A graduate student in public health and bioethics has misgivings about whether debating a future technology like gene editing is worthwhile:
All of these questions, in my opinion, become wasted energy, because we can’t even DO this yet. And none of them matter, because you haven’t addressed the much larger issue, which is WHO IS PAYING FOR THIS? And that question gets to the heart of why I’m responding to you, rather than working on the 35 pages of papers I need to be writing. Every time journalists and academics write on these topics, they are missing the larger social question: the logistical question of how this technology actually gets applied and who has access to it, particularly when you situate this issue in the current context of our reproductive political reality.
In that current reality, women don’t even have access to BASIC reproductive healthcare. Low-income women in states that didn't accept the ACA expansion don’t have access to contraception. Eighty-nine percent of counties in America are without abortion access. Trump just gave states permission to stop funding ANY women’s health-care clinic that provides abortion services—meaning that they will stop paying for pap tests, breast exams, STI testing, prenatal exams, and other cancer screenings. Women who are carrying fetuses with fatal anomalies can’t access abortions because insurance won’t cover it, and many states have banned abortion beyond 20 weeks without exception.
Reproductive access in America is already stratified. Many couples who know that they are at risk for bearing a child with a genetic disorder can’t afford to access PGD [Ed. note: pre-implantation genetic diagnosis, the method this reader and her partner considered] because many insurance plans don’t cover it. These technologies are only available to the well-insured or the well-off.
On that note, a nurse and medical-school student predicts that uneven access to gene-editing will stigmatize certain diseases, affecting their treatment:
Any prenatal gene editing technology is only possible in an IVF process. While theoretically this technology could be further developed to be implemented in vivo, this would need to occur very early after conception—close timing that would only be possible after a medically managed insemination. Since half of all pregnancies in the country are unplanned and many more are conceived naturally due to the higher cost, logistical barriers, and health risks of IVF, I find it very unlikely that gene editing will become the “norm.”
That said, this ability will add to the privilege of conceiving via IVF, which already allows families to screen egg and sperm donors as well as screen pre-implantation embryos for chromosomal abnormalities. Said another way, single-gene diseases such as muscular dystrophy, cystic fibrosis or sickle cell will soon be eliminated among the IVF population and thus will become a marker for disadvantage.