DNA – The Promise & The Price provides an excellent resource for discussing the ethical implications of advancing genetic research, focusing on; gene therapy, stem cells and cloning. The documentary examines the frontiers of genetic science, revealing how researchers attempt to fulfil DNA’s potential to help cure and prevent disease. It also questions how some aspects of these novel technologies may have significant consequences for individuals and society. Bill Paterson: “Much is promised by genetic science, the manipulation of our genes. But can it deliver? And if it does are we ready to take responsibility for meddling with the very fabric of life itself: our DNA”.
The topics found in DNA – The Promise & The Price include: genetics; genetic diseases; gene therapy; transplantation; stem cells; and cloning can all be found in the UK National Curriculum. Please note all timings mentioned include advertisement breaks – (00:04:51 – 00:08:00, 00:25:31 – 00:28:40 and 00:46:50 – 00:50:00)
Gene therapy: (00:08:00 – 00:23:15).
Gene therapy is a technique that is hoped will help treat and cure genetic diseases such as Cystic Fibrosis, Muscular Dystrophy and Haemophilia, by directly manipulating the faulty genes that causes these diseases. (Please note this section contains some good animations illustrating how gene therapy works).
Gene therapy exploits the ability of a virus to insert a normal working gene into the genome of the patient’s cells. The documentary explains that despite the great hope that surrounds gene therapy it has so far been very risky. In 1999 Jesse Gelsinger died as a result of taking part in a gene therapy trial and in a separate trial several French patients developed leukaemia as a result of the gene therapy (See Gene therapy – Horizon “trial and error” and Designer Babies – three documentaries).
The unfortunate events mentioned above highlight two potential flaws with gene therapy (at least as carried out to date):
- The vector virus itself can cause a severe immune response in the patient, as seen in the case of Jesse Gelsinger.
- When the virus inserts the gene into the genome it can cause catastrophic consequences if the new gene inserted disrupts, or activates, a pre-existing gene in the genome. In the French patients, the virus inserted the new gene alongside LMO-2, a cancer-causing gene on Chromosome 11. The strong promoter (control box) on the inserted gene activated the LMO-2 gene leading to the development of leukaemia.
The documentary moves to explain how scientists are working to overcome the risk factors associated with gene therapy, trialling new techniques on patients with Haemophilia. The trials yield some initial success, but the uncertainty that surrounds this technology means the work of scientists is often slow and frustrating.
The documentary also highlights the pioneering research to prevent cervical cancer by Professor Jo Milner (00:18:56 – 00:23:15). It is now recognised that the sexually transmitted virus human papillomavirus (HPV) can cause cervical cancer, by inserting two of its own genes E6 and E7 into the genome of the cells found in the future patient. These viral specific genes override the regulatory systems that normally control cell division and thus cause uncontrollable cell growth – cancer. Professor Milner proposes using short-interfering RNA to block the viral genes from working allowing the cells to regulate their rate of growth. This section illustrates how gene therapy has developed over recent years, looking towards innovative techniques to deliver the therapy.
Since this documentary was broadcast, the UK has seen the start of a major immunisation programme to protect future generations of women against cervical cancer (See this NHS website and also see ‘The jab that can stop cancer – Dispatches’).
Stem cells: (00:23:50 – 00:41:45)
In this next section (00:23:50 – 00:33:30) , the documentary focuses on how scientists are helping doctors to overcome complex genetic illness, such as heart disease. A Brazilian patient who suffered from chronic heart disease and was waiting for a heart transplant, underwent a revolutionary procedure to help save his life. His heart was regenerated by stem cells, the master cells in the body that repair and regenerate all types of tissues. Collaboration at the Texas Heart Institute between Dr James Willerson and Dr Emerson Perin to use adult bone marrow stem cells to regenerate damaged tissue in the heart, led to significant improvements in the patients heart blood flow and its over all function. Using high-tech computers to help map the damaged and healthy cells in the patients heart, allowed the doctors to precisely inject the patients bone marrow stem cells directly between these areas. The heart has little or no stem cells of its own, however when the bone marrow stem cells where injected into the heart tissue the new chemical environment caused them to regenerate the damaged heart.
