Positive Health Online

The true men of old
Slept without dreams,
Woke without worries.
Their food was plain .
They breathed deep.  (Chuang tsu.)

Concerns

Gene editing and genome analysis, together, these are known as genetic technologies. This is seemingly the future of modern medicine but there are concerns around some aspects of these technologies. I am not a geneticist but researching this field for this piece has alarmed me somewhat .

Scientists have developed the ability to create pieces of genetic material to add, remove or replace sections of DNA – this is known as gene editing and it can be used to fix genetic faults that cause inherited conditions. However gene editing is also the stuff of sci-fi. For example, in a laboratory in Kyoto geneticists have used gene-editing technology to insert a single variant of a gene once carried by Neanderthal man into the genomes of mice. These rodents then began to show signs of anatomical differences like those of these extinct species.[1]. This sort of experimentation, understandably, causes concerns around the direction in which  gene editing is heading.  And there are also concerns around the use of genome analysis  to identify and diagnose disease and its progression. 

Genome analysis is perhaps, on the surface of it, not as concerning as gene editing. A relative of mine recently had a diagnosis of a blood cancer and with gene diagnosis she has been placed in a low-risk group for her disease which means a slower disease progression and a better prognosis. This suggests that she has a higher chance of responding well to treatment and having a longer period of remission or survival.  Scientists can now read the code, or sequence, in a strand of DNA to identify the genes we carry and comprehend what they do and no doubt this technique can be helpful, as in the case of my relative, when used to identify and diagnose disease and its progression. 

DNA, Biology, Science

Photo Credit: Image by M. Richter from Pixabay

Full human genome analysis is seemingly the answer to so many medical mysteries. Certainly it now provides large numbers of patients experiencing previously hard to diagnose neurodevelopmental disorders with a diagnosis after years of not receiving one. And genetic information can help identify individuals at higher risk for diseases such as cystic fibrosis or heart disease and guide them to preventive measures where appropriate, such as lifestyle changes. However the truth of the matter is that although the technology may look impressive,  scientists have barely started to be able to decode genetic information fully. As Suzanne O’Sullivan says in her book The Age of Diagnosis….[2]

“The impressive technology involved

in genetic testing belies the fact that we

have only just garnered the ability to read

the whole genome and have barely started

on the road to decoding it fully, genetic results

can look like precise formulae but the

distillation of that to something that has

clinical meaning to the patient is considerably

less precise”[2]

Gene diagnosis may seemingly be useful when used for someone, like my relative, already manifesting disease. However it might be advisable to consider rejecting the use of genetic information for people who have little or no symptoms of disease. Genetic testing is currently easily available online to pinpoint both a variety of diseases and specific diseases for individuals who are not manifesting symptoms of any particular illnesses. There are concerns that genetic testing for those free of symptoms, but who are curious to see what diseases they might manifest in the future, might be problematic. If we are symptom free, perhaps we should simply be focusing on increasing our wellbeing by taking care to exercise, watch what we eat, get sufficient sleep and do our best to avoid stress.

Misunderstandings are often a problem with genetic testing bought online – in 2019 the then Health Secretary Matt Hancock revealed that he had bought and taken a on line genetic test. It showed he had a 15% chance of developing prostate cancer and he was very grateful believing the test might have saved his life. He had however misunderstood the result – the average risk in a lifetime for prostate cancer for men of his age was only 12% so his personal risk was only a tiny fraction higher than average. – his chance of developing the disease in the next ten years was close to zero.[3]

Imprecise results and misunderstood results perhaps suggests that we should not trust the total reliability of genetic diagnosis. And altering, "editing", DNA – is that a safe, ethical way to treat patients – or even mice as in the Kyoto laboratory?

The Daoist Perspective

There are very clear reasons why genetic technologies do not sit well with the Daoist perspective. Genetic diagnosis is used to pinpoint specific diseases even before symptoms arise. With Daoist medicine, although also able to identify a pattern of imbalance even before symptoms appear, the focus is on restoring balance and promoting overall wellbeing rather than pinpointing a specific, labelled disease. Daoism views disease as an imbalance within the body's natural harmony linked to disruptions in fields of energy and diagnosis in a Daoist context may involve assessing imbalances through methods such as observing the patient's tongue and taking her pulses. Once assessed, a decision is made on treatments such as acupuncture and herbal medicine to return the whole body mind to a state of balance. This is truly holistic medicine.

