ISSN: 2706-8870
Volume 7, Number 2 (2022)
Year Launched: 2016

From the externally augmented soldier to the internally modified soldier: using the genome against chemical and biological weapons

Volume 7, Issue 2, April 2022     |     PP. 107-127      |     PDF (276 K)    |     Pub. Date: March 24, 2022
DOI: 10.54647/cm32764    112 Downloads     4676 Views  

Author(s)

B.Massoubre, Military pharmacist; Hôpital d'Instruction des Armées Desgenettes, Lyon, France
C.Boulliat, Head of the Pharmacy Department, military pharmacist; Hôpital d'Instruction des Armées Desgenettes, Lyon, France

Abstract
The development of molecular biology has allowed a considerable advance in medicine. But applications, both civil and military, can be malicious and must be strictly controlled by the international scientific community. Ethical reflection is necessary to target and circumscribe abuses.
The use of genome editing can protect the soldier in case of biological or chemical attacks. Nevertheless, medical ethics within the armed forces must not be overlooked, even if this genetic modification is an advance in the protection of the combatant in a theater of operations. The soldier is affected in his deepest intimacy, that of his genetic heritage.
Whatever the cause, and even if it is noble, an augmented or modified soldier must not be a dehumanized soldier. We must ensure that the dignity of the soldier, but also of the human being, is respected.
The medical ethics of the armed forces are present to accompany the progress of science and to ensure the respect of its principles.

Keywords
Augmented soldier, modified soldier. Genomic editing. CRISPR-Cas 9. Ethics. Chemical and biological weapons. Military health service

Cite this paper
B.Massoubre, C.Boulliat, From the externally augmented soldier to the internally modified soldier: using the genome against chemical and biological weapons , SCIREA Journal of Clinical Medicine. Volume 7, Issue 2, April 2022 | PP. 107-127. 10.54647/cm32764

