美国国家公共电台 NPR--Experts weigh medical advances in gene-editing with ethical dilemmas

Experts weigh medical advances in gene¹-editing with ethical² dilemmas³

Transcript⁴

Hundreds of scientists, doctors, bioethicists, patients, and others started gathering⁵ in London Monday for the Third International Summit on Human Genome Editing. The summit this week will debate and possibly issue recommendations about the thorny⁶ issues raised by powerful new gene-editing technologies.

The last time the world's scientists gathered to debate the pros⁷ and cons⁸ of gene-editing — in Hong Kong in late 2018 — He Jiankui, a biophysicist and researcher at Southern University of Science and Technology in Shenzhen, China, shocked his audience with a bombshell announcement. He had created the first gene-edited babies, he told the crowd — twin girls born from embryos⁹ he had modified using the gene-editing technique CRISPR.

He, who had trained at Rice University and Stanford, said he did it in hopes of protecting the girls from getting infected with the virus that causes AIDS. (The girls' father was HIV-positive.) But his announcement was immediately condemned¹¹ as irresponsible human experimentation¹². Far too little research had been done, critics said, to know if altering the genetics of embryos in this way was safe. He ultimately was sentenced by a Chinese court to three years in prison for violating medical regulations.

In the more than four years since He's stunning¹⁴ announcement, scientists have continued to hone their gene-editing powers.

"A lot has happened over the last five years. It's been a busy period," says Robin¹⁵ Lovell-Badge from the Francis Crick Institute in London, who led the committee convening¹⁶ the new summit.

Doctors have made advances using CRISPR to try to treat or better understand many diseases, including devastating¹⁷ disorders¹⁸ like sickle¹⁹ cell disease, and conditions like heart disease and cancer that are even more common and influenced by genetics.

In recent years, scientists have produced new evidence about the risks and possible shortcomings of gene-editing, while also developing more sophisticated techniques that could be safer and more precise.

"We're at an exciting moment for sure with genome-editing," says Jennifer Doudna at the University of California, Berkeley, who helped discover CRISPR. "At the same time, we certainly have challenges."

"We could help a lot of people"

One big remaining challenge and ethical question is whether scientists should ever again try to make gene-edited babies by modifying the DNA²⁰ in human sperm²¹, eggs or embryos. Such techniques, if successful could help families that have been plagued by devastating genetic¹³ disorders.

"There are more than 10,000 single genetic mutations that collectively affect probably hundreds of million of people around the world," says Shoukhrat Mitalipov, a biologist at the Oregon Health and Science University in Portland who's been trying to find ways to safely gene-edit human embryos. "We could help a lot of people."

But the fear is a mistake could create new genetic diseases that could then be passed down for generations. Some scientists are also concerned about opening a slippery slope to "designer babies" — children whose parents try to pick and choose their traits.

"If we were to allow parents to genetically²² modify their children, we would be creating new groups of people who are different from each other biologically and some would have been modified in ways that are supposed to enhance them," says Marcy Darnovsky heads the Center for Genetics and Society in San Francisco. "And they would be — unfortunately I think — considered an enhanced race — a better group of people. And I think that could really just super-charge the inequities we already have in our world."

The debate among many scientists seems to have shifted to how to edit a genome safely

Despite those concerns, some critics say the debate over the last five years has shifted from whether a prohibition²³ on inheritable genetic modifications²⁴ should ever be lifted to what technical hurdles²⁵ need to be overcome to do it safely — and which diseases doctors might try to eradicate²⁶.

As evidence of that, the critics point to the fact that the subject of genetically modifying embryos, sperm or eggs to engineer modifications that would then be passed along to every subsequent generation is the focus of only one of three days of this summit — the first such conference since the CRISPR babies were announced.

"This is quite an ironic²⁷ outcome," says Sheila Jasanoff is a professor of science and technology studies at Harvard's Kennedy School of Government.

"Instead of rejuvenating²⁸ the calls to say: 'We should be much more careful,' " Jasanoff says, "it was as if the whole scientific community heaved a kind of sigh of relief and said: 'Well, look, of course there are limits. This guy has transgressed²⁹ the limits. He's clearly outside the limits. And therefore everything else is now open for grabs. And therefore the problem before us now is to make sure that we lay out the guidelines and the rules.'"

