Speaker 1: Pushkin from Pushkin Industries. This is deep background the show
Speaker 1: where we explored the stories behind the stories in the news.
Speaker 1: I'm Noah Feldman. Welcome to this week's program, where we're
Speaker 1: going to talk about gene editing, designer babies, and the
Speaker 1: future of science. These are all topics of importance all
Speaker 1: the time, but they've become more pressing since the announcement
Speaker 1: that a Chinese scientist had actually used Crisper Cast nine,
Speaker 1: the leading cutting edge editing technology, to edit the genomes
Speaker 1: of two embryos to assure that they would not be
Speaker 1: able to be susceptible to the HIV virus. This was
Speaker 1: good for the embryos, but it wasn't necessary scientifically, and
Speaker 1: it's led to lots of intense discussion about whether the
Speaker 1: era of designer babies was too close and needed to
Speaker 1: be headed off by regulation. To discuss these and closely
Speaker 1: related issues were super fortunate to have with us George Church.
Speaker 1: George is the Robert Winthrop Professor of Genetics at Harvard
Speaker 1: Medical School. He also teaches at MIT. He's been a
Speaker 1: central actor in the development of the technologies of gene
Speaker 1: editing and in applying them to the creation of new genomes.
Speaker 1: He sometimes, in fact calls himself a genome engineer. George,
Speaker 1: thank you so much for joining us. It's a great
Speaker 1: pleasure to be here. Noah, let's just start with the
Speaker 1: headline in order to make sense of what it really
Speaker 1: means and whether there are dangerous associated with it of
Speaker 1: the kind that many imagine. We read in the paper
Speaker 1: that Jan Qui, a Chinese scientist, says, or has it
Speaker 1: said about him, that he used Crisper cast nine to
Speaker 1: engineer the DNA of a couple of babies, and that
Speaker 1: they were then subsequently carried to term. That's what appears
Speaker 1: to be new here, and he's been The Chinese government's
Speaker 1: not very happy with him, and he has been under
Speaker 1: house arrest and radio silence more or less since. From
Speaker 1: the standpoint of the state of crisper technology, was there
Speaker 1: anything remarkable about the accomplishment, assuming it was accomplished, or
Speaker 1: is it relatively a trivial step compared to the scientific
Speaker 1: advances that had already been in place? Yeah, I would
Speaker 1: think similar things had been done by other groups, including
Speaker 1: groups in the United States and Oregon on human embryos,
Speaker 1: and even more amazing things had been done on other
Speaker 1: mammalian embryos, including altering dozens of genes. So is here
Speaker 1: the claim was only the altering of onengenee. You know,
Speaker 1: there's some interesting questions about choice of genes. You know,
Speaker 1: one of the things that's challenging in this field is
Speaker 1: picking a gene that even a few other people would
Speaker 1: agree is a good choice of gene, because you know,
Speaker 1: a fair number of genes could be fixed by other methods,
Speaker 1: Like you have to be in in vitro fertilization or
Speaker 1: IVS clinic to do this at all, and if you're
Speaker 1: in that clinic, you could fix it by just IVF
Speaker 1: prenatal genetic testing EGT. So when it goes to question
Speaker 1: of choosing the target of the intervention, what are the
Speaker 1: right criteria or what do you see as the main
Speaker 1: criteria people would consider. I mean, you've mentioned now one
Speaker 1: could you get there by some other means? Could you
Speaker 1: get there without without changing the germ line? But what
Speaker 1: are other criteria that you think would be relevant here?
Speaker 1: So in addition to could you get thereout altering the
Speaker 1: germ line, there's also the criteria of is it a
Speaker 1: net positive for that person or in a public health
Speaker 1: sinse on average on that positive and environmentally dependent. So
Speaker 1: if you're in an environment where everybody gets HIV and
Speaker 1: dies young, and that's a very different environment than or
Speaker 1: nobody gets HIV and China is not ground zero for
Speaker 1: the highest level of HIV in the world, who is
Speaker 1: highly stigmatized there, but you know places in Africa have
Speaker 1: higher incidence of it and it would be better candidates.
Speaker 1: Another one is, you know, is costs is a consideration
Speaker 1: if you want something that's going to be of true
Speaker 1: public health benefit for a disease like this impacts a
Speaker 1: lot of impoverished individuals because you have the alternative is
Speaker 1: drugs or safe sex. There there are a few alternatives,
Speaker 1: none of what you're working perfectly worldwide because a million
Speaker 1: people die for years, it's about two percent of all
Speaker 1: human deaths. So to claim that this is a solved
Speaker 1: problem is just as Naives saying that this is the
Speaker 1: only way to solve the problem. Right, it's not a
Speaker 1: self problem in real world descriptive terms, even though in
Speaker 1: principle it could be solvable. So what about the criterion
Speaker 1: that asks whether something is presently an immediate threat to
Speaker 1: either the embryo or the local population as opposed to
Speaker 1: offering some background improvement for the potential person who might
Speaker 1: come to be created, or for the environment more generally,
Speaker 1: does that seem like a meaningful difference to you? And
Speaker 1: I just to show that I'm why I'm asking that question.
