Jamie Metzl Hacking Darwin Talks at Google

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Thank. You so much and thank you to all of you for for, coming if you just, open. The newspaper or. Open any news site and. What do we what do you see what do we all see we see Trump we. See the molar report, we, see brexit. When. We look back at today from, ten, years from now 20 years from now 50, years from now and ask, what was the story of this moment, this moment in, our lives this moment in the history of our species it, won't, be Trump, and it. Won't be Muller and it won't be brexit, it'll. Be that after 3.8. Billion years. Of, evolving. By, the set of rules we, call Darwinian. Evolution, of random mutation, and natural selection. This. Was the moment the incredible. Moment where. We took, the reins of, our own evolutionary, process, we took the reins increasingly. Of. Managing. And manipulating. Biology. And. Think about that I mean what, these. Is this is a power, that. For, our whole, recorded. History we. Have ascribed to, the, gods but. Now we are assuming the power of those, gods that we have have, imagined, when. Watson and Crick identified, the double helix structure of DNA the, 1950s. What. They were doing was recognizing. That, there is a book, of life and the book, of life is structured, into. The famous DNA. Double, helix and, when. The human genome project came, to fruition in, 2003. What. Was being identified was, that the book of human, life could be read in the A's and the C's and the T's and the G's and now. With, the advent of our, world of precision, gene, editing we're recognizing that. This book of life can. Be written. So. We're at Google now and we think about what are technologies, that, are readable and writable, and hackable. This. Is the, house that IT, built. But. What if we. Come to see our biology. As being. As readable, and writable, and hackable. As RIT. And, that. Is where, we, are going we. Have this view, which. Doesn't really make sense that, our IT is variable, which is why we, expect, that every new version of our iPhone is going to be better than, the last, but. We also have this strange sense that.

Our Biology. Is fixed, that we, are biologically. Going to be like our parents that. Our kids are biologically. Going to be kind of like us. But. When you take a step back and look at this from a historical, perspective well it doesn't really make sense because somehow, 3.8. Billion years ago we were single-cell, organisms, and then. We got to be what we are now Homo, sapiens, we've only been this for. About three hundred thousand, years, and with. All the, changes, that happen, in evolution of any species it, would be crazy, to imagine that homo sapien was, just the end of this. Evolutionary. Journey so we know that we are on, a path, that we are going to evolve we're not going to stay Homo. Sapiens, forever and yet, it's so hard for us to internalize, that and yet, we are beginning, this. Genetic. Revolution that. Is going to fundamentally, transform, the. Way we think about all of life including. Our own and, it, has will. Have housing. Will have just, tremendous. Upsides. We, are going to be able to fix a lot, of the bugs in. Humanity. And some, of those bugs we call fate right. Now when people die of terrible, genetic. Diseases including, little kids we say god it's terrible, what a terrible, fate what a terrible, tragedy. And right. Now when. Someone an older person gets dementia, or Alzheimer's. We. Have a whole lifetime, of investment, in learning and, in getting wisdom. In. Building, relationships, and it's, just thrown, away it's, this incredible, loss imagine, if people had five more years, of healthy. Life what, a tremendous contribution, that would be not just to them but to all of us how. We would make the world so much better. By, unlocking. These. Secrets. Of our biology. And that's wonderful we have to embrace that and yet. There are some very real dangers. And downsides. Of, taking. This power that. We have as. I said attributed. To the gods having, this ability to, recreate. All, of life comes. With a tremendous. Responsibility. And the challenge, is that this. Future, is arriving. Far sooner, than most, people, most of us myself included fully, understand, or, appreciate, and, we're, not ready and that. Means everyone you and me and everybody, else, we. Need to recognize, that this future is coming and we. Have to prepare not just for ourselves but, because. All of us have a responsibility in. Shaping. This revolution. To, maximize. The, upside and minimize. Whatever. Potential, harms, they. There, may be and, it's. Really, up to us, so. As as, many of you know my, new book hacking Darwin genetic engineering and the future of humanity is out this, week the, reason why I've written the book the reason why I'm here speaking, with you today is I, want everybody. To recognize that, the genetic revolution isn't, some crazy, sci-fi. Future, it's, now and it's here and how it plays out is up, to you and you need to see yourself, as an, essential, hub, in, that process, so. This revolution, is going. To play out and is. Already playing, out in three, major, areas. The. First one is in, our healthcare, we. Have still live in a world of, generalized. Health care based on population, averages, and, that means that. If you go and you're taking most drugs you get a drug that. Is it. Is is given, to you based. On a guess, based, on population, averages let's say you have a cancer for. 88% of people in the United States you get a cancer, drug, and. There's, it's not based on you into your own individual, biology, it's just based on the type of cancer in many cases that you have and let's you can it's. Not just a third a third a third but let's just say it is for now let's, say there's a third of chance. It'll help you a third. Of a chance it'll do nothing and a, third of a chance it'll harm you or kill you and so, if it helps you great you found the right drug on the first try, if.