Ben Hurlbut, a bioethicist at Arizona State University, agrees.

"There was a time when this was considered taboo," he says. "But since the last summit, there's been a shift from asking the question of 'whether' to asking the question of 'how.' "

It was too easy to scapegoat³⁰ He, some ethicists say

Hurlbut and others also say scientists have failed to fully³¹ come to terms with the high-pressure environment of biomedical research that they say encouraged He to do what he did.

"It just feels easier to condemn¹⁰ He and say all bad resides in his person and he should be ostracized³² forever as we proceed apace. Not reckoning with what happened and why fosters a certain thoughtlessness, and I would say recklessness," Hurlbut says.

That lack of reckoning with what happened could be dangerous, critics say. It could, they fear, encourage others to try make more gene-edited babies, at a time when the public may never have been more skeptical³³ about scientific experts.

"We have seen in recent years a sense that the experts have taken on too big a role and that they have tried to run roughshod over our our day-to day-lives," says Hank Greely, a longtime Stanford University bioethicist. But whether or not inheritable genetic modifications should be allowed is "ultimately a decision for societies and not a decision for science."

A new lab in Beijing

Meanwhile, He Jiankui appears to be trying to rehabilitate³⁴ himself after serving his three-year prison sentence. He's set up a new lab in Beijing, is promising³⁵ to develop new gene-therapies for diseases like muscular dystrophy, is giving scientific presentations, and is trying to raise money.

He's not expected to join the London summit this week, and is no longer talking about creating more gene-edited babies. Still, his activities are raising alarm in the scientific and bioethics communities. He declined NPR's request for an interview. But in a recently published interview with The Guardian³⁶ the only regret he mentioned was in moving too fast.

"I'm concerned," Lovell-Badge says. "I'm surprised that that he's being allowed to practice science again. It just scares me."

Others agree.

"What he did was atrocious," says Dr. Kiran Musunuru, a professor of medicine at the University of Pennsylvania. "He shouldn't be allowed anywhere near a patient again. He's proven himself to be utterly³⁷ unqualified."

Lovell-Badge and other organizers of the summit dispute criticisms that scientists are assuming gene-edited babies are inevitable³⁸ and that the agenda for this week's conference short-changes a debate about the ethical and societal landmines³⁹ that remain in this field of study.

Summit leaders say they'll dedicate the last day of the meeting to genetic modifications that can be passed down through generations; panel participants will feature scientists as well as a broad array of watchdog groups, patient advocates, bioethicists, sociologists and others.

Conference organizers say they have good reasons for focusing the first two-thirds of the meeting on the use of gene-editing to treat people who have already been born.

"The summit is a chance to really hear about what's happening in the field that has the greatest potential for improving human health," says R. Alta Charo, a professor emerta of law and bioethics from the University of Wisconsin, who helped organize the summit.

Questions of equity⁴⁰ have moved center stage

But those current treatments raise their own ethical concerns — including questions of equity. Will the the current and coming gene therapies be widely available, given how expensive and technologically⁴¹ complicated they can be to create and administer?

"We're not moving away from the conversation around heritable genome editing, but we are trying to shift some of that focus," says Francoise Baylis, a bioethicist who recently retired⁴² from Dalhousie University in Canada and helped plan the meeting. "Really important in this context is the issue of cost, because we have been seeing gene-therapies come onto the market with million-dollar price tags. That's not going to be available to the average person."

The availability of gene-therapy treatments in lower-income countries must be a focus of concern, Baylis says.

"We're going to be asking questions about where are the people who are most likely to be benefit," she says, "and are they going to have access?"

