CRISPR is coming soon to DNA near you. And theologians and ethicists need to get ready

 

Three ethical guidelines for using what may turn out to be the most powerful tool in the history of humanity.

What’s the most important invention of our lifetime?

Ten years ago, I would have said the personal computer or the Internet. Now it looks like the most important invention of our lifetime is not going to be digital but biological—namely, the new technology called CRISPR-Cas9.

The Internet has revolutionized how we know. But CRISPR holds the potential to revolutionize who we are, physically speaking, at the basic level of our DNA.

Most people would not know or care that CRISPR stands for “clustered regularly interspaced short palindromic repeats,” anymore than most could recall that DNA stands for deoxyribonucleic acid. But we do know, in our information age, that no information matters more than DNA, because DNA is the molecule that tells cells what to do.

DNA instructs cells to grow bodies that are human, bovine, or equine. DNA tells cells in human bodies to become hearts, livers, or brains. It tells brain cells to become healthy or cancerous. The power and potential of CRISPR is that it lets us tell our cells something different—something we design. As scientists rapidly learn more of the genetic codes that cause a particular disease, they already have in hand an incredibly powerful tool for editing those codes and thus curing the disease.

Already CRISPR has been shown to work in animals, and human trials are in progress for treating diseases such as cystic fibrosis, sickle cell anemia, and muscular dystrophy. If there were ever a time and place to speak of curing cancer, this is it. They are not there yet, but significant strides are being made.

As CRISPR technology advances, it will probably make more sense to speak of gene rewriting, not just editing. Since the meaning of CRISPR is opaque (sounds like a lettuce drawer in the fridge), we will need a new name. Maybe a brand name. Instead of CRISPR, how does “The Re-gene-erator” sound? Certainly names will be forthcoming, because business interests are involved, and the technology can be made inexpensive to implement. You may be able to purchase a CRISPR modification to your body more cheaply than an iPhone.

The same technology that lets us treat disease could also in time empower us to enhance health. Imagine putting in a CRISPR order for denser bones or stronger heart. Modifications based on personal choice will no doubt be on the menu as well. Would you like larger muscles, bluer or browner eyes, a fuller head of blonder or redder hair?

Up to now, attempts to modify DNA have been much clumsier. Radiation breaks up DNA, causing cancer cells to die, but radiation also wreaks havoc on good DNA. Positive gene therapy, which delivers nucleic acid into a patient’s cells, has been in use for thirty years, though with minimal success.

CRISPR, however, is gene therapy of an entirely different order. For the first time, we can target and precisely edit letters of the genome, in order to eradicate disease or enhance health—and not just for one individual but potentially an entire species. If CRISPR is used on egg and sperm, this “germline modification” will affect all future offspring. We can now do in hours what evolution could not accomplish in a million years.

Not this exact hour, however. Scientists at the forefront of CRISPR research have repeatedly called for an international moratorium on using CRISPR to produce genetically modified children. They know humanity needs time, not just to refine the technology, but to think through all the ethical implications.

Not every scientist was willing to wait. The first CRISPR-edited babies, twin girls, were born in China in 2019. The scientist who did this procedure said he wanted to make the babies immune to the HIV virus. For his efforts he received a jail sentence, not a Noble Prize. Yet no expert doubted CRISPR’s potential to improve the human condition.

And let’s not forget the rest of the biosphere.  It too has DNA, every living organism, which can be altered the same way, by rewriting sections of genetic code.  We have in our hands the power to alter the physical makeup of all fish of the sea and birds of the air, all creatures that creep upon the earth and every fruit-bearing tree.  

For example, CRISPR could be used to make malaria-proof mosquitos—bugs that are immune to the malaria parasite and thus unable to transmit it to humans.  This is no small benefit.  Every two minutes, a child dies of malaria.  Over the years, malaria has been much deadlier than Covid 19.  Imagine eradicating this scourge.

Some of the endless options sound like science fiction.  It is possible that we will be able not only to change all living things, but also bring back dead things (a process called “de-extinction”).  Imagine repopulating Yellowstone National Park with woolly mammoths.