It Doesn't then, you have. A new drug with the same percentage. Chances, of each outcome and, that's. A crazy way to, do medicine, if we can do better and we can do better and we're starting to do better and that, is leading us into this world of personalized, or precision medicine based. On each person's, individualize. Biology. And. What. That means is that when, you go to your, doctor, you, will get for, example drugs, prescribed, based, not just on population, averages, but, based on your personal. Biology. Understood. Through, genome sequencing, and biometrics. And other things when, you have cancer there's right, now there's a revolution. And how cancers, are being treated you, will be treated based on the sequencing. Of your. Cancer, cells and your can your cancer tumors to get treatments, based on you when. You think of all kinds of treatments where there's an N of thousands. Right. Now there, are new there are new treatments called gene therapies, where you, have like you can call it cancer your cells are taken out they. Are manipulated. To give you to boost your natural. Cancer. Fighting capabilities, and those cells are put back into your body, those stem cells and then they proliferate and can, be used to fight cancer. And so. In all of these it's, an N of one and that n is view. And what. That means though is that to gain access to the world of precision, medicine. Everyone. Is going to need to have their, genome, sequenced and we're going to need to have uniform. Health and other and other life records and what. Does that mean well it means that right now we, are in may. Be at low millions if people have had, their whole genome sequenced, we. Are moving into a world we'll be millions, tens of millions hundreds. Of millions and, in. Very short order billions. Of people will, have had their, genome. Sequence estimated, that two billion people will have their whole genome sequence within a decade so, what does that mean now you've got a billion, people with, sequenced there are two billion people with sequence genomes and, you have access, to these roughly, or uniform, enough electronic, health and life records and then. Humans. Become. A big data analytics problem. We're here at Google and you guys understand, big data analytics. 100. Years ago 200 years ago people thought there was this magic, in inexplicable. Magic, in, humans, but, I think many of us would recognize that humans, are just.

Just. Single-cell. Organisms, gone wild, over, billion years of evolution. And just as we can understand pretty well how single-cell. Organisms, function with, the tools we have today with the tools that people, like you are developing, we. Are going to have the, ability to understand, much, more not, just of our genomics, but, of the complex systems, of our, of, our biology and part, of them the easy graph for that is the. Complexity, of our biology has remained constant for, millions, of years but, the sophistication, of our tools is, on is on an exponential J. Curve so. Now we're, going to be able we are increasingly, being. Able to understand, not just the simple, genetics, because we have a number of diseases, disorder, and traits that, are single, gene mutation. Meaning. Well it's like an on/off switch whether, it's tay-sachs. Or, sickle-cell disease or, Huntington's disease that so-called Mendelian, disease or genetically. Relatively. Simple traits like hair color and. Eye color but we're moving into a world where we are going to use something called polygenic. Scoring to, be able to make predictions, of complex. Diseases. Disorders. And traits, and that's going to move healthcare, from. This world of precision. Very. Quickly, into. A world of prediction. And so. You, are going to have information. Your. Parents will have information from, a few, days after, your. Egg. Fertilized, or. The. People, will have information about their children from, the moment, of birth and that, is going to include information about the percentage. Greater than average risk of having, some bad things happen or, the, percentage, greater than average probability. Or possibility of. Having great things happen like having. Super, capabilities. When whether it's health or or. Anything, else and so, the second change that that's going to push is it, change where. Genomics, which right now we think of in the context, of health care is, going to move way way way beyond healthcare because our, genome, isn't just about healthcare. We don't have a healthcare genome, we have a human, genome. And that, human. Genome, tells. Us about who we are in, every, way you look around the room I don't see a bunch of health care I see a bunch of people who. Have a different. Genetic foundation. That's why you look different that's why you are different, yes environment. Is still matters, now, but we are primarily. Genetic. Beings, and we're going to understand, a lot, more of the, underlying, genetics. Of what, it means to be human so right now I'm, sure many of you have done your. Mouth swabs through companies like like, 23andme, and you, get information back, and certainly about, your carrier status which is about these on-off switch single. Gene mutation, disorders that's actually, relevant, there's, some fun stuff like, like. Your, ancestry. I'm actually, 0.01%. Yeah coot and shout out to ne-yo coots in the house I, guess. There aren't any yeah. But. In the future you. Parents, and people. Are going to have a lot of information about. All sorts of traits like, I have a greater than average. Possibility. Of being, really, excellent, at abstract. Math or. Sprinting. Or having. An outgoing personality. Anything. That, is that has a yeah. That is partly. Genetic. We're going to, be able to increasingly. Predict, the, genetic component, healthcare. Non. Healthcare. Everything. That has a genetic. Foundation, that means that the jannat tonight excuse, me the genetics and genomics revolution is, moving way way way beyond. Healthcare. But. The third application the, killer application is, in. Reproduction. Right. Now most. People this is like a test right, now most. People on earth. Create, babies through. Sex. Good. This. Is why Google has such, a high market cap on smart, people like it right through sex and sex.

