Prenatal gene editing for neurodevelopmental diseases: Ethical considerations.

Area of Science:

• Genetics
• Bioethics
• Neuroscience

Background:

• Neurodevelopmental diseases (NDDs) originate during prenatal development, making them challenging to treat postnatally.
• Current treatments for NDDs are limited due to the early onset of disease processes.
• Prenatal gene editing presents a novel therapeutic strategy for NDDs by targeting genetic causes before birth.

Purpose of the Study:

• To explore the potential of prenatal gene editing for treating NDDs.
• To identify ethical challenges and develop a framework for safe and ethical implementation of prenatal gene editing.
• To leverage historical frameworks from in utero therapies to guide prenatal gene editing development.

Main Methods:

• Review of 17 ethical frameworks, literature, consensus statements, and government reports on prenatal interventions.
• Identification of 12 key themes from existing ethical guidelines for prenatal therapies.
• Integration of themes with current criteria for postnatal gene therapies for NDDs.

Main Results:

• Prenatal gene editing holds promise for addressing the root causes of NDDs.
• Significant ethical concerns exist regarding unintended edits and their irreversible consequences.
• A historical review of in utero therapy frameworks provides a basis for developing ethical guidelines for prenatal gene editing.

Conclusions:

• Establishing ethical frameworks is crucial for the responsible development of prenatal gene editing.
• A path forward for prenatal gene editing interventions for NDDs can be informed by past in utero therapy ethical considerations.
• Careful ethical deliberation is required to balance the potential benefits of prenatal gene editing against its inherent risks.