Really? If scientists will be able to do all this, why don’t they say so? The February 28, 2020 cover of Science magazine says: “Human CRISPR: Gene editing meets cancer immunotherapy.” It does not say “Cure for Cancer!” or even “Cure for Cancer?” There are three reasons why the science headlines regarding CRISPR, though bold, are not nearly so bold as they could be. These reasons involve the nature of scientists, the nature of CRISPR, and the nature of Nature.

First, most scientists are, by personality and training, careful in their procedures and modest in their claims. Scientific articles, whatever the field or journal, do not usually end with a call to change the world, but rather to do more research. Scientists know that not every promising avenue leads to breakthrough, and those that do must pass through seasons of making mistakes. They have already made mistakes using CRISPR with mice, editing more of the DNA than they had planned, which is better to do in mice than in humans (from the human, not the mouse, point of view). Yet biologists agree that the science behind CRISPR technology is sound. A breakthrough has indeed been found.

Second, therefore, the nature of CRISPR technology. As we know, technologies often start slow before making rapid progress. Air travel today is much safer than driving, though not so when the Wright brothers were fighting wind gusts off the beaches of Kitty Hawk. Sequencing the first human genome took 13 years and cost a billion dollars. Ten years later, a genome can be sequenced in two days for about four thousand dollars. CRISPR technology today is still in its infancy. But the biologists’ baby is rapidly gaining weight and stature.

Third, however, the nature of Nature. The greater part of any science is always mystery. The unknown looms so large simply because it is unquantifiable: we don’t know what we don’t know. This is true for the genetics of any one organism, and even truer for the question of how that one organism fits together with the whole—with the rest of life on earth. Nature develops delicate balances over long stretches of time. For example, a person who carries a mutant sickle cell gene has some natural protection against malaria, which could be why sickle cell occurs more frequently in sub-Saharan Africa. Natural problems, in other words, may contain hidden benefits. By the same token, humanly instigated benefits may contain hidden problems.

Since I abhor suffering, I would want to use CRISPR technology to eradicate both sickle cell and malaria. But what other parts of nature might be affected in the process? What other suffering might we inadvertently incur? We don’t know. People are better at sparking revolutions, whether political or scientific, than being able to determine where the fire will go. The cave dwellers who lit wood to stay warm did not envision combustion engines, and the people who invented combustion engines did not envision global warming. The people who mixed saltpeter and sulfur to make “fire medicine” did not envision all the deaths in all the wars that would result from the mixture being adjusted to make gunpowder.

The charge that people are trying to play God hardly ever sticks. But it does always contain a grain of truth.

Given all the unknowns, we can see why many new developments in science and technology are disparaged on the grounds that people should not be playing God. But these words of restraint can go too far in the opposite direction. The Wright brothers were told that human flight would and should be impossible, because God would have given us wings if we were meant to fly. Yet many people now enjoy air travel without feeling they have transgressed the Creator’s fixed bounds.

The charge that people are trying to play God hardly ever sticks. But it does always contain some grain of truth. Created in God’s image, we are inherently, consumingly creative. This creativity holds enormous potential for giving life or destroying it. Airplanes do not just carry people. They also carry viruses that become pandemics. As another outflow of the Wright brother’s invention, we are now able to fly through the air and drop bombs from the sky—a considerable military benefit, but no benefit at all to the bomb recipients, intended or unintended. And after seeing the photograph of a small girl, burned with napalm and running naked down the street, one could reasonably conclude that humans have indeed been playing God and the results have not been good.

And yet—we pause to come to a balanced assessment—human ingenuity can also be used in the service of compassion and human betterment. We can discover new ways to feed the hungry, clothe the naked, and heal the sick. Whether for good or ill, we are compelled to be creative and bound to push beyond our boundaries, so the question is not whether we will use CRISPR to make major revisions of our bodies and the biosphere, but rather when and how. And these are questions not only for science and technology, but also theology and ethics.

Part II

Theologians and ethicists must begin their own work on CRISPR now and without delay. Not because it is a bad technology but because it is so good it may seduce us to do bad things. Government-sponsored and privately implemented eugenics—which reached its nadir in the forced sterilization and castration of U.S. citizens during the Progressive Era of the 1890s to 1920s—started out as the science of plant breeding, a very good thing. We don’t know where CRISPR will lead. Designer pets? Jurassic Parks? Designer babies? Soldiers who can be tortured without feeling pain?

