
Many of us have either been personally affected by or know someone who has been diagnosed with cancer or a genetic disorder.  Whether that be a parent, sibling, grandparent, co-worker or friend, these diseases impact almost everyone in one way or another.  According to the Global Genes and American Cancer Society, 1 in 10 Americans are living with a rare genetic disease caused by faulty genes (“RARE Diseases”) and approximately 39.6% of men and women will be diagnosed with cancer at some point during their lifetimes (“Cancer Statistics.”). Cancer and genetic disorders, including fetal growth restriction, are all horrible diagnoses that no one wants to face.  Current treatments for these diagnoses can have negative outcomes that cause excruciating side effects and can sometimes be fatal.  Scientists and researchers have discovered new ways of treating these diseases through gene therapy.  Some may believe that gene therapy can be unethical and cause more harm than good, but with today’s advances in medical technology and treatment, gene therapy should be a treatment open to all. At  

Gene therapy is a treatment that alters people’s genetic makeup to restore the function of a mutated protein.  It is the process of introducing genetic material into cells through a vector.  Vectors serve as a transport system for the DNA.  Viruses can operate as these vectors which are injected into the designated body tissue.  Individual cells then engulf the virus and if successful, the protein will start functioning properly (“How does gene therapy work”).   In other words, the correct version of DNA is inserted into the patient allowing for the protein to work properly or reverse the disease, cancer, or fetal growth restriction causing proteins.  This process can be used for several different medical cases and can improve one’s overall health and prolong life.

Although there are several positive aspects to gene therapy, some researchers still argue that gene therapy should not be performed on humans.  With any new medical treatment, there are some questions and debate on whether or not it is safe for patients.  Gene therapy is one of these new treatments that has caused a lot of controversy in the medical industry.  Some researchers argue that there are several ethical issues that can arise from this procedure.  These issues include the treatment can possibly lead to several side effects that can cause harm to the patient, it can be against people’s religious beliefs, as well as the procedure being too expensive that only the wealthy would be able to afford leading to a separation between the upper and lower.  Regarding religion, people may believe that altering genetic material could be disrespectful to God and his creation.  

According to Julie Robilard’s article regarding Ethics of Gene Therapy, she states that the main ethical concerns regarding this procedure were “the potential for disparities in resource allocation, access to the procedure, and discrimination” (Robillard, 740).  These issues can arise when determining who should be able to partake in gene therapy.  For example, if a child is affected by a genetic disease it is up to the physician, parents, and child to decide if he or she should undergo gene therapy.  Together, they will have to decide what would be best for this child, even when the physician may not know whether or not the treatment will be beneficial to the patient.  Ethics and morals come in play at this time because even though they are making this decision for one child, this decision affects other possible gene therapy patients.  The outcome of the procedure on this individual child affects future studies and whether or not other patients should receive gene therapy as well (Fletcher, 515-516).  

 Others argue that it is not ethical for people to alter their own genetic makeup, and as gene therapy becomes more widespread, then it would be used to “enhance basic human traits such as height, intelligence, or athletic ability” (“What are the ethical issues surrounding gene therapy?”) which may lead to creating “designer babies” (Robillard, 470).  Another ethical reason people are opposed to gene therapy is if a lot of people have the procedure, then society would be less accepting of those who still have a certain disease or disability because they did not partake in the treatment (“What are the ethical issues surrounding gene therapy?”).  These are all important factors to discuss when creating a new treatment that directly affects a person’s genetic makeup and why it should not be performed on people.  However, there are also several reasons why people should be able to undergo gene therapy. 

We can all agree that the patient’s health and well-being are doctors number one priority. Researchers and doctors would not approve a new medical treatment without thoroughly investigating the procedure and looking at all the pros and cons.  Researchers have taken into consideration the ethical dilemmas, but believe that there are ways to prevent these issues from arising.  Regarding religious beliefs, there is a separation between church and state, which allows for procedures to be available to the public regardless of someone’s religious beliefs.  Other ethical dilemmas include the expense of the procedure.  In comparison to the costs of alternative treatments that the patient may have to receive throughout their lifetime, these treatments can add up to the cost of the gene therapy procedure.  This procedure can then eliminate the need and cost for all continuation of the alternative treatments.  Researchers also believe that the chance that this procedure can help treat cancer and genetic disorders, then patients should have the right to choose whether or not they want to have gene therapy. 

Although several people believe that gene therapy is not safe enough for humans to partake in, there are laws and regulations in place to protect people’s rights.  In order for any treatment to start clinical trials and become available to the public, there are guidelines that need to be completed.  These guidelines include scientist having “reasonable evidence from animal studies that the patient will benefit, as well as a reasonable expectation of acceptable risk, before they perform experiments on humans” (Fletcher, 528).  The procedure on animals must show that the new gene injected targets the correct cells and it produces a reasonable amount of corrected genes while not causing serious harm to the animal or offspring (Fletcher, 529).  In order for clinical trials to begin, trials “require approval from ethics committees and regulatory bodies” (Habib, 9).  Clinical trials are “research studies that explore whether a medical treatment is safe and effective for humans” (“What Are Clinical Trials?”).  These protocols and guidelines are set in place so that there are no ethical issues that may arise during clinical trials.  Overall, those opposed to gene therapy should not be solely based on the reasoning that the procedure is too harmful because with any procedure, there are side effects that may occur.  

