Counseling after CRISPR

Bret D Asbury

This Article explores the implications of Clustered Regularly Interspaced Short Palindromic Repeats (CRISPR) gene editing and its emergent ability to treat human diseases by altering prenatal DNA. After surveying current scientific capabilities, this Article narrows its scope to focus on how this rapidly evolving technique will impact prenatal genetic counseling, an area in which there has been both federal and state legislation in recent years and one in which the most spirited debates relating to human genome editing are likely to emerge. Whereas recent scholarly debates surrounding prenatal genetic counseling have addressed how genetic counselors can and should assist potential parents in deciding whether to bring genetically anomalous fetuses to term, the arrival of CRISPR—a relatively simple and cost-effective method of editing genomes that has the potential to mitigate or eliminate many fetal genetic abnormalities—presents a new set of questions for prenatal genetic counselors. As CRISPR’s ability to alter human genomes expands and becomes more refined, a number of ethical, financial, and regulatory challenges will emerge. This Article describes these novel challenges and sets forth a framework for how prenatal genetic counseling can best meet them. In doing so, it focuses on three questions. First, under what medical circumstances might it be appropriate for a prenatal genetic counselor to raise the possibility of a genetic intervention? Second, what role, if any, should state and federal legislation play in promoting awareness of genetic interventions? Third, to what extent might it be appropriate medically, ethically, and financially to subsidize access to gene therapy?

Counseling after CRISPR

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Counseling after CRISPR

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