Modifying Our Genes

Modifying Our Genes: Theology, Science, and “Playing God” achieves a balance between breadth and depth that is the elusive goal of most introductory texts on a topic––a feat all the more impressive when that topic lies at the complicated intersection of religion, ethics, and gene modification. Coming in at under 150 pages, the authors of this compact book, Alexander Massmann and Keith R. Fox, manage to not only provide an informative overview of many of the key issues at play in this arena, but also offer a measured argument about the potential promises and perils of genome editing. The result is an accessible entry point into a field that is ripe for further exploration.

Following an introductory chapter 1, the second chapter describes the science behind genes and gene-editing technologies, attending specifically to CRISPR/Cas9––a novel tool that allows researchers to “rearrange genetic material with unprecedented ease and precision,” and one that will likely soon be approved in several countries for use on humans in clinical settings (2, 43). Of note here is the authors’ resistance to genetic determinism, emphasizing the critical role that both genes and environmental factors play in a person’s development. In doing so, they underscore a simple but important point: the way we think about genes determines our ethical debates around modifying them (12).

The next two chapters form the heart of the book, as they address the science and ethics of gene editing for medical purposes (chapter 3) and for non-medical enhancements (chapter 4). In each case, the authors are careful to distinguish between editing somatic cells, which change only some of the genes of a living individual, and editing germline cells, which change the genes of someone’s offspring (the change is inherited). The book thus addresses four types of gene modification: medical/somatic, medical/germline, enhancement/somatic, and enhancement/germline. For each type, the authors provide examples of conditions or traits for which gene editing might be applied, assess whether current or near-future technologies could feasibly solve the condition or bring about the desired trait, and evaluate the ethics of doing so, drawing on empirical, philosophical, and theological resources.

Before highlighting some themes that cut across the analysis in these chapters, it is first worth noting that Massmann and Fox are are not against new medical technologies: they reject the idea that technological interventions into nature that aim to improve life are intrinsically bad or that modifying DNA is akin to “playing God” (2, 76). Both thinkers, while critical of the notion that gene editing can bring about some sort of utopia, are nevertheless keen on taking advantage of the benefits that CRISPR might offer. The main question, for them, is how and when to use it (40).

As for medical applications, Massmann and Fox begin by observing that the ethics of gene modification, in whatever form, goes far beyond calculating risks and benefits (though it does entail that) and taps into deeper considerations about what it means to be human and what sort of societies we want to inhabit. Indeed, one of the themes that comes out strongest in chapter 3––and the whole book––is the authors’ attention to the social implications of gene editing. More specifically, they are concerned that, despite the good intentions that motivate technologies like CRISPR, it may very well lead to the stigmatization, marginalization, and discrimination of certain populations (42). For this reason, Massmann and Fox stress the importance of including the voices of people living with genetic conditions when discussing the ethics of gene modification, and of ensuring that medical progress goes “hand-in-hand with a renewed, visible public commitment to support people with chronic diseases or disabilities” (58).

With these qualifications in mind, the authors support editing somatic cells for some conditions––assuming that the procedure has been proven safe and the patient understands and consents to the risks involved. And while they are not necessarily opposed to germline editing for severe genetic diseases, they remain unpersuaded that CRISPR would provide medical benefits that pre-implantation genetic screening does not, the latter of which avoids the risk of off-target effects.

Massmann and Fox are less receptive to using gene editing for enhancement. In addition to safety concerns, the authors are skeptical of its fundamental premise: namely, that possessing greater mental or physical capabilities will lead to a more fulfilling life (85). Moreover, they contend that traits that are deemed worth “enhancing” will inevitably be determined by the dominant values of a given social context––the values of individualism and productivity that mark democratic consumer cultures, for example––further pushing those who cannot conform with those values to the margins of society. This is a lesson that is elaborated upon in chapter 5, which presents a concise history of eugenics in the West.

For readers coming to this book with a strong interest in theological perspectives on gene modification, a few things to note: the “theology” in its subtitle denotes a particular Christian perspective, which the authors are transparent about early in the text (12). There is also little engagement with theological viewpoints from non-Christian traditions, although, to be fair, this would be a tall task for an introduction to a topic such as this. Finally, most of the book is quite light on religion, with the most in-depth theological analysis coming in chapter 6, which offers a portrait of being human in a biotechnological age. This is less a criticism as it is a desire for more: Massmann and Fox’s elucidation of a Christian theological anthropology and its relevance to gene editing is not only an illuminating contribution to the topic, but also a good example of how religious voices might participate in contemporary public bioethics.

Overall, Modifying Our Genes achieves admirable brevity––it can be read in a few sittings––without sacrificing depth or nuance. I recommend it to anyone interested in entering a very timely conversation on religion, ethics, and genetics.

Nicholas Covaleski is a PhD candidate in the Department of Religion at Boston University.

Nicholas Covaleski

Date Of Review:

October 16, 2023