1 gene   

n.遗传因子，基因

参考例句：

• A single gene may have many effects.单一基因可能具有很多种效应。
• The targeting of gene therapy has been paid close attention.其中基因治疗的靶向性是值得密切关注的问题之一。

2 ethical   

adj.伦理的，道德的，合乎道德的

参考例句：

• It is necessary to get the youth to have a high ethical concept.必须使青年具有高度的道德观念。
• It was a debate which aroused fervent ethical arguments.那是一场引发强烈的伦理道德争论的辩论。

3 dilemmas   

n.左右为难( dilemma的名词复数 )；窘境，困境

参考例句：

• They dealt with their dilemmas by mixing perhaps unintentionally an explosive brew. 他们――也许是无意地――把爆炸性的佐料混合在一起，以此来应付困难处境。 来自辞典例句
• Ten years later we encountered the same dilemmas in Vietnam. 十年后，我们又在越南遇到了同样进退两难的局面。 来自辞典例句

4 transcript   

n.抄本，誊本，副本，肄业证书

参考例句：

• A transcript of the tapes was presented as evidence in court.一份录音带的文字本作为证据被呈交法庭。
• They wouldn't let me have a transcript of the interview.他们拒绝给我一份采访的文字整理稿。

5 gathering   

n.集会，聚会，聚集

参考例句：

• He called on Mr. White to speak at the gathering.他请怀特先生在集会上讲话。
• He is on the wing gathering material for his novels.他正忙于为他的小说收集资料。

6 thorny   

adj.多刺的，棘手的

参考例句：

• The young captain is pondering over a thorny problem.年轻的上尉正在思考一个棘手的问题。
• The boys argued over the thorny points in the lesson.孩子们辩论功课中的难点。

7 pros   

abbr.prosecuting 起诉；prosecutor 起诉人；professionals 自由职业者；proscenium （舞台）前部n.赞成的意见( pro的名词复数 )；赞成的理由；抵偿物；交换物

参考例句：

• The pros and cons cancel out. 正反两种意见抵消。 来自《现代英汉综合大词典》
• We should hear all the pros and cons of the matter before we make a decision. 我们在对这事做出决定之前，应该先听取正反两方面的意见。 来自《简明英汉词典》

8 cons   

n.欺骗，骗局( con的名词复数 )v.诈骗，哄骗( con的第三人称单数 )

参考例句：

• The pros and cons cancel out. 正反两种意见抵消。 来自《现代英汉综合大词典》
• We should hear all the pros and cons of the matter before we make a decision. 我们在对这事做出决定之前，应该先听取正反两方面的意见。 来自《简明英汉词典》

9 embryos   

n.晶胚；胚，胚胎( embryo的名词复数 )

参考例句：

• Somatic cells of angiosperms enter a regenerative phase and behave like embryos. 被子植物体细胞进入一个生殖阶段，而且其行为象胚。 来自辞典例句
• Evolution can explain why human embryos look like gilled fishes. 进化论能够解释为什么人类的胚胎看起来象除去了内脏的鱼一样。 来自辞典例句

10 condemn   

vt.谴责，指责；宣判(罪犯)，判刑

参考例句：

• Some praise him,whereas others condemn him.有些人赞扬他，而有些人谴责他。
• We mustn't condemn him on mere suppositions.我们不可全凭臆测来指责他。

11 condemned   

adj. 被责难的, 被宣告有罪的 动词condemn的过去式和过去分词

参考例句：

• He condemned the hypocrisy of those politicians who do one thing and say another. 他谴责了那些说一套做一套的政客的虚伪。
• The policy has been condemned as a regressive step. 这项政策被认为是一种倒退而受到谴责。

12 experimentation   

n.实验，试验，实验法

参考例句：

• Many people object to experimentation on animals.许多人反对用动物做实验。
• Study and analysis are likely to be far cheaper than experimentation.研究和分析的费用可能要比实验少得多。

13 genetic   

adj.遗传的，遗传学的

参考例句：

• It's very difficult to treat genetic diseases.遗传性疾病治疗起来很困难。
• Each daughter cell can receive a full complement of the genetic information.每个子细胞可以收到遗传信息的一个完全补偿物。

14 stunning   

adj.极好的；使人晕倒的

参考例句：

• His plays are distinguished only by their stunning mediocrity.他的戏剧与众不同之处就是平凡得出奇。
• The finished effect was absolutely stunning.完工后的效果非常美。

15 robin   

n.知更鸟，红襟鸟

参考例句：

• The robin is the messenger of spring.知更鸟是报春的使者。
• We knew spring was coming as we had seen a robin.我们看见了一只知更鸟，知道春天要到了。

