To CRISPR or not to CRISPR Group 2

Background • CRISPR/Cas is an adaptive immune system in prokaryotes • A CRISPR/Cas system

Use the system to change the inherited human genetic material? • Setting the scene:

The problem “Should we develop the CRISPR method on humans to cure disease, knowing

Solutions & Consequences Solutions Go ahead Proceed with caution Stop Interested Parties Researcher University

Solution 1 – ”Go Ahead” Solutions & Consequences Go ahead Interested Parties Researcher +:

Solution 1 – ”Go Ahead” Solutions & Consequences Go ahead Interested Parties Researcher University

Solution 2 – ”Proceed with caution” Solutions & Consequences Interested Parties Researcher Go ahead

Solution 2 – ”Proceed with caution” Solutions & Consequences Interested Parties Researcher University +:

Solution 2 – ”Proceed with caution” Solutions & Consequences Interested Parties Researcher University Company

Solution 3 – ”I just can’t go on. . . ” Solutions & Consequences

So …. What? Solutions & Consequences Go ahead Interested Parties Researcher University Company Users/Public

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To CRISPR or not to CRISPR? Group 2 Ethics of technology and science: Seminar II

Background • CRISPR/Cas is an adaptive immune system in prokaryotes • A CRISPR/Cas system has been developed as a genetic tool for precise gene modifications: – Deletions and insertions • Widely used as tool in research in both eukaryotes and prokaryotes • Easy design, easy execution and can be used on many different sequences

Use the system to change the inherited human genetic material? • Setting the scene: – More knowledge about gene and gene function than a few years ago – Delivery vehicle for editing in developed cells is available – In vitro fertilization techniques already in place Y. Wu, D. Liang, Y. Wang, M. Bai, W. i Tang, S. Bao, Z. Yan, D. Li, J. Li Correction of a Genetic Disease in Mouse via Use of CRISPR-Cas 9 Cell Stem Cell 2013, 13(6): 659 -662. • Unknown “off-target” effects and unknown long-term “ontarget” effects

The problem “Should we develop the CRISPR method on humans to cure disease, knowing that it could be used for other things? ”

Solutions & Consequences Solutions Go ahead Proceed with caution Stop Interested Parties Researcher University Company (associated with researcher) Users/Public Religious Organ.

Solution 1 – ”Go Ahead” Solutions & Consequences Go ahead Interested Parties Researcher +: Glory, career opportunity, scientific esteem Solutions - : Increase competition & targeted by opponents, big responsibility, risk of failure & possible negative legacy Proceed with caution Stop University Company (associated with researcher) Users/Public Religious Organ.

Solution 1 – ”Go Ahead” Solutions & Consequences Go ahead Interested Parties Researcher University +: Glory, career opportunity, scientific esteem +: Prestige & increase funding Solutions - : Increase competition & targeted by opponents, big responsibility, risk of failure & possible negative legacy Proceed with caution Stop -: Risk of bad PR & costly legal issues Company (associated with researcher) Users/Public Religious Organ.

Solution 1 – ”Go Ahead” Solutions & Consequences Go ahead Interested Parties Researcher University Company +: Glory, career opportunity, scientific esteem +: Prestige & increase funding +: Possible huge revenue -: Risk of bad PR & costly legal issues +/-: Good/Bad PR Solutions - : Increase competition & targeted by opponents, big responsibility, risk of failure & possible negative legacy Proceed with caution Stop (associated with researcher) -: Costly legal issues, patent cost Users/Public Religious Organ.

Solution 1 – ”Go Ahead” Solutions & Consequences Go ahead Interested Parties Researcher University Company Users/Public +: Glory, career opportunity, scientific esteem +: Prestige & increase funding +: Possible huge revenue -: Risk of bad PR & costly legal issues +/-: Good/Bad PR +: Eradicate genetic diseases +/-: “Designer babies”, unpredictable effects on society, long term effects unknown -: Identity issues, loss of diversity Solutions - : Increase competition & targeted by opponents, big responsibility, risk of failure & possible negative legacy Proceed with caution Stop (associated with researcher) -: Costly legal issues, patent cost Religious Organ.

Solution 1 – ”Go Ahead” Solutions & Consequences Go ahead Interested Parties Researcher University Company Users/Public Religious Organ. +: Glory, career opportunity, scientific esteem +: Prestige & increase funding +: Possible huge revenue -: Angry -: Risk of bad PR & costly legal issues +/-: Good/Bad PR +: Eradicate genetic diseases +/-: “Designer babies”, unpredictable effects on society, long term effects unknown -: Identity issues, loss of diversity Solutions - : Increase competition & targeted by opponents, big responsibility, risk of failure & possible negative legacy Proceed with caution Stop (associated with researcher) -: Costly legal issues, patent cost

Solution 2 – ”Proceed with caution” Solutions & Consequences Interested Parties Researcher Go ahead Solutions Proceed with caution +: Possible recognition & esteem, discovery of important side effect/issues, “clean conscience” -: Might get scooped, time consuming legal ‘stuff’ Stop University Company (associated with researcher) Users/Public Religious Organ.

Solution 2 – ”Proceed with caution” Solutions & Consequences Interested Parties Researcher University +: Possible recognition & esteem, discovery of important side effect/issues, “clean conscience” +: Less risk of legal issues Go ahead Solutions Proceed with caution -: Might get scooped, time consuming legal ‘stuff’ Stop -: Less prestige, perhaps less funding (less risk & less benefit) Company (associated with researcher) Users/Public Religious Organ.