The Brazilian patient was part of a clinical trial and the treatment remains in the experimental stage. Some scientists believe that stem cells offer an even greater source of medical treatment, suggesting that in the future it might be possible to grow entire organs to replace damaged ones. Adult stem cells are limited by the number of different tissue types they can grow into, therefore scientists are concentrating on embryonic stem cells. The special characteristics of these cells means that they have the potential to adapt and grow into any cell type found in the human body. The following section (00:33:30 – 00:39:20) describes scientists are working towards growing organs for transplantation.
Professor Steve Jones: “The most exciting part of genetics, is without question, the genetics of development – how do you get from an egg to a human being. How do you get a streak of tissues in the embryo to a heart? If we can crack that then it is conceivable, only conceivable, that we can do the job ourselves and re-grow a heart. Think of the medical problems we could solve.”
Jeremy Rifkin – Author, ‘BiotechCentury’: “When we create embryos specifically to harvest stem cells for experimental purposes, with the idea that the embryo will be destroyed so it wont come to term. That is really dangerous, that’s eugenics, that should not be the way that we proceed with science.”
A Japanese scientist that uses frogs in his experiments has become the first to successfully grow a sensitive organ (eyes) from scratch and then transplant them back into the frog. Stem cells are universally found in all living organisms; and Professor Makoto Asashima from University of Tokyo has taken embryonic stem cells from a tadpole embryo and stimulated them to grow into eyes, kidneys, livers and the heart. He admits however that despite this success he still does not know how the stem cells in the new eye know how to successfully connect to cells in the frogs brain.
Despite the promise that Professor Asahima’s work could some day be transferred to humans, there are significant ethical problems with this technology (00:39:00 – 00:41:52). If these innovative organs were to succeed in humans, the embryonic stem cells generated to grow the organs would need to originate from the individual them self, to ensure that the new organ was not rejected. Therefore the only way to produce stem cells which exclusively contain our own genes is to produce a cloned embryo. Dr Robert Lanza – Advanced Cell Technology, describes how his group carries out experiments using primate cloned embryonic stem cells, and how they have so far being able to stimulate these cells to produce dopamine producing cells which could help treat Parkinson’s disease sufferers or beating heart cells used to treat heart disease. This work is contributing to their main aim of growing an entire organ, however he admits that at the time of filming such breakthroughs are at least 10 or 15 years away.
Cloning: (00:41:35 – end)
This final section focuses on the ethical arguments that surround the human embryo and cloning, in particular the embryos right to life. It is important also while examining these arguments to understand the difference between ‘therapeutic cloning’ and ‘reproductive cloning’, a point the programme fails to do. Therapeutic cloning is when stem cells are harvested from a cloned embryo to treat a patient or carry out research (as mentioned above), however reproductive cloning is when a cloned embryo is implanted into the womb to produce a cloned human. There is significant opposition towards reproductive cloning.
However despite these concerns Dr Panos Zavos – Director of Andrology Institute of America, believes that reproductive cloning is essential to help couple’s who can not have children naturally, and that they have the right to have a child through cloning. He also believes that because of his extensive fertility expertise, he has the skill needed to successfully achieve a clone child, and therefore overcome any risks associated with this technique. The documentary makes its clear that there are many arguments both in favour and against human cloning, and that it is essential that the scientific community does not pursue such venture unethically.
DNA: The Promise & The Price, highlights many new aspects of genetic science while discussing the ethical arguments that surround them. Through out the documentary it reports on an international public opinion poll conducted by the documentary, regards the issues discussed in the programme. Below are some questions which would complement teaching any of the topics above, and the relevant times in which the public poll is referred to.
- Genetic science: (00:03:30 – 00:04:20) – Will genetic science decide the future of the human race?
- Gene therapy: (00:15:55 – 00:17:10) – Would you take part in a gene therapy trial if you knew people had died from the treatment? What are the risks associated with gene therapy?
- Genetic disease: (00:22:45 – 00:23:20) – Do you think genetic science will help cure all disease?
- Stem cells: (00:41:35 – 00:44:23) – Should embryonic stem cells research be banned? What are the different uses of embryonic stem cells?
- Human Cloning:(00:46:15 – 00:46:23, 00:52:51 – 00:53:28 and 00:54:20 – 00:54:40) – When do you think a human will be sucessfully cloned? Do you think human cloning is right? Who could benefit from human cloning?
DNA – The Promise & The Price was first broadcast on Discovery Science on 5th September 2008, 21:00 (60 minutes). TRILT Identifier: 001DC831. Repeated on 6th, 7th, 8th, 12th, 13th, 14th September 2008. An earlier programme of the same name has different content.