Speaker 1: It goes to the broader societal fear about what are
Speaker 1: sometimes called designer babies, you know, babies who are who
Speaker 1: might have their genomes edited to give them some advantage,
Speaker 1: which could be a health advantage to begin with, but
Speaker 1: could also be other kinds of advantages, whether in esthetics
Speaker 1: or intelligence, or athletics or what have you. I think
Speaker 1: this is something that is very interesting entanglement of concerns.
Speaker 1: So the concerns are that we will create a monoculture
Speaker 1: number one, where everyone is the same, the way that
Speaker 1: you might have a you know, many square kilometers of
Speaker 1: identical crops. The second is that it will be inequably distributed,
Speaker 1: in no words, that some people have some people don't.
Speaker 1: That's a very different concern than you don't want anybody
Speaker 1: to have it, as you want everybody to have it, okay,
Speaker 1: you know. A third one is you could make a
Speaker 1: mistake that it could be a very popular fad, but
Speaker 1: it was a mistake that has long term consequences, either
Speaker 1: for the people who had it or the people who
Speaker 1: didn't get it. There could be stigmatization issues direction. Yeah,
Speaker 1: it could beat not to have had the intention or
Speaker 1: to have absolutely and there are a few more things
Speaker 1: that get tangled up here. Sometimes it's phrased as blondere
Speaker 1: blue eye, which doesn't make any sense at all. You know,
Speaker 1: that's not a public health threat. It's unlikely to have
Speaker 1: long term consequences even if it were a monoculture. It's
Speaker 1: not a monoculture that threatens society if it's not. But
Speaker 1: it's not an accident that people use that as the example.
Speaker 1: What they're invoking when they say that is there associating
Speaker 1: genetic engineering with the eugenics movement of the eighteen eighties,
Speaker 1: nineties or early twentieth century, which was not only by
Speaker 1: any stretch of imagination, popular in Germany but all over
Speaker 1: the world, including very much the US. Yeah, the United
Speaker 1: States kept doing it long after World War Two. I
Speaker 1: think it was into early nineteen seventies, and so eugenics
Speaker 1: though this wasn't the only line of eugenic thinking at all,
Speaker 1: but it married itself up at least in the European context,
Speaker 1: even you know now long discredited racialized theories. That's what
Speaker 1: people mean, I think when they say absolutely absolutely. And furthermore,
Speaker 1: there's all kinds of body image issues, shaming and so
Speaker 1: forth the en conjures up, which some of which are
Speaker 1: racially independent. You know that within a race you'll have
Speaker 1: you know, obesity shaming and many other features that determine
Speaker 1: your status of society, your socio economic status, enhance your
Speaker 1: health status. So even though it's not health explicitly, that
Speaker 1: has ramifications in that direction. So some of those can
Speaker 1: be addressed. So you know, equitable distribution, we could bring
Speaker 1: down the price as we have for various technologies like smallpox.
Speaker 1: Vaccine has made it extinct and so it's basically free now.
Speaker 1: So there are technologies that come down pretty quickly to zero,
Speaker 1: so that you can take some of these things at
Speaker 1: least not necessarily off the table, but you can put
Speaker 1: them aside in a separate category. But another one is
Speaker 1: that you could create It falls a bit in the
Speaker 1: equitable distribution, but you could create people that it's not
Speaker 1: necessarily racial. It's just a new capability right now, most
Speaker 1: new capabilities. I believe that the human population at present
Speaker 1: doesn't have right, and that enhancement is something that we
Speaker 1: should feel very familiar with because we are enormously enhanced
Speaker 1: relatives to our enhancestors. We're not actually fearful of enhancement
Speaker 1: as far as I can tell. But that do you
Speaker 1: mean incrementally enhanced? I mean so if you look at
Speaker 1: I don't know the fastest one hundred meter dash times,
Speaker 1: they're getting faster, though presumably they're also going to a
Speaker 1: mutual limit. But I can beat one hundred meter dash
Speaker 1: person any day in my jet. But that's a capacity
Speaker 1: enhancement that is not embodied. We have developed tools that
Speaker 1: enable us to do things, but they're not quite the
Speaker 1: same as being incorporated. It's an interesting question why we
Speaker 1: treat them differently because they are hurtable in a certain
Speaker 1: sense culturally culturally inheritable. But culture is an inheritance. I
Speaker 1: consider many ways more threatening and more rapid than DNA
Speaker 1: obsessed inheritance. You know, it's much more likely that my
Speaker 1: daughter will have my cell phone then she will have
Speaker 1: my facial features. Thankfully, so we get hung up on
Speaker 1: this sort of DNA obsession. If they actually knew less science. Oddly,
Speaker 1: we might draw less of a line between these, Right,
Speaker 1: we didn't know how we inherited these things. We didn't
Speaker 1: really understand culture and technology and DNA they would kind
Speaker 1: of look similar. Oh then it's your fault for helping
Speaker 1: us understand it, so well. Sorry, Well, you're making a
Speaker 1: really interesting observation that culture has a wide range of effects.