Has Really, worked well for our, species for. Hundreds. Of millions, of, years it's how we. Got here but, there's, a risk that's, woven into, sex and that. Risk is that about three percent of all, children are, born with some kind of harmful. Genetic. Abnormality. And we. Are going to be able to, reduce. That risk very, significantly. Provided. That we. Don't conceive, our babies, through sex because. The the way to do, this will. Be to use IVF, which is a technology that's been around for more than 40. Years and. Screen, embryos, using a process called pre-implantation. Genetic. Testing, has been around for more than 30, years, and right, now this is used to. Screen for these these, simple genetic. Diseases. And disorders and chromosomal. Abnormalities. But. As we develop, this greater knowledge of, genomics. And, in, in very short order we are going to be able to use this kind of screening with a lot of knowledge about very. Human, traits. Height. IQ. Personality. Style so. Many other things that, have, a genetic. Component as, I said life has a genetic, genetic. Component. And then, beyond that we, are going to use stem, cell technology the 2012, Nobel. Prize was, given to Shinya Yamanaka who, developed a process for, creating what, are called induced pluripotent stem, cells iPS cells and, what IPS cells. Our is, that, it that process allows us to take adult cells and induce, them into stem cells and then those stem cells can. Be turned in this case into, egg precursor, cells and egg. Precursor, cells into eggs and. So. Now with the average woman undergoing IVF has, about 15 eggs extracted, now using, IPS cells we. Are going to be able to have thousands. Tens of thousands hundreds of thousands millions, so. Let's call it ten thousand, because, if you're using let's say a skin graft there's millions of skin cells in a skin graft average, male ejaculation, I. Don't know if this is the way you guys talk it at Google but, average male, ejaculation has. About a billion sperm, cells so that's readily. Available. Fertilized. 10,000. Eggs grow. Them all for about five days extract. A few cells from, each, sequenced. Them and the cost of genome sequencing has, gone down from. About a billion, dollars in 2003, to about eight hundred dollars today to, really negligible 'ti in, under, a decade so. Sequence. 10,000. Of these, of, these. Early-stage pre, implanted, embryos, and then. You, have to pick the. Valve that what you're looking for I mean some of you may have seen my, editorial, and in the New York Times last, week about this but in, that editorial I was in imagine what will it be like to go to a fertility clinic in 2045. And basically. What, you're going to need to do is say here are my priorities, so certainly, health, will. Be at the top of everybody's priority list I want to have a kid who's, going, to be healthy who's not going to for example die of some terrible genetic, disease, but. When you when, it will be an option to choose healthy, lifespan. To say that we know that there are genetic patterns, that allow what it allow or create the increase. The odds that somebody could live a longer, and healthier life. Than they then many, of the other embryos, that would be the options might, people. Will want that and, when. They, right now you. Can say we can make a pretty good guess of your 15, fertilized, egg we can probably, rank. Them pretty well from. Tallest, potentially. To shortest, provided, they get the necessary inputs. Like healthy, food. But. In 10 years and 20 years I think it's quite likely we're, going to be able to say we can make a pretty, rough.