16 convening   

召开( convene的现在分词 )； 召集； （为正式会议而）聚集； 集合

参考例句：

• When convening the assembly, however, you shall blow without sounding an alarm. 民10:7但招聚会众的时候、们要吹号、不要吹出大声。
• We warmly welcome the convening of Asia-Europe meeting in London. 热烈欢迎亚欧会议在伦敦召开。

17 devastating   

adj.毁灭性的，令人震惊的，强有力的

参考例句：

• It is the most devastating storm in 20 years.这是20年来破坏性最大的风暴。
• Affairs do have a devastating effect on marriages.婚外情确实会对婚姻造成毁灭性的影响。

18 disorders   

n.混乱( disorder的名词复数 )；凌乱；骚乱；（身心、机能）失调

参考例句：

• Reports of anorexia and other eating disorders are on the increase. 据报告，厌食症和其他饮食方面的功能紊乱发生率正在不断增长。 来自《简明英汉词典》
• The announcement led to violent civil disorders. 这项宣布引起剧烈的骚乱。 来自《简明英汉词典》

19 sickle   

n.镰刀

参考例句：

• The gardener was swishing off the tops of weeds with a sickle.园丁正在用镰刀嗖嗖地割掉杂草的顶端。
• There is a picture of the sickle on the flag. 旗帜上有镰刀的图案。

20 DNA   

(缩)deoxyribonucleic acid 脱氧核糖核酸

参考例句：

• DNA is stored in the nucleus of a cell.脱氧核糖核酸储存于细胞的细胞核里。
• Gene mutations are alterations in the DNA code.基因突变是指DNA密码的改变。

21 sperm   

n.精子，精液

参考例句：

• Only one sperm fertilises an egg.只有一个精子使卵子受精。
• In human reproduction,one female egg is usually fertilized by one sperm.在人体生殖过程中，一个精子使一个卵子受精。

22 genetically   

adv.遗传上

参考例句：

• All the bees in the colony are genetically related. 同一群体的蜜蜂都有亲缘关系。
• Genetically modified foods have already arrived on American dinner tables. 经基因改造加工过的食物已端上了美国人的餐桌。 来自英汉非文学 - 生命科学 - 基因与食物

23 prohibition   

n.禁止；禁令，禁律

参考例句：

• The prohibition against drunken driving will save many lives.禁止酒后开车将会减少许多死亡事故。
• They voted in favour of the prohibition of smoking in public areas.他们投票赞成禁止在公共场所吸烟。

24 modifications   

n.缓和( modification的名词复数 )；限制；更改；改变

参考例句：

• The engine was pulled apart for modifications and then reassembled. 发动机被拆开改型，然后再组装起来。 来自《简明英汉词典》
• The original plan had undergone fairly extensive modifications. 原计划已经作了相当大的修改。 来自《简明英汉词典》

25 hurdles   

n.障碍( hurdle的名词复数 )；跳栏；（供人或马跳跃的）栏架；跨栏赛

参考例句：

• In starting a new company, many hurdles must be crossed. 刚开办一个公司时，必须克服许多障碍。 来自《简明英汉词典》
• There are several hurdles to be got over in this project. 在这项工程中有一些困难要克服。 来自辞典例句

26 eradicate   

v.根除，消灭，杜绝

参考例句：

• These insects are very difficult to eradicate.这些昆虫很难根除。
• They are already battling to eradicate illnesses such as malaria and tetanus.他们已经在努力消灭疟疾、破伤风等疾病。

27 ironic   

adj.讽刺的，有讽刺意味的，出乎意料的

参考例句：

• That is a summary and ironic end.那是一个具有概括性和讽刺意味的结局。
• People used to call me Mr Popularity at high school,but they were being ironic.人们中学时常把我称作“万人迷先生”，但他们是在挖苦我。

28 rejuvenating   

使变得年轻，使恢复活力( rejuvenate的现在分词 )