Speaker 1: It's in some broad sense heritable. But I want to
Speaker 1: add that it's also subject to the full range nearly
Speaker 1: every one of the serious risks that you described with
Speaker 1: respect to genetic editing. In fact, in many cases, the
Speaker 1: way we come up with our fear is we look
Speaker 1: at the distortions or the injustices produced by culture and
Speaker 1: we say, well, oh boy, you know, genetic editing might
Speaker 1: have the same effect, so you know, societal inequity. Check
Speaker 1: on that. Right. It can also these target effects which
Speaker 1: we haven't yet gotten to. But you know, that's broadly speaking,
Speaker 1: the idea that if we edit one thing, there will
Speaker 1: be unforeseen effects somewhere else in the genome. Check on that.
Speaker 1: In culture, all the time, we improve one thing and
Speaker 1: we make other things much worse, so certain consequences. Check
Speaker 1: on that. Go ahead, Yeah, I mean the early adopters
Speaker 1: sometimes they're more exposed to the unintended consequences the off targets,
Speaker 1: and so they're essentially be signing up with their extra
Speaker 1: dollars to become the first guinea pigs. So it seems
Speaker 1: like there's some meaningful debate within the scientific community about
Speaker 1: how concerned we should be that particular desirable genetic edits.
Speaker 1: This is assume it's we're avoiding a disease, that there's
Speaker 1: no other way to avoid it, that we fit your
Speaker 1: other criteria. There seems to be some disagreement between one
Speaker 1: campus scientists who say, because we don't know for sure
Speaker 1: what the off target effects might be of a given intervention,
Speaker 1: we should proceed extremely slowly and carefully, and another campus scientists,
Speaker 1: again this is a continuum, who seem to say, we
Speaker 1: can measure off target effects like we can measure anything else,
Speaker 1: and if we reach the point that off target effects
Speaker 1: are less likely to occur from a genetic edit than
Speaker 1: they are in nature, then it's absurd to be so
Speaker 1: worried about it. And I'm fascinated by this question because
Speaker 1: as a layman, I have no idea how to go
Speaker 1: about answering it right. Well, the probably the most glib
Speaker 1: answer to it is this is the responsibility of food
Speaker 1: and drug administration in the United States and equivalence in
Speaker 1: other countries. And it happens with every single technology to
Speaker 1: something expose. Certainly the medical technologies were the medical devices,
Speaker 1: or molecule drugs or protein drugs. Every category has all
Speaker 1: target effects which are physiological, so you need to do
Speaker 1: as much as you can theoretically, followed by as much
Speaker 1: as you can with animal models or human cells in culture,
Speaker 1: and then you move on very cautlessly to one person
Speaker 1: to do phase one toxicity and then efficacy, and then
Speaker 1: make sure that it's really ready for primetime, and you
Speaker 1: scale up the size of the cohort cautlessly so you
Speaker 1: expose the minimum number of people to risk for good
Speaker 1: theoretical reasons. So this combination of theory and testing cautiously
Speaker 1: is what protects us from all our new technologies. Is
Speaker 1: the timescale particularly challenging in the case of genetic editing
Speaker 1: because you're editing an embryo, but it might be that
Speaker 1: the off target effect doesn't express itself, you know, typically
Speaker 1: until much later in life, so that it might take
Speaker 1: much longer to find out what potential left target effects are.
Speaker 1: Absolutely you know, preventive medicine is a nice buzzword, but
Speaker 1: it's very hard to develop powerful preventive medicines because you're
Speaker 1: testing them on people that are healthy. And it's not
Speaker 1: restricted to embryo editing, its fetal surgery with actual microscalpels
Speaker 1: of things and monus sickness drugs like Blood of Mind,
Speaker 1: which which failed disastrous effects. Extreme caution is required when
Speaker 1: you're dealing with prevented in medicine. For example, you take
Speaker 1: chemotherapy as an adult woman, you could be affecting your
Speaker 1: German line in ways that you also won't see until
Speaker 1: your babies are born, and maybe their babies are born.
