summarise:
The development of genome editing technologies that have the potential to precisely and efficiently make modifications to DNA inside cells has resulted in renewed attention to the implications of such advances for clinical use in humans. These technologies can be used in different ways; this report focuses on one type of use—making changes to human DNA that could be inherited by future generations. This possibility occurs when genome editing results in the alteration of the DNA in gametes (eggs or sperm) or any cells that give rise to gametes, including the single cell zygote resulting from fertilization of an egg by a sperm cell, or cells of an early embryo. When used clinically, changes to the DNA in such cells can be passed on to the next generation—a process referred to in the report as heritable human genome editing (HHGE) (see Box 1-1). Germline genome editing is already in use in plant and non-human
animal species, primarily in a research context. But the use in humans of heritable genome editing raises many critical and potentially contentious issues. The challenge of assessing safety and efficacy is particularly great, since the effects may not be immediately apparent and could affect future generations. Moreover, individuals’ ability to access HHGE, as with other medical technologies, would likely be uneven, raising issues of equity and social justice. Decisions about whether or not to make heritable changes in
human DNA sequences and, if so, the nature of genetic changes that should or should not be permitted, requires extensive input from across a country. If extensive societal discussions were to result in approval to consider certain clinical applications of HHGE, it would be essential to have an effective