Solution 2 – ”Proceed with caution” Solutions & Consequences Interested Parties Researcher University Company +: Possible recognition & esteem, discovery of important side effect/issues, “clean conscience” +: Less risk of legal issues +: Profit, better / more reliable product (associated with researcher) Go ahead Solutions Proceed with caution -: Might get scooped, time consuming legal ‘stuff’ Stop -: Less prestige, perhaps less funding (less risk & less benefit) -: Delays, less profit than solution 1, more regulations Users/Public Religious Organ.

Solution 2 – ”Proceed with caution” Solutions & Consequences Interested Parties Researcher University Company Users/Public +: Possible recognition & esteem, discovery of important side effect/issues, “clean conscience” +: Less risk of legal issues +: Profit, better / more reliable product +: More effective treatment, more informed public, legislation might prevent “designer babies” (associated with researcher) Go ahead Solutions Proceed with caution -: Might get scooped, time consuming legal ‘stuff’ Stop -: Less prestige, perhaps less funding (less risk & less benefit) -: Delays, less profit than solution 1, more regulations -: Delayed application of method Religious Organ.

Solution 2 – ”Proceed with caution” Solutions & Consequences Interested Parties Researcher University Company Users/Public Religious Organ. +: Possible recognition & esteem, discovery of important side effect/issues, “clean conscience” +: Less risk of legal issues +: Profit, better / more reliable product +: More effective treatment, more informed public, legislation might prevent “designer babies” -: Still angry (associated with researcher) Go ahead Solutions Proceed with caution -: Might get scooped, time consuming legal ‘stuff’ Stop -: Less prestige, perhaps less funding (less risk & less benefit) -: Delays, less profit than solution 1, more regulations -: Delayed application of method

Solution 3 – ”I just can’t go on. . . ” Solutions & Consequences Interested Parties Researcher Go ahead Proceed with caution Solutions Stop +: “Very clean conscience”, no risk of adverse effects -: No glory, less career opportunities, lose influence over development of field University Company (associated with researcher) Users/Public Religious Organ.

Solution 3 – ”I just can’t go on. . . ” Solutions & Consequences Interested Parties Researcher University +: “Very clean conscience”, no risk of adverse effects +: No legal issues Go ahead Proceed with caution Solutions Stop -: No glory, less career opportunities, lose influence over development of field -: Missed opportunity, loss of funding / PR / prestige Company (associated with researcher) Users/Public Religious Organ.

Solution 3 – ”I just can’t go on. . . ” Solutions & Consequences Interested Parties Researcher University Company +: “Very clean conscience”, no risk of adverse effects +: No legal issues +: No legal risk -: Missed opportunity, loss of funding / PR / prestige -: No revenue from CRISPR (associated with researcher) Go ahead Proceed with caution Solutions Stop -: No glory, less career opportunities, lose influence over development of field Users/Public Religious Organ.

Solution 3 – ”I just can’t go on. . . ” Solutions & Consequences Interested Parties Researcher University Company Users/Public +: “Very clean conscience”, no risk of adverse effects +: No legal issues +: No legal risk -: Missed opportunity, loss of funding / PR / prestige -: No revenue from CRISPR +: Slower progress but eventual eradication of genetic diseases (associated with researcher) Go ahead Proceed with caution Solutions Stop -: No glory, less career opportunities, lose influence over development of field -: Public will lose researcher’s voice of reason Religious Organ.

Solution 3 – ”I just can’t go on. . . ” Solutions & Consequences Interested Parties Researcher University Company Users/Public Religious Organ. +: “Very clean conscience”, no risk of adverse effects +: No legal issues +: No legal risk -: Missed opportunity, loss of funding / PR / prestige -: No revenue from CRISPR +: Slower progress but eventual eradication of genetic diseases -: Angry, but about something else (associated with researcher) Go ahead Proceed with caution Solutions Stop -: No glory, less career opportunities, lose influence over development of field -: Public will lose researcher’s voice of reason

So …. What? Solutions & Consequences Go ahead Interested Parties Researcher University Company Users/Public Religious Organ. +: Glory, career opportunity, scientific esteem +: Prestige & increase funding +: Possible huge revenue +: Eradicate genetic diseases -: Angry Solutions - : Increase competition & targeted by opponents, big responsibility, risk of failure & possible negative legacy Proceed with caution +: Possible recognition & esteem, discovery of important side effect/issues, “clean conscience” -: Might get scooped, time consuming legal ‘stuff’ Stop +: “Very clean conscience”, no risk of adverse effects -: No glory, less career opportunities, lose influence over development of field -: Risk of bad PR & costly legal issues (associated with researcher) +/-: Good/Bad PR -: Costly legal issues, patent cost +/-: “Designer babies”, unpredictable effects on society, long term effects unknown -: Identity issues, loss of diversity +: Less risk of legal issues -: Less prestige, perhaps less funding +: Profit, better / more reliable product (less risk & less benefit) -: Delays, less profit than solution 1, more regulations +: No legal issues +: No legal risk -: Missed opportunity, loss of funding / PR / prestige -: No revenue from CRISPR +: More effective treatment, more informed public, legislation might prevent “designer babies” -: Still angry -: Delayed application of method +: Slower progress but eventual eradication of genetic diseases -: Public will lose researcher’s voice of reason -: Angry, but about something else