Speaker 1: Right used sub interesting words now, which I think are
Speaker 1: maybe they are characteristic give you, although I don't think
Speaker 1: of them as characteristic of you, namely the words extreme caution.
Speaker 1: So I want to ask you about your headge about
Speaker 1: the FDA. Of course, institutionally we assign those decisions in
Speaker 1: our democracy to the FDA, but that doesn't necessarily tell
Speaker 1: us what criteria the FDA ought to apply, or, more
Speaker 1: to the point, how cautious the FDA should be, or
Speaker 1: how risk taking the FDA should be. I mean, real
Speaker 1: human beings. Ideally, scientists and statisticians sitting in the FDA
Speaker 1: have to make these decisions on the basis of what
Speaker 1: data is known. So I guess what I wanted to
Speaker 1: ask you is, if I'm right that there is this
Speaker 1: continuum of how much risk we should take in the
Speaker 1: scientific community around gene editing, where do you fall on
Speaker 1: that continuum? The words extreme cautions sort of put you
Speaker 1: sound like they put you among the Really, let's not
Speaker 1: rush this side. I think tend to fall on the
Speaker 1: I worry about everything, and I want everybody else. I
Speaker 1: don't want to reassure people necessarily, I'm not in a
Speaker 1: big rush for most things, even aging reversal, even though
Speaker 1: I'm I'm not in a big rush show, so don't
Speaker 1: worry about it. I'm not in a big rush. But
Speaker 1: that said, I I don't fall into the camp of
Speaker 1: we should put as many barriers in the way as
Speaker 1: possible so that it never happens, or be so vague
Speaker 1: about it that we can never be satisfied as to
Speaker 1: what the criteria are for letting it go forward. And
Speaker 1: it is a continuum, and I think the FDA does
Speaker 1: an admirable job of prioritizing so if you have a
Speaker 1: very serious disease is going to kill you tomorrow, they
Speaker 1: have a different threshold. Then if you have a healthy
Speaker 1: baby who has every expectation of being healthy, and you're
Speaker 1: going to give it something that might extend its life
Speaker 1: by ten years eight years from now, that barrier is
Speaker 1: very hard to get permission to do that study. And
Speaker 1: rightly so, there's a line of thought that says, using
Speaker 1: the FDA as one pole of you describe pretty admirable
Speaker 1: cost benefit weighing, and then on the other side, looking
Speaker 1: at China, where at least in one instance, there seems
Speaker 1: to have been a lot of risk taking, it says, look,
Speaker 1: it's all well and good to say that the FDA
Speaker 1: should be cautious, but out there in the world, outside
Speaker 1: the reach of more cautious and maybe typically democratic although
Speaker 1: that doesn't have to follow governments, we're going to get
Speaker 1: lots of innovation, lots of risk taking, and that we'll
Speaker 1: fall behind if we listen to the FDA or we
Speaker 1: allow the FDA to be cautious, or alternatively, that says
Speaker 1: we ought to be very aggressively going out and trying
Speaker 1: to export our own limitations by pressuring foreign governments to
Speaker 1: make sure that they crack down to a greater extent.
Speaker 1: How do you think about that phenomenon? The science is
Speaker 1: increasingly globalized, as prices come down, as scientists train across borders.
Speaker 1: There's no in principal reason that a country with a
Speaker 1: reasonable infrastructure scientific infrastructure can't make all kinds of innovations
Speaker 1: under a very different regular environment. Well, and first of all,
Speaker 1: I would say that the Chinese FDA to c FDA
Speaker 1: is very similar. I think they have a similar risk profile.
Speaker 1: I think their government whether you want to call it
Speaker 1: capital hyper capitalistic, or less than perfectly democratic, it doesn't
Speaker 1: really matter. The point is they are capable and often
Speaker 1: do crackdown better than we do. So in the United
Speaker 1: States it's very hard to interfere with the industry, not
Speaker 1: because they run Congress or anything, but because there's an
Speaker 1: obsession with freedom. And in the Chinese government they can
Speaker 1: crack down on things that are unsafe in ways that
Speaker 1: are very difficult to do otherwise. So for example, cleaning
Speaker 1: up Pijing for the Olympics, and that's something that I
Speaker 1: don't think we could have done. And they're very technocratic too.
