GP / Blog / Science & Technology

Issue briefing

Genetic engineering and biotech ethics: the line between cure and enhancement

Gene editing has crossed from theory to the clinic: there is now an approved therapy that edits a patient's cells to cure a disease. The harder question is not whether to cure, which few would refuse, but where the line sits between healing a body and redesigning it, and whether we can hold that line once the tools are routine.

Theme · Science & TechnologyLast set at A-Level · 2012 (on whether having children by artificial means can be justified, and overdue as biotech accelerates)SEAB sets the paper

In short

A genetic-engineering question rewards a student who finds the real fault line. 'Editing genes is good' and 'editing genes is playing God' are both too blunt. The arguable line runs between therapy and enhancement: curing sickle cell is one thing, choosing a child's traits is another, and the danger is that the same tool slides from one to the other.

Why this could come up now

This is a long-dormant strand at A-Level. The bank last touched assisted reproduction and the engineering of life in 2012, with children by artificial means, and it has not returned to the heart of biotech ethics since, even as the science has transformed.

The technology has moved decisively in the intervening years. The first CRISPR-based therapy was approved in 2023, the 2018 gene-edited-babies scandal showed how fast the line can be crossed, and germline editing and gene drives keep the designer-baby debate live in 2026. An overdue theme meeting an accelerating science is exactly the sleeper worth preparing.

Framed honestly: a question cold since 2012 is not a sign that it returns this year. It is a strong case for rehearsing an issue the bank has neglected while the world raced ahead, so that you can argue the therapy-versus-enhancement line rather than reaching for tired 'playing God' rhetoric.

201220152017202020232025

set at A-Level most recent appearance. Cold at A-Level since 2012 while the science was rebuilt. Overdue, and louder in the world than ever.

What an essay on this would test

These questions test whether you can move past reflex to a real line. 'It is unnatural' and 'it is progress' are both slogans. The examiner wants you to locate the morally relevant distinction, usually between therapy and enhancement, or between editing one patient and editing the human germline that passes to all descendants, and to defend where you draw it.

They also test whether you can weigh a slippery slope honestly. The strongest answer neither dismisses the slope as fearmongering nor treats it as certain, but asks whether the step from curing disease to enhancing traits is one we can actually stop at, and what would hold the line if we wanted to.

Operative angles

therapy versus enhancement: curing a disease versus upgrading a healthy trait, the line most genetic-engineering questions turn on
germline versus somatic: editing one patient versus editing changes that pass to every descendant, a far higher-stakes act
designer babies: the slippery-slope endpoint, where choice of traits raises equality and consent problems the cure case does not

How to answer it: two ways in

Two distinct, defensible routes through the question. A strong script commits to one and uses the other as the concession it answers, rather than sitting on the fence.

Editing to cure is a duty

If we can end a disease, we should

Where gene editing can cure or prevent serious inherited disease, refusing it on grounds of squeamishness condemns real people to suffering, so the presumption should be to heal, with caution about method, not about the goal.

An approved gene-editing therapy already relieves a brutal inherited disease, which is a concrete good, not a hypothetical.
Much of the 'unnatural' objection would, applied consistently, have blocked vaccines, transplants and IVF, all once called unnatural and now routine.
Refusing a cure within reach is itself a moral choice with victims, not a neutral act of restraint.

Worked exampleIn December 2023 the first CRISPR-based gene-editing therapy was approved, editing a patient's own cells to treat sickle cell disease, a painful inherited condition, the clearest case that gene editing can deliver a genuine cure rather than a sci-fi fantasy (US FDA approval of Casgevy, as of 2026-06).

The therapy-enhancement line is the danger

The real risk is where the same tool goes next

The hard problem is not curing disease but the line beyond it, because the same technology that cures slides toward enhancement and germline design, and the danger is that we cannot stop at therapy once the tools are routine.

The step from editing out a disease to editing in a preferred trait is technical, not absolute, so the slope from therapy to enhancement is real.
Germline editing changes descendants who never consented, turning a personal medical choice into a permanent decision for people not yet born.
If enhancement becomes purchasable, it threatens to make inequality biological, baking advantage into the body rather than the bank account.

Worked exampleIn 2018 a Chinese scientist announced the first gene-edited babies, editing embryos that became living children, which drew near-universal condemnation and a prison sentence and showed how quickly the line from therapy to germline enhancement can be crossed once the tools exist (He Jiankui affair, as of 2026-06).

The fuel: stats, facts and examples

Dec 2023

the first CRISPR-based gene-editing therapy was approved, to treat sickle cell disease

Source: US FDA approval of Casgevy · as of 2026-06

2018

year a scientist announced the first gene-edited babies, crossing the germline line and drawing global condemnation

Source: He Jiankui affair, widely documented · as of 2026-06

3 years

the prison sentence given to the scientist behind the 2018 gene-edited babies, a marker of where the ethical line was drawn

Source: He Jiankui affair, widely documented · as of 2026-06

Facts worth deploying

The approved CRISPR therapy edits a patient's own cells, which is somatic editing and affects only that person; the 2018 scandal involved germline editing, which alters embryos and passes to all descendants, a far higher-stakes act.Source: FDA / He Jiankui affair, as of 2026-06

The objection that gene editing is unnatural has historically been raised against vaccines, organ transplants and IVF, all of which were once condemned as unnatural and are now widely accepted, which complicates the 'unnatural' argument.Source: history of medical ethics, as of 2026-06

Gene drives, which engineer a trait to spread through a wild population, extend the same ethical problem beyond humans, since a released edit cannot easily be recalled from an ecosystem.Source: biotech-ethics literature, as of 2026-06

FAQ

Can I just argue gene editing is playing God?

You can raise the objection, but if it carries your whole essay you will land in the middle band. 'Playing God' is an assertion, not an argument, and it would have ruled out IVF and transplants too. Convert it into the real claim, about consent, the germline, or the therapy-enhancement line, and argue that instead.

Do I need to understand the science of CRISPR?

Only enough to use it accurately. Know that gene editing can target a patient's own cells (somatic) or an embryo's germline that passes to descendants, because that distinction does real ethical work. You do not need the molecular detail; you need the line that the ethics turns on.

Is the designer-baby worry science fiction?

Less than it was. The 2018 case showed embryo editing is already possible, and the equality and consent problems it raises are live, not hypothetical. Treat it as a real slope to argue about, neither certain nor fanciful, and your essay will read as informed rather than alarmist.