Question

1: whose germline is it anyway?
while some forms of human genetic modification have been in use since 1989 to prevent genetic diseases, known as \gene therapy\, these modifications are somatic, meaning they exist only in the targeted individual, and cannot be inherited. however, in november 2018, biophysicist he jiankui unexpectedly announced the birth of twin girls, pseudonymously named lulu and nana, he had genetically modified with the intent to confer partial immunity to hiv. unlike past modifications, these were germline modifications using crispr, which directly modified the entire genome, creating heritable changes.
detractors of human germline engineering claim that the modifications introduce unnecessary risk to offspring without their consent. in lulu and nana’s case, safer means of preventing hiv were available, and the genes altered likely play other roles, such as brain function. additionally, successful germline modifications run the risk of exacerbating class disparities, as medical procedures only available to the wealthy may grant generations of children anything from disease resistance, to altered physical features like height and eye color.
of course, germline engineering offers permanent solutions to otherwise heritable and debilitating diseases. children born with germline edits preventing things like huntington’s disease and cystic fibrosis can have their own children freely without risk of passing on the condition. in addition, non - preventive genetic enhancements could provide benefits to individuals, like improved eyesight, which would eventually become dispersed throughout the human population.
discussion questions

1. should doctors prioritize patient safety, or medical breakthrough? in the case of lulu & nana does the benefit outweigh the fact that there were safer, proven ways to achieve the same result?
2. what role does patient age and consent play in medical decisions? do we ever have the obligation to perform medical procedures without the consent of a patient?
3. is there a moral distinction between therapeutic edits (e.g., removing disease) and enhancements (e.g., altering intelligence or appearance)?

Explanation:

Since the problem is about the ethical and social aspects of human germline modification, along with medical decision - making and consent, the relevant subfield under Social Science is Ethics (within the broader scope of topics like Medicine and Health, or a more general ethical analysis in Social Science). But as per the given subfields for Social Science, we can consider it under a broader "Others" or relate it to areas like Medicine and Health (as part of Natural Science? No, the ethical and social aspects are more Social Science) or more appropriately, the discussion is about the ethical, social, and medical decision - making aspects which fall under Social Science (with subfields like Ethics, Medical Ethics which can be considered under "Others" in the given Social Science subfields or related to areas like Public Administration, or more broadly, the social implications of medical technology).

For a question like "Should doctors prioritize patient safety, or medical breakthrough? In the case of Lulu & Nana does the benefit outweigh the fact that there were safer, proven ways to achieve the same result?" (the first discussion question), we can analyze it as follows:

To answer this, we consider the ethical and medical principles. Patient safety is a fundamental medical principle (e.g., the Hippocratic Oath to do no harm). In Lulu and Nana's case, there were safer methods (like pre - exposure prophylaxis or other HIV prevention methods) available. A medical breakthrough should not come at the cost of unnecessary risk to patients, especially when safer alternatives exist. The benefit of a potential breakthrough (here, germline modification for HIV resistance) does not outweigh the risks because the modification introduced unknown long - term risks (e.g., the altered genes may affect other functions like brain function) and there were established safer methods.

Answer:

Doctors should prioritize patient safety. In Lulu and Nana's case, the benefit does not outweigh the fact that there were safer, proven ways. Patient safety (avoiding unnecessary risk, especially with unknown long - term effects of germline modification) is a core medical principle, and the existence of safer alternatives means the potential breakthrough's risks are not justified.