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Narrator Bill Paterson: "A child born in 1953, the structure of DNA has just been discovered. 1989 and this baby's
genetic fingerprint can be identified. The first single gene for Huntington's disease has been discovered. 2003 this
child's entire genetic code can now be read and faulty genes in his DNA can be adjusted. Another birth, but this time
no ordinary miracle. The baby's sex and eye colour were decided before she was conceived; also her hair, the shape of
her nose and her intelligence. The date of her birth? Perhaps only a few years from now. She's born from a revolution
in genetics. A revolution where each new step brings new questions of ethics and responsibility. And as the promises
of the science gets greater, so do the questions for all of us get bigger."

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  provides an excellent resource for discussing the ethical implications of advancing
genetic research, focusing on;  , 
 and  . The documentary examines the frontiers
of genetic science, revealing how researchers attempt to fulfil DNA¶s potential to help cure and prevent disease. It also
questions how some aspects of these novel technologies may have significant consequences for individuals and
society. Bill Paterson: ³Much is promised by genetic science, the manipulation of our genes. But can it deliver? And if
it does are we ready to take responsibility for meddling with the very fabric of life itself: our DNA´.
Professor Steve Jones: "When it comes to medical research, any medical technology that works, it is very quickly
accepted by the public. Ethicists may not like it, scientists may not like it, but the public, if they believe it works they
will accept it, and the legislation will always follow. Ethics has always followed science, it's never led it and I don't see
any reason why genetics is going to be any different. Ethicists would love to tell geneticists what to do, but I'm afraid
the geneticists are not going to listen."

The topics found in c


  include: genetics; genetic diseases; gene therapy;
transplantation; stem cells; and cloning can all be found in the UK National Curriculum. Please note all timings
mentioned include advertisement breaks - (00:04:51 ± 00:08:00, 00:25:31 ± 00:28:40 and 00:46:50 - 00:50:00)

* (00:08:00 ± 00:23:15).

Gene therapy is a technique that is hoped will help treat and cure genetic diseases such asCystic Fibrosis, Muscular
Dystrophy and Haemophilia, by directly manipulating the faulty genes that causes these diseases. (Please note this
section contains some good animations illustrating how gene therapy works).

Animation explaining how gene therapy works

Gene therapy exploits the ability of a virus to insert a normal working gene into the genome of the patient¶s
cells. The documentary explains that despite the great hope that surrounds gene therapy it has so far been very risky.
In 1999 Jesse Gelsinger died as a result of taking part in a gene therapy trial and in a separate trial several French
patients developed leukaemia as a result of the gene therapy (See Gene therapy ± Horizon ³trial and
error´ andDesigner Babies ± three documentaries).
The unfortunate events mentioned above highlight two potential flaws with gene therapy (at least as carried out to
date):

a The vector virus itself can cause a severe immune response in the patient, as seen in the case of Jesse
Gelsinger.
a When the virus inserts the gene into the genome it can cause catastrophic consequences if the new gene
inserted disrupts, or activates, a pre-existing gene in the genome. In the French patients, the virus inserted
the new gene alongside LMO-2, a cancer-causing gene on Chromosome 11. The strong promoter (control
box) on the inserted gene activated the LMO-2 gene leading to the development of leukaemia.

Jeremy Rifkin - Author, 'Biotech Century': "My problem with gene therapy is not in the principle of it but its
execution. The young Jesse Gelsinger, this young man was not near death at all, he was leading a fairly healthy life.
He died almost immediately from the actual therapy, so he died and he didn't need to."

The documentary moves to explain how scientists are working to overcome the risk factors associated with gene
therapy, trialling new techniques on patients with Haemophilia. The trials yield some initial success, but the
uncertainty that surrounds this technology means the work of scientists is often slow and frustrating.

HPV inserts the viral specific genes E6 and E7 into the genome of normal cells in the patient

The documentary also highlights the pioneering research to prevent cervical cancer byProfessor Jo Milner (00:18:56
± 00:23:15). It is now recognised that the sexually transmitted virus human papillomavirus (HPV) can cause cervical
cancer, by inserting two of its own genes E6 and E7 into the genome of the cells found in the future patient. These
viral specific genes override the regulatory systems that normally control cell division and thus cause uncontrollable
cell growth - cancer. Professor Milner proposes using short-interfering RNA to block the viral genes from working
allowing the cells to regulate their rate of growth. This section illustrates how gene therapy has developed over recent
years, looking towards innovative techniques to deliver the therapy.

Since this documentary was broadcast, the UK has seen the start of a major immunisation programme to protect
future generations of women against cervical cancer (See this NHS website and also see µThe jab that can stop cancer
± Dispatches¶).

^
(00:23:50 ± 00:41:45)

Dr James Willerson - Texas Heart Institute

In this next section (00:23:50 ± 00:33:30) , the documentary focuses on how scientists are helping doctors to
overcome complex genetic illness, such as heart disease. A Brazilian patient who suffered from chronic heart
disease and was waiting for a heart transplant, underwent a revolutionary procedure to help save his life. His heart
was regenerated by stem cells the master cells in the body that repair and regenerate all types of tissues.
Collaboration at the Texas Heart Institute between Dr James Willerson and Dr Emerson Perin to use adult bone
marrow stem cells to regenerate damaged tissue in the heart, led to significant improvements in the patients heart
blood flow and its over all function. Using high-tech computers to help map the damaged and healthy cells in the
patients heart, allowed the doctors to precisely inject the patients bone marrow stem cells directly between these
areas. The heart has little or no stem cells of its own, however when the bone marrow stem cells where injected into
the heart tissue the new chemical environment caused them to regenerate the damaged heart.

