CRISPR gene editing technology in humans has the potential to cause profound social impacts, such as in the long-term prevention of diseases in humans. However, Hes human experiments raised ethical concerns the effect are unknown on future generations. Ethical concerns have been raised relative to the four ethical criteria of autonomy, justice, beneficence, and non-maleficence, first postulated by Tom Beauchamp and James Childress in Principles of Biomedical Ethics'.
The ethical principle of autonomy requires that individuals have the ability and comprehensive information to make their own decisions based on their values and beliefs.  He violated this by failing to inform patients of potential risks, including off-target mutations that might be a threat to the twins' lives. 
Since He had forged the approval certificate from the hospitals Director of Direct Genomics, the procedure was likely "unlawful", which is against the principle of non-maleficence. Off-target mutations are likely to start at undesired sites, causing cell death or cell transformation. Sonia Ouagrham-Gormley, an associate professor in the Schar School of Policy and Government at George Mason University, and Kathleen Vogel, a professor in the School for the Future of Innovation in Society at Arizona State University, stated that the procedure was "unnecessary" and "risks the safety of the patients". The researchers criticized Hes unethical action by presenting the fact that the prevention of HIV transmission from parents to newborn babies can be safely achieved with existing standard methods, such as sperm washing and caesarian section delivery.
The principle of justice argues that individuals should have the right to receive the same amount of care from medical providers regardless of their social and economic background. Beneficence requires healthcare providers to maximize benefits and put the benefit of the patients first. Hes intervention in the twins genes cannot be justified, and the risk-benefit is unacceptable. He paid the couple $40,000 to ensure that they would keep his operation confidential. This action can be viewed as an inducement and violates China's regulations on the prohibition of genetic manipulation of human gametes, zygotes, and embryos for reproductive purposes; HIV carriers being not allowed to have assisted reproductive technologies, and the manipulation of a human embryo for research being only permitted within 14 days.
Thus, while genome editing in humans has potential as an effective and cost-efficient method for manipulating genes within living cells, it requires more research and transparent procedures to be ethically justified.