I am not meaning to be alarmist, nor predicting that CRISPR will inevitably lead us down the same path as the twentieth-century eugenics movement. For one thing, CRISPR is based on sound science, whereas eugenics was not.

Further, our social conditions are different. Eugenics as public policy was able to gain a foothold because many people believed that individuals should sacrifice for the common good; they believed that then more fervently than they do now, and they also believed that men and women in positions of power could decide what those sacrifices should be, then coerce weaker and poorer people into making them. These men and women forgot, if they ever knew, that God chooses the weak to shame the strong (1 Cor. 1:27).

CRISPR is more likely to be misused because of some misguided private desire.

People today believe much more firmly in the goodness of individual autonomy and personal pursuits of happiness. CRISPR is much more likely to be misused because of some misguided private desire than a mistaken notion of the public good.

However, as a common thread, both scenarios raise the question of goodness. What constitutes a good life? A good society? What uses of CRISPR will truly benefit an individual personally or humanity as a whole?

For all their remarkable power, modern science and technology are not designed to ask, let alone answer, these questions. But questions of goodness do obviously fall within the purview of theology and ethics. Like it or not, personal decisions and public policies regarding CRISPR are going to be made in the near future. Those decisions and policies are will be based on assumptions and intuitions about what makes for a good life, a good society, a good world. It is the job of Christians (and other religious people) to question these assumptions, to make them explicit, and perhaps to offer better premises from which to start.

If we skip over this step of understanding goodness, Christians cannot really hope to make a contribution. Sometimes church organizations rush in with political petitions and proclamations that go unheeded and even unheard, because most people think: what do church bureaucrats really know about economics or statecraft or any other topic on which they presume to pontificate? In an age of specialization, most people would rather trust experts. Well, goodness is a topic on which religious people are supposed to have expertise. It should be our specialty.

We have a duty to understand and articulate what is good. This responsibility is too easily abdicated. After all, we reason, it is not our place to tell others what to do. Individuals must decide for themselves what makes for a good life. The prevailing ethos says that everyone should live and act however they want, so long as it isn’t hurting others. I do my life and you do yours.

Longing for the moral rectitude of the Civil Rights era, councils of churches feel more comfortable making demands of governments or courts than of private citizens in their private lives, even members of their own flock. The prevailing ethos assumes, in other words, that vast swaths of human activity are indeed private, personal, and relatively inconsequential to the rest of humanity.

‘How I edit or rewrite my DNA is my business.’…What might be a Christian response to this sentiment?

We can anticipate how this mentality would shape thinking about CRISPR. The same ethos that a society develops for economic rights, reproductive rights, and sexual rights could easily become applied to DNA rights. Each person should be able to decide what kind of body they want to have. Each parent should be able to decide what kind of child they want to have. It’s my DNA, so no one else has a right to tell me what to do with it. How I edit or rewrite my DNA is my business. If you like your DNA, fine—keep it. But don’t tell me what to do with mine. What might be a Christian response to this sentiment?

Two thoughts come to mind. First, with respect to CRISPR this line of reasoning is flawed, and it may expose a faultline in much of our individualistic thinking. Human organisms, no less than other organisms, are knit together in an intricate web of relationality. Strictly speaking, there are no private actions in biology. Like the distant flapping of the proverbial butterfly wings, seemingly private human acts may ripple outward with far-reaching effects. Each person affects the whole society, just as each organism affects the whole biosphere. This dynamic is most apparent in germline modification. As scientist internationally have agreed, it cannot be a private decision. Editing egg and sperm will affect all future offspring and therefore ultimately all of humanity, and therefore indirectly all life on earth.

As well as being a biological principle, mutual interdependence is also a theological directive. We have a God-given opportunity and obligation to bear one another’s burdens, to suffer and rejoice together, to care for the least and the weakest as if we were doing it for Jesus himself, because in some sense we are (Matt. 25:40-45). We are knit together spiritually as well as physically.

If the first thought, therefore, is to recognize our mutual interdependence, the second is to respect our God-given freedom. Ideally people will want to engage in prayerful, communal decision-making, but if we are talking about society as a whole—and with CRISPR, we will be—then individualism seems to hold fewer dangers than collectivism. We need to expose the fiction that personal decisions have no public repercussions, but still it will be good to maximize personal freedom.

