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Speaker 1: Pushkin from Pushkin Industries. This is deep background the show

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Speaker 1: where we explored the stories behind the stories in the news.

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Speaker 1: I'm Noah Feldman. Welcome to this week's program, where we're

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Speaker 1: going to talk about gene editing, designer babies, and the

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Speaker 1: future of science. These are all topics of importance all

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Speaker 1: the time, but they've become more pressing since the announcement

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Speaker 1: that a Chinese scientist had actually used Crisper Cast nine,

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Speaker 1: the leading cutting edge editing technology, to edit the genomes

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Speaker 1: of two embryos to assure that they would not be

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Speaker 1: able to be susceptible to the HIV virus. This was

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Speaker 1: good for the embryos, but it wasn't necessary scientifically, and

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Speaker 1: it's led to lots of intense discussion about whether the

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Speaker 1: era of designer babies was too close and needed to

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Speaker 1: be headed off by regulation. To discuss these and closely

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Speaker 1: related issues were super fortunate to have with us George Church.

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Speaker 1: George is the Robert Winthrop Professor of Genetics at Harvard

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Speaker 1: Medical School. He also teaches at MIT. He's been a

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Speaker 1: central actor in the development of the technologies of gene

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Speaker 1: editing and in applying them to the creation of new genomes.

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Speaker 1: He sometimes, in fact calls himself a genome engineer. George,

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Speaker 1: thank you so much for joining us. It's a great

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Speaker 1: pleasure to be here. Noah, let's just start with the

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Speaker 1: headline in order to make sense of what it really

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Speaker 1: means and whether there are dangerous associated with it of

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Speaker 1: the kind that many imagine. We read in the paper

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Speaker 1: that Jan Qui, a Chinese scientist, says, or has it

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Speaker 1: said about him, that he used Crisper cast nine to

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Speaker 1: engineer the DNA of a couple of babies, and that

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Speaker 1: they were then subsequently carried to term. That's what appears

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Speaker 1: to be new here, and he's been The Chinese government's

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Speaker 1: not very happy with him, and he has been under

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Speaker 1: house arrest and radio silence more or less since. From

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Speaker 1: the standpoint of the state of crisper technology, was there

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Speaker 1: anything remarkable about the accomplishment, assuming it was accomplished, or

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Speaker 1: is it relatively a trivial step compared to the scientific

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Speaker 1: advances that had already been in place? Yeah, I would

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Speaker 1: think similar things had been done by other groups, including

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Speaker 1: groups in the United States and Oregon on human embryos,

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Speaker 1: and even more amazing things had been done on other

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Speaker 1: mammalian embryos, including altering dozens of genes. So is here

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Speaker 1: the claim was only the altering of onengenee. You know,

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Speaker 1: there's some interesting questions about choice of genes. You know,

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Speaker 1: one of the things that's challenging in this field is

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Speaker 1: picking a gene that even a few other people would

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Speaker 1: agree is a good choice of gene, because you know,

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Speaker 1: a fair number of genes could be fixed by other methods,

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Speaker 1: Like you have to be in in vitro fertilization or

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Speaker 1: IVS clinic to do this at all, and if you're

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Speaker 1: in that clinic, you could fix it by just IVF

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Speaker 1: prenatal genetic testing EGT. So when it goes to question

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Speaker 1: of choosing the target of the intervention, what are the

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Speaker 1: right criteria or what do you see as the main

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Speaker 1: criteria people would consider. I mean, you've mentioned now one

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Speaker 1: could you get there by some other means? Could you

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Speaker 1: get there without without changing the germ line? But what

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Speaker 1: are other criteria that you think would be relevant here?

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Speaker 1: So in addition to could you get thereout altering the

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Speaker 1: germ line, there's also the criteria of is it a

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Speaker 1: net positive for that person or in a public health

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Speaker 1: sinse on average on that positive and environmentally dependent. So

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Speaker 1: if you're in an environment where everybody gets HIV and

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Speaker 1: dies young, and that's a very different environment than or

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Speaker 1: nobody gets HIV and China is not ground zero for

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Speaker 1: the highest level of HIV in the world, who is

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Speaker 1: highly stigmatized there, but you know places in Africa have

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Speaker 1: higher incidence of it and it would be better candidates.

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Speaker 1: Another one is, you know, is costs is a consideration

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Speaker 1: if you want something that's going to be of true

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Speaker 1: public health benefit for a disease like this impacts a

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Speaker 1: lot of impoverished individuals because you have the alternative is

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Speaker 1: drugs or safe sex. There there are a few alternatives,

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Speaker 1: none of what you're working perfectly worldwide because a million

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Speaker 1: people die for years, it's about two percent of all

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Speaker 1: human deaths. So to claim that this is a solved

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Speaker 1: problem is just as Naives saying that this is the

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Speaker 1: only way to solve the problem. Right, it's not a

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Speaker 1: self problem in real world descriptive terms, even though in

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Speaker 1: principle it could be solvable. So what about the criterion

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Speaker 1: that asks whether something is presently an immediate threat to

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Speaker 1: either the embryo or the local population as opposed to

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Speaker 1: offering some background improvement for the potential person who might

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Speaker 1: come to be created, or for the environment more generally,

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Speaker 1: does that seem like a meaningful difference to you? And

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Speaker 1: I just to show that I'm why I'm asking that question.

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Speaker 1: It goes to the broader societal fear about what are

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Speaker 1: sometimes called designer babies, you know, babies who are who

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Speaker 1: might have their genomes edited to give them some advantage,

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Speaker 1: which could be a health advantage to begin with, but

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Speaker 1: could also be other kinds of advantages, whether in esthetics

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Speaker 1: or intelligence, or athletics or what have you. I think

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Speaker 1: this is something that is very interesting entanglement of concerns.

