A year ago, Dr. Matthew Porteus, a genetics researcher at Stanford university, received an unexpected letter from a young Chinese scientist asking to meet with him.
A few weeks later, the scientist, he jiankui, arrived at his office and dropped a bombast. He said he had obtained approval from a Chinese ethics committee to use human embryos he edited for pregnancy, a previously untried experiment that is illegal in many countries.
I spent about 40 minutes telling him in very clear language how wrong and reckless it was, Mr. Portes said in a recent interview.
Portes didn't tell anyone about Dr. He's intentions because he thought he had persuaded him not to do so, and he didn't know how to report a Chinese scientist's plans. The other two American scientists who got information from Dr. He did not tell anyone.
Now, nearly two months after he jiankui stunned the scientific community by announcing the creation of the first gene-edited baby - a twin born in November - the world's leading scientific and medical institutions are urgently trying to put in place international safeguards to prevent such a wild experiment from happening again.
But while scientists around the world agree that such horrors must be stopped, they disagree on how. Even the inventors of Crispr, the gene-editing tool Dr. He used, disagree about the best method.
Some scientists want a moratorium lasting several years to stop the use of genetically edited human embryos for pregnancy. Others say the ban is too restrictive or unenforceable. Some argue that scientific journals should agree not to publish embryo editing research. Others say it is misleading or futile.
But most agree that major health and scientific agencies should act quickly. The world health organization is convening panels to develop global standards for governments to follow. The heads of the National Academy of Medicine and the National Academy of Sciences have jointly proposed setting up committees with academic institutions in other countries to set standards so that scientists cannot "find convenient places to conduct dangerous and unethical experiments". The proposal includes the establishment of "an international mechanism to enable scientists to raise their concerns". On Thursday, the world economic forum in davos scheduled discussions on the topic. Enforcement will require individual countries, many of which already have laws and regulations in place. But global standards set by scientists can give countries a powerful push.
但多数人同意，主要的健康和科学机构应迅速采取行动。世界卫生组织正在召集小组讨论会，制定全球标准供各国政府遵循。美国国家医学院(National Academy of Medicine)和美国国家科学院(National Academy of Sciences)的负责人已联合提议，与其他国家的学术机构成立委员会，制定标准，这样科学家就无法“寻找方便的地点开展危险、不符合伦理的实验”。该提议包括建立“一项国际机制，使科学家能够提出他们的担忧”。周四，达沃斯的世界经济论坛安排了该议题的讨论环节。执行将需要各个国家去做，许多国家已经有相关的法律法规。但由科学家制定的全球标准可以给各国一个有力的推动。
The concern is not just that genetically edited babies can cause unexpected health problems, but that they can be passed on to future generations, or that people may attempt to produce engineered babies that gain physical traits, intelligence or athletic ability through genetic changes.
Scientists also worry that this could drag down less controversial gene editing, which does not involve embryos and has greater potential for disease treatment or prevention.
Not only were some American scientists aware of Dr. He's intentions, but one may have supported him. Michael Deem, his doctoral supervisor at Rice University, told the Associated Press that he was in China during the informed consent process for the couples involved in the embryo editing program.
不仅一些美国科学家知道贺建奎的意图，其中一位可能还支持过他。他在莱斯大学(Rice University)的博士生导师迈克尔·迪恩(Michael Deem)告诉美联社称，在针对参与胚胎编辑项目夫妇的知情同意环节期间，他就在中国。
Rice university is investigating. Dean's lawyer also told the Associated Press that he had a "minority stake" in Dr. He's genomics company. "Michael doesn't do human research, and he didn't do human research on this project," he said.
Mr. He and Mr. Dean haven't responded to emails from the New York times. A rice university spokesman declined to provide any information about the investigation.
Dr. He, who is in his mid-30s, published his research in a video statement in November after the MIT Technology Review broke the news ahead of a genome editing conference in Hong Kong.
《麻省理工科技评论》(MIT Technology Review)在香港举行的一场基因组编辑大会召开前披露了此事，而后年龄在35岁上下的贺建奎于11月通过一则视频声明对外公布了他的研究。
I was terrified and could feel some physical discomfort, said Jennifer Doudna, one of Crispr's inventors. He jiankui sent her an email on Thanksgiving entitled "the baby has been born" and it was the first time she knew what he was doing.
Dr. He said he disabled a gene in an embryo that makes people infected with HIV, but that was medically unnecessary because there were easier and safer ways to prevent the virus.
The data he presented suggested that gene editing might have inadvertently led to genetic changes with unknown health problems. There is still a lot of doubt about whether he jiankui made sure that the baby's parents understood the risks of gene editing. He said he had also completed a second pregnancy, which Chinese authorities said was still ongoing.
Mr. Portes says he now feels he should have consulted his colleagues after learning about Mr. He's plans, and wrote an email to a senior Chinese ethicist while he was still in his office.
Dr. William Hurlbut, another American who spoke to Dr. He and a professor of ethics at Stanford university, said that in his discussions with Dr. He in 2017-18, he had expressed strong objections to his work, including warning him, "' it will hurt you, it will shame you. '"
As of October, Mr. Hulbert said, "I am personally convinced that he had either an implant or a live birth."
He said he didn't tell anyone, because "what I was thinking was, it's not like I knew someone was going to kill someone; This is a fait accompli. I don't feel that I have any moral obligation or practical benefit to speak out about it."
