Ethical considerations on CRISPR/Cas9: Therapeutic use in embryos and future governance

Abstract

The CRISPR-Cas9 gene editing technique has made a revolution in science and has also generated discussions about its use in humans, both at the safety, ethical and political levels. In this paper, I argue that it is not possible to perform gene editing for therapeutic use of the CRISPR-Cas9 technique in embryos with monogenic diseases that will become future children until greater safety and efficacy are guaranteed. To this end, I consider that there must be a balance between prevention in its therapeutic use and its use in research. First, I explain the different possible uses of the CRISPR-Cas9 technique, differentiating its therapeutic use (validated practice and non-validated practice), its use for improvement and its use in research. Secondly, I analyze the risks of performing gene editing for therapeutic use. In addition, I list a series of ethical considerations to be considered in the future in case this technique is approved. Thirdly, I evaluate the international consensus reached so far and describe the case of Argentina, its prohibition and the problems it generates at the time of doing research. Fourthly, I analyze the different existing reproductive alternatives and perform a risk/benefit analysis for their possible use. Finally, I evaluate a possible objection to my work by explaining that it does not contemplate the reproductive freedom of prospective parents. In response, I consider that a conflict between the principles of autonomy and non-maleficence is generated.