References

[ 1 ] Deltcheva E, Chylinski K, Sharma CM, Gonzales K, Chao Y, Pirzada ZA et al. CRISPR RNA maturation by trans-encoded small RNA and host factor RNase III. Nature. 2011; 471(7340) :602-7.
[ 2 ] Mangeot PE, Risson V, Fusil F, Marnef A, Laurent E, Blin J. Genome editing in primary cells and in vivo using viral-derived nanoblades loaded with Cas9-sgRNA ribonucleoproteins. Nature Communications. 2019; 10 :1-15.
[ 3 ] Lander ES, Baylis F, Zhang F, Charpentier E, Berg P, Bourgain C. Adopt a moratorium on heritable genome editing. Nature. 2019 ; 567 :165-168.
[ 4 ] Goffette J. Naissance de l'anthropotechnie : De la médecine au modelage de l'humain. Edition Vrin. 2006.
[ 5 ] De Boisboissel G., Naut C. Some forward-looking scenarios for increasing combatant performance. Enhancing soldiers. A European ethical approach. Enriched proceeding of the symposium. 2019 Oct 16, Paris.
[ 6 ] Beauchamp T., Childress J. Les principes de l’éthique biomédicale. 2ème édition ; Paris : Les belles lettres ; 2020.
[ 7 ] Greene M, Master Z. Ethical Issues of Using CRISPR Technologies for Research on Military Enhancement. Bioeth Inq. 2018; 15(3): 327–335.
[ 8 ] Li JR, Walker S, Nie JB, Zhang XQ. Experiments that led to the first gene-edited babies: the ethical failings and the urgent need for better governance. J Zhejiang Univ Sci B. 2019; 20(1): 32-38.
[ 9 ] Sand M, Bredenoord AL, Jongsma KR. After the fact-the case of CRISPR babies. Eur J Hum Genet. 2019; 27(11): 1621-1624.
[ 10 ] Neuhaus CP, Caplan AL. Genome editing: Bioethics shows the way. PLoS Biol. 2017 ;15(3) : e200193.
[ 11 ] Doucet H. L'éthique de la recherche. À la source des normes en éthique de la recherche. Presses de l’Université de Montréal ; 2002. p.51-72.
[ 12 ] Plan d’action Recherche clinique du Service de santé des armées 2012-2014. Document technique N°2176/DEF/DCSSA/AST/REC du 29 décembre 2011.
[ 13 ] Verret C, Agher A, Claus JP, Marimoutou C, Ricard D, Thibault F et al. La recherche clinique dans le Service de santé des armées : aspects réglementaires et pragmatiques. Médecine et armées. 2015; 43 (3) :231-240.
[ 14 ] Smith E, Master Z. Ethical practice of research involving humans. In: Reference module in biomedical research, 3rd edition, Oxford Elsiever: 2014, p.1-11.
[ 15 ] Chan S, Harris J.  In support of human enhancement. Studies of Ethics, Law and Technology. 2007, 1 (1). Article 10.
[ 16 ] Scheufele DA, Xenos MA, Howell EL, Rose KM, Brossard D, Hardy BW. US attitudes on human genome editing. Science. 2017; 357(6351): 553-554.
[ 17 ] Annas CL, Annas GJ. Enhancing the fighting force: Medical research on American soldiers. Journal of Contemporary Health, Law and Policy. 2009; 25 (2): 283-308.
[ 18 ] Cribbs AP, Perera SMW. Science and Bioethics of CRISPR-Cas9 Gene Editing: An Analysis Towards Separating Facts and Fiction. Yale J Biol Med. 2017 Dec 19;90(4):625-634
[ 19 ] Amoroso, PJ, and Wenger L. The human volunteer in military biomedical research. In Military medical ethics, edited by T. Beam and L.R. Sparacino. Office of The Surgeon General. Washington; 2003, vol 2. http://hdl.handle.net/10822/1004386.
[ 20 ] Katz RD. Friendly fire: The mandatory military anthrax vaccination program. Duke Law Journal. 2000; 50: 1835–1865.
[ 21 ] Dresser R. First-in-Human trial participants: Not a vulnerable population, but vulnerable nonetheless. Journal of Law, Medicine and Ethics. 2009; 37(1): 38-50.
[ 22 ] Boyce RM. Waiver of consent: The use of pyridostigmine bromide during the Persian Gulf War. Journal of Military Ethics. 2009; 8(1): 1-18.
[ 23 ] Abelson J, Forest PG, Eyles J, Smith P, Martin E, Gauvin FP. Deliberations about deliberative methods: issues in the design and evaluation of public participation processes Social Science et Medicine. 2003; 57: 239–251.
[ 24 ] Comité d’Éthique de la Défense. Ministère des armées. Avis portant sur le soldat augmenté. 4 décembre 2020.
[ 25 ] Brockie A,  Breeze J. Highlights of the edition: the military medical ethics special issue. J R Army Med Corps. 2019; 165(4):217-218.
[ 26 ] Bernthal EMM, Draper HJA, Henning J, Kelly JC. “A band of brothers”: A qualitative study exploring the range medical ethical issues faced by British senior military clinicians on deployment to Afghanistan. J R Army Med Corps. 2017 ;163 :199–205.
[ 27 ] Draper H, Jenkins S. Ethical challenges experienced by UK military medical personnel deployed to Sierra Leone (operation GRITROCK) during the 2014–2015 Ebola outbreak: a qualitative study. BMC Med Ethics. 2017 ;18 :1–13.
[ 28 ] Vollmar C– Military Medicine in War: The Geneva Conventions Today’. In: Beam TE, Sparacino LR, eds. Military medical ethics. Falls Church VA: Office of the Surgeon General, 2003: p.741.
[ 29 ] Kaiser J. Genetic modification could protect soldiers from chemical weapons. Science. 2020. doi:10.1126/science.abb0103.
[ 30 ] Gupta RD, Goldsmith M, Ashani Y, Simo Y, Mullokandov G, Bar H, et al. Directed evolution of hydrolases for prevention of G-type nerve agent intoxication. Nature Chemical Biology. 2011;7 :120-125. www.nature.com/naturechemicalbiology
[ 31 ] Betapudi V, Goswami R, Silayeva L, Doctor DM, Chilukuri N. Gene therapy delivering a paraoxonase 1 variant offers long-term prophylactic protection against nerve agents in mice. Sci. Transl. Med. 2020; 12: 1-13. http://stm.sciencemag.org/content/12/527/eaay0356.
[ 32 ] Martchenko M, Candille SI, Tang H, Cohen SN. Human genetic variation altering anthrax toxi sensitivity. PNAS.2012; 109(8): 2972-2977.
[ 33 ] Arévalo MT, Navarro A, Arico CD, Li J, Alkhatib O, Chen S, Diaz-Arévalo D et al. Targeted silencing of anthrax toxin receptors protects against anthrax toxins. J Biol Chem. 2014; 289 (22): 15730-15738.
[ 34 ] Qi LS., Larson MH, Gilbert LA, Doudna JA, Weissman JS, Arkin AP et al. Repurposing CRISPR as an RNA-guided platform for sequence-specific control of gene expression. Cell. 2013; 152(5): 1173–1183.
[ 35 ] Beecher HK. Ethics and clinical research. N Engl J Med. 1966; 274: 1354-1360.
[ 36 ] Décrets du 16 novembre 2016 et du 9 mai 2017 : Art. L1121-1 du Code de la Santé Publique.
[ 37 ] Article L 4122-1 du Code de la Défense
[ 38 ] Boulliat C, Callu MF, Massoubre B. Le Service de Santé des Armées face aux risques sanitaires majeurs d’origine infectieuse. Une mise en œuvre de l’éthique de responsabilité. Éthique et santé. 2021 ;18 : 11-17.
[ 39 ] Royal B. L’éthique du soldat français. Edition Economica ; 2008.