Speaker 1: I meant I'd heard that a huge faction, maybe eighty
Speaker 1: percent of their top politicians have degrees in science for engineering,
Speaker 1: and not because they're failed scientists or engineers, but because
Speaker 1: as politicians they went back and got those degrees because
Speaker 1: I felt it was important for understanding the issues. That
Speaker 1: is so far from where we are. We're more in
Speaker 1: a culture of if I need some facts, I'll give
Speaker 1: them to you, right. You know, this is a question
Speaker 1: that I've been very curious to ask you today. To
Speaker 1: be a cutting edge researcher as you are, it's also
Speaker 1: perhaps expect it is too strong a word, but not
Speaker 1: surprising when one also holds lots of patents and starts
Speaker 1: companies that develop those patents or that try to develop
Speaker 1: those patterns. So the entrepreneurial side seems to coexist very naturally, easily,
Speaker 1: almost normatively with being a leading scientist. How do you
Speaker 1: think about that relationship, because that's been an important part
Speaker 1: of your practice. So if you have an invention where
Speaker 1: you've gone from the vast cloud of scientific discovery to
Speaker 1: something that you think might be useful, it's not sufficient
Speaker 1: to write up academic ivory tower paper and hope for
Speaker 1: the best because nobody's going to use it. You know,
Speaker 1: sometimes there's some concern that capitalism in that form will
Speaker 1: infect us, you know, that affects us by manipulating us,
Speaker 1: or as market scientists entrepreneur cannot be as pure as
Speaker 1: the scientist who's received grants and does basic research. I
Speaker 1: think a lot of people fear that. Yeah, and they
Speaker 1: fear that even after the sign us steps away and
Speaker 1: goes back the Ivory Tower, a company that has been
Speaker 1: created as a life of its own, and it will
Speaker 1: be motivated to use marketing and advertising and operative lobbying
Speaker 1: to give us our opinion, run listen to us. And
Speaker 1: I think these are all valid things. On the other hand,
Speaker 1: if you're talking about companies going rogue, there's certain challenges
Speaker 1: to that, meaning that the CEO reports the bord of
Speaker 1: directors and to the stockholders in general, and so to
Speaker 1: do something blatantly irresponsible result in a huge public relations problem,
Speaker 1: your stots value and rash and so forth. While an
Speaker 1: academic with tenure who has acted responsible, they can go
Speaker 1: off and do whatever they want. They don't really report
Speaker 1: to anybody. So there's a danger in other words, also
Speaker 1: in having the pure scientists who can do whatever he
Speaker 1: wants or she wants, and it's not responsible at all.
Speaker 1: So let's take this then back to the question of
Speaker 1: the future of Crisper or other similar editing technologies in
Speaker 1: terms of the state of the science. Now, how credible
Speaker 1: is it that existing editing technologies could, if they were
Speaker 1: allowed to by regulators, actually make interventions at population level
Speaker 1: in a significant way. Are there actually traits enough traits
Speaker 1: that matter that are addressable by editing one or two
Speaker 1: genes or a handful of genes to actually make it
Speaker 1: make an impact. How much of this is science fiction
Speaker 1: fantasy and how much of this is within the reach
Speaker 1: of reality. So there's an interesting phenomenon. I would say
Speaker 1: a huge fraction of my colleagues would reassure you that
Speaker 1: human genetics is so complex that we are so far
Speaker 1: away we don't need to worry about it. I think
Speaker 1: that is false to some of them. I think that
Speaker 1: is false reassurance. So I think that we have sort
Speaker 1: of the textbook cases of complex genetics or things like height. Right,
Speaker 1: thousands of genes involved, possibly all the genes are involved,
Speaker 1: and they each have a very tiny effect along with
Speaker 1: hundreds of environmental effects. You know, why is it over
Speaker 1: the generations we've gotten taller and tallerance better nutritions. So
Speaker 1: this seems hard to predict, much less to manipulate. And
Speaker 1: when your colleagues just to flush out the argument for
Speaker 1: listeners when they say nothing to worry about, they often
Speaker 1: do use height and they say, well, look, if we
Speaker 1: know right now that there are four or five hundred
Speaker 1: genes involved in just producing a time percentage of the
Speaker 1: variants right in thousands to get you to the whole variety,
Speaker 1: we're never, or at least not in the foreseeable future,
Speaker 1: are going to be able to edit all of those
Speaker 1: different locations. So therefore, you know, don't worry your pretty
Speaker 1: little head about it, or that's what they say to me. Sore.
