The clinical applications of HHGE would be:

• Preventing the transmission of genetic variations that come along with severe genetic diseases (single gene disorders)

• Reducing the risk of common diseases (polygenic diseases), with the promise of improving human health

• Enhancing human capabilities far beyond what is currently possible for human beings, thereby overcoming human limitations. (Human Enhancement)

"Severe genetic disease": What is severe? What is seen as "severe", is an extremely loaded expression of an emotive and cultural construction.

Safety concerns regarding HHGE:

There are unintended changes to the genome (called 'off-target', 'on-target' and 'mosaic'), which could possibly lead to cancer and other disabling pathologies. This would make the clinical application of HHGE rather ineffective. The child and subsequent generations could have unpredictable diseases at unpredictable times of their lives, which would make long-term follow up almost impossible.

The clinical application of HHGE is controversial:

Prevention of suffering is usually quoted in this context, but Heritable Human Genome Editing is carried out before the symptoms appear. Therefore the argument in favour of those interventions seems to be on wobbly chairs.

Proponents suggest that

• the safety risk associated to off-target mutation shouldn't hamper the pursuing of HHGE. Safety risks to participants, they imply, are found in nearly all medical research.

• serious birth defects of genetic origin are found in 6% of all babies being born. Therefor there are moral reasons to prevent the occurrence of these genetic diseases in future generation. The clinical application of HHGE will be there to prevent genetic disease.

Proponents argue that the pursuing of HHGE is morally permissible and morally desirable.

Questions:

• Is it justifiable to proceed with the clinical application of HHGE?

• Do you think that the clinical application of HHGE is irresponsible, due to the considerable safety problems (medical and social) of the new technique?

• If the procedure for somatic (non hereditary) genome editing would be considered as medically safe, would germline (hereditary) genome editing fall under the same assumption?