参考例句：

• The rejuvenating ambience of autumn is immeasurably more ancient than even the calendar. 秋天那让人恢复青春活力的气氛远比历法还要古老。 来自名作英译部分
• Rhoda says that it's embarrassing to be so idolized, but also very sweet and rejuvenating. 罗达说，给人这样过份地崇拜是很发窘的，不过也是愉快惬意使人年轻的。

29 transgressed   

v.超越( transgress的过去式和过去分词 )；越过；违反；违背

参考例句：

• You transgressed against the law. 你犯法了。 来自《现代英汉综合大词典》
• His behavior transgressed the unwritten rules of social conduct. 他的行为违反了不成文的社交规范。 来自辞典例句

30 scapegoat   

n.替罪的羔羊，替人顶罪者；v.使…成为替罪羊

参考例句：

• He has been made a scapegoat for the company's failures.他成了公司倒闭的替罪羊。
• They ask me to join the party so that I'll be their scapegoat when trouble comes.他们想叫我入伙，出了乱子，好让我替他们垫背。

31 fully   

adv.完全地，全部地，彻底地；充分地

参考例句：

• The doctor asked me to breathe in,then to breathe out fully.医生让我先吸气，然后全部呼出。
• They soon became fully integrated into the local community.他们很快就完全融入了当地人的圈子。

32 ostracized   

v.放逐( ostracize的过去式和过去分词 )；流放；摈弃；排斥

参考例句：

• He was ostracized by his colleagues for refusing to support the strike. 他因拒绝支持罢工而受到同事的排斥。
• The family were ostracized by the neighborhood. 邻居们都不理睬那一家人。 来自《现代英汉综合大词典》

33 skeptical   

adj.怀疑的，多疑的

参考例句：

• Others here are more skeptical about the chances for justice being done.这里的其他人更为怀疑正义能否得到伸张。
• Her look was skeptical and resigned.她的表情是将信将疑而又无可奈何。

34 rehabilitate   

vt.改造(罪犯)，修复；vi.复兴，(罪犯)经受改造

参考例句：

• There was no money to rehabilitate the tower.没有资金修复那座塔。
• He used exercise programmes to rehabilitate the patients.他采用体育锻炼疗法使患者恢复健康。

35 promising   

adj.有希望的，有前途的

参考例句：

• The results of the experiments are very promising.实验的结果充满了希望。
• We're trying to bring along one or two promising young swimmers.我们正设法培养出一两名有前途的年轻游泳选手。

36 guardian   

n.监护人；守卫者，保护者

参考例句：

• The form must be signed by the child's parents or guardian. 这张表格须由孩子的家长或监护人签字。
• The press is a guardian of the public weal. 报刊是公共福利的卫护者。

37 utterly   

adv.完全地，绝对地

参考例句：

• Utterly devoted to the people,he gave his life in saving his patients.他忠于人民，把毕生精力用于挽救患者的生命。
• I was utterly ravished by the way she smiled.她的微笑使我完全陶醉了。

38 inevitable   

adj.不可避免的，必然发生的

参考例句：

• Mary was wearing her inevitable large hat.玛丽戴着她总是戴的那顶大帽子。
• The defeat had inevitable consequences for British policy.战败对英国政策不可避免地产生了影响。

39 landmines   

潜在的冲突； 地雷，投伞水雷( landmine的名词复数 )

参考例句：

• The treaty bans the use production and trade of landmines. 该条约规定，禁止使用地雷相关产品及贸易。
• One of the weapon's of special concern was landmines. 在引起人们特别关注的武器中就有地雷。

40 equity   

n.公正，公平，（无固定利息的）股票

参考例句：

• They shared the work of the house with equity.他们公平地分担家务。
• To capture his equity,Murphy must either sell or refinance.要获得资产净值，墨菲必须出售或者重新融资。

41 technologically   

ad.技术上地

参考例句：

• Shanghai is a technologically advanced city. 上海是中国的一个技术先进的城市。
• Many senior managers are technologically illiterate. 许多高级经理都对技术知之甚少。

42 retired   

adj.隐退的，退休的，退役的

参考例句：

• The old man retired to the country for rest.这位老人下乡休息去了。
• Many retired people take up gardening as a hobby.许多退休的人都以从事园艺为嗜好。