There appear to be two categories of decisions, and the fairly bright line between them is the germline.

Christianity embraces the insight that true liberty is found in surrender to God. But this insight cannot be coerced. Baptizing people at sword point was never good evangelism. People doing their own thing are usually in bondage to self-will, which is a kind of tyranny, but still a better kind of tyranny than bondage to a dictator. Individualism distributes the dangers of sin more evenly, and it avoids the danger of a dictator who might decide to outlaw Christian faith (as dictators have been known to do).

Assuming the preceding premises are correct, where does that leave us with regard to CRISPR? There appear to be two categories of decisions, and the fairly bright line between them is the germline. Modifying my own DNA—after conception, after birth, possibly in my adult years—is a personal decision. Recognizing the rippling societal affects, still everyone should be free to decide for themselves, in consultation with their doctors, family, friends, and trusted advisors. For children, parental rights and responsibilities would pertain in making decisions about whether to use CRISPR to treat a particular child for leukemia, sickle cell anemia, or other problems.

However, germline modification of egg and sperm is a decision in which the state has an interest, because it will more clearly have direct repercussions on the rest of society, even if the nature and extent of those repercussions are cloudy. Hopefully governments will be able reach international agreements. Full compliance with such agreement might be impossible to achieve, but such pacts do have teeth. International pressure has been relatively successful in banning germ warfare, as well as promoting human rights. International pressure has already caused restraint in using CRISPR on the human germline.

By extrapolation, the same principles would hold for modification of other species. While modifying individual organisms should require the checks and regulations currently in place (approval of ethics boards, scrutiny of animal rights groups, oversight by the FDA, etc.), germline modifications ought to involve international consensus.

The legal issues will be complex, and this essay is no place to work out the policy details. Instead, let’s return to the Christian responsibility of understanding and articulating what makes for a good life. Our vision of the good life is going to guide our thinking about CRISPR, whether we are making personal decisions about its use, giving counsel to friends, or weighing in on government policies.

Part III

Here are three pairs of ideas to consider as we develop an ethical understanding of CRISPR, or other technologies for that matter. Each pair represents a tension between two competing goods, and the goal will to strike a wise balance between them. Derived from the Bible, these principles will be most pertinent to Christians, yet they may apply to other people too. (Other people will have to decide for themselves.)

First, control is good. We have a God-given impulse to control. This impulse is the impetus behind technology. It is also the first blessing and command in the Bible—to “fill the earth and subdue it,” which does not mean to abuse or destroy, but to care and cultivate.

There is no evading this command. Our survival depends on it. We subdue the earth when we turn wood into energy, by building a fire to provide warmth and cook good food. We subdue the earth when we farm it and build storehouses for grain. A good life involves having some measure of control over our environment, including some measure of protection against the ravages of disease and locusts, of flooding and drought.

All technology gives us this benefit of control, but modern technology has increased human control exponentially. Electricity lets there be light round the clock, and clocks tabulate time, and our time on earth is radically extended via medical technology, and our years on earth are filled with activities unavailable to any other species, and nearly every place on earth, plus one or two spots on the moon, is marked with evidence of our human technology. Soon, even our DNA will bear the imprint of human interference—human control.

…innovation is born of desire—the desire to control as much as we can.

Technology takes us beyond bare necessities. Is necessity really the mother of invention? Sometimes, but more often in our present age, technological innovation is born of desire—the desire to control as much as we can. We do not really need to stream endless videos as we simultaneously tap on our phones or issue commands to personal robots. But reason not the need; we control because we can. It feels good. And in general, it is good and part of a good life.

At the same time, the value of control needs to be balanced with another good—which is learning acceptance. Acceptance is also part of a good life. Spiritual maturity sometimes comes from accepting things we cannot change. To subdue is good, but sometimes it is good to allow ourselves, freely and voluntarily, to be subdued. Sometimes, at the hour of death or well before, our only choice is whether to accept and embrace what lies beyond our power to control.

