Bioethics Forum Essay
He Jiankui’s Genetic Misadventure: Why Him? Why China?
The birth of gene-edited twin girls was announced by a young Chinese scientist He Jiankui through one of four self-made promotional videos in English on YouTube (a website officially banned in China) on November 25. Three days later, at the Second International Summit on Human Genome Editing held in Hong Kong, He revealed that another woman was in the early stages of pregnancy with a genetically modified embryo. While He’s claims are yet to be independently verified, the news has shocked the world. The experiments on embryos intended to be implanted and born, a well-kept secret until a few weeks after the twins’ birth, obviously violates international and Chinese ethical guidelines on embryonic genetic research, essential ethical norms of biomedical research, and the most basic rules of scientific investigation.
Why then, did He dare to risk condemnation of the whole world (what Chinese would call “mao tianxia zhi da buwei”)? And why in China?
These are extremely complicated questions that call upon many in-depth inquiries. From a broad sociological and historical perspective, He’s genetic misadventure is unsurprising. A series of political and social forces in China in the past several decades have created a fertile environment for Chinese researchers to undertake daring but unethical (or ethically problematic) “world’s firsts.” In many ways, He’s human experimentation constitutes one of the fruits of his personal ambition nourished and directly supported by China’s authoritarian pursuit for a nation strong in science and technology. The drive to be a science superpower is part of an even grander Chinese dream chased by the party-government and Chinese society.
Although currently under investigation by Chinese authorities, He Jiankui has become a rising science star in China. Since his youth, he has been known to people around him as an aspiring Chinese Einstein. He first studied physics in China. In the United States, he shifted to genetics, particularly gene-editing technologies, for its greater potential to realize his ambition. He returned to China because he believed he would be able to “gan dashi” (accomplish something tremendous) there and only there.
He Jiankui has been a darling of China’s current system of sciences. He has many accolades and received extremely generous support from central and local governments and scientific organizations. He was recruited to the Southern University of Science and Technology in Shenzhen through the city’s “Talent Peacock Plan” in 2012. His research has been funded by grants from the government of Guangdong Province and the Ministry of Science and Technology. In 2018, he was nominated for the China Youth Science and Technology Award of the Central Government and the Chinese Association of Science and Technology. More importantly, He was selected to the Central Government’s top science program, Qianren Jihua (Thousand Talents Plan). The plan claims to be “world’s most prestigious and influential state science program,” involving almost every department of the government. The program’s overall goal is to advance a number of specific scientific and financial areas, such as gene technologies and genetics industry, that the state deems to be of primary strategic importance.
Taking advantage of the enormous official efforts to commercialize scientific research, He Jiankui has also been a rising entrepreneurial star in China in just five or six years. With governmental, domestic and international investment, He has become the owner and/or significant shareholder of at least seven gene companies, being worth of at least a few billion yuan (more than half a billion U.S. dollars). One of them is Direct Genomics Biotechnology, which He chairs. But, in their paper on the ethics of germline gene-editing published online in The CRISPR Journal on November 28, He and his team declared “no competing financial interests.” Nor were any funding sources of their research disclosed.
The Chinese model of sciences is authoritarian and nationalistic. It often lacks transparency. It takes a top-down approach and advances sciences through the conventional Chinese Communist Party means of planned economy and Mao’s Great Leap Forward campaign. Nationalism is almost always justified and promoted in the name of patriotism and the great revival of the Chinese people, and it is reshaping every aspect of China. Science and technology play a prominent role in this nationalism agenda. In China and Asia, nationalism has become a defining and sweeping ideology for the sciences, social sciences, and bioethics. While some pioneering works have appeared, more critical analysis on the ethical implications of nationalism for biomedical research and other areas of medicine on a global stage are overdue.
The nationalistic and military spirit is expressed in the strategic goals of He’s project of gene-edited babies, which He outlined in his brief protocol to the ethics committee of Harmonicare Shenzhen Women and Children’s Hospital (its approval might be faked):
“We ardently expect that . . . [the project] will occupy the commanding elevation of the entire field of gene editing technologies. Like the point of an awl sticking out through a bag, the project will stand out in the increasingly intense international competition of gene editing technologies. This creative research will be more significant than the IVF technique which won the 2010 Noble Prize, and bring about the dawn of the cure for numberless severe genetic diseases.” (my English translation)
In the Chinese context, the declaration that his project would make China the world’s first in this area is too obvious to be mentioned directly. Indeed, an initial short report of He’s research appeared on the website of chief official newspaper People’s Daily on November 26, titled “The World’s First Gene-edited Babies Genetically Resistant to AIDS Were Born in China.” It hailed He’s venture as “a milestone accomplishment China has achieved in the area of gene-editing technologies” (italics added). While still available on other websites, the report was soon removed, possibly due to the international as well as domestic outcry.
Along with China’s remarkable rise in general has come China’s rise in science and technology. In the process, a number of serious and extensive ethical challenges have already occurred. For example, partly due to the enormous administrative pressure upon researchers to publish in international journals, the incidents of scientific misconducts have been rapidly increasing. In 2016, Han Chunyu, a young scientist at Hebei University of Science and Technology in northern China, nearly became an overnight science superstar and national hero after publishing a paper in Nature Biotechnology on NgAgo, a genome editing technique supposed to be superior to CRISPR-Cas9, the technology used by He. Fabrication of data was soon emerged and Han withdrew his paper. But he has never been really disgraced in China, and he still enjoys support from the university and local government. In 2017, a world record was reached when Tumor Journal retracted 107 papers because of fake peer reviews. A great majority of the authors involved are hundreds of Chinese researchers at mostly biomedical and even some traditional Chinese medical universities throughout the country.
The governmental strong drive for sciences, like ambition on a personal level, is definitely not intrinsically bad, and can lead to immense goodness for Chinese people and humankind. Yet, as manifested in the rising cases breaching scientific integrity, and especially He Jiankui’s human experiments, China’s science schemes have much to do with the developing mentality that ethics is merely secondary and instrumental for cutting-edge scientific investigation and technological invention. Ethical considerations and the ultimate moral goals of science and medicine can be compromised or alienated by the unchecked pursuit of personal ambition, financial interests, interests of the Party-governments and institutions, economic growth, or national glory.
The case of He Jiankui’s transgression, as well as the authoritarian model of sciences, needs to be critically examined from bioethical and particularly socio-ethical perspectives. The moral stakes are high for China and the world.
Jing-Bao Nie, BMed, MMed, MA, PhD, is a professor at Bioethics Centre, University of Otago, New Zealand, and a Hastings Center Fellow.
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To do less than everything that can be done to prevent tragic disease, I consider to be an immoral and unethical action. This scientist has courage and ability few people possess. If you want certainty in medicine, think about all the incurable genetically transmitted diseases there are in the world, making millions of people miserable for the course of their entire lives. Personally, I find the risks more objectionable than the certain miseries of millions.