But Informed, guess, ranking. Your pre implanted, embryos based. On which, is likely, to have the, highest to lowest genetic. Component. Of IQ and that's. A very, very different way of thinking about making babies than what we've done in the, past and then, beyond that there. Is technology, of gene. Editing many. Of you have heard of CRISPR, many. Of you know. What happened in China last year where it was announced in, in. November, that, two Chinese twins had, been born the month before in October, whose, genes. Because. Genomes, had been edited, by, an extremely. Unethical. Chinese. Biophysicist, not a biologist, not a physician at biophysicist. But, we are in the era of precision gene, editing and even. Had this not happened last. Year it. Would have happened next, year or the year after have been done much more responsibly. In a much more transparent way and it, would have been done to, address an actual. Threat to. These future, children not to attempt. And it looks like it was a failed attempt to confer, an enhancement. Or an. Advantage, but. We are moving toward, the. Era of precision. Gene, editing of pre implanted embryos I don't think we're going to do I'm speaking, on a panel at Harvard later tonight with with, George Church and. George, is leading, a process, for, making multiple, genetic, changes simultaneously. And that can work well in plants it probably can be can work well in animals, but. In humans I think that's going to be risky for a very long time but we will absolutely be. Able to make a small number of genetic changes either to. Reduce or eliminate risks. And/or. To. Confer, benefits and. That's. Where that's where we are going and the science is advancing. Extremely. Extremely. Rapidly. And. It's. Expanding. In a context, in a context, of. Humanity, of our humanity, and our, world and it's, a world where people, are different communities, are different and countries. Are different so, within any country certainly within this, country of the United States there are going to be people and many, of you know them um who, are these. Transhumanists. Biohackers. Who say this is great no-holds-barred. Let's. Race into this transhumanist. Future and there, others who are going to say this, is really scary, we're, quote-unquote playing God we, can't do it and, there. Will be differences, and people. Are going to try to do whatever, is in. Line with, their, value. System and the, same thing is going to happen on an international, level there may be entire, countries, this may be one of them that. Decide to, entirely, opt out just. To say this is really scary. We. Don't know enough to start making these kinds of changes there.

Are Certainly. Going to be unintended, consequences. Better. We not do it at all better we forego, potential, benefits. Because. We think the risk is too high and that's a legitimate choice that some countries, will make and there. Will be other countries, they will say hey we recognize, that using, this technology we. Can dramatically. Reduce potentially. Health care costs. We. Can confer, all kinds, of advantages, whether, on an individual, or a population, level and that's. Going to be appealing to some countries and, this. Process is going to be pushed forward in a very significant. Way, because. We live in a competitive world people. Are competing with each other and countries. Are competing with each other I have a, good, friend in Korea who. Has 12 tutors, coming. Every, week for his 11, year old daughter coming, to the coming to the house in Korea they, have a, law now that national. Cram schools have, to close at 10:00 p.m. because people were having their 7 and 8 year old kids staying, out until after, midnight every. Night 7, days a week prepping, for exams that, they were going to take 10. Years into. The future and, when. I asked my friend I said hey if you could select, among your, natural. Rolle pre implanted embryos to, try to pick the one that was going to have a competitive, advantage by. Potentially. Having a higher at least genetic component, of IQ than the others, he. Looked at me like I was insane he's like like it was like is that even a choice and when, I said of the people you know who are competing for access. To these universities. If, they had a choice what would they do and it just honestly, he looked at me like. They used to say like I was from Mars now being from Mars is like normal. Like from Pluto. And. That's. That's, where where we are heading there are all of these kinds, of competitive. Pressures and. Because. This science. Is moving so quickly because, there are all these forces propelling, it forward now. Is the time where. We need to say hey what. Are the values, that, we need to apply to. Make sure that. This great. Hope. This, great dream, doesn't. Become a nightmare and there's a lot of real things to, be worried, about certainly. What we're talking about are incredibly. Complex, systems, the the genome is complex enough but.