Speaker 1: There's three things wrong with that. One is, there are
Speaker 1: single genes that are so impactful that even though in
Speaker 1: the natural population they hardly add anything to it, in
Speaker 1: the medical situation, they have a huge impact, in particular
Speaker 1: for height. There's about seven different medical situations where physicians
Speaker 1: and patients want to do something about height. It isn't
Speaker 1: necessarily because they're genetically defective, and it's some other reason,
Speaker 1: And the answer is one gene. One gene product was
Speaker 1: somatotropin or sometimes called growth hormone. To me, that just
Speaker 1: really nails the counter arguments. So the counter argument is
Speaker 1: the geneticists who don't want you to worry, say there's
Speaker 1: so many different genes they're involved, and you naturally right,
Speaker 1: And you say, well, that might be true naturally, but
Speaker 1: that doesn't mean there isn't an intervention we could make
Speaker 1: exactly on a particular gene that would actually have the
Speaker 1: effect of overshadowing overshadowing the natural variations. So, in other words,
Speaker 1: and it's a mistake to reason from natural variation to
Speaker 1: the capacities of technological intervention exactly. And this is not
Speaker 1: an argument, and this is not hypothetical, because there are
Speaker 1: seven different so called diseases or medical treatments that are
Speaker 1: approved and are in routine use to involve this one
Speaker 1: genes a metatropa. Second, they'll say, oh, we'll have unintended consequences. Well,
Speaker 1: the fact is in medicine we always have unintended consequences.
Speaker 1: We almost always deal with them. We just say the
Speaker 1: benefits outweigh the risks. So that's an ethical argument that
Speaker 1: they make. That The first argument is a don't worry
Speaker 1: because it's not going to be practical to engage in
Speaker 1: these kinds of systematic edits. This argument set is the
Speaker 1: is the ethical concern that says, we don't know there
Speaker 1: might be off target effects, and you're saying, there always are,
Speaker 1: and we were accustomed to that, and we we balanced
Speaker 1: the costs in the benefit. The distinction is blurred between
Speaker 1: practical and ethical very often because you'll say it's impractical
Speaker 1: because there's these off targets. The thing is it is
Speaker 1: totally practical because almost everything has off targets and you
Speaker 1: maybe take a second drug to deal with it, or
Speaker 1: you stratify the population, or there's all sorts of things.
Speaker 1: There's the tricks you can use, so don't they might
Speaker 1: be target effects. When you hear those two arguments, these
Speaker 1: are the grains of salt, you should take it with, okay,
Speaker 1: because they're pretty big grains. And the third one is
Speaker 1: the technology is so far from standing still. I mean,
Speaker 1: it is growing exponentially that that even if you say
Speaker 1: we can't do it today, it could be you know,
Speaker 1: somewhere between minutes in years, not centuries. They often use
Speaker 1: the word centuries. It's incredible, there's no centuries anymore. So.
Speaker 1: So for example, my blab's personal record, a pretty much
Speaker 1: world record for editing genes free Crisper or around the
Speaker 1: time of Christophers two, we could addit two genes, and
Speaker 1: we were very proud of ourselves. We edited more than one.
Speaker 1: Just just literally two years later, we had edited sixty
Speaker 1: two genes simultaneously to make a pig that didn't have
Speaker 1: any viruses and retroviruses in its you know. Just a
Speaker 1: year or two after that, we now have edited thirteen
Speaker 1: thousand genes simultaneously in a mammal in human human cells. Okay,
Speaker 1: not a human important to think. So the point is
Speaker 1: this is moving very quickly. What's great is we're having
Speaker 1: these conversations well in advance. But what used to be
Speaker 1: well in advance. We started talking about designer babies in
Speaker 1: the early days of our comment at DNA and in
Speaker 1: vitro fertilizations sort of in the early seventies. That was
Speaker 1: well in advance. But the conversations we're having now are
Speaker 1: not forty years in advance. They're more like a decade.
Speaker 1: When I look at the overall picture that you describe,
Speaker 1: you know, the extraordinary change, the speed of change. I
Speaker 1: wonder whether the institutions that we've talked about before the
Speaker 1: FDA or the Chinese FDA are really strong enough and
Speaker 1: capable enough to resist the temptations they're going to come
Speaker 1: with the tremendous technological capacities that are being developed. I mean,
Speaker 1: if we look at our history, we don't have a
Speaker 1: great history of using institutions, regulatory institutions to block the
Speaker 1: cutting edge. The cutting edge usually tends to emerge. And
Speaker 1: that's partly, I think because of the power of capital,
Speaker 1: you know, which you've mentioned here. It's also partly that
Speaker 1: once something is possible, there will be people advocating for it.
