CRISPR-Cas systems, base editing, and prime editing have made precise genetic interventions possible, and several approved therapies now treat monogenic disorders that were previously untreatable. Heritable genome editing remains ethically contested. We argue that heritable interventions should not be treated as a single category subject to uniform prohibition. We distinguish three targets: catastrophic monogenic disorders, polygenic risk reduction, and non-disease trait enhancement. For catastrophic monogenic conditions in which preimplantation selection cannot yield unaffected embryos, heritable editing is permissible, and the duty of beneficence toward future persons may require it. When the alternative is certain severe suffering or early death, the expected benefits clearly outweigh the risks. For polygenic interventions, current scientific uncertainty makes clinical application premature: predictive validity remains insufficient and pleiotropic effects are poorly understood. For enhancement, the case is weaker still. Some of its benefits are positional; the risks of social stratification are significant; and the evidence base is absent. We conclude that governance frameworks should permit what the evidence supports under stringent safeguards and prohibit what it does not. The central ethical questions concern welfare, not appeals to nature or abstract notions of dignity. Where the evidence warrants it, failing to pursue heritable gene therapy responsibly may itself be an ethical failure. We outline a translational pathway for ethical germline gene editing.
Julian Savulescu, Sebastian Porsdam Mann, C. Gyngell et al.· i Medicina· 0 citations
Some advances in reproductive technologies raise substantial ethical and psychological challenges, for example, the use of preimplantation genetic testing to select embryos based on non-medical traits. While studies have explored public willingness to use preimplantation genetic testing for medical or non-medical attributes, stated willingness may not reflect implantation decisions when such information is available. This large cross-national study examined public views on polygenic embryo testing. In a US sample (N = 1,467), participants were more willing to test for medical conditions (for example, heart disease) than non-medical traits (for example, antisocial behaviour or low intelligence), although over half supported testing for non-medical traits. In a forced-choice implantation task, participants used medical and non-medical information to a similar extent when making decisions. Similar patterns were observed in Chinese participants (N = 623). These findings suggest variability in choices across specific traits and conditions, rather than a uniform distinction between medical conditions and non-medical traits. The Stage 1 protocol for this Registered Report was accepted in principle on 7 October 2025. The protocol, as accepted by the journal, can be found at https://osf.io/vb9c2 .
Edmond Awad, Clara Colombatto, J. Demaree-Cotton et al.· Nature Human Behaviour· 0 citations