The Genome is embedded, within the the multi-omics, system, biology, of what. Makes us human which. Is dynamic. And interactive and, then, our entire biology. Is constantly, interaction. Interacting. With. The environment around. Us, so nothing is static you could understand a it, would be very difficult if you understand understood, a perfect, human, perfectly, in one moment the, next moment, everything would, change and you would need to understand, the. Human perfectly, in that next moment, to maintain, your. Level, of comprehension. So we, need to be cautious about, meddling. With systems that we don't fully understand, and, equity. Issues right now if, this technology, is as powerful as I, believe it will be, we. Have if. What happens, if people, some communities. And groups and even countries have a lot more access than. Others, we need inequality, there have to be first mover's with any technology, and that will have to be the case here but. We've also seen what, happens, when, there. Our two great of divisions. It can be very disruptive it can be disruptive. Internally. Within a country it can be disruptive. Internationally. Because there are all these kinds of of, differences, as I as, I said so. We really, need to be mindful of the equity issues diversity, come. To I look around a room like this you, say well it's great, that we have this diversity, and I'm sure that, having diversity makes Google, a stronger. Company but, that's not what diversity yes I mean it's it's a one manifestation of, it diversity. At in its essence, is our, sole survival. Strategy, as a. Species, if we didn't have diversity, you. Could say we'd still be single-cell, organisms, but, we wouldn't even be that because, what we call diversity, Darwin, called random mutation, and if. You didn't if we were all exactly, the same the. Environment, wouldn't have sustained, this. Exact same single-cell, organism, for four billion years we wouldn't even be here and, so, we think about making changes that even make a lot of sense to us like for, example, eliminating. Disease risk even of these relatively, simple Mendelian, disorders. We. Think we're doing something good, because it's scary to be a carrier, of some, kind, of potentially, deadly disease but. If you use the case the, classic case of sickle-cell disease it's, terrible to have sickle cell disease and you will in, most cases die, very young but. If you are a carrier, of sickle cell disease, you, actually have, increased resistance to malaria, so. We could eliminate, some, kind of thing that we think is terrible, but, it could have some kind of benefit, that we don't know because it hasn't been tested in the world that we have known to date but maybe that will be tested in the future so we really need to be mindful. Of our diversity and the, challenge, is, that this technology, is moving extremely, rapidly. And we're. Going to have to make very big. Decisions, before. We fully understand, the consequences, of the, decisions, we will make and that. Is a really. Big challenge and it's a really, big, responsibility. And the good news for us though is. That, while, the technology, is new the. Values, that, we're going to need to bring to bear to, use it wisely or in, many cases very gold we are really, going. To have to ask ourselves who, are we what. Are our values, how. Do we apply those, values, in, making, the huge. Decisions. That. We are going to have to make over the coming years. Because. The, genetics, revolution, is not just, coming. The. Genetics, revolution. Is here, it's here it's here now it's. Happening, it's changing. The world around us but. That speed, of change is, only going. To pick up and it's, going to touch us in very, very, intimate. Ways. And, the, difference between, having this play out in a way that does as much as possible, to. Help us and bring us together and, having. A play out in a way that could harm us in, many ways in in, unnecessary. Unnecessary reasons. Because we haven't done a Nuka good enough job of applying our values the difference between those outcomes. Is. Us, and. So the reason why I've written this book is I, feel, that this revolution. Is so important, we, can't leave it to the experts the scientists, are actually doing a very good job of meeting. And. Participating. In many of those conversations but. This isn't an issue just for the scientists this is about our future it's. Really, up to all. Of us so on an individual, level what, are our responsibilities. One, needs to be informed. And everybody. Needs to recognize that, if there is going to be a bottom-up, push, to. Encourage our. Representatives. And others to really address. These issues, in a way they, can optimize the good stuff and minimize the harm we're, all going to have to be part of that so I really want everybody here, to, feel that, you are now informed.

And That, you can be a hub in this kind of conversation. But, then on a national, level we. Really need to make sure that, our all, of our countries have. The. Regulatory, infrastructures. That can managed these kinds of issues the. United Kingdom in my mind is the, the, gold. Standard, for what, a well regulated country. On this set of issues looks. Like and the. U.s. is somewhere in the middle of FDA is actually, a very effective. Agency. And does a pretty good job of weighing. Risks, and benefits of, various, interventions. But. There are parts of the world that are either under. Regulated. Or have, good, rules that aren't well enforced. In China is certainly an example. Of, that and then, there are places which are regulatory black holes where, there's really nothing, and that. Can't be because if we have the kind of, tourism. Medical, tourism that we've had very dangerously, and, for stem-cell treatments. For. This it could have very very. Significant. Consequences. It could actually and. On, an international. Level so, you, know on a national, level every, country needs to, have a regulatory. System it. Doesn't need to be the same it needs to be, based on best practices, it needs to be based on each country's and traditions. Values. And ethics and culture but every country needs, needs. Something. And, then, on, an international. Level we really need to begin a, process of. Coming. Together to, develop global, rules I'm on the World Health Organization, International Advisory, Committee. On the, future of human genome, editing and, we're. Trying to think about what might an international. System look like but we are a long, way we collectively, are a long way from there and so. What we need to do is have what. I'm calling a species, wide dialogue, on the future of human, genetic, engineering everybody. Needs to be part, of that as America I've set up my website, as a very humble first step hacking Darwin comm where. People can go and share, and share views but. Then what, we need to do is to, make sure that those conversations on an individual, level on, a group level can. Feed up through governments. One of the reasons that my. Publisher, and I are making this book hacking Darwin avail for free to, any Member of Parliament of, any country, in the world is we, think it's so important. On that we have these conversations on, the individual, in the communal and on, the national level but, we have to do is work. To make sure that we these conversations. Lead. To norms. Which. Lead to standards, which lead to regulations, which. Lead to laws, because. What we are talking about here, is the future, of life, and it. Must be regulated, but, it must be regulated. Well, and. Because. We are at this incredible. Inflection, moment at the beginning of this, revolution. That's going to change our lives, because. The difference between the, greatest. Upside and the, most frightening downside. Is us. We. All need to feel empowered. We all need to recognize, that we, are the. Shapers, of this, future in. Which, we and our children will, live and I. Welcome, you to join, me on this journey so thank. You. Do. You think this, system. Of whatever-whatever. Mechanism. Is the thing that is actually allowing us to choose like, IQ. Penetrates. What have you do. You think it's even possible to exist in order, to have that exist ethically in a. Market economy or ad market system it's. A great question um, I, don't. Know the answer but. I do know, that people are going to be making these choices, I do, know, that we aren't going to want people to choose, anything. And there will have to be some kind of restrictions. And that, doesn't mean that we don't that mean there will be all kinds of very. Sensitive issues, that we raise on issues like skin. Color. But. Also there will be people and there already are people who are saying for. Example deaf. Parents, who, want to have a deaf, child and. That, this is already happening in the United States where this is legal who. Are choosing, embryos, to. Guarantee, that those, children will, be deaf is that something, we're going to be comfortable. With when. It's a choice. Will. We be comfortable, with parents choosing, to implant embryos, that will have. Genetic. Disorders. Or diseases that will kill, those kids in at an early age I think we're going to be uncomfortable with that there. Will be all kinds of other options, and just as you mentioned in your question IQ. Height. And I. Think that that, those people. Are going to want to make those choices, and then. The question is where does ethics come from does ethics come from law or. Does ethics come from, culture, and I think that, in different societies different. Sides will have different answers to that question in, the places where it comes from law there will be restrictions.

