10 Scientific American, October 2019SCIENCE AGENDA
OPINION AND ANALYSIS FROM
SCIENTIFIC AMERICAN’S BOARD OF EDITORSIllustration by Deshi DengChina’s Ethical
Crossroads
The nation needs better safeguards
if it wants to be a medical powerhouse
By the EditorsChina’s high-tech industrialization policy, known as Made in
China 2025, purports to take the country to the front ranks of ad-
vanced manufacturing in aerospace, robotics, clean energy, trans-
portation and the life sciences. But the transformation into a glob-
al biotech and pharmaceutical dynamo might prove more chal-
lenging than making robots or self-driving cars.
That is because China lacks a good regulatory and ethical re-
view process, a serious problem highlighted last November when
scientist He Jiankui gave the world an unwelcome surprise. He
announced that he had edited the genes of twin girls at the em-
bryo stage with the aim of enhancing their resistance to HIV—an
experiment with the potential to produce a host of genetic and
health problems that could be passed on to the twins’ offspring.
The rogue nature of He’s actions brought a wave of condem-
nation from inside and outside the country, but the experiment
was by no means an outlier. China stands out from other techno-
logically advanced countries because of its headlong embrace of
new biological and medical developments that raise weighty eth-
ical and human-rights issues.
After He went public, the Wall Street Journal reported that
other Chinese researchers working with CRISPR-Cas9 gene edit-
ing, the same technique used for the twins (but, in these instanc-
es, not in embryos), had lost track of the people who had partici-
pated in their study. The Journal also documented earlier this
year accusations that Uighur Muslims, practitioners of Falun
Gong, Tibetan Buddhists and “underground” Christians have had
organs forcibly removed for transplants. In addition, animal re-
search on the feasibility of head transplants and spinal cord re-
attachment has been carried out in China—a head transplant on
a living human volunteer has even been discussed.
He’s gene editing of embryos appears to have pushed Chinese
authorities to act. Although China lacks firm regulations on the
practice, tinkering with the twins’ genes violated its guidelines on
human-assisted reproduction, and the scientist was fired from a
Chinese university and left a start-up company he founded. Chi-
na has also begun to open up a process of national self-scrutiny
that could put the country on a sturdier foundation of ethical safe-
guards more in line with international norms. A May commentary
in Nature by four bioethicists from Chinese universities and insti-
tutes laid out both the problem and a series of solutions with ex-
traordinary clarity and forthrightness. The authors assert China
is at a crossroads requiring “substantial changes to protect others
from the potential effects of reckless human experimentation.”
The article criticized Chinese science culture as beset by jigongjinli: a motivation to seek “quick successes and short-term gains.”
Lei Ruipeng of Huazhong University of Science and Technology in
Wuhan and three co-authors from other institutions called for bet-
ter regulation, stringent penalties and clear codes of conduct for
research that involves gene editing, stem cells, mitochondrial
transfer, neurotechnologies, synthetic biology, nanotechnology
and xenotransplantation. They want these codes to supersede the
fragmented framework of oversight responsibilities currently ap-
portioned among different government ministries. Policy makers
seem to be edging in the same direction: in February the Nation-
al Health Commission put out draft regulations that propose
stricter controls on gene editing.
The bioethicists also suggest a registry that tracks clinical tri-
als and collects ethics evaluations for studies using new medical
technologies. They advocate other measures such as dissemina-
tion of regulations by a national organization and ethics educa-
tion for everyone from scientists to the general public. And they
call for an end to discrimination of people with disabilities based
on the rationale that they are inferior or a societal burden, an at-
titude biasing any attempt to formulate a set of ethical principles.
China is not the only country that has lagged at some point in
developing a regulatory infrastructure to address experiments on
humans. In the U.S., the 1978 Belmont Report set out ethics guide-
lines for human research subjects in the aftermath of the 40-year
Tuskegee experiment, which tracked the progress of syphilis in un-
treated black men who were, unforgivably, not told clearly that
they had the disease. As the Nature commentary’s authors point
out, the field of bioethics has only a 30-year history in China. He’s
regrettable decision to edit the genes of twin sisters could serve
as the impetus to spur the nation toward a profound rethinking
of its public policy on human research—a necessary prerequisite
before China can responsibly become a biotech colossus.JOIN THE CONVERSATION ONLINE
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