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Speaker 1: So the concerns are that we will create a monoculture

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Speaker 1: number one, where everyone is the same, the way that

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Speaker 1: you might have a you know, many square kilometers of

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Speaker 1: identical crops. The second is that it will be inequably distributed,

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Speaker 1: in no words, that some people have some people don't.

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Speaker 1: That's a very different concern than you don't want anybody

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Speaker 1: to have it, as you want everybody to have it, okay,

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Speaker 1: you know. A third one is you could make a

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Speaker 1: mistake that it could be a very popular fad, but

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Speaker 1: it was a mistake that has long term consequences, either

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Speaker 1: for the people who had it or the people who

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Speaker 1: didn't get it. There could be stigmatization issues direction. Yeah,

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Speaker 1: it could beat not to have had the intention or

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Speaker 1: to have absolutely and there are a few more things

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Speaker 1: that get tangled up here. Sometimes it's phrased as blondere

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Speaker 1: blue eye, which doesn't make any sense at all. You know,

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Speaker 1: that's not a public health threat. It's unlikely to have

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Speaker 1: long term consequences even if it were a monoculture. It's

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Speaker 1: not a monoculture that threatens society if it's not. But

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Speaker 1: it's not an accident that people use that as the example.

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Speaker 1: What they're invoking when they say that is there associating

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Speaker 1: genetic engineering with the eugenics movement of the eighteen eighties,

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Speaker 1: nineties or early twentieth century, which was not only by

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Speaker 1: any stretch of imagination, popular in Germany but all over

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Speaker 1: the world, including very much the US. Yeah, the United

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Speaker 1: States kept doing it long after World War Two. I

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Speaker 1: think it was into early nineteen seventies, and so eugenics

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Speaker 1: though this wasn't the only line of eugenic thinking at all,

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Speaker 1: but it married itself up at least in the European context,

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Speaker 1: even you know now long discredited racialized theories. That's what

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Speaker 1: people mean, I think when they say absolutely absolutely. And furthermore,

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Speaker 1: there's all kinds of body image issues, shaming and so

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Speaker 1: forth the en conjures up, which some of which are

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Speaker 1: racially independent. You know that within a race you'll have

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Speaker 1: you know, obesity shaming and many other features that determine

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Speaker 1: your status of society, your socio economic status, enhance your

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Speaker 1: health status. So even though it's not health explicitly, that

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Speaker 1: has ramifications in that direction. So some of those can

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Speaker 1: be addressed. So you know, equitable distribution, we could bring

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Speaker 1: down the price as we have for various technologies like smallpox.

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Speaker 1: Vaccine has made it extinct and so it's basically free now.

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Speaker 1: So there are technologies that come down pretty quickly to zero,

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Speaker 1: so that you can take some of these things at

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Speaker 1: least not necessarily off the table, but you can put

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Speaker 1: them aside in a separate category. But another one is

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Speaker 1: that you could create It falls a bit in the

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Speaker 1: equitable distribution, but you could create people that it's not

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Speaker 1: necessarily racial. It's just a new capability right now, most

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Speaker 1: new capabilities. I believe that the human population at present

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Speaker 1: doesn't have right, and that enhancement is something that we

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Speaker 1: should feel very familiar with because we are enormously enhanced

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Speaker 1: relatives to our enhancestors. We're not actually fearful of enhancement

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Speaker 1: as far as I can tell. But that do you

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Speaker 1: mean incrementally enhanced? I mean so if you look at

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Speaker 1: I don't know the fastest one hundred meter dash times,

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Speaker 1: they're getting faster, though presumably they're also going to a

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Speaker 1: mutual limit. But I can beat one hundred meter dash

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Speaker 1: person any day in my jet. But that's a capacity

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Speaker 1: enhancement that is not embodied. We have developed tools that

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Speaker 1: enable us to do things, but they're not quite the

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Speaker 1: same as being incorporated. It's an interesting question why we

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Speaker 1: treat them differently because they are hurtable in a certain

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Speaker 1: sense culturally culturally inheritable. But culture is an inheritance. I

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Speaker 1: consider many ways more threatening and more rapid than DNA

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Speaker 1: obsessed inheritance. You know, it's much more likely that my

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Speaker 1: daughter will have my cell phone then she will have

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Speaker 1: my facial features. Thankfully, so we get hung up on

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Speaker 1: this sort of DNA obsession. If they actually knew less science. Oddly,

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Speaker 1: we might draw less of a line between these, Right,

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Speaker 1: we didn't know how we inherited these things. We didn't

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Speaker 1: really understand culture and technology and DNA they would kind

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Speaker 1: of look similar. Oh then it's your fault for helping

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Speaker 1: us understand it, so well. Sorry, Well, you're making a

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Speaker 1: really interesting observation that culture has a wide range of effects.

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Speaker 1: It's in some broad sense heritable. But I want to

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Speaker 1: add that it's also subject to the full range nearly

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Speaker 1: every one of the serious risks that you described with

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Speaker 1: respect to genetic editing. In fact, in many cases, the

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Speaker 1: way we come up with our fear is we look

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Speaker 1: at the distortions or the injustices produced by culture and

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Speaker 1: we say, well, oh boy, you know, genetic editing might

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Speaker 1: have the same effect, so you know, societal inequity. Check

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Speaker 1: on that. Right. It can also these target effects which

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Speaker 1: we haven't yet gotten to. But you know, that's broadly speaking,

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Speaker 1: the idea that if we edit one thing, there will

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Speaker 1: be unforeseen effects somewhere else in the genome. Check on that.

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Speaker 1: In culture, all the time, we improve one thing and

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Speaker 1: we make other things much worse, so certain consequences. Check

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Speaker 1: on that. Go ahead, Yeah, I mean the early adopters

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Speaker 1: sometimes they're more exposed to the unintended consequences the off targets,

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Speaker 1: and so they're essentially be signing up with their extra

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Speaker 1: dollars to become the first guinea pigs. So it seems

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Speaker 1: like there's some meaningful debate within the scientific community about

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Speaker 1: how concerned we should be that particular desirable genetic edits.

