Nerd alert

One of the things I love best about living in a big city is the opportunity to geek out on lectures and events. City Arts and Lectures always has amazing things going on, and tonight was no exception: Drs. Siddhartha Mukherjee and Paul Berg sat down to chat about genetic engineering.

I know, I just put most of you to sleep. Lucky for me, I was able to round up some like-minded buddies to go with me! And I promise, it’s pretty cool stuff, and stuff we should all at least be aware of.

In case those aren’t household names for you: Dr. Mukherjee is the author of “The Emperor of All Maladies,” which was recently made into a PBS mini-series (involving an actual household name, Ken Burns). He’s recently written a new book, “The Gene: An Intimate History,” which he plugged during the talk and is going on my to-read list. Dr. Berg is a Nobel laureate, winning the Prize for Chemistry in 1980 for work on recombinant DNA technology (he shared the Prize with Frederick Sanger, certainly a household name for any biology student, at least as far as my generation, for the DNA sequencing technique named after him. Probably no one has to do this in college lab anymore, although it puts everything into perspective—kind of like learning how to type on a typewriter would explain why we have the QWERTY keyboard and a caps lock key).

Their conversation centered around the scientific advances that are making it possible not just to “read” our DNA genome—the ATCG combos that make up our identity—but then to understand how changes in those sequences can increase the chances of disease. Not cause disease, per se, but increase the probability of getting, say, breast cancer. Because even if a gene is identified that is linked to an increase in breast cancer (e.g., BRCA), there are so many other genes and chemical modifications to those genes and environmental factors that also come into play that affect whether or not that gene will result in the disease.

Now, in addition to reading comprehension, there is an additional, almost sci-fi technology being developed that allows us to specifically edit a sequence of DNA. That BRCA gene, for instance, could be edited to be “normal” rather than the mutation linked to cancer. This can be done either in the cells of the body that we don’t pass onto our children (somatic), or in the egg and sperm (germline), which could be edited not for our sake, but for the sake of our daughter not carrying the BRCA mutation.

I think we can all agree there is a gut feeling as to what are “appropriate” edits to make—ones that would lower the risk of disease. Dr. Berg pointed out, which is something I hadn’t thought of in exactly this way, that IVF labs already allow this sort of selection: they genetically screen fertilized eggs for certain gene variants, and any that are found to have them are not implanted into the uterus.

The National Academies recently launched an initiative to “inform decision making related to recent advances in human gene-editing research.”

I actually have faith in scientists that they will reach a consensus surrounding the ethical and moral dilemmas this type of research causes.

Where the conversation did touch upon too briefly, and really only tackled towards the end in response to one of the audience questions, is: are we, as a society, able to face these dilemmas as well? If current political leaders cannot take the consensus of experts on climate change, or even if evolution is true, how can they be trusted to make decisions on something as intricate and technical as germline gene editing? (side note – my autocorrect really wants “germline” to be “gremlin.”)

Dr. Mukherjee talked about how individuals will make a decision based on their perspective, on their instincts. Of course, a mother or father would want to remove a 15% chance of their kid having an increased risk of cancer.

But what happens when this power is extrapolated out to society? It could be epically harmful. What if, due to the costs of these technologies, only the rich are in a position to rid their offspring of disease risk? Our upper and lower classes are already split enough—what if this further divides us? What if there are some unseen benefits to the gene mutations that we only learn about when it’s too late? For example, the gene for sickle cell anemia needs to be present on both chromosomes (so, two copies) to get the disease. If you only have one copy, however, you’re resistant to malaria. Finally, there is the challenge of heterogeneity in any population. This is normally most evident in agriculture (something this technology could also affect), but if we’re all the same genetically, all it takes is one virus to knock us all out.

The pair made a plea specifically about this topic, but I think it’s relevant to all decision points at this volatile time in our nation. We are the stewards of our genetics. We need to be informed enough, maybe not to make decisions ourselves, but to know if the decisions being made for us are in our best interest. And to be informed enough to realize that decisions for the greater good of society may not be what we would choose as an individual. It’s not to place blame, but to place responsibility, in Dr. Mukherjee’s words.

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