Aashmi – Year 11 Student
Editor’s Note: Year 11 student Aashmi elected to write this extended essay on the chosen word ‘duty’ in response to The Dukes Essay Prize organised by Dukes Education. This competition is inspired by the famous entrance test for All Souls College, Oxford, where students write an essay in response to a single word, from the perspective of a specific academic subject. The Prize rewards creativity, lateral approaches, and engagement with a subject beyond the curriculum. It is a fantastic opportunity to practice university-style assignments, and a prize is a great achievement to discuss on a personal statement. The words for this year’s competition were: Environment – Value – Citizen – Movement – Sequence – Vision – Duty. CPD
[Featured image: Biomedical Engineering Laboratory. (Wikipedia: Creative Commons)]
Some say that man’s greatest invention was the wheel – it revolutionized transport and is the very basis of movement. Centuries ago, it was but a mere donut-like wooden disk but over time, our ancestors altered and modified it to shape the agricultural and industrial sectors that we are familiar with today. They utilised their resources and knowledge of the time to provide the future with a tool that they themselves did not possess. In this way, we are indebted to the past but with no way to reimburse them, the question arises: how does one repay the favour?
The world that we leave behind becomes the world of generations to come and thus, much like our forefathers who created the necessary tools to enhance our life, we must do the same. By being indebted to the past, we gain a duty to the future. Nobel Prize winner and president of The Royal Society, Sir Venki Ramakrishanan emphasised that “modern inventions often rely on discoveries that are a few hundred years old” [1]. This underlines the duty for us to provide the forthcoming generations with the scaffolding for innovation.
Medicine is one of such sectors in which the concept of duty is more profound. The medical industry has grown exponentially since the 18th century; the invention of the smallpox vaccine is just one of many revolutionary turning points in the history of medical science. Discoveries continue to be made, moving towards the goal of an extremely idealistic world where all diseases could be cured with ease and made accessible to the entire population. If the minds of today discover new knowledge to be used in the future, we could potentially contribute to the utopia that we wish to have. In this way, a duty could be performed.
In order to decipher the sense of duty in medical science, we can turn to the story of Layla Richards. In 2015, doctors at Great Ormond Street Hospital, London used TALENs1 technology in an attempt to reverse the one-year old’s leukaemia. A considerable improvement was seen in the child’s conditions, Professor Waseem Qasim, the consultant who carried out the procedure wrote that the infant had fully recovered and showed no signs of cancerous cells in the bone marrow [2]. This advancement in gene editing was made possible only due to the works of Watson, Crick and Franklin in the 1950s who discovered the structure of DNA. However, it must be noted that their discovery used the foundations that were laid by the likes of Darwin’s ‘Origins of Species’ and Mendel’s ‘Principles of Hereditary’ which were published a little under a century before the first DNA x-ray was taken. The works of Mendel from 1866 eventually led to an infant recovering from what was previously thought to be a terminal cancer. Researchers can now take advantage of such a medical breakthrough and reform the necessary technology through application of knowledge and experimentation to allow procedures to become far more efficient. The bioengineering industry has recently turned to CRISPR2– a method of genome editing which utilises Cas9 proteins and RNA- while more advanced than the TALENs method, which became very popular after its discovery in 2007, the concept and function is the same. Currently, CRISPR is predominantly used “in creating laboratory animals and cell lines with key genetic characteristics that help scientists better study human diseases” [3], however, many researchers are working towards using the technology to cure a plethora of diseases by altering the patients’ DNA.
In April of 2016 scientists at Guangzhou Medical University published a paper sharing details of an experiment that they carried out in an attempt to make non-viable embryos HIV resistant using CRISPR [4]. While only a portion of the embryos became successfully immune after harbouring the CCR5Δ32 mutation (responsible for HIV immunity), the experiment showed the science community both the flaws in CRISPR technology and its infinite possibilities. With the new knowledge that Kang’s paper provided, bioengineers are able to improve gene-editing methods and with each improvement, we get one step closer to an idealistic world where HIV could be cured and, eventually, prevented as a whole. This reflects our time’s contribution to the future’s battle with HIV and highlights the sense of duty we have to diminish it as much as possible.
