Considering genetic modification

In September 2015, it was reported that researchers at London's Francis Crick Institute (2015) had sought permission from the Human Fertilisation and Embryology Authority (HFEA) to use so-called ‘gene editing’ techniques on human embryos. Although it is illegal to use gene editing techniques in treatment, it is permissible for research if carried out under an HFEA license, and provided the embryos are destroyed within a fortnight.

So what is gene editing, and how might it influence the ethical landscape in which midwives operate? The essential tools of the process allow ‘molecular scissors’ to remove and replace defective portions of DNA from a genome. Although the basic technology has been available for some years, a recent refinement—clustered regularly interspaced short palindromic repeats (CRISPR) allied with a bacterial enzyme Cas9—has prompted major advances in this expanding field of research.

In spring 2015, Chinese scientists reported having used CRISPR/Cas9 technology on ‘non-viable’ embryos in an attempt to modify the gene responsible for the potentially fatal blood disorder ß-thalassaemia (Liang et al, 2015). Of 86 embryos treated with CRISPR/Cas9, 71 survived, 54 of which were genetically tested. Testing showed that although the technique had worked on 28, only a fraction contained the replacement DNA. The paper was published in the journal Protein & Cell after it had been rejected by Nature and Science, partly on ethical grounds.