Health is a very important factor in a person's life and biotechnology has always been seen as a potential area that can give answers to many unsolved problems. Such an issue is some of the diseases that have genetic origin, which cannot be treated by any medicine or cured by any current technology. The discovery of targeted activities of certain biological entities like transposons, small interfering RNAs, etc. and the development of a method to isolate the genetic material, technologies to modify the same and the achievement of successfully transferring the modified form into organisms through certain selected vectors led to the idea of genetic engineering and gene therapy. Even though gene therapy is in its initial stages of research and development, it is important to discuss the ethical concerns associated with it, as a broad prospect for wide applications in clinical medicine.
In gene therapy, the genetic material in the cells of a patient is altered in order to correct the action of a defective gene, thereby bringing about a therapeutic effect. It is the only way of treating certain genetic disorders which does not have any other effective treatment method. The process involves the introduction of an exogenous DNA into the cell using viral vectors in vivo or in vitro. To understand the ethical issues linked to gene therapy, one should first know the methods adopted for the treatment. Gene therapy allows us not only to introduce a corrective gene, but also opens up a possibility of improvement of any phenotypic character, of which we know the responsible gene. Also, gene therapy can be done either to somatic cells or to germ cells. The somatic cell gene therapy is the most researched where cells from bone marrow, liver, lung or vascular epithelium are used. In this method, the effect of the treatment is only for the patient during his or her life time and sometimes may even need repeated treatment. Whereas in germ cell gene therapy, the sperm or ova is modified to produce a permanent cure for the disease, not only for the patient but also for his next generations.
Now coming to the ethical issues, firstly, as gene therapy involves the modification of genetic material, it is argued as a violation of nature's law or what we say as 'playing God'. But there is an agreement by the mass population that gene therapy if used, should only be for treating diseases and not for improving the human race. Otherwise, there are chances of an intentional creation of a new generation of super humans, when parents try to give their children improvements in their genetic make-up, for better intelligence, talent and smartness. The technology in wrong hands can result in disastrous consequences, as this can also enhance the negative traits. The use of somatic cell gene therapy is not contradicted much, provided the subjects chosen for clinical trial show their consent. As germ cell therapy helps to provide a permanent cure for a genetic disease once and for all, there is an ethical problem in it. A clinical trial would indirectly involve unconsented people, who are the future generations of the patient, who will also be affected by the treatment. Also, the after effects of such treatments are unknown.
Another debated issue in gene therapy is the possibility of wide experimentation of germ cell therapy on human embryos. The germ line in human embryo is not fully evolved in early stages, making it a useful tool for clinical trials for genetic modification. This creates an issue of moral disagreement about using early embryos for experimentation, for those who consider the embryo at such early stage eligible for moral consideration or at least believed to be 'like' a human being. People who think this way will surely oppose it and even completely fight against the concept of germ cell gene therapy. There are several other questions that arise regarding who will make decisions regarding the policies, distinguishing 'right' and 'wrong' and controlling the research activities, if the high cost of the technology make it available only for the wealthy, and most importantly about making out what is good and what is bad, and the potential positive and negative outcomes of gene therapy.
Anything concerning life and living beings can raise a discussion over the moral aspect of the same. As the opinion of individuals differ in everything, it is not possible to reach a conclusion in such issues. In this case, it is absolutely true that gene therapy and the innovations of genetic engineering like edible vaccines can help a large number of people world-wide. The technology and science involved should be openly discussed with the public so that the people can think from all points of view. The opinion of the public should be considered and a strict rule should be formed to avoid the misuse of the technology and to develop it into a useful application for the human race.
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