Mark DeWitt of the university of California, Berkeley, declined to be interviewed, but said he had tried to dissuade Dr. He.
All three American scientists pointed out that Dr. He told them he expected them to keep it secret, which is how scientists often share preliminary research.
Dr. Francis Collins, the director of the National Institutes of Health, said that if Dr. He had worked at a university or funding institution in the United States, scientists might have raised the alarm. His organization does not fund human embryo editing research. The Chinese system is so complex that American scientists may not know "exactly what alarm bells they should ring and to whom," he said.
美国国家卫生研究院(National Institutes of Health)院长弗朗西斯·柯林斯(Francis Collins)博士说，如果贺建奎是在美国的大学或资助机构完成工作，科学家们可能已经就此事发出了警报。他所在的这个机构不资助人类胚胎编辑研究。中国的体制太过复杂，美国科学家可能不了解“究竟他们该敲响什么样的警钟，该向谁敲响警钟，”他说。
The international effort to come up with a coordinated response came after Chinese state media reported that authorities had indicated that a preliminary investigation had found he had "seriously violated" state regulations.
The findings -- that he forged ethical documents, used genetic editing methods that were not precise about safety or effectiveness, and deliberately evaded regulation -- suggest that he could face criminal charges. He jiankui's academic unit, shenzhen southern university of science and technology, terminated his employment contract.
Clearly, the Chinese government is taking this seriously, said Dr. Victor Dzau, President of the national academy of medical sciences in Washington.
It was unclear at first whether he would be punished. China has invested heavily in recent years to become a technology powerhouse, including paying to lure back scientists like he jiankui, who completed his doctorate and postdoctoral work in the United States. Some shocking experiments, such as the idea of transplanting a head into another body, have not been blocked.
This dangerous and unwarranted research must be formally recognized and determined to be illegal, Mr. Dahoner said after the preliminary results were released. "This announcement confirms an international 'red line' of ethical and scientific conduct to help ensure that this type of radical, medically unnecessary and unregulated research never happens again."
During the investigation, Dr. He has been living in a dormitory, walking around campus, going to the gym and communicating with some western scientists. Helbert, who has spoken to him by phone and email, said that in those conversations, he sounded "hopeful that he could make a contribution in the future."
Mr. He initially said he was "proud" of what he had done, and when asked if he had expressed remorse, Mr. Hulbert replied: "he really regrets the way and the timing of this disclosure to the world."
He also emailed the British geneticist Robin lovell-badge recently, saying: "I totally agree that 'for those who want to conduct human gene editing, there should be a clear set of DOS and don 'ts. '"
At least one major journal decided not to publish Dr. He's work before the Hong Kong announcement, and scientists are debating whether to do so.
Portes said he initially thought it would be appropriate to post it on a BBS of an earlier study that had not been peer-reviewed because "we could go through a thorough comb to get to every detail." But now, he said, "I don't think it's appropriate anymore. This is too much to allow for any form of recognition."
Although he jiankui says his motivation is to protect people from HIV, he clearly wants to be recognized by leading scientists. In the months before the twins were born, he asked to meet feng zhang, Crispr's other inventor. At Mr. Zhang's lab at the Broad Institute in Boston, Dr. He showed data from gene editing of human embryos in lab petri dishes, which didn't alarm him because several scientists had done so. But Mr Zhang pointedly criticised the "big problem" in Dr He's gene-editing results.
He made no mention of the embryo implantation. "Maybe I shouldn't have picked so many holes, so he would have revealed more information," Mr. Zhang said.
Some experts say the best way to stop the erroneous use of embryo editing is for all public and private actors in new science and technology to coordinate their actions, including regulators, patent offices, funding organizations and liability insurance companies. In a recent paper in the New England Journal of Medicine, r. Alta Charo, a bioethicist at the University of wisconsin-madison, proposed creating "an integrated ecosystem of public and private entities that can constrain the willful among us."
一些专家说，阻止错误使用胚胎编辑的最佳方法是由所有新科学技术的公共和私人参与者协调行动，包括监管机构、专利局、资助组织和责任保险公司。威斯康星大学麦迪逊分校(University of Wisconsin-Madison)的生物伦理学家R·奥塔·查洛(R. Alta Charo)最近在《新英格兰医学杂志》(New England Journal of Medicine)上发表的文章中提议，建立一个“由公共和私人实体组成的综合生态系统，可以约束我们当中的任意妄为者”。
The first step could be the creation of an international commission led by the us academy of science and medicine. Cao wenkai, President of the national academy of medical sciences, says many countries have now agreed to the commission. It will publish a report this year with detailed guidelines.
The current standards, reflected in a 2017 report from the national academy of sciences, say that edited embryos can only be used for human pregnancy if they prevent or treat "serious illness or disability" and there are no "reasonable alternatives." Mr. Cao wants to be more specific about which diseases are serious enough to justify the risks, which are acceptable, and how much preliminary testing is needed.
He said the committee might recommend a moratorium on the implantation of edited human embryos until the report was published. Some leading scientists want a longer moratorium.
Mr. Zhang said the five-year moratorium would allow scientists to engage in the necessary public discussion.
Dionne disagrees, arguing for "very strict international standards" for journals to "state that they will not publish such work".
She has been arguing in an email with Dr. Collins of the national institutes of health, who favors a moratorium.
If you use the word 'suspension,' it's a little bit more powerful, Mr. Collins said. For that to happen, he said, it would require an international agreement to stop individual countries from thinking "we think it's ok now".