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Speaker 1: This is assume it's we're avoiding a disease, that there's

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Speaker 1: no other way to avoid it, that we fit your

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Speaker 1: other criteria. There seems to be some disagreement between one

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Speaker 1: campus scientists who say, because we don't know for sure

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Speaker 1: what the off target effects might be of a given intervention,

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Speaker 1: we should proceed extremely slowly and carefully, and another campus scientists,

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Speaker 1: again this is a continuum, who seem to say, we

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Speaker 1: can measure off target effects like we can measure anything else,

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Speaker 1: and if we reach the point that off target effects

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Speaker 1: are less likely to occur from a genetic edit than

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Speaker 1: they are in nature, then it's absurd to be so

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Speaker 1: worried about it. And I'm fascinated by this question because

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Speaker 1: as a layman, I have no idea how to go

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Speaker 1: about answering it right. Well, the probably the most glib

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Speaker 1: answer to it is this is the responsibility of food

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Speaker 1: and drug administration in the United States and equivalence in

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Speaker 1: other countries. And it happens with every single technology to

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Speaker 1: something expose. Certainly the medical technologies were the medical devices,

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Speaker 1: or molecule drugs or protein drugs. Every category has all

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Speaker 1: target effects which are physiological, so you need to do

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Speaker 1: as much as you can theoretically, followed by as much

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Speaker 1: as you can with animal models or human cells in culture,

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Speaker 1: and then you move on very cautlessly to one person

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Speaker 1: to do phase one toxicity and then efficacy, and then

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Speaker 1: make sure that it's really ready for primetime, and you

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Speaker 1: scale up the size of the cohort cautlessly so you

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Speaker 1: expose the minimum number of people to risk for good

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Speaker 1: theoretical reasons. So this combination of theory and testing cautiously

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Speaker 1: is what protects us from all our new technologies. Is

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Speaker 1: the timescale particularly challenging in the case of genetic editing

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Speaker 1: because you're editing an embryo, but it might be that

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Speaker 1: the off target effect doesn't express itself, you know, typically

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Speaker 1: until much later in life, so that it might take

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Speaker 1: much longer to find out what potential left target effects are.

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Speaker 1: Absolutely you know, preventive medicine is a nice buzzword, but

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Speaker 1: it's very hard to develop powerful preventive medicines because you're

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Speaker 1: testing them on people that are healthy. And it's not

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Speaker 1: restricted to embryo editing, its fetal surgery with actual microscalpels

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Speaker 1: of things and monus sickness drugs like Blood of Mind,

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Speaker 1: which which failed disastrous effects. Extreme caution is required when

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Speaker 1: you're dealing with prevented in medicine. For example, you take

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Speaker 1: chemotherapy as an adult woman, you could be affecting your

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Speaker 1: German line in ways that you also won't see until

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Speaker 1: your babies are born, and maybe their babies are born.

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Speaker 1: Right used sub interesting words now, which I think are

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Speaker 1: maybe they are characteristic give you, although I don't think

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Speaker 1: of them as characteristic of you, namely the words extreme caution.

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Speaker 1: So I want to ask you about your headge about

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Speaker 1: the FDA. Of course, institutionally we assign those decisions in

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Speaker 1: our democracy to the FDA, but that doesn't necessarily tell

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Speaker 1: us what criteria the FDA ought to apply, or, more

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Speaker 1: to the point, how cautious the FDA should be, or

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Speaker 1: how risk taking the FDA should be. I mean, real

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Speaker 1: human beings. Ideally, scientists and statisticians sitting in the FDA

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Speaker 1: have to make these decisions on the basis of what

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Speaker 1: data is known. So I guess what I wanted to

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Speaker 1: ask you is, if I'm right that there is this

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Speaker 1: continuum of how much risk we should take in the

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Speaker 1: scientific community around gene editing, where do you fall on

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Speaker 1: that continuum? The words extreme cautions sort of put you

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Speaker 1: sound like they put you among the Really, let's not

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Speaker 1: rush this side. I think tend to fall on the

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Speaker 1: I worry about everything, and I want everybody else. I

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Speaker 1: don't want to reassure people necessarily, I'm not in a

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Speaker 1: big rush for most things, even aging reversal, even though

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Speaker 1: I'm I'm not in a big rush show, so don't

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Speaker 1: worry about it. I'm not in a big rush. But

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Speaker 1: that said, I I don't fall into the camp of

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Speaker 1: we should put as many barriers in the way as

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Speaker 1: possible so that it never happens, or be so vague

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Speaker 1: about it that we can never be satisfied as to

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Speaker 1: what the criteria are for letting it go forward. And

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Speaker 1: it is a continuum, and I think the FDA does

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Speaker 1: an admirable job of prioritizing so if you have a

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Speaker 1: very serious disease is going to kill you tomorrow, they

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Speaker 1: have a different threshold. Then if you have a healthy

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Speaker 1: baby who has every expectation of being healthy, and you're

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Speaker 1: going to give it something that might extend its life

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Speaker 1: by ten years eight years from now, that barrier is

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Speaker 1: very hard to get permission to do that study. And

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Speaker 1: rightly so, there's a line of thought that says, using

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Speaker 1: the FDA as one pole of you describe pretty admirable

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Speaker 1: cost benefit weighing, and then on the other side, looking

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Speaker 1: at China, where at least in one instance, there seems

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Speaker 1: to have been a lot of risk taking, it says, look,

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Speaker 1: it's all well and good to say that the FDA

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Speaker 1: should be cautious, but out there in the world, outside

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Speaker 1: the reach of more cautious and maybe typically democratic although

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Speaker 1: that doesn't have to follow governments, we're going to get

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Speaker 1: lots of innovation, lots of risk taking, and that we'll

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Speaker 1: fall behind if we listen to the FDA or we

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Speaker 1: allow the FDA to be cautious, or alternatively, that says

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Speaker 1: we ought to be very aggressively going out and trying

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Speaker 1: to export our own limitations by pressuring foreign governments to

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Speaker 1: make sure that they crack down to a greater extent.