Love in a human family, within a marriage or between parents and children, calls for more than exertions of control. Love often entails acceptance of others, “just as they are,” with all their limitations, and acceptance of ourselves the same way, by respecting our finitude and embracing our vulnerability, even at the basic level of our bodies.

Different from control, acceptance can feel hard and not at all good, at least in the near term. But multiple mystics have told us acceptance is sometimes the only path to peace. Take death, for example. We can fight, and usually should fight, against this fundamental constraint on human life. At the same time, the reality of death, once accepted, can enable us to direct our energies toward living more fully in the present moment.

Scientists are hardly ever mad scientists who want to take control of the world. Most scientists simply want to know. They want to understand as much as possible. Most scientists strongly caution us in the use of CRISPR, because so much remains to be known. But technologists as a rule are different. Ready to take on real-world challenges, technologists are champing at the bit to turn knowledge into power. Technologists seek control. This desire, I stress, is basically good, but it needs to be balanced by the insight that accepting limitations is also part of a good life, a good society, and a good world.

…parental love, like God’s love for us, does not depend on engineering the ‘perfect’ child.

To use CRISPR wisely, therefore, we need to see how acceptance and control are complementary aspects of our human vocation. In offering counsel, Christians can simply pose the question, in regard to any context, problem, or situation: Should we be striving for the power that comes from control? Or the serenity that can come from acceptance?

These are not trick questions, as if surrender is always the right answer. If God is calling us to take a matter into our hands, then we will feel no serenity in letting it be. Mother Theresa could not accept that the lepers should be left alone to suffer their karma. Taking the problem into her own hands, she used her hands to wash and feed them, and inspired others to go and do likewise. Christian compassion summons us to intervene in situations of suffering, which includes medical interventions, which will in time include CRISPR. But not interventions at every turn. The fact that we will able to change DNA does not mean that in every case we should.

For example, consider the scenario of a couple who want to use CRISPR to ensure their baby will have blue eyes. On the surface, this desire sounds completely frivolous. Then you learn the tragic fact that this couple recently lost a child. This child, who died suddenly and in infancy, had radiant blue eyes. They want their new child to carry on some small feature of the one they lost. They say this minor step, this harmless alteration of DNA, will help them get past the grief. Who are we to judge?

Even without judging, we can explore. We can think or say words along these lines. As you may know, many babies, especially Caucasian babies, start out with blue eyes that change over time. We don’t know what might have happened to your child over time. We somehow have to accept all the things we cannot know about your child in this lifetime. But can we entrust your child to God’s care? And can we think also of the baby about to be born, and of the love you intend for your new baby, right away and growing over time? Does this love depend on eye color? Does it depend of the new child reminding you of the one you lost?

It would seem this use of CRISPR to change eye color would be ill advised, even though we can imagine it will at some point be legal. It would seem goodness here consists in acceptance, not control. Maybe this hypothetical example is too easy, but it makes the point.

Control brings obvious benefits, whereas acceptance may disclose hidden benefits. Many people can recount things in life that were beyond their control, which they would never have chosen in the moment, but which became over time the very features of life they value most. They would not have picked it then, but they would not trade it now, because they have found hidden benefits.

Think of parents whose hearts sink upon learning their child will be born with a genetic abnormality—cell division that results in extra genetic material from chromosome 21. The words “Down Syndrome” echo in their mind as they leave the doctor’s office.

Should we be striving for the power that comes from control? Or the serenity that can come from acceptance?

But they decide to accept and live into this new reality, and in time they come to declare: “Bobby has been our family’s greatest blessing. The love we have for him and the love he gives to us—these are things you just cannot imagine.” I have friends who have spoken these words, and though they do not speak for everyone, they do speak to the Christian reality that goodness consists in loving the people God puts in our life and places on path. In short, parental love, like God’s love for us, does not depend on engineering the “perfect” child.

In the film Human Nature, director Adam Bolt lets us hear contrasting insights, which shed light on the dynamic tension between acceptance and control. A national meeting of scientists invited parents to speak on the ethics of using CRISPR. Most parents in attendance strongly urged deployment of this new technology, as soon as possible. They were eloquent advocates for control.

‘Anything that will stop my child from suffering, I’m for.’

One African American father stated plainly: “Anything that will stop my child from suffering, I’m for.”

