Ethical Issues and Other Problems of Gene Therapy

‘There is always something good in a bad person and something bad in a good person’ as shown from the yin-yang symbol.

Thus there are also quite a number of ethical issues about gene therapy which raises many questions and discussions on how it should be used. This includes:

  1. How can “good” and “bad” uses of gene therapy be distinguished?
  2. Who decides which traits are normal and which constitute a disability or disorder?
  3. Will the high costs of gene therapy make it available only to the wealthy?                                                            
  4. Could the widespread use of gene therapy make society less accepting of people who are different?
  5. Should people be allowed to use gene therapy to enhance basic human traits such as height, intelligence, or athletic ability (might use eugenics)?
  6. Is religion a factor? If yes, then somatic cell therapy should be applied and the following generations would also be able to make their own decisions.
  7. Regulations might be hard to control, even with laws, there
    is the possibility of gene therapy being available on the black market. It
    could be used for any genetically linked trait such as personality, or physical enhancement. These concerns will have to be dealt with
    in time.
  8. Invasion of privacy. Insurance companies could make it mandatory to have genetic screening because of their policies. This could cause discrimination to families with genetic diseases. Or potential employers could question a person’s genetic background before passing them up for a promotion or job.
  9. Even if gene therapy have been tested many times before both on humans and mice, it might react differently with various people with a different set of genetics and thus, there might be a chance of rejection of the inserted gene or a bad reaction and worsen the illness or condition.
  10. Gene Therapy is short-lived as it has to be ensured that the therapeutic DNA into the target cells must remain functional and the target cells must be long-lived and stable. Thus in certain cases, the patient would have to undergo many roundsof gene therapy.
  11. Multigene disorders e.g. high blood pressure, diabetes, arthritis caused by combined effects of variations in many genes are very difficult to treat.
  12. Viral Vectors might cause some unwanted side effects by having the ability to cause diseases again, and might also lead to toxicity, immune and inflammatory responses.
  13. Immune responses reduce the effectiveness of Gene Therapy as they would fight against unwanted invaders. This would prevent repetition of gene theraphy die to the immune system’s enhanced response to invaders.
  14. If DNA is integrated in the wrong place in the genome, it might induce a tumor. One  X-linked severe combined immunodeficiency (X-SCID) patient died of leukemia following gene therapy treatment in 2003.

Also, current gene therapy research has focused on treating individuals by targeting the therapy to body cells such as bone marrow or blood cells. This type of gene therapy cannot be passed on to a person’s children. Gene therapy could be targeted to egg and sperm cells (germ cells), of which the inserted gene would be passed on to future generations. This approach is known as germline gene therapy.

But, the idea of germline gene therapy is controversial. While it could spare future generations in a family from having a particular genetic disorder, it might affect the development of a fetus in unexpected ways or have long-term side effects that are not yet known. Because people who would be affected by germline gene therapy are not yet born, they can’t choose whether to have the treatment. Because of these ethical concerns, the U.S. Government does not allow federal funds to be used for research on germline gene therapy in people. Several teenagers have undergone clinical trials of gene therapy and died or developed leukemia too.

But from the recent news, European regulators have recommended approval of the Western world’s first gene therapy drug. (3 recent news articles about this in 5.)In China, Shenzhen SiBiono GeneTech won approval for a gene therapy drug for head and neck cancer in 2003 but no products have been approved until now in Europe or the United States.



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