Speaker 1: If you have a rare disease, you will say, look,
Speaker 1: it's not that it would be unethical to try to
Speaker 1: cure this disease. It would be unethical not to try
Speaker 1: to cure this disease. So can we hold back against
Speaker 1: the potential risks here? You know, we say, now, well,
Speaker 1: of course we would never do this to give people
Speaker 1: purely esthetic advantages, but in reality maybe we would. It
Speaker 1: is true that capitalism can distort the FDA, and it's
Speaker 1: ilk around the world, but I think there is a
Speaker 1: there is still feedback mechanism that's bigger than all of this,
Speaker 1: which is that if it really doesn't work or isn't
Speaker 1: cost effective or desirable, we will stop using it. In fact,
Speaker 1: if it doesn't work. My worry is more, what if
Speaker 1: by work, I mean doesn't work for society that the
Speaker 1: long term benefits society. And they are examples. So first,
Speaker 1: what do FDAs around the world not do? So they
Speaker 1: do safety and efficacy, but they don't necessarily do equitable
Speaker 1: distribution or very long term risk. They have long term
Speaker 1: risks in mind, but the way they've set up the
Speaker 1: structure is if you can convince that on a short
Speaker 1: term risk basis that you've done all the experiments, you
Speaker 1: get to test in phase four, which is basically selling it,
Speaker 1: and then once capitalism kicks in, then it's very hard
Speaker 1: to regulate. So perfect examples of this are nutritional supplements
Speaker 1: and stem cells. Those managed to get into the marketplace
Speaker 1: without full FDA approval and now they're bigger than the
Speaker 1: rest of the pharmaceutical industry and so they're hard to regulate.
Speaker 1: But bad example will be the opioid crisis. I mean,
Speaker 1: it was just about gerty. It's a good one. So
Speaker 1: this is something where if you create something that's sufficiently addictive,
Speaker 1: people will try it and then they become lobbyists. They vote,
Speaker 1: They vote with their wallet, which is in many ways
Speaker 1: more powerful than voting with ballots. That said, there will
Speaker 1: be a feedback system. If any country manages to get
Speaker 1: a business model or a country policy model that prevents this,
Speaker 1: they will win because the nations that can't control their
Speaker 1: opiated crisis become impoverished, mismanaged, etc. They become the new cash.
Speaker 1: Can I push back on that? I mean, so everything
Speaker 1: we've talked about until now, I'm the purest lay person,
Speaker 1: But now when we talk about feedback and the governments,
Speaker 1: I have something to say. And here's what I would
Speaker 1: want to say. We've got lots of examples where societies
Speaker 1: inflict huge costs on themselves, but the costs are not
Speaker 1: so great that they turn them into, as you would say,
Speaker 1: third world countries, because they have other tremendous advantages. So
Speaker 1: tobacco would be a really good example. Yeah, you know,
Speaker 1: I remember my grandfather, who was trained in pharmacy school
Speaker 1: in the nineteen twenties, describing a film that they were
Speaker 1: all shown of the horrible effects on the human lung
Speaker 1: of tobacco smoking. And then the tobacco industry literally came
Speaker 1: bought up all the copies of those films, destroyed them
Speaker 1: and block that from, you know, from being publicly. No,
Speaker 1: it wasn't the same as a cause of a relationship
Speaker 1: to cancer necessarily, but they knew the health effects were
Speaker 1: absolutely terrible incomparable to what you got by working in
Speaker 1: a mind. Yeah, so you know, there's an example of
Speaker 1: total failure of regulatory institution. Absolutely, and the handful of
Speaker 1: countries that we're able to regulate smoking to a slightly
Speaker 1: greater degree did not enjoy any great In fact, there's
Speaker 1: an even an argument, it's a perverse argument, but the
Speaker 1: tobacco companies didn't make it at one point that it
Speaker 1: was good for the economy that people smoked because you
Speaker 1: didn't spend a lot of money on their latent life
Speaker 1: healthcare because they died of lung cancer. So it's not
Speaker 1: always the case that really bad social effects right impoverish
Speaker 1: a country. That's correct. So I was I was just
Speaker 1: saying that there is a feedback mechanism. Yeah, do we
Speaker 1: need other things? We probably do, But do we think
Speaker 1: that we can be a voluntary moratoria do something more
Speaker 1: powerful in capitalism that I think is a little naive.
Speaker 1: We need to think of all the ways we can
Speaker 1: do surveillance, for example, is one of the things I've advocated.
Speaker 1: Rather than being falsely reassured, let's have strong surveillance. You know,
Speaker 1: in the topic today of these Cristopher babies, there were
Speaker 1: plenty of people in the world, both in China and
Speaker 1: the United States who knew about it, but they weren't
Speaker 1: reporting it. We need to encourage whistleblowers, and we need
Speaker 1: to optimize surveillance. I mean this one form of surveillance.