Dr Emerson Perin - Texas Heart Institute

The Brazilian patient was part of a clinical trial and the treatment remains in the experimental stage. Some scientists
believe that stem cells offer an even greater source of medical treatment, suggesting that in the future it might be
possible to grow entire organs to replace damaged ones. Adult stem cells are limited by the number of different tissue
types they can grow into, therefore scientists are concentrating on embryonic stem cells. The special characteristics of
these cells means that they have the potential to adapt and grow into any cell type found in the human body. The
following section (00:33:30 ± 00:39:20) describes scientists are working towards growing organs for transplantation.
Professor Steve Jones: ³The most exciting part of genetics, is without question, the genetics of development ± how do
you get from an egg to a human being. How do you get a streak of tissues in the embryo to a heart? If we can crack
that then it is conceivable, only conceivable, that we can do the job ourselves and re-grow a heart. Think of the
medical problems we could solve.´

Jeremy Rifkin ± Author, µBiotechCentury¶: ³When we create embryos specifically to harvest stem cells for
experimental purposes, with the idea that the embryo will be destroyed so it wont come to term. That is really
dangerous, that¶s eugenics, that should not be the way that we proceed with science.´

Professor Makoto Asashima - University of Tokyo

A Japanese scientist that uses frogs in his experiments has become the first to successfully grow a sensitive organ
(eyes) from scratch and then transplant them back into the frog. Stem cells are universally found in all living
organisms; and Professor Makoto Asashima from University of Tokyo has taken embryonic stem cells from a tadpole
embryo and stimulated them to grow into eyes, kidneys, livers and the heart. He admits however that despite this
success he still does not know how the stem cells in the new eye know how to successfully connect to cells in the frogs
brain.

Despite the promise that Professor Asahima¶s work could some day be transferred to humans, there are significant
ethical problems with this technology (00:39:00 ± 00:41:52). If these innovative organs were to succeed in humans,
the embryonic stem cells generated to grow the organs would need to originate from the individual them self, to
ensure that the new organ was not rejected. Therefore the only way to produce stem cells which exclusively contain
our own genes is to produce a cloned embryo. Dr Robert Lanza ± Advanced Cell Technology, describes how his
group carries out experiments using primate cloned embryonic stem cells, and how they have so far being able to
stimulate these cells to produce dopamine producing cells which could help treatParkinson¶s disease sufferers or
beating heart cells used to treat heart disease. This work is contributing to their main aim of growing an entire organ,
however he admits that at the time of filming such breakthroughs are at least 10 or 15 years away.

   (00:41:35 ± end)

This final section focuses on the ethical arguments that surround the human embryoand cloning, in particular the
embryos right to life. It is important also while examining these arguments to understand the
difference between µtherapeutic cloning¶ and µreproductive cloning¶, a point the programme fails to do. Therapeutic
cloning is when stem cells are harvested from a cloned embryo to treat a patient or carry out research (as mentioned
above), however reproductive cloning is when a cloned embryo is implanted into the womb to produce a cloned
human. There is significant opposition towards reproductive cloning.
Professor Keith Campbell - Nottingham University, and co-creator of Dolly the sheep, argues that: "To my knowledge
I don't think that there was any evidence that Dolly aged prematurely compared to another animal of the same age
produced by natural ageing techniques. It may appear that all of the animals we porduce by this technique are
normal, but it is a very inefficient technique. And we don't understand the mechanisms which control development,
so we produce some abnormal and also dead foetuses... Their offspring may well have abnormalities that with human
medicine may not be life-threatening, the chances of that happening are not worth the risks at presant and we should
not attempt human cloning."

However despite these concerns Dr Panos Zavos ± Director of Andrology Institute of America, believes that
reproductive cloning is essential to help couple¶s who can not have children naturally, and that they have the right to
have a child through cloning. He also believes that because of his extensive fertility expertise, he has the skill needed
to successfully achieve a clone child, and therefore overcome any risks associated with this technique. The
documentary makes its clear that there are many arguments both in favour and against human cloning, and that it is
essential that the scientific community does not pursue such venture unethically.

DNA: The Promise & The Price, highlights many new aspects of genetic science while discussing the ethical
arguments that surround them. Through out the documentary it reports on an international public opinion poll
conducted by the documentary, regards the issues discussed in the programme. Below are some questions which
would complement teaching any of the topics above, and the relevant times in which the public poll is referred to.

a * (00:03:30 ± 00:04:20) - Will genetic science decide the future of the human race?
a *  (00:15:55 ± 00:17:10) - Would you take part in a gene therapy trial if you knew people
had died from the treatment? What are the risks associated with gene therapy?
a *  (00:22:45 ± 00:23:20) - Do you think genetic science will help cure all disease?
a ^
 (00:41:35 ± 00:44:23) - Should embryonic stem cells research be banned? What are the
different uses of embryonic stem cells?
a ½
  (00:46:15 - 00:46:23, 00:52:51 ± 00:53:28 and 00:54:20 ± 00:54:40) - When do you
think a human will be sucessfully cloned? Do you think human cloning is right? Who could benefit from
human cloning?

c

  was first broadcast on Discovery Science on 5th September 2008, 21:00 (60
minutes). TRILT Identifier: 001DC831. Repeated on 6th, 7th, 8th, 12th, 13th, 14th September 2008. An earlier
programme of the same name has different content.