Dr. Mohammed Ghaly (left) and Dr. Sahar Da’as
Doha, Qatar: A progressive move taken by Qatar to do generic screening for potential spouses has made it possible to identify hereditary diseases that a child may be born with but also take early intervention measures to prevent them.
Dr. Sahar Da’as, Laboratory Manager of the Zebrafish Facility at Sidra Medicine, member of Qatar Foundation (QF), explains that if one or both parents carry a genetic mutation that increases the likelihood of their child inheriting a hereditary disease. However early intervention and planning can be done by screening that particular gene in the embryos’ DNA to prevent its inheritance or alleviate the resulting symptoms at early stages.
Pre-marital medical tests, which are mandatory in Qatar, include performing genetic testing for potential spouses to detect potential genetic mutations that may affect their future children.
“In case of unfavourable results from these tests, couples are advised to undergo in vitro fertilization in the laboratory and early screenings to prevent the development of any genetic mutations in the future child.
“Qatar provides pregnant women with several tests in the early stages of pregnancy, such as blood tests in the first stage, foetal examination through ultrasound imaging, and testing the amniotic fluid. These tests can be in the form of regular blood tests or genetic tests” said Dr. Da’as.
With regards to the available methods for early intervention to correct genetic mutations, Dr. Da’as explains that it can be done in two ways: “The first is in utero, either through surgical intervention to treat congenital deformities affecting the heart or spine or through gene therapy to reverse any genetic mutations carried by the foetus. The latter is still in experimental stages”.
The other method, according to Dr. Da’as is, “genetic intervention outside the womb using two types of cells, either cells from the patient’s own body to treat conditions such as muscular dystrophy or cystic fibrosis, where genetic modification is done to the patient’s cells (somatic genome editing) and then returned to the body, or through intervention with stem cells transplantation where genetic modification is done for patient cells in cases of genetic blood disorders such as sickle cell anaemia or immune diseases affecting humans”.
Despite the promising results shown by the uses of precision medicine and genetic therapy, Dr. Da’as points out that much of it is still in the early stages and under experimentation.
“Scientific research is ongoing to study rare medical cases that have not yet been diagnosed. To enhance our understanding of human disease, at Sidra Medicine’s Zebrafish Functional Genomics Facility, we conduct research using Zebra fish as it shares 70 percent of its genes with humans,”.
When talking about genetic modification, ethical aspects and boundaries cannot be ignored. While some view genetic testing as a means to reduce the spread of hereditary diseases and improve the health of future generations, others believe that this approach may lead to ethical challenges such as (genetic) discrimination or pressuring individuals to make decisions that may not align with their personal values.
According to Dr. Mohammed Ghaly, Professor of Islam and Biomedical Ethics at QF’s Hamad Bin Khalifa University (HBKU), Research Center for Islamic Legislation and Ethics (CILE), religious scholars encourage genetic testing in the pre-marital stage, so individuals are aware of potential health conditions their children may have and can make an informed decision.
“Genetic modification is ethically acceptable when employed as an efficient and safe medical tool to address severe diseases, aiming to improve an individual’s health condition, mitigate excessive suffering, and elevate overall quality of life. The guiding principle underscores the necessity for these modifications to align with individuals’ values while maintaining a delicate equilibrium between scientific progress and ethical considerations. Thus, using this technology for non-medical purposes, such as enhancements or cosmetic modifications (e.g., changing hair or eye colour), is ethically unacceptable.
“Some scholars also permit making decisions to prevent the birth of a child affected by severe genetic disorders that bring harm not only to the prospective child but may also pose a threat to the mother’s life or health. This permission is granted within the framework of a time limit, typically before 120 days of pregnancy, a period believed to mark the moment of ensoulment.”
Dr. Ghaly underscores the considerable ethical debates surrounding genetic modification or gene editing, particularly in the context of germline gene editing. This form of modification entails the permanent editing of genes in foundational cells, rendering the reversal of changes challenging, if not entirely impossible. “Such a decision is crucial due to its impact on genetic diversity and biological evolution, as genetic intervention in fundamental body cells may raise concerns about unexpected or negative effects on the child’s life and subsequent generations. “This underscores the imperative for a robust ethical framework to steer the utilization of these technologies, establishing clear ethical boundaries to guarantee their safe and responsible application.”