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Speaker 1: How do you think about that phenomenon? The science is

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Speaker 1: increasingly globalized, as prices come down, as scientists train across borders.

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Speaker 1: There's no in principal reason that a country with a

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Speaker 1: reasonable infrastructure scientific infrastructure can't make all kinds of innovations

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Speaker 1: under a very different regular environment. Well, and first of all,

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Speaker 1: I would say that the Chinese FDA to c FDA

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Speaker 1: is very similar. I think they have a similar risk profile.

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Speaker 1: I think their government whether you want to call it

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Speaker 1: capital hyper capitalistic, or less than perfectly democratic, it doesn't

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Speaker 1: really matter. The point is they are capable and often

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Speaker 1: do crackdown better than we do. So in the United

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Speaker 1: States it's very hard to interfere with the industry, not

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Speaker 1: because they run Congress or anything, but because there's an

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Speaker 1: obsession with freedom. And in the Chinese government they can

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Speaker 1: crack down on things that are unsafe in ways that

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Speaker 1: are very difficult to do otherwise. So for example, cleaning

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Speaker 1: up Pijing for the Olympics, and that's something that I

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Speaker 1: don't think we could have done. And they're very technocratic too.

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Speaker 1: I meant I'd heard that a huge faction, maybe eighty

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Speaker 1: percent of their top politicians have degrees in science for engineering,

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Speaker 1: and not because they're failed scientists or engineers, but because

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Speaker 1: as politicians they went back and got those degrees because

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Speaker 1: I felt it was important for understanding the issues. That

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Speaker 1: is so far from where we are. We're more in

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Speaker 1: a culture of if I need some facts, I'll give

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Speaker 1: them to you, right. You know, this is a question

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Speaker 1: that I've been very curious to ask you today. To

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Speaker 1: be a cutting edge researcher as you are, it's also

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Speaker 1: perhaps expect it is too strong a word, but not

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Speaker 1: surprising when one also holds lots of patents and starts

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Speaker 1: companies that develop those patents or that try to develop

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Speaker 1: those patterns. So the entrepreneurial side seems to coexist very naturally, easily,

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Speaker 1: almost normatively with being a leading scientist. How do you

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Speaker 1: think about that relationship, because that's been an important part

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Speaker 1: of your practice. So if you have an invention where

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Speaker 1: you've gone from the vast cloud of scientific discovery to

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Speaker 1: something that you think might be useful, it's not sufficient

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Speaker 1: to write up academic ivory tower paper and hope for

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Speaker 1: the best because nobody's going to use it. You know,

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Speaker 1: sometimes there's some concern that capitalism in that form will

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Speaker 1: infect us, you know, that affects us by manipulating us,

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Speaker 1: or as market scientists entrepreneur cannot be as pure as

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Speaker 1: the scientist who's received grants and does basic research. I

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Speaker 1: think a lot of people fear that. Yeah, and they

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Speaker 1: fear that even after the sign us steps away and

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Speaker 1: goes back the Ivory Tower, a company that has been

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Speaker 1: created as a life of its own, and it will

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Speaker 1: be motivated to use marketing and advertising and operative lobbying

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Speaker 1: to give us our opinion, run listen to us. And

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Speaker 1: I think these are all valid things. On the other hand,

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Speaker 1: if you're talking about companies going rogue, there's certain challenges

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Speaker 1: to that, meaning that the CEO reports the bord of

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Speaker 1: directors and to the stockholders in general, and so to

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Speaker 1: do something blatantly irresponsible result in a huge public relations problem,

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Speaker 1: your stots value and rash and so forth. While an

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Speaker 1: academic with tenure who has acted responsible, they can go

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Speaker 1: off and do whatever they want. They don't really report

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Speaker 1: to anybody. So there's a danger in other words, also

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Speaker 1: in having the pure scientists who can do whatever he

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Speaker 1: wants or she wants, and it's not responsible at all.

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Speaker 1: So let's take this then back to the question of

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Speaker 1: the future of Crisper or other similar editing technologies in

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Speaker 1: terms of the state of the science. Now, how credible

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Speaker 1: is it that existing editing technologies could, if they were

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Speaker 1: allowed to by regulators, actually make interventions at population level

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Speaker 1: in a significant way. Are there actually traits enough traits

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Speaker 1: that matter that are addressable by editing one or two

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Speaker 1: genes or a handful of genes to actually make it

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Speaker 1: make an impact. How much of this is science fiction

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Speaker 1: fantasy and how much of this is within the reach

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Speaker 1: of reality. So there's an interesting phenomenon. I would say

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Speaker 1: a huge fraction of my colleagues would reassure you that

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Speaker 1: human genetics is so complex that we are so far

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Speaker 1: away we don't need to worry about it. I think

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Speaker 1: that is false to some of them. I think that

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Speaker 1: is false reassurance. So I think that we have sort

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Speaker 1: of the textbook cases of complex genetics or things like height. Right,

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Speaker 1: thousands of genes involved, possibly all the genes are involved,

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Speaker 1: and they each have a very tiny effect along with

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Speaker 1: hundreds of environmental effects. You know, why is it over

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Speaker 1: the generations we've gotten taller and tallerance better nutritions. So

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Speaker 1: this seems hard to predict, much less to manipulate. And

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Speaker 1: when your colleagues just to flush out the argument for

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Speaker 1: listeners when they say nothing to worry about, they often

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Speaker 1: do use height and they say, well, look, if we

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Speaker 1: know right now that there are four or five hundred

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Speaker 1: genes involved in just producing a time percentage of the

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Speaker 1: variants right in thousands to get you to the whole variety,

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Speaker 1: we're never, or at least not in the foreseeable future,

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Speaker 1: are going to be able to edit all of those

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Speaker 1: different locations. So therefore, you know, don't worry your pretty

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Speaker 1: little head about it, or that's what they say to me. Sore.

