Gene-edited babies

No doubt, one is aware of controversy surrounding the creation of “designer babies.” Experts debate vigorously whether it is ethical, moral, or legal to alter the genetic library of a human embryo. Many argue this should be forbidden-at least for now-until we better understand the science and have more time to reflect on the implications of attempting such work.

The discourse splashed across the headlines recently when a scientist in China, He Jiankui, PhD, announced that he had done exactly this using CRISPR-Cas9 technology. The first (and reportedly also second) designer human baby was created with the intention of making it resistant to infection with HIV.

Could designer babies soon be our reality?
Before our society goes down this path, I wish to offer a few words of caution. What all the debate so far has failed to grasp is that designer babies, if nurtured over many, many years in absurdly expensive undergraduate universities followed by more years in incredibly expensive medical schools, and then trained for many more years in internships, residency programs, and fellowships, have the potential to one day become-yes, that’s right- “designer ophthalmologists.”

Given this sobering fact, it would be wrong to give a green light to implementing this genetic technology until someone has carefully considered what should be the exact characteristics of these designer ophthalmologists. I’ve given this careful thought and present the results of my analysis (to the best I can read my handwriting on the cocktail napkin from last night).

Presuming we can learn what genes to insert to create these desired effects, the ideal “designer ophthalmologist” should:

• Be two-faced: So one empathic appearing face is looking at the patient while the other “real” face is staring at the computer screen while documenting in the electronic medical record.

• Be three-handed: So they can do 50% more bevacizumab injections per hour in clinic.

• Be illogical: So the Byzantine rules and regulations imposed on us doctors by insurers and regulators will seem reasonable and not upsetting.

• Have led a sheltered life: So the Chief Medical Editor’s columns in Ophthalmology Times impress them as being witty.

• Be impervious to pain: So they can enjoy the OKAPs, board examinations, and maintenance of certification programs.

• Possess a prodigious memory: So they can memorize all the causes of white-dot syndromes in the retina in order to pass their board examinations and commit to memory as many orthopedic surgeon jokes as possible so they can amuse themselves and others.

• Have a large rear end with wheels: So they can examine patients and operate without first having to find a stool.

• Have no ears: So they can’t hear what those people on political talk shows are saying.

• Be rich: So they can afford to pay their American Academy of Ophthalmology dues.

• Be generous: So they can forgive their department chairs for any cranky comments during residency and make donations to the department once they become wealthy ophthalmologists.

• Have three eyes: So the extra eye can see the humor and fun in a typical day of patients.

• Have two hearts: So one can pump blood while allowing the other to fully concentrate on feeling the joy that comes from providing compassionate care to his/her patients.

Disclosures:

Peter J. McDonnell, MD
E: pmcdonn1@jhmi.edu; P: 443/287-1511
Dr. McDonnell is the director of the Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, and chief medical editor of Ophthalmology Times.

References:

1. https://nypost.com/2018/12/12/making-designer-babies-without-ethics-is-a-recipe-for-disaster/