A white, middle-age woman described her child, who died from a heritable disease. “He had seizures every day…” she recalled. “…We donated his body for research.” Her voice, halting and choked with emotion, grew suddenly assertive: “If you have the skills and the knowledge to fix these diseases, then frickin do it!”

So then, where do we draw the ethical line between proper and improper gene editing? One scientist observed how most people respond to this question: “Draw the line anywhere you want, but don’t draw it in front of my disease.” And most parents might add: “Or even if you do draw it in front of my disease, don’t draw it front of my child’s.” To protect my child or “stop my child from suffering,” no measure seems too heroic. For this reason, we can anticipate that CRISPR will become widely used to treat childhood diseases.

As protocols became more proven and established, more green lights will be given to treat children, before birth or in infancy, for cystic fibrosis, sickle cell anemia, and muscular dystrophy. These diseases cause obvious suffering, and they are diseases for which we can pinpoint genetic causality. Why wouldn’t we employ CRISPR? Why wouldn’t we exercise control?

Yet even apparently clear-cut cases become more complex when we introduce real people into the picture. The complexity is not just medical but theological. The makers of Human Nature interviewed many renowned scientists, yet the star of the film is David Sanchez, a teenager with sickle cell disease.

An opening vignette shows David visiting Stanford Children’s Hospital for his monthly blood treatment (what the nurse calls his “oil change”). Then the film cuts to footage of him playing basketball. David looks like other kids, except the pain of a sickle cell crisis can be crippling. The onset is sudden and he has no idea how long it will go on. It may last for an hour or for several days. The pain may be a throbbing or a stabbing sensation, as his sickle-shaped red cells push, squeeze, and become blocked in the vessels that carry blood to the bones.

Arms outstretched, David gives voice to what his body is telling his brain: “This hurts!” He explains: “I can have a little pain crisis where it really doesn’t count, and then I can have something really bad. But I’m not going to not play basketball. You can’t just not play basketball.”

Near the end of the film, we hear David Sanchez being told about CRISPR therapies that would change the shape of the red cells, allowing blood to flow freely to the bones, causing the pain to cease. Here is how he responds.

“I guess that’s kind of cool, that they are thinking about doing that in the future. But I think it would be up to the kid later.”

“What do you mean?” the interviewer asks.

“There’s a lot of things I learned having sickle cell. Just because I had it, I learned patience…with everyone. I learned just to be positive.”

“So you don’t wish that you never had it?”

“I don’t wish that I never had it, no. I don’t think I’d be me if I didn’t have sickle cell.”

Amid the chorus of parents understandably urging greater control over their children’s DNA, David Sanchez speaks convincingly in favor of acceptance. He knows he speaks only for himself. Other kids might decide differently. But in almost every case, balancing these two goods of acceptance and control will call for prayerful discernment. A good life includes elements of both, as we can see from the Bible. In the garden, Adam and Eve are given control over the earth. In another garden, the second Adam prays for acceptance: “Nevertheless, not my will, but thine be done.” The same voice, we recall, had also controlled the wind and waves, commanding them to be still.

Recognizing the value of both control and acceptance, Christian prayer might proceed along these lines: “Lord, lead me in the right path. Is this a situation where we should learn acceptance, or strive to take control? Give us your wisdom and your peace.” These words echo another well-known prayer: “God, grant me the serenity to accept the things I cannot change, the courage to change the things I can, and the wisdom to know the difference.” Perhaps this “Serenity Prayer” would need modification, given all the genetic modifications made possible by CRISPR. Sometimes we will need courage not to change the things we can. And always we will need wisdom—much wisdom.

Part IV

Two other complementary concerns can be discussed more quickly. In addition to acceptance and control, a good life—and good use of CRISPR—will weigh the value of both personal freedom and communal responsibility.

These sorts of scenarios sound like recipes for narcissism

Technology in general makes us more independent. Reproductive technology, for example, has advanced to the stage where I, as an independent individual, could conceivably contract to have a baby using the eggs, sperm, and surrogate womb of three other independent individuals. If CRISPR technology advances along anticipated lines, I would soon be able to edit the baby’s DNA to select and reject many features of my choosing. These sorts of scenarios sound like recipes for narcissism, which is a real danger, especially in a consumer-minded culture.

