The Code Breaker: Jennifer Doudna, Gene Editing, and the Future of the Human Race

Nonfiction | Biography | Adult | Published in 2021

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Chapters 35-36Chapter Summaries & Analyses

Chapter 35 Summary: “Rules of the Road”

In 1972, Paul Berg published his seminal paper on recombinant DNA, ushering in the era of genetic engineering. Simultaneously, ethical and philosophical debates around genetic engineering kicked into high gear. In the following decades, three conferences around the possibilities and limitations of genetic engineering would stand out.

The first two were Asilomar I and II of 1973 and 1975, held in Monterey, California. Asilomar I ended with a moratorium on recombinant DNA technology until safety guidelines about creating hybrid genetic material were formulated. David Baltimore—who showed that viruses containing RNA (like coronaviruses) can insert their genetic material into a host cell to hijack its DNA in a process called “reverse transcription”—was one of the stars of Asilomar II. While Berg argued for banning recombinant technology for fear of misuse, Baltimore suggested a more middle-of-the-road approach: restricting the use of recombinant DNA to viruses that were “crippled” so they would not spread. In the end, the attending scientists agreed to lift the moratorium on recombinant DNA technology, but with many safeguards in place. However, both conferences elided another important question: Even if genetic engineering was safe, was pursuing it to every possible end ethical?

At the third conference, held in 1998 and called “Engineering the Human Germline,” James Watson challenged all ethical doubts around gene editing. The conference debated the idea of editing germ or founder cells of embryos. Editing such cells precipitated changes far more long-reaching than editing somatic cells and needed careful consideration. For one, genetic edits made to germ cells are inheritable. But Watson had his own reasons to kibosh the idea of the natural human being. If nature knew best, why had his son Rufus developed schizophrenia? For Watson, engineering the human germ cell was not just desirable, it was the next step of human evolution.

Chapter 36 Summary: “Doudna Steps In”

Doudna stepped into the ethics and safety issues around CRISPR for two reasons: one was a nightmare featuring Adolf Hitler with a pig’s head, and the other was a real-life startup promising perfect babies. The first Doudna considered a premonition about the use of genetic editing as a bioterror tool; the second was a means to widen inequality. “Happy Healthy Baby” was started by young entrepreneur Lauren Buchman. Buchman wrote to Doudna’s teammate Sam Sternberg to discuss how CRISPR could be used to edit (not merely screen) IVF embryos to prevent genetic diseases. Though Buchman wanted Sternberg to come in as a cofounder, he declined. Eventually, Buchman gave up her idea, since her research suggested it was too early for the market—and society—to accept.

For Doudna, the ethical implications of CRISPR as a genetic-editing tool needed to be discussed at an Asilomar-like conference. She invited Berg and Baltimore to attend a similar conference in Napa Valley. However, unlike Asilomar, Napa would also consider the ethical implications of using gene-editing technologies like CRISPR-Cas9. In the end, the Napa group decided that though gene editing of somatic cells was a good thing, the concept of editing germline cells should be paused until ethical guidelines were put in place. Doudna was pleased with this outcome, but unknown to her, gene editing on embryos had already started in China.

On April 18, 2015, a little-known Chinese journal called Protein and Cell published a paper that described how researchers had used CRISPR-Cas9 to edit a disease-causing mutation in 86 nonviable zygotes (fertilized cells that are precursors to embryos). This was the sort of application of CRISPR-Cas9 that Doudna had been dreading. The Chinese paper drew the attention of the US government, and another conference was organized in Washington in December 2015: the first International Summit on Human Gene Editing. The mega-gathering reached a consensus close to that of Napa, but with one major difference: Broad societal consensus before permitting inheritable gene editing was no longer needed.

Chapters 35-36 Analysis

In Chapter 35, Isaacson explores the ethics of gene editing, one of the most important themes of the book. From Mary Shelly’s Frankenstein (1818) to Aldous Huxley’s Brave New World (1932), the idea of bioengineered humans has been the stuff of science and dystopian fiction for centuries. However, by the 1970s, the prospect had moved into the realm of probability. It was now possible to combine DNA from different organisms (recombinant DNA technology) and fertilize embryos in test tubes and petri dishes. Isaacson discusses how these advances led to increasing questions about the ethics of gene editing, a debate which is ongoing.

Since genetic engineering procedures are so expensive, they can increase inequality in society. Further, gene editing encourages the notion of creating “perfect babies,” which is deeply problematic. Many of these concerns are aptly mirrored in the fiction of the 1990s, such as the movie Gattaca (1997), which is set in a society where embryos are edited not just for disease but also imperfections. Isaacson links this scenario to another technological advance: pre-implantation diagnosis. The assisted reproductive technology of in vitro fertilization (IVF) began using pre-implantation diagnosis in 1990, in which an egg and a sperm are fertilized in a petri dish, and the resultant embryos are tested to rule out genetic abnormalities. Some couples even choose the child’s gender. What if such technology is misused, say, in a deeply patriarchal culture that chooses to weed out female embryos? In Gattaca, non-genetically engineered humans are considered inferior, triggering a new caste system. Is such a future possible? Isaacson leaves the question open-ended at this stage.

Doudna expresses similar concerns in Chapter 36. Doudna’s thoughtful attitude directly contrasts that of James Watson, who believes gene editing should be used uninhibitedly. Doudna’s position is in line with many important thinkers and scientists who suggest genetic engineering be used to treat diseases but not to enhance the capabilities of human beings. Treatment versus enhancement as the limit of gene editing is a motif the text will continue to explore. Of course, sometimes the boundaries between the two categories are more blurred than scientists and ethicists would like.

If gene-editing technology can alleviate human suffering, would it be wrong to not use it? Like Asilomar II, the Napa conference concluded that germline editing should be pursued, but with safeguards. However, David Baltimore’s distinction about Napa is crucial: The conference was held in January 2015, a far cry from the 1970s. In contemporary times the link between academia and industry has strengthened, biasing any consensus in the favor of commercial interests. This is an extremely pertinent point, which adds another layer of consideration to the ethics of gene editing. Further, it connects with the argument that reduced government involvement and public university funding is generally a bad thing for science. For science to thrive, the state, the university, and the corporation must balance each other.

Some bioethicists were dismayed by the Napa report, but others were more circumspect because it is better to have germline editing practiced in the open rather than as a clandestine operation. Further, an international moratorium may be irrelevant, since countries have their own laws on gene editing. China, for instance, has tougher restrictions against germline editing than most countries, which is why the next big development around germline editing in China was so shocking.