This May be one of those places there. Will be other places where it will come from culture, and then there will may, well be places. Like black holes or people go to do, whatever they want I was. Actually questioning, I mean do you think the system at all could exist like not even just like the the mechanism by which we edit. Genes but the system's, themselves could exist on a by nation, basis. Because if, you think is there something like IQ or. Like. Trending. Towards like a certain trait fast running our bio certain, pattern recognition what happened do. You think I mean at that point we would have to have some sort of an international regulation, on discrimination. Based on those things because if someone who writing is quote-unquote. Selected, genetically by their parents to run quit ready or to jam something like that if they were to go get a job at something that wasn't what they were effectively, built for right would. We, is it, wrong, to say like no I mean in my case like if, I listen to what my parents did I wouldn't be here right now like. Yeah be I don't know doctor or somewhere, but like I know, I'm not sure if it's fully ethical or you know in any way possible for that to exist ethically yeah yeah I think it's a very legitimate view and there are many others who believe that and who, will believe that and as I mentioned when I was talking about the, diversity there will be others who believe differently. And that's, and, in, an ideal world and I'd love to live in that world and I'm doing my best with the World Health Organization, to try to do a little bit toward building, it we would have some, international, standards, about what, happens and what doesn't, happen I'd at peace come out in courts, yesterday, about how I think that this this issue could. Lead to international, conflict, because a society. That opted out for the exactly the kinds of ethical reasons. That you described what are they going to do with another country opt in are they going to make it illegal for their, people to procreate with people from that other country are they going to do, do, genetic, testing of, every every woman, who may be pregnant who's who's coming, in and maybe these issues are really tough there's, no easy answer but, ethics, are at the core of everything, and either we're going to find a way that's.