But medical interventions can also be an expression of love beyond oneself—wanting children and then wanting the best for one’s children. People have to make many non-narcissistic decisions about health and well-being. Should a child who is born unable to hear receive cochlear implant surgery? Should a couple unable to conceive try in vitro fertilization or some other treatment? Should a disease such as sickle cell or cystic fibrosis be corrected in utero? CRISPR would be utilized only in the last instance, but the three cases exist on a continuum. With all three, there are advantages and disadvantages, risks of taking action and risks of inaction. And all three, we could say, are personal decisions, to be made by autonomous individuals in consultation with people they trust.

At the same time, individual decisions reverberate into wider society. Whenever we stake out an area and say, “this domain belongs to the individual,” it inevitably shapes the development of the whole society, regardless of what particular individuals decide to do. In the past seventy years, court rulings with respect to no-fault divorce, legal abortion, prayer in public schools, and same-sex marriage have put more decisions into the hands of individuals. These same rulings have also altered the course of society and changed the nature of communal life.

Personal autonomy is good. God gives us freedom, and it is only fair that we extend freedom to one another. At the same time, communal responsibility is also good. No CRISPR-edited baby is an island. The connection to others is most obvious with germline editing. Changing the DNA of egg and sperm will over time change the human race. Does this fact mean we don’t do it? Not necessarily, but it does call for discernment. Let’s say we can eradicate a disease. We can implant an immunity. Let’s say, for sake of argument, the day comes when we are able to make humans, from birth, immune to coronaviruses. Do we do it? Yes or no, this is a we, not a me, decision. Just as everyone is affected by pandemics, so everyone would be affected by CRISPR-based attempts to stop them.

We are born connected. The umbilical cord gets cut right away, but we stay conjoined to people and the earth through multiple ties we never can sever, nor should we want to. Even uses of CRISPR that do not alter the germline will still affect other people.

A third couplet of concerns is physical improvement and spiritual growth

Editing skin color might be a personal decision, but it would likely carry communal implications, given the world’s racial and colonial histories. In short, we should value both personal autonomy and communal responsibility. They are complementary features of a good life and a good use of CRISPR.

A third couplet of concerns is physical improvement and spiritual growth. This juxtaposition calls for a little explanation, since “spiritual” is a vague-sounding concept. People who do not consider themselves spiritual still often perceive mental, emotional, or psychological states that emerge from a physical basis yet stand in contrast to it. So the juxtaposition of physical and spiritual could for some readers be reframed as physical health and mental health.

Physical health is good and so too are most of the measures we take to improve health and prolong life. A good diet and good exercise routine; strong bones and healthy teeth—many physical activities and attributes can contribute to a good life. What about orthodontics? Or teeth whitening? Straighter teeth do chew better, and whiter teeth have less decay, but the main motive for these procedures is cosmetic. Cosmetic is not necessarily bad. “God looks at the heart, whereas people look at outward appearances,” and since people do look there, there is some limited value in wanting to look and feel our best, for our own sake as well as onlookers.

Look and feel our best—the connection between these two is what calls for scrutiny. Looks and feelings do not always correlate. Society’s beautiful-looking people do not always feel beautiful, because they may be focused on their imperfections. Or recall pictures of ourselves, taken in our youth, the looks of which we did not particularly like at the time. But over time our feelings may change. Our youthful looks somehow improve from a more mature perspective. I guess I didn’t look too bad back then, compared with now. To state the obvious: there is a strong subjective dimension to physical appearance, which ought to give us pause before changing DNA for cosmetic reasons.

Cosmetic CRISPR seems like a bizarre concern, when presently the energy is focused on problems like cystic fibrosis and muscular dystrophy. But then again, life and death surgery paved the way for cosmetic surgery. The entire beauty and fashion industries are founded on the premise that younger people want to look prettier, and older people want to look younger. These motives are strong.

Physical improvement is good, but this concern needs to be balanced with another: the emotional growth that comes from embracing our physical limitations. (This pair of concerns connects with the control and acceptance themes just discussed.) Not always, but sometimes the best looking people have the hardest time reaching emotional maturity. They are used to getting attention and getting their way. They are accustomed to having the world smile upon them, in the classroom, in the supermarket, on the Internet, in the job market, and in the competition for mates. They may therefore have less incentive to learn kindness, patience, gentleness and self-control. Of course, character development is complex. There is no shame in being beautiful. But there is also great gain in valuing what the Bible calls “inner beauty.” The latter involves emotional growth, which is an important part of a good life.