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Speaker 1: There's three things wrong with that. One is, there are

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Speaker 1: single genes that are so impactful that even though in

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Speaker 1: the natural population they hardly add anything to it, in

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Speaker 1: the medical situation, they have a huge impact, in particular

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Speaker 1: for height. There's about seven different medical situations where physicians

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Speaker 1: and patients want to do something about height. It isn't

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Speaker 1: necessarily because they're genetically defective, and it's some other reason,

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Speaker 1: And the answer is one gene. One gene product was

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Speaker 1: somatotropin or sometimes called growth hormone. To me, that just

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Speaker 1: really nails the counter arguments. So the counter argument is

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Speaker 1: the geneticists who don't want you to worry, say there's

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Speaker 1: so many different genes they're involved, and you naturally right,

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Speaker 1: And you say, well, that might be true naturally, but

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Speaker 1: that doesn't mean there isn't an intervention we could make

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Speaker 1: exactly on a particular gene that would actually have the

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Speaker 1: effect of overshadowing overshadowing the natural variations. So, in other words,

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Speaker 1: and it's a mistake to reason from natural variation to

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Speaker 1: the capacities of technological intervention exactly. And this is not

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Speaker 1: an argument, and this is not hypothetical, because there are

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Speaker 1: seven different so called diseases or medical treatments that are

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Speaker 1: approved and are in routine use to involve this one

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Speaker 1: genes a metatropa. Second, they'll say, oh, we'll have unintended consequences. Well,

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Speaker 1: the fact is in medicine we always have unintended consequences.

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Speaker 1: We almost always deal with them. We just say the

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Speaker 1: benefits outweigh the risks. So that's an ethical argument that

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Speaker 1: they make. That The first argument is a don't worry

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Speaker 1: because it's not going to be practical to engage in

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Speaker 1: these kinds of systematic edits. This argument set is the

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Speaker 1: is the ethical concern that says, we don't know there

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Speaker 1: might be off target effects, and you're saying, there always are,

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Speaker 1: and we were accustomed to that, and we we balanced

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Speaker 1: the costs in the benefit. The distinction is blurred between

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Speaker 1: practical and ethical very often because you'll say it's impractical

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Speaker 1: because there's these off targets. The thing is it is

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Speaker 1: totally practical because almost everything has off targets and you

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Speaker 1: maybe take a second drug to deal with it, or

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Speaker 1: you stratify the population, or there's all sorts of things.

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Speaker 1: There's the tricks you can use, so don't they might

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Speaker 1: be target effects. When you hear those two arguments, these

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Speaker 1: are the grains of salt, you should take it with, okay,

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Speaker 1: because they're pretty big grains. And the third one is

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Speaker 1: the technology is so far from standing still. I mean,

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Speaker 1: it is growing exponentially that that even if you say

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Speaker 1: we can't do it today, it could be you know,

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Speaker 1: somewhere between minutes in years, not centuries. They often use

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Speaker 1: the word centuries. It's incredible, there's no centuries anymore. So.

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Speaker 1: So for example, my blab's personal record, a pretty much

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Speaker 1: world record for editing genes free Crisper or around the

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Speaker 1: time of Christophers two, we could addit two genes, and

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Speaker 1: we were very proud of ourselves. We edited more than one.

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Speaker 1: Just just literally two years later, we had edited sixty

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Speaker 1: two genes simultaneously to make a pig that didn't have

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Speaker 1: any viruses and retroviruses in its you know. Just a

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Speaker 1: year or two after that, we now have edited thirteen

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Speaker 1: thousand genes simultaneously in a mammal in human human cells. Okay,

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Speaker 1: not a human important to think. So the point is

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Speaker 1: this is moving very quickly. What's great is we're having

430
00:25:56,276 --> 00:25:59,516
Speaker 1: these conversations well in advance. But what used to be

431
00:25:59,516 --> 00:26:02,276
Speaker 1: well in advance. We started talking about designer babies in

432
00:26:02,316 --> 00:26:04,556
Speaker 1: the early days of our comment at DNA and in

433
00:26:04,676 --> 00:26:08,396
Speaker 1: vitro fertilizations sort of in the early seventies. That was

434
00:26:08,436 --> 00:26:11,436
Speaker 1: well in advance. But the conversations we're having now are

435
00:26:11,516 --> 00:26:15,876
Speaker 1: not forty years in advance. They're more like a decade.

436
00:26:16,876 --> 00:26:19,956
Speaker 1: When I look at the overall picture that you describe,

437
00:26:20,156 --> 00:26:25,356
Speaker 1: you know, the extraordinary change, the speed of change. I

438
00:26:25,436 --> 00:26:28,276
Speaker 1: wonder whether the institutions that we've talked about before the

439
00:26:28,316 --> 00:26:32,236
Speaker 1: FDA or the Chinese FDA are really strong enough and

440
00:26:32,316 --> 00:26:36,836
Speaker 1: capable enough to resist the temptations they're going to come

441
00:26:37,276 --> 00:26:41,396
Speaker 1: with the tremendous technological capacities that are being developed. I mean,

442
00:26:41,436 --> 00:26:42,756
Speaker 1: if we look at our history, we don't have a

443
00:26:42,756 --> 00:26:47,916
Speaker 1: great history of using institutions, regulatory institutions to block the

444
00:26:47,956 --> 00:26:50,916
Speaker 1: cutting edge. The cutting edge usually tends to emerge. And

445
00:26:50,956 --> 00:26:53,036
Speaker 1: that's partly, I think because of the power of capital,

446
00:26:53,596 --> 00:26:56,276
Speaker 1: you know, which you've mentioned here. It's also partly that

447
00:26:56,516 --> 00:26:59,796
Speaker 1: once something is possible, there will be people advocating for it.

