The International Summit on Human Gene Editing: A Successful Production

I attended almost every minute of the Great CRISPR Summit of 2015[1] and came away thinking that it was a success in many ways.

First, it was not a circus. Before the event I often referred to it as the Great CRISPR Summit/Circus of 2015. I was wrong. It was a smoothly flowing event, with good organization, which did not surprise me, and an almost entirely self-controlled, on point, audience and speakers, which did. That’s the first success, which owes much to National Academies staffer Anne-Marie Mazza, who is one of the most competent, and enjoyable, people to work with I know.

The second success? The organizing committee, which spanned a wide range of both geography and opinion, came up with a consensus statement at the end, one that was both largely consistent with the proceedings and that made sense. It said four things:

First, basic and preclinical research on genome editing[2] should continue, even in the human germline.

Second, clinical use of genome editing in somatic cells – edits that cannot be passed on to the next generation – should be pursued.

Third, as to it clinical use in the human germline (to make babies):

“It would be irresponsible to proceed with any clinical use of germline editing unless and until (i) the relevant safety and efficacy issues have been resolved, based on appropriate understanding and balancing of risks, potential benefits, and alternatives, and (ii) there is broad societal consensus about the appropriateness of the proposed application.”

And, fourth, the Academies that sponsored the Summit (from the United States, the United Kingdom, and China) should organize and on-going, inclusive, and public forum to discuss possible future clinical uses of the technology.

These were safe and, more importantly, wise recommendations. No one will disagree with the second recommendation or with the underlying thrust of the fourth, for continued discussion and scrutiny. A few will disagree with the first, on a slippery slope theory, but the Summit’s panelists made a strong case for the value of such research for understanding human development and reproduction even if actual clinical use of germline therapy were never to be allowed.

Some, who wanted a ban on making babies by human germline genome editing, were disappointed with the third conclusion. But only those deeply committed, for whatever reasons, to the position that such editing could never, under any circumstances, be ethical, should be disappointed. And that kind of absolutist position was never likely to emerge from this largely scientific group, both from mental predispositions and because (I think) because the arguments for it are weak. Instead, the committee called for an indefinite stay: unless and until it is proven safe (which, if ever achieved, will clearly take many years) and it has a “broad social consensus” (whatever that turns out to mean) for its use. Both points, and particularly the second, give opponents more time and opportunities to make their case. (Proponents of clinical use, if and when proven safe, also have time to seek ­– and define – such a broad social consensus.

Some also were concerned that the committee did not intentionally chose not to use the words “moratorium.” Although “moratorium” isn’t used, it seems a good description of the committee’s third point. It says, “do not do this,” unless and until specific conditions are met. That sure sounds like a moratorium to me, but without using that sometimes ambiguous term.

There is a third success, the most important of all. Although this is ultimately an empirical question (Rotten Tomatoes, anyone?), I believe Summit was successful as political theater. It was not always successful as dramatic theater (and almost never as comedy, with the honorable exception of John Harris’s remarks). There were times, I’ll confess, when my attention lagged . . . and I don’t think I was alone.

But, overall, the Summit portrayed for the watching publics a scientific community that was concerned about the ethical implications of its work and that was reaching out for input from the broader world.   There was no obvious hubris; there were no plausibly “mad scientists.” Instead, “science” looked prudent, international, and perhaps even close to humble.

This was the main accomplishment of, and (I suspect) the main goal of the Summit’s organizers. The actual statement and its four recommendations did not need a Summit. The recommendations are almost identical to those published by eighteen authors (including me) in a letter to the journal Science in mid-March – and those recommendations had been drawn from a consensus reached in a conference room in Napa Valley in late January. The key was having the recommendations emerge after a three day show of science explaining itself and its goals to the public and listening politely to public voices, including critical ones. The speakers on the international panel, for example, were not uniformly scintillating, but the visual image of speakers from Nigeria, Germany, France, Israel, South Africa, Sweden, and India was powerful.

The Summit – and of course the research that made it both possible and necessary – gave science, or at least bioscience, a chance to influence the world’s view of science and of scientists. I think most of the watching world, whether watching directly or indirectly through the media coverage, came away with a better impression of both than it had before. I happen to think that more favorable impression is, by and large, accurate, but whether it is or is not, it certainly helps science, on this issue and more generally.

Even apart from the proposed international forum, the Summit does not end the National Academies’ involvement in these issues.  In addition to the international forum, the Academies have appointed a study committee to do a thorough report on human genome editing, expected sometime in 2016.  The conclusions announced at the end of the Summit were those of the Summit Organizing Committee, not necessarily those of any of the sponsoring academies and certainly not of the study committee, which is just starting its process.

The Summit did not end with a dramatic denouement followed by a standing ovation; it rather meandered to an end in questions to and answers by David Baltimore after his presentation of the committee’s statement. But it deserves an ovation – for the actors, directors, producers, and playwrights.

Bravo!

Hank Greely is the Director of the Stanford Center for Law and the Biosciences

 

[1]           I did have a small role other than sitting and listening; I moderated the Summit’s last panel, on “governance, regulation, and control” and was a co-moderator of a breakout session. But those were my only participation in the Summit’s events; I had none in its planning.

[2]           By the way the terminology used about the Summit has not always been consistent. The Committee talked about gene editing; many others, including me, talked about genome editing. I prefer the latter as CRISPR (and related techniques) will often be used not to modify “genes” as generally understood but other parts of the human DNA sequence. (Though one must note that the definition of “gene” is often unclear.)