Professionalism/He Jiankui and Designer Babies

Background on He Jiankui
He Jiankui is a Chinese biophysics researcher who studied at Rice University for his PhD and taught at Southern University of Science and Technology in China. He founded the company Direct Genomics in 2012, which developed single molecule sequencing devices. In 2018, He Jiankui claimed to have created the first gene-edited twins "Lula and Nina" and a baby named "Amy". He recruited couples in which the father had HIV and through in vitro fertilization, edited the genomes of embryos to be protected from HIV later in life.

 Background on CRISPR 

CRISPR is highly efficient, relatively easy to use, and has revolutionized the field of genetic engineering. It has the potential to treat and cure a wide range of genetic diseases, improve crop yields, and enhance our understanding of genetics and biology. First, scientists design a guide RNA molecule that matches the target DNA sequence they want to edit. This guide RNA molecule then binds to the Cas9 protein, which acts as scissors, cutting the DNA at the precise location where the guide RNA has bound. Once the DNA has been cut, scientists can then introduce a new DNA sequence into the cell, which the cell uses as a template to repair the break in the DNA. This process can be used to either insert or delete specific genes or to correct genetic mutations that cause diseases.

Guidelines and Regulations
Starting in 2015, industry groups began releasing statements regarding the ethical implications of genetic modifications of embryos. The U.C. Berkeley Institute for Genome Innovation "strongly discourage[d]…any attempts at germline genome modification" and the International Summit on Human Gene Editing said "it would be irresponsible...until the relevant safety and efficacy issues have been resolved...and there is broad societal consensus". In 2017, the National Academy of Science and the National Academy of Medicine released the official position of the US Academies, stating that genome modification should only occur with a clear regulatory framework. They recommended that genetic editing be restricted to preventing a serious disease or condition, restricted to converting genes to versions that are prevalent in the population, and take place with "ongoing, rigorous oversight" and "maximum transparency".

Beyond industry guidelines, many countries have implemented laws that ban clinical trials of genome editing in embryos. As of 2020, no country allows for the genetic modification of embryos in pregnant women, through either explicit or de facto bans. However, at the time of He's experiment, the regulations surrounding genetic modification research in China were dubious at best, and did not explicitly prohibit clinical studies of this kind. Additionally, the regulatory environment surrounding research in China is relatively new, making it easy for He Jiankui to avoid any oversight from both industry and governmental agencies. Regardless of the lack of robust legislation on genetic modification, He blatantly violated a number of other ethical and legal restrictions in order to carry out his experiment covertly. He forged documents to get medical approval, fabricated a fake ethical review certificate, and misled doctors "misled doctors into unknowingly implanting gene-edited embryos into two women." In the years since He's research, China has passed new regulations restricting genome editing and created a new national medical ethics committee to oversee future genetic experiments.

Controversy
In China, the government immediately launched an investigation into the experiment, and in January 2019, He Jiankui was fired from his position at the Southern University of Science and Technology in Shenzhen. The Chinese government also issued a statement condemning the experiment, stating that the researchers had "violated China's laws and regulations, breached the morality and ethics of academia, and damaged China's international reputation in the field of science and technology." While the babies' parents were aware of the gene editing, He broke Chinese laws by forging Chinese documents. In December 2019, He Jiankui was sentenced to three years in prison and fined three million yuan (approximately $430,000) by a Chinese court for his involvement in the experiment. Two of his colleagues, Zhang Renli and Qin Jinzhou, were also sentenced to prison and fined.

 Media Response 

There was immediate outcry from many people in the industry against He's actions. The NIH, Chinese Academy of Medical Science, WHO, and countless other bioethicists, geneticists, and other biomedical researchers all strongly condemned He Jiankui and his experiments. A documentary called "Make People Better" about the activities of He Jiankui and his relations with the Chinese Government was released in 2022. It provided a critical perspective on He yet claims that he is part of a larger trend in China and was thrown under the bus. The National Academy of Sciences, which has been outspoken about the ethical concerns of gene-editing, tweeted in 2019 seemingly in support of using gene-editing to create designer babies with enhanced abilities beyond resistance to diseases. He Jiankui's research has prompted much public discussion on the ethics of genetic modification and "designer babies". While most people disagree with using genome editing to make babies more intelligent, public opinion is more mixed on its use to cure diseases.

Impact
There is a lot of uncertainty surrounding the effects of the gene editing experiment. He Jiankui attempted to disable the CCR5 gene that is responsible for HIV infection, but this is far from a guarantee. This experiment he conducted is still being monitored with no concrete evidence that this gene is completely disabled. In a video released on his YouTube channel, He Jiankui said that gene editing should only be used for healing rather than enhancing IQ or physical appearances. Interestingly, the CCR5 gene is a suppressant of memory and brain plasticity. Disabling this gene may prevent the contraction of HIV, but it also has implications in creating highly intelligent babies. There are loads of possible consequences these babies can face from higher risk of West Nile Virus and severe flu to cancer. The impact on babies "Lula and Nina" it yet to be seen, but this experiment has launched a heated debate between scientists over the use of CRISPR-Cas9.

Conclusion
He Jiankui's actions have been almost universally denounced by researchers and governments around the world, and he paid the price when he was sentenced to prison. However, in 2022, He was released from prison and is already attempting to raise money to perform new experiments, this time working to "develop affordable gene therapies for rare diseases." To this day, He has never apologized for his actions or experiments. The only regret He has expressed is that he "did it too quickly." While He's work brought the ethical dilemma to the forefront of public attention, it did not result in any definitive answers. Research on genome modification continues, albeit under stricter oversight than in He's experiment, and ethical debates within the industry are still ongoing. He Jiankui received an array of opinions for his work. In a professional sense, He should have informed others at the institute he was working with due to the fact he was using their resources and the ethical questions associated with his experiment. A question that comes into play is how will He Jiankui be viewed in 100 years? Will he be revered for his trail blazing work or continue to be condemned due to the fact that he violated the regulations and ethical guidelines of the time?