448
00:26:59,836 --> 00:27:02,716
Speaker 1: If you have a rare disease, you will say, look,

449
00:27:02,716 --> 00:27:04,396
Speaker 1: it's not that it would be unethical to try to

450
00:27:04,436 --> 00:27:06,636
Speaker 1: cure this disease. It would be unethical not to try

451
00:27:06,636 --> 00:27:11,036
Speaker 1: to cure this disease. So can we hold back against

452
00:27:11,116 --> 00:27:15,196
Speaker 1: the potential risks here? You know, we say, now, well,

453
00:27:15,236 --> 00:27:17,636
Speaker 1: of course we would never do this to give people

454
00:27:17,716 --> 00:27:23,756
Speaker 1: purely esthetic advantages, but in reality maybe we would. It

455
00:27:23,916 --> 00:27:27,956
Speaker 1: is true that capitalism can distort the FDA, and it's

456
00:27:28,036 --> 00:27:30,796
Speaker 1: ilk around the world, but I think there is a

457
00:27:30,996 --> 00:27:34,076
Speaker 1: there is still feedback mechanism that's bigger than all of this,

458
00:27:34,476 --> 00:27:38,356
Speaker 1: which is that if it really doesn't work or isn't

459
00:27:38,676 --> 00:27:43,076
Speaker 1: cost effective or desirable, we will stop using it. In fact,

460
00:27:43,796 --> 00:27:45,836
Speaker 1: if it doesn't work. My worry is more, what if

461
00:27:46,916 --> 00:27:50,036
Speaker 1: by work, I mean doesn't work for society that the

462
00:27:50,196 --> 00:27:53,836
Speaker 1: long term benefits society. And they are examples. So first,

463
00:27:53,836 --> 00:27:57,316
Speaker 1: what do FDAs around the world not do? So they

464
00:27:57,356 --> 00:28:01,396
Speaker 1: do safety and efficacy, but they don't necessarily do equitable

465
00:28:01,476 --> 00:28:05,356
Speaker 1: distribution or very long term risk. They have long term

466
00:28:05,396 --> 00:28:07,236
Speaker 1: risks in mind, but the way they've set up the

467
00:28:07,276 --> 00:28:10,916
Speaker 1: structure is if you can convince that on a short

468
00:28:11,036 --> 00:28:13,916
Speaker 1: term risk basis that you've done all the experiments, you

469
00:28:13,996 --> 00:28:17,356
Speaker 1: get to test in phase four, which is basically selling it,

470
00:28:17,556 --> 00:28:20,316
Speaker 1: and then once capitalism kicks in, then it's very hard

471
00:28:20,356 --> 00:28:24,556
Speaker 1: to regulate. So perfect examples of this are nutritional supplements

472
00:28:24,556 --> 00:28:29,316
Speaker 1: and stem cells. Those managed to get into the marketplace

473
00:28:29,356 --> 00:28:33,756
Speaker 1: without full FDA approval and now they're bigger than the

474
00:28:33,796 --> 00:28:36,956
Speaker 1: rest of the pharmaceutical industry and so they're hard to regulate.

475
00:28:37,716 --> 00:28:41,036
Speaker 1: But bad example will be the opioid crisis. I mean,

476
00:28:41,076 --> 00:28:43,956
Speaker 1: it was just about gerty. It's a good one. So

477
00:28:44,676 --> 00:28:48,876
Speaker 1: this is something where if you create something that's sufficiently addictive,

478
00:28:49,196 --> 00:28:52,876
Speaker 1: people will try it and then they become lobbyists. They vote,

479
00:28:52,876 --> 00:28:54,996
Speaker 1: They vote with their wallet, which is in many ways

480
00:28:55,036 --> 00:28:59,476
Speaker 1: more powerful than voting with ballots. That said, there will

481
00:28:59,516 --> 00:29:02,436
Speaker 1: be a feedback system. If any country manages to get

482
00:29:02,476 --> 00:29:07,116
Speaker 1: a business model or a country policy model that prevents this,

483
00:29:08,316 --> 00:29:11,636
Speaker 1: they will win because the nations that can't control their

484
00:29:11,636 --> 00:29:19,396
Speaker 1: opiated crisis become impoverished, mismanaged, etc. They become the new cash.

485
00:29:19,436 --> 00:29:20,916
Speaker 1: Can I push back on that? I mean, so everything

486
00:29:20,916 --> 00:29:23,796
Speaker 1: we've talked about until now, I'm the purest lay person,

487
00:29:24,116 --> 00:29:26,676
Speaker 1: But now when we talk about feedback and the governments,

488
00:29:26,676 --> 00:29:28,276
Speaker 1: I have something to say. And here's what I would

489
00:29:28,276 --> 00:29:32,556
Speaker 1: want to say. We've got lots of examples where societies

490
00:29:32,596 --> 00:29:35,636
Speaker 1: inflict huge costs on themselves, but the costs are not

491
00:29:35,756 --> 00:29:38,396
Speaker 1: so great that they turn them into, as you would say,

492
00:29:38,396 --> 00:29:40,956
Speaker 1: third world countries, because they have other tremendous advantages. So

493
00:29:41,076 --> 00:29:43,116
Speaker 1: tobacco would be a really good example. Yeah, you know,

494
00:29:43,156 --> 00:29:46,596
Speaker 1: I remember my grandfather, who was trained in pharmacy school

495
00:29:46,676 --> 00:29:49,716
Speaker 1: in the nineteen twenties, describing a film that they were

496
00:29:49,716 --> 00:29:53,476
Speaker 1: all shown of the horrible effects on the human lung

