The Ethics of Changing Genes Through Surgery

In the age of rapid medical advancement, the idea of altering human genes via surgical or genetic intervention is no longer science fiction. Diseases that once seemed untreatable—like certain cancers, muscular disorders, or genetic syndromes—can now be approached at their source: our DNA. Through advances in genetic surgery and gene-editing technology like CRISPR-Cas9, scientists can now target, cut, and even replace faulty genes. This opens up the possibility of curing hereditary diseases entirely. But it also raises a difficult question: just because we can change genes, should we?

Every cell in the human body contains DNA, a long code that determines how we look, grow, and function. Sometimes, this code has small mistakes called mutations that can cause diseases like sickle cell anemia or cystic fibrosis. Gene surgery—or genetic editing—allows doctors and scientists to fix these mistakes. There are two main types of gene editing: Somatic editing changes the genes in body cells to treat one person’s disease, while Germline editing changes the DNA in embryos, sperm, or eggs, so the changes can be passed on to future generations. While somatic editing is already used in experimental treatments, germline editing is much more controversial because it affects people who aren’t even born yet.

The potential benefits are enormous. Gene surgery could prevent thousands of genetic diseases and reduce human suffering. Imagine a world where no one is born with cystic fibrosis or muscular dystrophy. It could also help make treatments more personal where it is tailored to each person’s genetic makeup. However, these advances come with serious ethical and safety concerns. Changing genes permanently alters the building blocks of life, and we can’t always predict the long-term consequences. Mistakes might create new health problems or affect future generations in ways we don’t yet understand.

Ethicists use four key principles to guide decisions in medicine: autonomy, beneficence, non-maleficence, and justice. Autonomy means patients have the right to make informed choices about their bodies. But in germline editing, the future child cannot consent. Beneficence focuses on doing good by using gene editing to prevent disease. Non-maleficence warns us not to cause harm, even unintentionally. However, since gene editing can have unpredictable effects, this principle calls for extreme caution. Justice asks whether these technologies will be fair and available to everyone, not just the wealthy. If only rich countries or individuals can afford genetic surgery, inequality could worsen dramatically.

Another ethical question is where to draw the line between treatment and enhancement. Using gene editing to cure a child’s genetic disease seems morally justified. But what about editing embryos to increase intelligence, height, or athletic ability? Once we start enhancing traits, the technology could become a modern form of eugenics, where we are trying to create “better” humans instead of accepting natural diversity

Because of these ethical challenges, many countries have strict rules on human gene editing. Some, like the U.S. and the U.K., allow limited somatic editing for research and therapy but ban germline editing in humans. International organizations like the World Health Organization are working to create global guidelines to ensure safety, fairness, and respect for human dignity.

by Shanisse Tan at Incisionary

APA References

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Guttinger S. (2018). Trust in Science: CRISPR-Cas9 and the Ban on Human Germline Editing. Science and engineering ethics, 24(4), 1077–1096. https://doi.org/10.1007/s11948-017-9931-1.

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Chan, S. (n.d.). The ethics of changing genes in the embryo. Eurostemcell. https://www.eurostemcell.org/ethics-changing-genes-embryo.