Gene Therapy: the Danger of Enhancement
Gene therapy has the potential to revolutionize modern medicine. The techniques of gene therapy are still in their infancy as medical treatments and there are still many problems which must be solved before gene therapy will live up to its potential. However, it is very likely that gene therapy will become a reality at some point in the future and when that time comes, the ethical questions surrounding gene therapy will be pushed to the forefront of medicine. Science may find a way to reduce the risks associated with gene therapy but science alone cannot eliminate the serious ethical and societal risks which gene therapy brings to bear on the world. We need to put people's fear about the dangers of altering the genetic makeup of human beings to rest by establishing ethical principles which clear the way for advancement in medical therapy. Ethical guidelines for gene therapy must be established which emphasize medical uses over uses for human enhancement.
II. Concepts of Gene Therapy
Gene therapy involves the transfer of genetic material into the cells of an organism in order to cause a specific protein to be produced or in order to cease the production of a specific protein. This procedure usually involves transferring a specific gene into host cells to be incorporated into the chromosomal DNA of the host and later to be expressed. However, according to Dorothy Bonn, the future of gene therapy may also include the use of antisense DNA strands to disrupt expression of a gene or the use of homologous recombination to alter host DNA (1996). In medical terms Jeffrey Leiden, M.D. (1995) defines gene therapy as, "the introduction and expression of recombinant genes in cells for the purpose of treating a disease" (p. 871).
In order to transfer foreign genes into a cell, a vector is necessary. Currently, modified viruses, liposomes and bacteria are being employed as vectors for gene transfer with viruses being by far the most commonly used (Bonn, 1996). According to Craig Donegan, there are three basic methods of delivery: the ex vivo method transfers DNA to cells extracted from the patient and reinjects those cells, the in vivo method injects vectors into the bloodstream to seek and bind targeted cells, and the in situ method injects vectors directly into the affected tissue (1995).
We currently group types of gene therapy by the nature of the cells which are affected and the goal of the therapy. Nelson Wivel, director of the Office of Recombinant DNA Activities at the National Institutes of Health (NIH), and Georgetown University professor of philosophy and ethics Leroy Walters (1993) group types of gene therapy into three categories: type 1 is gene therapy which affects only non-reproductive or somatic cells, type 2 is gene therapy which involves gene transfer to reproductive or germ-line cells, types 3 and 4 are the use of somatic and germ-line modifications respectively to...