497
00:29:53,916 --> 00:29:57,196
Speaker 1: of tobacco smoking. And then the tobacco industry literally came

498
00:29:57,436 --> 00:30:00,756
Speaker 1: bought up all the copies of those films, destroyed them

499
00:30:01,036 --> 00:30:03,676
Speaker 1: and block that from, you know, from being publicly. No,

500
00:30:03,796 --> 00:30:05,556
Speaker 1: it wasn't the same as a cause of a relationship

501
00:30:05,596 --> 00:30:08,276
Speaker 1: to cancer necessarily, but they knew the health effects were

502
00:30:08,316 --> 00:30:11,116
Speaker 1: absolutely terrible incomparable to what you got by working in

503
00:30:11,196 --> 00:30:14,316
Speaker 1: a mind. Yeah, so you know, there's an example of

504
00:30:14,396 --> 00:30:17,876
Speaker 1: total failure of regulatory institution. Absolutely, and the handful of

505
00:30:17,916 --> 00:30:21,156
Speaker 1: countries that we're able to regulate smoking to a slightly

506
00:30:21,196 --> 00:30:24,556
Speaker 1: greater degree did not enjoy any great In fact, there's

507
00:30:24,556 --> 00:30:26,556
Speaker 1: an even an argument, it's a perverse argument, but the

508
00:30:26,596 --> 00:30:29,476
Speaker 1: tobacco companies didn't make it at one point that it

509
00:30:29,556 --> 00:30:31,916
Speaker 1: was good for the economy that people smoked because you

510
00:30:31,916 --> 00:30:33,836
Speaker 1: didn't spend a lot of money on their latent life

511
00:30:33,916 --> 00:30:38,196
Speaker 1: healthcare because they died of lung cancer. So it's not

512
00:30:38,276 --> 00:30:42,436
Speaker 1: always the case that really bad social effects right impoverish

513
00:30:42,476 --> 00:30:45,836
Speaker 1: a country. That's correct. So I was I was just

514
00:30:45,956 --> 00:30:50,156
Speaker 1: saying that there is a feedback mechanism. Yeah, do we

515
00:30:50,236 --> 00:30:53,556
Speaker 1: need other things? We probably do, But do we think

516
00:30:53,596 --> 00:30:57,556
Speaker 1: that we can be a voluntary moratoria do something more

517
00:30:57,556 --> 00:31:00,636
Speaker 1: powerful in capitalism that I think is a little naive.

518
00:31:01,156 --> 00:31:03,476
Speaker 1: We need to think of all the ways we can

519
00:31:03,516 --> 00:31:06,236
Speaker 1: do surveillance, for example, is one of the things I've advocated.

520
00:31:06,676 --> 00:31:12,396
Speaker 1: Rather than being falsely reassured, let's have strong surveillance. You know,

521
00:31:12,476 --> 00:31:16,316
Speaker 1: in the topic today of these Cristopher babies, there were

522
00:31:16,316 --> 00:31:18,396
Speaker 1: plenty of people in the world, both in China and

523
00:31:18,396 --> 00:31:20,276
Speaker 1: the United States who knew about it, but they weren't

524
00:31:20,956 --> 00:31:24,836
Speaker 1: reporting it. We need to encourage whistleblowers, and we need

525
00:31:24,836 --> 00:31:29,076
Speaker 1: to optimize surveillance. I mean this one form of surveillance.

526
00:31:29,156 --> 00:31:32,676
Speaker 1: The other form of surveillance is computer surveillance. So we

527
00:31:32,716 --> 00:31:36,316
Speaker 1: should have computers looking through all the orders that are

528
00:31:36,476 --> 00:31:41,116
Speaker 1: relevant to synthetic biology broadly, and maybe other technologies as well,

529
00:31:41,276 --> 00:31:43,676
Speaker 1: to see if people are doing things for which they

530
00:31:43,756 --> 00:31:46,516
Speaker 1: do not have a license. So the privacy concerns interview

531
00:31:46,556 --> 00:31:50,356
Speaker 1: are just outweighed by the tremendous dangers associate with lack

532
00:31:50,396 --> 00:31:54,756
Speaker 1: of So I think that everybody who practices synthetic biology

533
00:31:54,876 --> 00:31:58,796
Speaker 1: and it's close relatives has given up some of their

534
00:31:59,036 --> 00:32:02,836
Speaker 1: privacy rights in the same sense that when you get

535
00:32:02,876 --> 00:32:05,196
Speaker 1: a driver's license, you give up certain rights. There are

536
00:32:05,316 --> 00:32:07,596
Speaker 1: radars that are looking to see what you're doing. You

537
00:32:07,636 --> 00:32:10,316
Speaker 1: can get pulled over if you're weaving around and you

538
00:32:10,316 --> 00:32:12,316
Speaker 1: can get an alcohol test, and you can get they

539
00:32:12,356 --> 00:32:15,236
Speaker 1: can check your age and so forth. You have to

540
00:32:15,276 --> 00:32:18,436
Speaker 1: have surveillance, and we do have more resistance typically those

541
00:32:18,436 --> 00:32:20,836
Speaker 1: forms of surveillance in the US than they do, for example,

542
00:32:21,196 --> 00:32:23,836
Speaker 1: in Europe. Here we think, you know, it would be

543
00:32:23,836 --> 00:32:26,076
Speaker 1: a terrible violation of our civil liberties if when we

544
00:32:26,116 --> 00:32:28,556
Speaker 1: got onto the highway they check the time, and when

545
00:32:28,596 --> 00:32:30,116
Speaker 1: we got off the highway they check the time and

546
00:32:30,156 --> 00:32:33,036
Speaker 1: saw whether we were speeding in between. But in you know,

547
00:32:33,036 --> 00:32:34,756
Speaker 1: if you did it on the mass Pike, you know

548
00:32:34,796 --> 00:32:37,236
Speaker 1: there would be a riot here in Massachusetts. But in

549
00:32:37,356 --> 00:32:41,236
Speaker 1: Europe there are speed cameras everywhere. The fines are enormous.

