[W]e know that natural nonsense mutations in the PCSK9 gene protect against high cholesterol. Subsequent work has led to PCSK9 inhibitors that reduce cholesterol and cardiac deaths if taken regularly. In monkeys, introduction of such mutations into the liver succeeded lowering LDL cholesterol by 60%. While there were some off-target effects and inflammation caused by viruses used to deliver the gene therapy, these are expected to be fixable by additional research. The real question now is not whether such therapeutic gene editing is possible, but rather — do we want it and are we ready for it?
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If gene editing becomes a safe and final solution, society risks becoming progressively more unequal — not just in opportunity but in capacity — in a self-reinforcing fashion, creating new social orders and caste systems. The risk to humanity is an extension of the risk to society: once we become confident enough in the technology to move from somatic editing to germline editing. While removing ‘bad’ genes from the gene-pool may sound sensible, it is not. Loss of genetic diversity would leave us genetically fragile — susceptible to new threats that may wipe out a homogenous humanity. These technical, moral, ethical and foresight issues will need to be resolved before gene-editing become widely accepted.
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