Other advancements are also being seen in the medicine field which can be applied to the future such as, MRI scans, the application of nanotechnology and bionic prosthetics to name but a few. All of the aforementioned as well as many more medical breakthroughs of our time are contributing to the ultimate goal of the future but one field, which is widely conversed about, is organ growth. In 2014, scientists at the MRC Centre for Regenerative Medicine at the University of Edinburgh, led by Professor Clare Blackburn, successfully grew a working organ in a mouse by transplanting cells that were created in the laboratory. The team had grown a thymus; an organ within which T cells (a critical component of our immune system) mature. This breakthrough was soon followed by a paper being published in the Science Transnational Medicine journal by researchers at the University of Texas medical branch, outlining details of the successful transplant of lab-grown lungs into pigs. Although the lungs were not capable of respiration and the pigs relied on their one remaining original lung to breathe, each pig lived for about 2 months – this showed the biomedical science community that lab-grown organ transplantation for humans is closer than ever before.
There are around 6000 people in the UK who are waiting for an organ transplant, which is why advancements in bioengineered organ technology are so significant. It is estimated that 400 people in the UK died last year (2019) while waiting for an organ [5], however, with the potential of ‘grow-your-own’ organs all those on the waiting list can go through an organ transplant without the need for a donor. Such a drastic enhancement in the medical field will lead to an increase in life expectancy as more and more people above the age of 60 (who are most prone to things such as kidney disease) will receive treatment in the case of organ failure.
Despite the countless possibilities that may be achievable with CRISPR and lab grown organs, bioengineering is a controversial field in which ethics are frequently debated. The ethics of scientific research and experimentation has been critically discussed for years and continues to be a predominant issue. The infamous case of the Chinese CRISPR twins Lulu and Nana was an affair that led to the entire fundamental morals of gene-editing technology to be questioned. Similarly, the idea of blastocyst complementation is one that is met with an abundance of ethical questions- mostly targeted at the animal-cruelty process. This brings about the age-old question of how far is too far?
In developing technology further in order to fulfil our duty to the future, it is inevitable that ethics will be questioned. Some would argue that you cannot progress without crossing ethical boundaries. Maurizio Iaccarino (Secretary General of the UNESCO-ICSU World Conference on Science) believes that “scientific knowledge alone can create ethical problems of its own” [6]. However, if we work ethically, are we depriving the future of the utopia? By following ethical guidelines, are we leaving our duty incomplete?
Although ethics are subjective, the ethical guidelines and principles set by authorities need to be translated from theory into practice, more so for medical advancement in which research and experiments are conducted on both animals and humans on a daily basis. Due to a better understanding of the human body, more and more research is being executed into how we function, thus, it is more important now than ever before to adhere to set ethical principles. While it is evident that we have a duty to enhance scientific knowledge and technology, we must fulfil this through methods that are ethical.
Aashmi
References
- Ramakrishanan, V. (2017). How science transformed the world in 100 years. [Online]. Available at: https://www.bbc.co.uk/news/science-environment-41698375. Accessed on 25052020.
- Qasim, W., Zhan, H., Samarasinghe, S. et al. (2017). Molecular remission of infant B-ALL after infusion of universal TALEN gene-edited CAR T cells. Science Translational Medicine, 9 (374).
- Wanjek, C. (2018). How Close Are We, Really, to Curing Cancer with CRISPR? [Online]. Available at: https://www.livescience.com/63192-curing-cancer-crispr.html. Accessed on 16042020.
- Kang, X., He, W., Huang Y. et al. (2016). Introducing precise genetic modifications into human 3PN embryos by CRISPR/Cas-mediated genome editing. Journal of Assisted Reproduction and Genetics, 33 (5).
- NHS (2020). Organ donation and transplantation. [Online]. Available at: https://www.nhsbt.nhs.uk/what-we-do/transplantation-services/organ-donation-and-transplantation/. Accessed on 19042020.
- Iaccarino, M. (2001). Science and ethics. EMBO Reports, 2 (9), pp. 747-750.
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