550
00:32:41,996 --> 00:32:45,756
Speaker 1: You know, you are meant to feel surveilled when you drive,

551
00:32:45,996 --> 00:32:48,316
Speaker 1: right that you do feel surveiled when you drive there,

552
00:32:48,316 --> 00:32:51,076
Speaker 1: And that's pro social, that's that's that's desirable, and that's

553
00:32:51,116 --> 00:32:54,276
Speaker 1: why I think when we create boogeymen outside the United States,

554
00:32:54,276 --> 00:32:58,556
Speaker 1: were completely ignoring how we have a huge fraction of

555
00:32:58,596 --> 00:33:03,076
Speaker 1: the world's billionaires, many of whom are very pro libertarian.

556
00:33:03,596 --> 00:33:05,996
Speaker 1: I can do whatever I want, or I think it's

557
00:33:06,076 --> 00:33:12,316
Speaker 1: much more likely that the rogues are going to be us. George,

558
00:33:12,316 --> 00:33:14,316
Speaker 1: thank you so much for your fear time, and thanks

559
00:33:14,156 --> 00:33:18,036
Speaker 1: for sharing your ideas. I'm not sure I emerged less

560
00:33:18,036 --> 00:33:19,596
Speaker 1: worried than when I started, but you've told me that

561
00:33:19,676 --> 00:33:22,636
Speaker 1: worries healthy, so I guess I've got plenty of it.

562
00:33:23,076 --> 00:33:31,516
Speaker 1: Thank you very much, thank you, thank you. I asked

563
00:33:31,516 --> 00:33:33,676
Speaker 1: George Church to come on the show because I wanted

564
00:33:33,676 --> 00:33:36,076
Speaker 1: to get a better sense than I had about just

565
00:33:36,156 --> 00:33:38,916
Speaker 1: how worried we should be about the potential advent of

566
00:33:38,956 --> 00:33:43,556
Speaker 1: designer babies. When George first started talking, I started to

567
00:33:43,596 --> 00:33:46,476
Speaker 1: feel better. I began to think that maybe the FDA

568
00:33:46,716 --> 00:33:52,436
Speaker 1: was a reasonable institution for regulating the possible bad effects

569
00:33:52,716 --> 00:33:56,196
Speaker 1: of designer babies. And George was also reassuring about the

570
00:33:56,236 --> 00:34:00,796
Speaker 1: thought that the Chinese government also is interested in blocking

571
00:34:00,996 --> 00:34:03,556
Speaker 1: progress from going too quickly or getting out of hand.

572
00:34:04,676 --> 00:34:08,636
Speaker 1: But as our conversation proceeded, I started to get more

573
00:34:08,716 --> 00:34:13,436
Speaker 1: and more were nervous. In particular, George was pretty convincing

574
00:34:13,676 --> 00:34:16,236
Speaker 1: in suggesting that those scientists who say we don't have

575
00:34:16,316 --> 00:34:19,076
Speaker 1: to worry about gene editing leading to designer babies soon

576
00:34:19,476 --> 00:34:24,396
Speaker 1: are actually completely wrong about that. Then, as he began

577
00:34:24,436 --> 00:34:28,796
Speaker 1: to describe the potential effects of companies and capitalism on

578
00:34:28,836 --> 00:34:31,556
Speaker 1: the development of science. I began to think that maybe

579
00:34:31,596 --> 00:34:34,396
Speaker 1: they were going to be economic pressures driving us in

580
00:34:34,396 --> 00:34:37,436
Speaker 1: the direction of greater and greater innovation and greater and

581
00:34:37,436 --> 00:34:40,676
Speaker 1: greater risk taking. And finally, when we circled all the

582
00:34:40,716 --> 00:34:44,116
Speaker 1: way back to those same regulatory agencies, George seemed to

583
00:34:44,116 --> 00:34:46,076
Speaker 1: think that there was some possibility that in the long

584
00:34:46,156 --> 00:34:48,116
Speaker 1: run we would make mistakes, but that we would be

585
00:34:48,116 --> 00:34:51,436
Speaker 1: self correcting. And there he and I parted paths because

586
00:34:51,476 --> 00:34:55,116
Speaker 1: I'm deeply afraid that we're not that good at fixing

587
00:34:55,116 --> 00:34:57,796
Speaker 1: our mistakes, that there are too many examples of our

588
00:34:57,836 --> 00:35:02,116
Speaker 1: regulatory regimes breaking down. And we ended with George saying

589
00:35:02,156 --> 00:35:03,996
Speaker 1: that he thinks that if anyone's going to go rogue,

590
00:35:04,076 --> 00:35:06,756
Speaker 1: it's going to be us right here in the United States,

591
00:35:07,316 --> 00:35:11,676
Speaker 1: and that, my friends, leaves me more nervous than anything else.

592
00:35:15,996 --> 00:35:18,956
Speaker 1: Deep Background is brought to you by Pushkin Industries. Our

593
00:35:18,996 --> 00:35:22,076
Speaker 1: producer is Lydia gene Coott, with engineering by Jason Gambrel

594
00:35:22,276 --> 00:35:25,996
Speaker 1: and Jason Roskowski. Our showrunner is Sophie mckibbon. Our theme

595
00:35:26,076 --> 00:35:28,876
Speaker 1: music is composed by Luis GERA special thanks to the

596
00:35:28,876 --> 00:35:32,996
Speaker 1: Pushkin Brass Malcolm Gladwell, Jacob Weisberg, and Mia Lobel. I'm

597
00:35:33,076 --> 00:35:36,316
Speaker 1: Noah Feldman. You can follow me on Twitter at Noah R. Feldman.

598
00:35:36,676 --> 00:35:38,076
Speaker 1: This is deep background