Speaker 1: The other form of surveillance is computer surveillance. So we
Speaker 1: should have computers looking through all the orders that are
Speaker 1: relevant to synthetic biology broadly, and maybe other technologies as well,
Speaker 1: to see if people are doing things for which they
Speaker 1: do not have a license. So the privacy concerns interview
Speaker 1: are just outweighed by the tremendous dangers associate with lack
Speaker 1: of So I think that everybody who practices synthetic biology
Speaker 1: and it's close relatives has given up some of their
Speaker 1: privacy rights in the same sense that when you get
Speaker 1: a driver's license, you give up certain rights. There are
Speaker 1: radars that are looking to see what you're doing. You
Speaker 1: can get pulled over if you're weaving around and you
Speaker 1: can get an alcohol test, and you can get they
Speaker 1: can check your age and so forth. You have to
Speaker 1: have surveillance, and we do have more resistance typically those
Speaker 1: forms of surveillance in the US than they do, for example,
Speaker 1: in Europe. Here we think, you know, it would be
Speaker 1: a terrible violation of our civil liberties if when we
Speaker 1: got onto the highway they check the time, and when
Speaker 1: we got off the highway they check the time and
Speaker 1: saw whether we were speeding in between. But in you know,
Speaker 1: if you did it on the mass Pike, you know
Speaker 1: there would be a riot here in Massachusetts. But in
Speaker 1: Europe there are speed cameras everywhere. The fines are enormous.
Speaker 1: You know, you are meant to feel surveilled when you drive,
Speaker 1: right that you do feel surveiled when you drive there,
Speaker 1: And that's pro social, that's that's that's desirable, and that's
Speaker 1: why I think when we create boogeymen outside the United States,
Speaker 1: were completely ignoring how we have a huge fraction of
Speaker 1: the world's billionaires, many of whom are very pro libertarian.
Speaker 1: I can do whatever I want, or I think it's
Speaker 1: much more likely that the rogues are going to be us. George,
Speaker 1: thank you so much for your fear time, and thanks
Speaker 1: for sharing your ideas. I'm not sure I emerged less
Speaker 1: worried than when I started, but you've told me that
Speaker 1: worries healthy, so I guess I've got plenty of it.
Speaker 1: Thank you very much, thank you, thank you. I asked
Speaker 1: George Church to come on the show because I wanted
Speaker 1: to get a better sense than I had about just
Speaker 1: how worried we should be about the potential advent of
Speaker 1: designer babies. When George first started talking, I started to
Speaker 1: feel better. I began to think that maybe the FDA
Speaker 1: was a reasonable institution for regulating the possible bad effects
Speaker 1: of designer babies. And George was also reassuring about the
Speaker 1: thought that the Chinese government also is interested in blocking
Speaker 1: progress from going too quickly or getting out of hand.
Speaker 1: But as our conversation proceeded, I started to get more
Speaker 1: and more were nervous. In particular, George was pretty convincing
Speaker 1: in suggesting that those scientists who say we don't have
Speaker 1: to worry about gene editing leading to designer babies soon
Speaker 1: are actually completely wrong about that. Then, as he began
Speaker 1: to describe the potential effects of companies and capitalism on
Speaker 1: the development of science. I began to think that maybe
Speaker 1: they were going to be economic pressures driving us in
Speaker 1: the direction of greater and greater innovation and greater and
Speaker 1: greater risk taking. And finally, when we circled all the
Speaker 1: way back to those same regulatory agencies, George seemed to
Speaker 1: think that there was some possibility that in the long
Speaker 1: run we would make mistakes, but that we would be
Speaker 1: self correcting. And there he and I parted paths because
Speaker 1: I'm deeply afraid that we're not that good at fixing
Speaker 1: our mistakes, that there are too many examples of our
Speaker 1: regulatory regimes breaking down. And we ended with George saying
Speaker 1: that he thinks that if anyone's going to go rogue,
Speaker 1: it's going to be us right here in the United States,
Speaker 1: and that, my friends, leaves me more nervous than anything else.
Speaker 1: Deep Background is brought to you by Pushkin Industries. Our
Speaker 1: producer is Lydia gene Coott, with engineering by Jason Gambrel
Speaker 1: and Jason Roskowski. Our showrunner is Sophie mckibbon. Our theme
Speaker 1: music is composed by Luis GERA special thanks to the
Speaker 1: Pushkin Brass Malcolm Gladwell, Jacob Weisberg, and Mia Lobel. I'm
Speaker 1: Noah Feldman. You can follow me on Twitter at Noah R. Feldman.
Speaker 1: This is deep background