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4Comparative ethical evaluation of epigenome editing and genome editing in medicine: first steps and future directionsJournal of Medical Ethics 50 (6): 398-406. 2024.Targeted modifications of the human epigenome, epigenome editing (EE), are around the corner. For EE, techniques similar to genome editing (GE) techniques are used. While in GE the genetic information is changed by directly modifying DNA, intervening in the epigenome requires modifying the configuration of DNA, for example, how it is folded. This does not come with alterations in the base sequence (‘genetic code’). To date, there is almost no ethical debate about EE, whereas the discussions abou…Read more
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174Dürfen Gentherapien so viel kosten? – Ethische Bewertung der hohen Preise und des performanceorientierten ErstattungsmodellsIn Boris Fehse, Hannah Schickl, Sina Bartfels & Martin Zenke (eds.), Gen- und Zelltherapie 2.023 – Forschung, klinische Anwendung und Gesellschaft, Springer. pp. 317-337. 2023.This chapter examines whether high prices for gene therapies are justified and whether the problems associated with high prices can be solved by the "pay for performance" (P4P) reimbursement model. To this end, we first describe how prices for new drugs, including gene therapies, are set in Germany (section 2.). P4P is then presented as an example of a reimbursement model (section 3.). The subsequent ethical analysis (section 4.) first examines whether P4P models can sustainably guarantee the ri…Read more
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40Defusing the legal and ethical minefield of epigenetic applications in the military, defence and security contextJournal of Law and the Biosciences 10 (2): 1-32. 2023.Epigenetic research has brought several important technological achievements, including identifying epigenetic clocks and signatures, and developing epigenetic editing. The potential military applications of such technologies we discuss are stratifying soldiers’ health, exposure to trauma using epigenetic testing, information about biological clocks, confirming child soldiers’ minor status using epigenetic clocks, and inducing epigenetic modifications in soldiers. These uses could become a reali…Read more
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50Comparative ethical evaluation of epigenome editing and genome editing in medicine: first steps and future directionsJournal of Medical Ethics (doi: 10.1136/jme-2022-108888): 1-9. 2023.Targeted modifications of the human epigenome, epigenome editing (EE), are around the corner. For EE, techniques similar to genome editing (GE) techniques are used. While in GE the genetic information is changed by directly modifying DNA, intervening in the epigenome requires modifying the configuration of DNA, for example, how it is folded. This does not come with alterations in the base sequence (‘genetic code’). To date, there is almost no ethical debate about EE, whereas the discussions abou…Read more
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252Ethical Discourse on Epigenetics and Genome Editing: The Risk of (Epi-) genetic Determinism and Scientifically Controversial Basic AssumptionsIn Michael Welker, Eva Winkler & John Witte Jr (eds.), The Impact of Health Care on Character Formation, Ethical Education, and the Communication of Values in Late Modern Pluralistic Societies, Evangelische Verlagsanstalt & Wipf & Stock Publishers. pp. 77-99. 2021.Excerpt: 1. Introduction This chapter provides insight into the diverse ethical debates on genetics and epigenetics. Much controversy surrounds debates about intervening into the germline genome of human embryos, with catchwords such as genome editing, designer baby, and CRISPR/Cas. The idea that it is possible to design a child according to one’s personal preferences is, however, a quite distorted view of what is actually possible with new gene technologies and gene therapies. These are much m…Read more
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172Conference Abstract: Vergleichende ethische Bewertung von Genom- und Epigenomeditierung als experimentelle reproduktionsmedizinische Technologien: Natürlichkeit, Personenbezogenheit, Vererbbarkeit (Conference Abstract)In-Vitro-Gametogenese (Ivg) Und Artifizieller Uterus (au) – Problemauslöser Oder Problemlöser? Ethische, Soziale Und Rechtliche Aspekte Zukünftiger Reproduktionsmedizinischer Verfahren. Abstractband I. 2022.
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10Despite a vast amount of discussions on sustainability and on the right to health(care) within applied ethics, it has not been precisely determined how both concepts can be connected. This article argues that a sustainable right to health(care) comprises an agent-relative right to health(care), an agent-neutral right to health(care), economic aspects, and (only included in the conceptualization of a sustainable right to health, not to healthcare) environmental aspects. It starts with a formal ou…Read more
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28The Mutual Benefit of the Integration of Philosophy and Bioethics – Our Experience from an Interdisciplinary Research Project on (Epi-)Genome EditingAmerican Journal of Bioethics 22 (12): 61-63. 2022.We welcome Blumenthal-Barby’s et al. (2022) plaidoyer for the integration of philosophy in bioethics because of a perceived mutual benefit. Drawing on experience from a collaborative project, funde...
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248Gibt es einen therapeutischen Imperativ zum genome editing in der menschlichen Keimbahn? [Is there a therapeutic imperative for editing the human germline genome? / Existe-t-il un impératif thérapeutique à l'édition du génome dans la lignée germinale humaine]URPP Human Reproduction Reloaded | H2R (University of Zurich), Working Paper Series, 05/2022. Zurich and Geneva: Seismo 1 (5): 1-21. 2022.Abstract: This working paper focuses on the question whether there is a therapeutic imperative that, in specific situations, would oblige us to perform genome editing at the germline level in the context of assisted reproduction. The answer to this central question is discussed primarily with reference to specific scenarios where preimplantation genetic diagnosis (PGD) does not represent an acceptable alternative to germline genome editing based on either medical, or ethical, or – from the persp…Read more
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45Is Dupras and Bunnik’s Framework for Assessing Privacy Risks in Multi-Omic Research and Databases Still Too Exceptionalist?American Journal of Bioethics 21 (12): 80-82. 2021.Dupras and Bunnik’s strong statement against the normative approach of genetic exceptionalism, which can no longer be justified in the midst of multi-omic research, is of great importance fo...
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54Ethischer Diskurs zu Epigenetik und Genomeditierung: die Gefahr eines (epi-)genetischen Determinismus und naturwissenschaftlich strittiger GrundannahmenIn Boris Fehse, Ferdinand Hucho, Sina Bartfeld, Stephan Clemens, Tobias Erb, Heiner Fangerau, Jürgen Hampel, Martin Korte, Lilian Marx-Stölting, Stefan Mundlos, Angela Osterheider, Anja Pichl, Jens Reich, Hannah Schickl, Silke Schicktanz, Jochen Taupitz, Jörn Walter, Eva Winkler & Martin Zenke (eds.), Fünfter Gentechnologiebericht: Sachstand und Perspektiven für Forschung und Anwendung, . pp. 299-323. 2021.Slightly modified excerpt from the section 13.4 Zusammenfassung und Ausblick (translated into englisch): This chapter is based on an analysis of ethical debates on epigenetics and genome editing, debates, in which ethical arguments relating to future generations and justice play a central role. The analysis aims to contextualize new developments in genetic engineering, such as genome and epigenome editing, ethically. At the beginning, the assumptions of "genetic determinism," on which "genetic e…Read more
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32Internationale Klausurwoche (BMBF): „Defining the value of medical interventions – Normative and empirical challenges“ (review)Ethik in der Medizin 32 (1): 107-110. 2020.
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University of HeidelbergSection for Translational Medical Ethics, National Center for Tumor Diseases, Heidelberg University HospitalResearch Associate (in Specific Research Project)
Heidelberg, Baden-Württemberg, Germany