In November 2018, He Jiankui announced that he had created the world's first gene-edited babies, twin girls whose CCR5 gene had been modified using CRISPR to confer resistance to HIV. The announcement was met with near-universal condemnation from the scientific community, not primarily on the grounds that the goal was wrong, but because it was done recklessly, secretly, without proper regulatory review, on embryos that became children who now carry those edits permanently in every cell of their bodies. He Jiankui was imprisoned. The twins, known by pseudonyms, are growing up somewhere in China. Nobody knows exactly what was done to them.
The story is useful not because it proves gene editing is wrong but because it illustrates the difference between the technology's potential and the conditions under which that potential can be responsibly realised.
The Case for Therapeutic Editing
For serious inherited diseases, the ethical case for gene editing is strong and getting stronger. Huntington's disease is caused by a single dominant gene mutation that guarantees its carrier will develop a fatal degenerative neurological condition, typically between forty and fifty. Tay-Sachs disease kills children before five. Sickle cell disease causes a lifetime of severe pain crises and shortened life expectancy. These are not abstract risks or probabilistic outcomes. They are certain, severe, and traceable to specific genetic errors that are in principle correctable.
Somatic gene editing, modifying the cells of a living patient without affecting heritable DNA, has already produced remarkable results. CRISPR-based treatments for sickle cell disease received regulatory approval in 2023. Therapies for beta-thalassaemia followed. These are treatments for individuals, not inheritable changes. The ethical complications are comparatively manageable: the same consent frameworks that apply to any medical intervention apply here.
Germline editing, the kind He Jiankui performed, is more complex because the changes propagate. This means the benefits also propagate: a child whose germline CCR5 mutation was safely corrected would pass that correction to their children. For diseases that are both severe and heritable, there is a coherent argument that germline editing is not only permissible but obligatory, that we have the same duty to eliminate a heritable disease at its source that we have to treat any other preventable suffering. That argument is contested, but it deserves engagement rather than reflex rejection.
The Enhancement Problem
Therapeutic editing for serious disease is one conversation. Enhancement, using gene editing to improve traits beyond normal function, to increase intelligence, alter physical characteristics, or extend lifespan, is a different one, and it is where the ethical weight shifts decisively.
The central problem with genetic enhancement is access. Every technology starts expensive and becomes cheaper, but the trajectory is not instantaneous, and the effects of an enhancement advantage compound over time. A generation in which some children are genetically enhanced for intelligence, health, and physical capability while others are not would not merely be unequal, it would be unequal in a way that is permanent, biological, and self-reinforcing. Children of the enhanced would inherit enhanced genomes. The advantage would accumulate across generations into a genetic class distinction that makes every existing structural inequality look temporary by comparison.
We already have enormous inequality in educational opportunity, healthcare access, and inherited wealth. Genetic enhancement doesn't create inequality, it potentially makes existing inequality permanent and biological rather than contingent and social.
The Realistic Trajectory
Genetic enhancement of complex polygenic traits, intelligence, athleticism, longevity, is far further away than popular coverage suggests. Most traits we care about are influenced by thousands of genetic variants, each contributing a small effect, all interacting with each other and with environment in ways that are still not well understood. Editing for these traits would require interventions of enormous complexity, and the risk of off-target effects that cause serious harm in unpredictable ways is substantial. The scenario in which wealthy parents design their children for superior intelligence is less imminent than the coverage implies.
That doesn't make it unimportant to think about now. Regulatory frameworks take decades to develop and need to precede the technology, not chase it. The time to build the governance structures is before the capability is widespread, not after.
Edit for disease, with oversight: yes. Edit for enhancement, without equitable access: the engineering is the least of the problems.
Disagree? Say so.
Genuine pushback is welcome. Personal abuse is not.
