[gravelc]

I agree - we're a long long way off being able to accurately predict the impacts of genetic changes, particularly given effects like pleiotrophy.

We still don't even really understand why a tiny worm with around 1000 cells (C. elegans) has roughly the same number of genes as a human being. Sure, at the cellular level, the complexity of the two organisms is much the same, but at the macro level, it's not even close. Obviously all the information to build the organism is in the germ cells, but discrete genes are just a part of the equation.

In my opinion, as someone why tries to work this stuff out for a living, we are many years away from grasping how it all fits together. Until then, I'd be wary of modifying myself except in the most dire of circumstances.

[cixin]

We don't really understand how most of the treatments we have work. We have data, we have in many cases some ideas, but we don't know.

Take Psoriasis as an example, doctors are still prescribing coal tar based treatments. I guess they are ~100 years old. They don't work very well, and people don't really know why they should work at all.

Pretty much all Psoriasis treatments are like this, even the more recent ones. They interfere with some pathway related to the immune system... but we don't really understand why they work.

So we don't really understand "how it all fits together" for current treatments. It's still reasonable to use them if they are relatively safe, and work. Same is true of gene therapies.

Mostly we figure out that things work/are safe through experimentation. Not through totally understanding the system.