Furthermore gene technologies are very much associated with what has been called “our drive to mastery” – the need to have total control over ourselves and our environment by knowing what diseases might manifest from our gene pool and having the ability to change, edit, our genes. The Daoist sage Chuang Tsu writes of our drive to control when he says

“Sweating and labouring to the end of his days and never seeing his accomplishments, utterly exhausting himself and never knowing where to look for rest—can you help pitying him? I’m not dead yet! He says but what good is that? His body decays, his mind follows it –can you deny that this is a great sorrow? Man’s life has always been a muddle like this.”[4]

Chuang Tsu suggests that in order to resolve our ongoing suffering we need to cultivate a different perspective – one where we let go of rigidly trying to control our lives – behaviour that exhausts and depletes us.

A central theme of Daoism is the need to lead a simple life free from the creation of too many choices. To know in advance, through genetic testing, of every disease we might be brewing up in our genetic makeup , to have the ability to manipulate our genes – all of this may strengthen our drive to have control and mastery over ourselves and our environment but will this make us healthier and happier?  Chuang Tsu would no doubt suggest that it is only by letting go of our need to control everything that we will feel well in mind body and spirit. By living in the way of Wu Wei – going with the flow we become more relaxed, spontaneous and open to the moment and in this way can handle better whatever challenges may arise.

Gene editing clearly does not align with the Daoist perspective largely because a core concept of the Dao (the Way) is that it represents the natural order of the universe. Daoists encourage us to accept and flow with the natural cycle of change – gene editing obviously challenges that concept as a large aspect of gene manipulation is in order to correct what can be perceived as imperfections. Gene editing  allows scientists to precisely alter an organism's DNA by inserting, deleting, or modifying DNA sequences at specific locations in the genome and of particular  concern is the fact that ultimately this can perhaps be used to decide what counts as desirable and  undesirable traits in human beings. To the Daoist acceptance and tolerance is central. Consider this comment by bioethicist Dena Davis as she discusses testing for Downs syndrome.

"In my own mind i can discern a subtle shift in the way in which I view people with certain anomalies. Twenty years ago, seeing a woman in the supermarket with a child who has Down syndrome, my immediate actions were sympathy and a sense that that woman could be me. Now that testing for Down syndrome is virtually universal the United States, when I see such a mother and child I am more likely to wonder why she didn’t get tested."[5]

This is how we can fail to accept and value disability. 

I am aware that genetic medicine has many advantages – particularly for those people experiencing severe ill health but I would hope that scientists are advocating caution especially in regard to genetic  online testing and also  in regard to gene editing. 

Furthermore we need to remind ourselves that although we are given the impression that genes are absolute fixed entities current genetic research suggests that this is not so. In fact lifestyle behaviour and environment can change the way our genes are read by the body – diet, exercise and sleep can turn genes on and off. As with all things in nature it would appear genes are fluid and react to your environment and experiences. Simple changes to the way we live can impact how our genes are expressed and thus how they affect our health. For example, smoking can alter the function of a gene that regulates cell growth and that will increase the risk of cancer. But stopping smoking can reverse that change so that the gene behaves as it would for a non-smoker.

There is in fact no stopping the progress of science – the genie of genetics is now out of the bottle but I would hope that caution is taken by genetic scientists in their direction of travel. And perhaps, rather than uncovering, through genetic diagnosis, the possibility of developing certain diseases and, rather than manipulating our genes to correct what can be perceived as imperfections, we need to stop trying to control all aspects of our lives, cultivate a simple lifestyle with healthy habits and develop more acceptance, tolerance and understanding of ourselves and others.

Sources and References

1. https://www.iflscience.com/scientists-inserted-neanderthal-and-denisovan-genes-into-mice-heres-what-happened-69703
2. The Age of Diagnosis. Suzanne O’Sullivan Hodder Press 2025.
3. Are genetic tests useful to predict cancer ? Hannah Devlin. 23^rdwww.theguardian.com/society/2019/mar/23/are-predictive-genetic-test-useful-to-predict-cancer-matt-hancock
4. The Complete Works of Chuang Tsu.
5. Kim, Richard: Daoism, Flourishing and Gene Editing From Erik Parens & Josephine Johnston, Human Flourishing in an Age of Gene Editing. Oxford University Press. (2019)