Better Than what we have now to apply, ethics, or, this, could get very ugly no, certainly I mean even in just in the in the case that you mentioned the most the most the most upcoming. Or the most quickly upcoming, which is the sequencing of genomes to predict medical. Right, maladies, as you go through your life I mean, if you consider that in like America, alone. That's, forget. Pre-existing conditions you don't have to show up or you get us in condition to know yeah well everybody, has a pre-existing yeah, just for something once we look under the hood no of course of course but now it's not that it's, not that we require a look under hood to see that we don't actually have to present that previous and continue anymore an insurance company can just know oh we have access to your genetic information and, we can charge you a shitload more yeah and so yes so so right now we have the genetic information non-discrimination Act, Jeana which, makes it illegal for insurance companies, to discriminate, against you based on your genetic information but, it's still legal for life insurance companies, to, do so so there's what they really give it a chance for other people to ask questions but but. There are that's. These are the issues and they're not easy and the, point is we have to stare aren't answers I think your question is a great we have to be struggling with them now but. We're spending so, much of our time focusing, on these issues, that are less important, and this, is something where everybody needs to be involving our leaders that Tibbie involved because the exact issues, that you described are the ones we need to be wrestling with so. I believe. This is coming and humans, have a hard time putting gd's back in bottles so the, first people to do this will probably be rich yes. And, we're talking about something, that can give crazy. Advantages. To. Initial. Entrance yes, and it. Will like, we could I was listening to an NPR article and they were saying we could have a two. Different species the, rich, person species, and the poor person's, boy, and the morlocks yeah. And. So what. Is the world health organization doing. About this or thinking about this yeah I'm. Working with the World Health Organization, the answer is, something. But, nobody is doing enough I mean this is such an important, issue, and, it's, just being massively. Under, addressed so there will be first. Adopters, of this technology like every. Technology but. We've seen what happens when there are first adopters, of the machine, gun it's, you can really skew, the way the, world looks and on one hand there, will be some, democratic pressures, just. In the sense that there will be huge, savings. To at least rational, healthcare systems, that. These technologies, can, can bring and you. Know from a theoretical, perspective in a country like the UK where. They give you have a National Health System and a rational regulator. You can think about well if we're, going to eliminate. Lots of genetic diseases, that, cost hundreds. Of billions. Of pounds per year or more to treat and we, distribute, that benefit, across the population, by providing free, IVF, and embryo screening, to every everybody who wants to have a baby that is a rational thing.

But Even in that system there are going to be people because we are humans and humans are crazy who. Want more, and. So. I think it's just again, it's a very very, real issue but. I will say about these equity, issues, which are so serious in the future that, if we care if those are our values that we don't want to live in a world that's, as that's, divided, genetically, in the future the, best way to fix, that is to look at our values now if we're perfectly, comfortable having. Average, kid born in the Central African Republic being, born with brain damage because, his mother is malnourished and, so that kid's brain, will not function as well as our kids brains. Will, function even, though it's not based. On on genomics. If. We're comfortable, with that world and that world is OK for us how. Can we expect that there's going to be a different, us in the future but. If we say our values, are to live our, principles. Of equity, today when, we get to the future we'll, know who we are and we'll be able to apply those values yeah, I just, want to start by saying this conversation. Made me super uncomfortable but, that's exciting because I like when things sort of disrupt my expectations, of what's gonna come I sort of live for those moments I live for that moment where you walk into the water and you take a couple extra steps floating. So, what, I think is kind of interesting is you're, sort of talking about this continuum of stuff yeah like you've got your genome and if we can sort of edit it to make you more healthy to live longer that's one definition that's a belief system for, saying like that's a better life right I think. When you talk about making someone more intelligent, or making. Someone run faster it's pretty clear that's as a pearl that if you're making them better but, what about the lens of not, the IQ, but the EQ what about the emotional quotient what about the space of creativity the, space of cultural norms the fact that forgetting, things means that things you remember or meaningful. And certainly, this is less of a technology-driven question, more, of a question about like what makes us human yeah and I guess just sort of at a high level I'm curious, how does that work its way into your thoughts as, you start to extend beyond medicine yeah it's such, an essential question. Because if if we, any of us think of this as a, conversation. About science. We've, missed the whole point this. Is a conversation about. Humanities. Values. And ethics and it's, set in, the, context. Of a, revolutionary, technology, and and revolutionary, science, so we have. To be focusing, on those things but. The challenge, for us is. The, diversity, for the last almost four billion years has just been something that happens, to us like, we didn't say like, I didn't say oh I want to be born, looking like whatever, I look like or having, whatever genetic, inheritance. That, I have, my parents didn't say that other than in the process, of meeting each other but. Now these, things that have just happened are going to increasingly, become, choices. And that's, essentially, the point that I was making when I talked about diversity. That. We are going to have to articulate something that just happened to us and if we think that, the only way, not, to have value, in this world is to have 15, or 20 or 50 higher. Points. On an IQ test we. Are going to destroy, our, humanity. And not only that we're going to become less good. At a lot of things that we collectively, do, and so. I'm not saying that everybody I said what I am saying is if everybody starts making the same choices based on our cultural biases, of things, that seem perfectly.