Regarding the expense of gene therapy, gene therapy has the capability of curing a disease from not only an individual, but the population as a whole.  In the long run, the cost of one gene therapy procedure does not compare to how much money the US health care spends on alternative treatments. Alternative treatments, especially for cancer, require patients taking medication for long periods of time and in some cases, the rest of their lives.  The cost of these medications alone can be very expensive.  When you take into consideration the diseases that are hereditary, the costs of continuous treatment for future generations can quickly add up. Gene therapy has the opportunity to cure an individual as well as prevent future generations from inheriting this disease.  Gene therapy can “be come cost-effective than years of repeated hospitalizations” (“Gene Therapy”).  With gene therapy, the individual will benefit from paying for one procedure rather than multiple alternative treatments and medications.  We can agree that those who personally know someone suffering would do anything to help take their pain away and maybe even cure them.  These individuals can now have the opportunity to do so with gene therapy.

Aside from ethical concerns, there are several benefits that come from gene therapy especially with cancer patients. Gene therapy should be one of the treatment options for cancer patients. Current treatment options include surgery, chemotherapy, and radiation, all of which have several side effects and can be very toxic.  One of the disadvantages to chemotherapy is patients becoming drug resistant to the treatment (Habib, 3).  Antibiotic resistance is “the ability of microbes, such as bacteria, viruses, parasites, or fungi, to grow in the presence of a chemical (drug) that would normally kill it or limit its growth” (“What is Drug Resistance?”).  With gene therapy, those who have become drug resistant to chemotherapy can get specific genes injected into their bone marrow that would allow them to undergo more effective chemotherapy.  Gene therapy is also able to “restore tumour suppressor gene function or down-regulating oncogenic expression” (Habib, 3).  In other words, gene therapy can enhance the gene already present in patients to make the genes more effective in fighting cancer cells. There is also the risk of the cancer returning with these conventional treatments; chemotherapy, radiation, and surgery.  Combining these treatments with gene therapy increases the patients chances of staying cancer free.  In his article, Habib concludes this section regarding the gene therapy stating, “gene therapy should be well tolerated in combination with conventional treatments” (Habib, 9).   CBS Evening News has recently done a clip regarding gene therapy.  They discuss how gene therapy has high success rates for cancer patients and how this procedure has helped many patients when traditional cancer treatments were not successful.  They also describe a recent study of 59 cancer patients who went through gene therapy.  After the procedure, 26 people, 7 adults and 19 children, are in complete remission now and will continuously increase (CBS Evening News).

The Food and Drug Administration (FDA) has recently approved the first gene therapy treatment for childhood leukemia. This treatment, called CAR-T cells, consists of patients’ genes and T cells being genetically amplified to be able to detect and fight off cancer more efficiently. 

The first child to be treated with CAR-T cell therapy has been cancer-free for five years. Even though this first case was very successful, there is no guarantee how long patients will benefit from this procedure. However, this therapy has had a higher percentage of patient’s in remission than any other cancer treatment. During a study, 83 percent of patient’s that underwent gene therapy went into remission which is a higher percentage than any other cancer treatment (Neergaard).

Along with cancer, gene therapy allows women with unborn babies who suffer from fetal growth restriction (FGR) to alter the baby’s genetic makeup to improve their overall health.  Fetal growth restriction is a “condition in which a fetus is unable to achieve its … potential size” (Ross) which can result in undernourishment (Sheppard, 484).  Currently there are no treatments fetal growth restriction but the new organization, EVEREST, is trying to change that.  The EVEREST project will help fund a clinical trial to examine the safety and efficacy of maternal gene therapy (EVEREST).  When an unborn baby is diagnosed with severe fetal growth restriction, the baby must be delivered promptly, but there can be several complications with premature babies.  The only other option would be carrying the baby full term but there is the risk of stillbirth.  Either way, the baby risks having several health problems.  With advances in medical innovation and technology, gene therapy can be the solution to helping babes that are diagnosed with fetal growth restriction.  Gene therapy would allow the fetus to receive proper proteins and genes needed to reach a healthy weight, decreasing the chances of having a premature birth and overall allowing the child to have a better health outcome (Krishnan).

As you can see, cancer, genetic disorders, and fetal growth restriction can affect a lot of people.  Doctors and researchers, as well as family and friends, do not want to see their patient or loved ones go through pain and would do anything to take their pain away from and/or try to cure them. With recent advances in medical technology and innovation, researchers have found the solution, gene therapy.  Research and ongoing studies have proven to show that there should be no ethical restrictions on gene therapy.  Even though there are a few people still opposed to gene therapy, in the long run, gene therapy can be a major benefit to those diagnosed with cancer, genetic disorders, and fetal growth restriction.  As a solution, gene therapy should be available to everyone as a treatment option.  Patients will be informed of all the risk factors or ethical standpoints, but overall, it will be their decision if they want to proceed with this treatment plan.  This solution would allow those who are opposed to the procedure a chance to decline, but also those who are not opposed to have the opportunity to get gene therapy.  Patients would have the opportunity to go through and benefit from gene therapy.  Overall, gene therapy can ultimately be the solution to someone fighting cancer, living with a genetic disorder, or an unborn baby diagnosed with fetal growth restriction and everyone should have this treatment option.
