent human life—are neither arbitrary nor irrational. Such limits offer essential protections against abuses that could actually tarnish the image and standing of science, and limits also provide us opportunities to appreciate our shared humanity. These limits are not barriers but rather channels to move the scientific endeavor onto more productive ground. Science and ethics are not diametrically opposed approaches. In fact, in most cases the two walk hand in hand, enjoying each other’s company and benefitting from the shared journey.

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Gene Editing to Make Better Human Beings? September 14, 2017

The story of the gene-edited babies birthed in China continues to reverberate around the world. To review, the Chinese scientist He Jiankui disclosed in late 2018 that he had used gene editing tools to create genetically-modified human embryos, and he then gestated the embryos to birth. He discussed his experiments on the twin girls at an international genetics meeting co-sponsored by the U.S. National Academy of Sciences. While most of the scientific community condemned the experiments, some of the outrage seemed feigned. Nonetheless, in the months following his announcement, there were calls from leading scientists and ethicists for a global moratorium on human heritable genome editing and wide-ranging discussions on the ethics of manipulating the human genome. Over 60 global leaders wrote to U.S. Department of Health and Human Services (HHS) Secretary Alex Azar, saying “We write as scientific, industry, and bioethics leaders who are committed to translating the promise of gene editing into medicines to help patients in need, to express our views strongly condemning the recent reports of the birth of CRISPR-edited infants in China and to urge you to take action.”

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Medical breakthroughs are routinely touted in the media, whether they are actual breakthroughs or promising, potential information. Press outlets often make no distinction between real, evidence-based progress that can impact patients versus wished-for projections that can influence funding of projects. Rarely are the ethical choices noted regarding use, or development, of the research.

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There continues to be a push to “make better human beings” using genetic modifying technologies. This includes the use of gene editing enzyme tools such as the much talked about CRISPR-Cas system, as well as large scale heritable genetic technologies such as creation of three-parent embryos. As discussed previously, one aspect of gene editing has a very positive aspect: actually attempting to treat patients with genetic conditions and other maladies. Those clinical trials include potential treatments for cancers, sickle cell disease and even the first in-body gene editing to treat blindness. These are truly therapeutic trials, attempting to alleviate diseases in affected patients.

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Gene Editing to Make Better Human Beings? September 14, 2017

The promises of biotechnology are legion. Many excellent opportunities do exist to develop lifesaving therapies. Many more provide a tempting siren song of “cures!” And if you’re in the healthcare field, at some point you will be asked about your position on some of these wonderful new cures on the horizon. Here’s a short list of some of the recent melodies being sung regarding medical miracles, as well as some truth regarding these apparent wonders.

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New Chinese Study Opens Ethical Can of Worms October 19, 2017

Adult stem cells are the successful gold standard of stem cells, especially when it comes to patients and therapies. Adult stem cells are in fact the only type of stem cell to have shown validated, published results of therapeutic benefit to patients. A recent published review of stem cell research documents the significant efficacy gap between embryonic and adult stem cells.

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Better Science Without the Ideology of Fetal Tissue January 10, 2019

The debate about use of aborted fetal tissue for research continues, usually characterized as pitting science against ideology. Dr. David Prentice explains how the characterization is accurate, but the stereotypes of who fits in the categories are not.

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Techno-Babies: Some Assembly Required? November 10, 2016

In this week’s blog post, Dr. David Prentice discusses how emerging technologies offer opportunities for development of useful therapeutic interventions, but they can also offer temptations to rush ahead with risky, scientifically unproven and ethically questionable applications.

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Gene Editing to Make Better Human Beings? September 14, 2017

Manufacturing industries routinely do quality control on their products, testing them to be certain the items being produced meet certain specifications. Any flawed products, those that do not meet the required specifications, are discarded. But what if that same mindset were applied to human beings?

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New Chinese Study Opens Ethical Can of Worms October 19, 2017

Some recent stories illustrate the continuing obsession, by some in the scientific community, with trying to make embryos in a way that “gets around” the ethical and legal barriers erected to protect young human life. Dr. David Prentice explores these recent attempts.

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Genome Editing: Social and Ethical Issues August 16, 2018

Some scientists have said one reason they don’t consult bioethicists or think about the ethical implications of their research is because ethicists usually say “no” to new technologies, or that ethics is arbitrary. But what they are really avoiding is the necessity of setting rational limits on science, thinking they can thereby avoid any limits on their work. Limits that protect all human beings, even nascent human life, are not arbitrary and actually say “yes” to some exciting—and ethical—applications of new technologies.

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Gene editing has potential for great benefit but also for great evil. In the medical realm, great advances are possible, but this dual-use technology also could be used to design children, weaponize biological agents or even alter or dehumanize our concept of humanity. Dr. David Prentice explores how gene editing can be dangerous for healthcare professionals and their patients in this week’s blog post.

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There continue to be reports of new attempts to create life, sometimes labeled “synthetic” or “artificial” because the entity is not created the old-fashioned way, i.e., by fertilization of an egg with a sperm. The most recent report involved combining two different types of stem cells to form an embryo-like structure that was labeled “artificial.”

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Sometimes what seems like science fiction can actually be science fact, and sometimes new technologies can have the potential for both good and bad uses. So-called “dual-use technology” is most often thought of in connection with potential military as well as civilian use, e.g., weaponized forms of viruses or bacteria vs. using such altered pathogens for vaccine development.

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Science fiction is no longer fiction—the first three-parent baby was born a few months ago. Last month in The Point, Dr. Robert E. Cranston raised a series of important questions about the safety and ethics of the technique; now more information—and more questions—have arisen. As a reminder, the concept of creating a baby with three parents came as a proposal to “treat” individuals with mitochondrial genetic diseases, i.e., mutations in the mitochondrial DNA that lead to sometimes lethal physiological problems.

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Techno-Babies: Some Assembly Required? November 10, 2016

Despite the clear ethical problems, reports now show another three-parent child may have been born in China, and two more three-parent babies gestating in Ukraine. The practitioners of this cloning and embryo manipulation technology are pushing ahead, so Dr. David Prentice goes in-depth into the ethical and safety problems with this technique.

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