Good And we, don't have a conversation, about, diversity, which, is essentially, the core point of what you're making and how we value it and how, we're going to realize, that in, a world where biology. Is manipulable. And a choice we. Are going to, drive. Ourselves into. Potentially. Even an evolutionary, cul-de-sac, and, the drivers won't be. Authoritarian. Governments, the. Drivers, will be the, most well-meaning. Parents, who, are trying to give advantages. For their kids in, the world as they see it and so, I totally. Agree with the premise, of your question and, I'm. Sorry that had the same answer to every question but that's. Why we, have a little bit of a head start now that. If we, imagine. If we could have had an, open. Conversation at, the beginning, of the Industrial, Revolution. Or, at the beginning of the nuclear revolution, about well we know this stuff is coming what. Are the values that we want to weave into to everything, and we, have a little, window before everybody, retreats, to their barricades, and that will happen it will happen soon so this is that window and one one. Of the reasons why I like speaking with groups, like you is that I feel like this is this. Is a conversation, that, we're all part of and we all need to be hubs in that in that conversation. Yeah. Do. You see, abortion. Laws today, that we have in this country and let's. Say let. Me put it out in the world as, any, indicator, of how. The. World Health Organization, ends, are being laid out because, I feel like. Like. You aptly mentioned that there's always gonna be two sides yeah, and, how, do you how, do you see yeah, other, plane yeah sure, is if your worst being yeah implied into that so, the the debates that we've had over issues like abortion and, genetically modified crops are highly, relevant to where, we. May be going and they're, also a warning, that. With. Abortion, in the abortion debate there. Are people on on the, various, size who, have staked out, extremely. Rigid. Positions. And here in the United States the, politics, of abortion, makes, it much more difficult to have these, kinds of conversations on, a national, level than is the case in in other places and again the United Kingdom is a good a good, example of that but. When we look at abortion you have to ask yourself if you believe that, life begins at conception why. Is it that we have picketers and protesters, in front of clinics, where abortions, are taking place but, we don't have them in front of fertility, clinics, because if life begins at conception the. The place where abortions, are happening that's, retail, but the fertility clinics that's wholesaling.

If You think that's murder that's where it's happening but why aren't the picketers, there, and the reason is because this technology has normalized, and people in those communities, they, see these, parents, who, have benefited. From the miracle of life, who, otherwise wouldn't, have, they they, don't like to admit it but they recognize, that there, is a cost and a benefit and genetically. Modified crops are another example. Where. The scientists, actually did a pretty good job of, setting, ground rules and, behaving responsibly since. The 1970s. But. The, public didn't feel the, general public on average didn't feel that they were part of that process and so now you. Have pretty. Much all of the science, Nobel Prize winners, alive, who, are repeatedly. Saying GMOs. Are safe for human consumption which they are and, yet people have this gut, feeling particularly. But not exclusively in. Europe that, there's something wrong with, GMOs. Because it's not natural. And now. Millions. Of people need, to be harmed, in Africa, and South Asia because, they can't grow GMO, crops because if they do they won't be able to export to Europe and agriculture. Is their is their main industry. So, I, keep, coming back and saying boys so if we want to have, a, meaningful. Conversation, that, can guide, us and lead us toward. Optimizing, the benefits of this incredibly, powerful and in many ways wonderful, technology, we, all need to engage we, need to see ourselves as shapers, of this. Information, and ultimately regulatory. Environment, yes I was. Very happy to hear the, piece about skin cells, entered, me I would turn those battered eggs because, the undertone, of a lot of this is. Medicalization. And control for how women reproduce. Not. As a, goal or as a consequence, and it ties back to. The. Comments, about why, don't people pick it IVF. Clinics, has, a lot more to do with control. I mean one, can always argue about that but. And then you take this also you tie it to what we already see happening, across, Asia in terms of, sex discrimination. Abortion. Which is warping the population, right, we already have experience that, this is done poorly and so. One of my concerns as you, go in the world working. On this is that, they're actually women and there's work going on on the. Reproduction. Side you said toss IVF off oh yes this is here standardized, and we have a lot more multiple, births which, are hugely well, that's going down yeah yes but, they're riskier, yeah the chance of it the medicalization I mean it this all has huge, implications we, talked about wouldn't. It be lovely if your kids are smarter you, know I have three smart kids and asynchronous. Development there's all of these societal. Implications, that, are embedded in the culture assumptions oh oh this must be great but getting there, yeah, is I. Totally. Agree on that, there are huge, issues of women's health reproductive. Health and, we. Are moving into, a new world, of biology. And how biology, works so, I've talked about how, how, egg cells, will, be created, from adult cells. We. Already, have in the last year, two, male mice have, had their own 100%, related. Biological, child two. Female, mice have. Had their own 100%, related. Biological. Child we, are moving into a world where. Biology. Is, fundamentally. Different. Than what, we have known and the, limits, the possibilities, that that. Will bring are in many ways beyond. Most, of our imagination. Thank you so much it's really been a pleasure. You.

2019-06-03

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