I guess that vision of the future assumes healthcare will be provided as a service in a market economy. So only the rich get gene therapies to eliminate genetic disease, along with cosmetic surgery and exotic therapies?
That is not how healthcare usually works in other developed economies that have public heath services.
Gene therapy could be the key to a cure for some really debilitating diseases that impose a huge burden on society. A cure for Alzheimer’s, perhaps?
Agonising about ‘designer’ babies and what evil governments might get up to is a big stretch of the imagination.
However……looking back in history, there was a time when doctors considered pain to part of the human experience and resisted the introduction of anaesthesia. Was their judgement right, now that we find society cursed with opioid addiction?
The future is full of the unintended consequences of innovation. We solve one problem and another arises. If we did not innovate to benefit from the advantages and try to manage the disadvantages we would have become extinct like the Neanderthals.
Gene therapy is a huge step forward and one of the most exciting developments in medicine that may be able to treat many currently incurable diseases. I have no doubt there will be some unintended bad consequences. But we can only guess what they might be, they can be managed if care is taken.
This could be as significant an advance as the introduction of antibiotics to control infectious diseases.
If the techniques do not develop in one place, they will in another. I am reminded of the debate that raged over Genetic Modification techniques in agriculture and how that became politicised. It is still an issue in Europe.
Let’s say there’s a variant that slightly reduces the risk of coronary heart disease. The base version however gives a slight reduction in some specific cancer risks. Which version should prevail as the genetic superior one?
Because that’s what we discover as we get higher powered studies, that and sets of genes where different combinations lower or increase the risks of lots of conditions.
As long as we recognize this the number of overwhelmingly “bad” genes is going to be quite low, and we’ll have plenty of variation left even if we start eliminating them.
This is true, and everything in nature is a trade-off. For examples, us humans (and primates in general), as well as fruit bats, cannot produce vitamin C. We need it to live (or we get scurvy! Avast!) and our ancestors made it in their bodies, just like the vast majority of other animal species. But we lack the ability! Why? And should we just engineer that option right back in, so we can reduce our reliance on Big Citrus?
Maybe, maybe not. There are a handful of theories as to why the ancestors of primates (and the ancestor of fruit bats) lost the ability to synthesize vitamin c. I’ll split them into two main groups.
Both rely on the fact that early primates and fruit bats both live in trees, eating fruit. Fruit happens to be a great source of vitamin c, which means that now the ability to generate it is no longer under selective pressure. This is where the theories differ. One says that it was simple genetic drift that broke the ability to make vitamin c. With that ability no longer being the difference between life and death, random mutations broke the gene and weren’t selected against, so they spread through the population.
The other theories suggest that there is a hidden cost to vitamin c production, one that is selected AGAINST as soon as the need for the vitamin for survival doesn’t weigh against these costs. Suggestions include the production of free radical oxygen atoms or significantly less vitamin c being needed. And there is some interesting evidence for this theory, such as the fact that both primates, fruit bats, and a number of smaller groups (fish, birds, and so on) that have also lost this ability all did so via a mutation to the same exact gene, implying that the specific biochemical processes it allows may indeed have a hidden cost.
I imagine that as we gain a better and better understanding of both genetics and epigenetics, we might find more and more of these sorts of issues, as well as creative ways around that. Maybe some fish species found a way to modify a different gene down the line in a way that mitigates the harmful costs. Or something even crazier.