Some years ago, the cosmetic surgeon Maxwell Maltz explored the connection between physical appearance and emotional growth. He reported his findings in the book Psycho-Cybernetics. Maltz found that when he changed people’s faces through surgery, it changed their personality. Then he found that he if he could get people to change how they felt about their faces (without surgery), this move equally changed their personality. In other words, we carry inside our minds a picture of how we look, and this mental snapshot is more powerful than physical photographs. Improving our self-perception—for Christians, seeing ourselves through God’s eyes—can be an even better improvement than cosmetic surgery.

Now to apply this idea to CRISPR: physical improvements are good, but spiritual growth can come from living within life’s physical limitations. Here we can think not only of appearance but other bodily characteristics, other so-called abilities and disabilities. Very few people might be sanguine enough to say, as David Sanchez did, that our pain helped us learn patience, but we can all recognize the principle involved: physical, emotional, and spiritual improvement are not one and the same, and physical obstacles can sometimes inspire spiritual growth. We don’t want to focus solely on physical improvement when deciding whether to use CRISPR.

The problem of pain calls for further attention. Pain itself takes different forms, and sometimes its physical, emotional, and spiritual aspects are all intertwined. A single gene may be responsible for sending signals to the brain that cause us to feel physical pain. Let’s anticipate that CRISPR can be used to edit that gene. Should we do it? People who are slowly dying sometimes have weeks or months of excruciating and unrelenting pain. Using CRISPR to delete their pain, to allow a more blessed departure from this world, certainly looks like a good move. This physical improvement would make life better.

What about other kinds of pain—what about the pain caused by mental states such as fear, anxiety, anger, or depression? The connections between mental states and biological bases are intricate and mysterious, but let’s say we can identify some physical roots of mental pain, then make genetic adjustments. We are not talking about people for whom emotions come and go, but people who are attacked by emotions that become all-consuming and soul-deadening. Would we not call it a mercy to use CRISPR to alleviate such condition, if the alternative is suicide? We already use physical medications to treat emotional distress.

These situations are bound to be complex, and one answer may not be right for everyone. But we can say, in a general way, that emotional and spiritual growth come from working through pain and not simply blocking it out.

A good life is simultaneously physical and spiritual, and a good use of CRISPR will take both into account.

Further, emotions call for analysis—not just physical and psychological analysis, but ethical and theological analysis. Anxiety, for instance, can be a free-floating fear, a debilitating emotion that keeps people from living in reality. In this case, the proper goal is to reduce the anxiety, through physical and psychological methods. But some kinds of anxiety are actually reality-revealing. The soldier who experiences anxiety at the prospect of killing people is not sick; in reality, the situation is sick. The normal person who experiences anxiety, because their life has no meaning and their death holds no hope, is not out of touch with reality, but closer to truth (from the Christian perspective, closer to God) than the person who remains perpetually distracted by work and entertainment.

Our increased ability to alter our physical bodies, through drugs and soon through CRISPR, should not cause us always to seize immediate physical improvement at the expense of long-term emotional and spiritual growth. A good life is simultaneously physical and spiritual, and a good use of CRISPR will take both into account.

We need both knowledge and wisdom. With this dramatic increase in our scientific and technological knowledge—the remarkable ability to edit DNA—we will need a corresponding supply of wisdom to decide whether, when, and why to use this newfound power. These decisions will be based on our beliefs about what makes for a good life. It has been proposed that, with respect to CRISPR, a good life has these complementary features: control and acceptance; personal freedom and communal responsibility; physical improvement and spiritual growth. A good life can have many other features, but these three couplets seem particularly germane to public discussions of CRISPR.

These pairs all focus on humans and human relationships, and for Christians, our relationship to God. This article has only briefly touched on our relationship to the rest of the biosphere, which is no small matter. How do we balance two other complementary concerns—what is good for humans with what is good for the rest of the earth? This question calls for further scientific research and ethical reflection.

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