Should We Use Gene Editing to Make Better Babies?

Summary

In a riveting debate on Intelligence Squared, experts explored the contentious issue of using gene editing to create 'better babies.' With significant advancements in gene editing technology, the debate highlighted polarized views on ethical, social, and scientific implications. Proponents argue gene editing could eradicate genetic diseases, while critics warn of exacerbated inequalities and ethical dilemmas. Despite varied opinions, the discussion emphasized the need for robust regulations and a collective ethical framework moving forward.

Highlights

• Proponents like George Church argue gene editing can make babies healthier by eradicating genetic diseases. 🍼
• Critics like Marcie Darnovsky warn against potential societal divides and ethical dilemmas. 🚫
• The debate calls for a global consensus on regulations and ethical frameworks. 🌐
• There's an emphasis on preventing misuse of the technology for non-medical enhancements. 🌿

Key Takeaways

• The debate on gene editing for 'better babies' centers around ethics and capabilities. ⚖️
• Proponents see gene editing as a chance to eliminate genetic diseases. 🧬
• Critics fear it could lead to greater social and economic inequality. 📉
• Both sides agree on the necessity of stringent regulations. 🔍
• The discussion urges a focus on collective human values and responsibilities. 🌏

Overview

In an engaging and thought-provoking debate on Intelligence Squared, experts delved into the possibilities and perils of using gene editing to craft 'better babies.' With considerable technological advancements making this a tangible option, the conversation oscillated between optimism for eradicating genetic diseases and caution against ethical pitfalls.

Proponents of gene editing, such as renowned geneticist George Church, argue that gene editing technologies can be used ethically to enhance the health of newborns by removing genetic diseases. They emphasize its potential for creating healthier generations and alleviating genetic disorders, viewing it as a moral imperative to reduce human suffering.

On the opposing side, figures like bioethicist Marcie Darnovsky express concern over the ethical and social implications of gene editing, advocating for stringent regulations to prevent its misuse. They fear that without proper oversight, gene editing could widen social inequities and lead to undesirable societal transformations. The debate underscores the urgent need for a balanced approach that respects both scientific progress and ethical considerations.

Chapters

• 00:00 - 15:00: Introduction and Opening Statements The chapter introduces the concept of using gene editing technology to prevent hereditary diseases. It sets up the ethical debate surrounding its use, highlighting the potential to prevent genetic diseases in children while also addressing concerns about inequality, societal pressure, and moral implications. The chapter outlines the division in opinion—between critics worried about ethical drawbacks and proponents who see potential benefits with proper regulations.
• 15:00 - 45:00: Discussion and Rebuttals The chapter titled 'Discussion and Rebuttals' delves into the debate of whether gene editing should be used to make better babies. It considers the scientific advancements and ethical implications of humans having the power to alter DNA. The discussion is prompt due to rapid developments in gene editing. Despite the presence of regulations and guidelines, the discourse focuses on the responsibilities and moral challenges faced in this new era of genetic modification.
• 45:00 - 58:23: Closing Statements This chapter discusses the ongoing development of regulations surrounding gene editing technology. The central dilemma presented is the ethical question: 'Just because we can, does that mean we should?' The discussion is launched as part of the Intelligence Squared series, with John Donvan leading the conversation.

Should We Use Gene Editing to Make Better Babies? Transcription

• 00:00 - 00:30 [Music] picture this a genetic disease runs in your family your doctor warns you that if you try to have a child that child is likely to inherit the disease but new gene editing technology could change your child's fate critics say this technology will exacerbate inequality pressure everyone into editing their children to stay competitive and will meddle with the most basic aspect of our humanity our dna others say with safeguards against abuse this technology could benefit us
• 00:30 - 01:00 in a host of ways in that context we debate this question should we use gene editing to make better babies [Music] thanks everybody for joining us and today we are examining the science and the ethics of a new reality the fact that we humans now have the capability and perhaps we should call it the power to change our dna all because of stunning and stunningly fast developments in the field of gene editing yes there are rules and
• 01:00 - 01:30 regulations being written about this all of the time to try to catch up to where this science keeps going and different countries are doing that in different ways but the core issue surrounding the possibilities presented by gene edinting comes down to this just because we can does that mean we should that is the debate we're launching right now i'm john donvan and this is intelligence squared
• 01:30 - 02:00 okay everybody you have a duty to perform here now and that is to judge this debate to tell us which side you feel argued most persuasively we're going to ask you to
• 02:00 - 02:30 cast a vote on our motion use gene editing to make better babies before you've even heard any of the arguments and then we're going to ask you to vote a second time after you've heard what everyone has to say and here at intelligence squared we name as the winner of the debate the team whose numbers go up the most between the first and the second vote in percentage point terms the first vote happening right now here's what we want you to do go to iq2us.org that's iq2us.org
• 02:30 - 03:00 in a web browser you will there find a multiple choice field where you will tell us whether you are for against or undecided on the statement use gene editing to make better babies i'll give you just a couple more seconds to get that first vote in i'm watching you do it okay i think you've done it so now it is time to meet your debaters arguing for the motion use gene editing to make better babies is george church renowned geneticist who helped develop the first direct genomic
• 03:00 - 03:30 sequencing method which led to the human genome project his partner amy webb founder of the future today institute and author of the genesis machine opposing them francoise bayless a leading bioethicist and philosopher whose research extends to heritable human genome modification her partner marcie darnovsky executive director at the center for genetics and society who has written extensively about the politics of human biotech
• 03:30 - 04:00 and now here we are all together i want to thank everybody for joining us for this intelligence squared u.s debate great it's great to be here so let's move on to a round one and round one is comprised of opening statements from each debater in turn these statements will be four minutes each again our motion is use gene editing to make better babies and speaking first in support of the motion here is george church george the screen is all yours thank you uh the answer is yes we should use gene
• 04:00 - 04:30 editing to make better babies unpacking this a little bit gene editing includes subtracting adding or substituting dna in cells our debate topic very notably does not mention heritable or germline to make better babies means making them healthier as in how is your baby feeling better today this debate is not about can anything go wrong
• 04:30 - 05:00 of course it could go wrong but rather than banning cars completely we regulate we minimize risk via airbags children's car seats and speed limits benefits must weigh outweigh the harm that's the decision similarly we've been working very hard to minimize potential risks of gene gene therapy and editing the negatives uh off-target effects slippery slopes unneeded enhancements high costs
• 05:00 - 05:30 and high unknown impact in unconsented future generations this debate is about given extensive safety improvements and testing will we accept fda approved use of gene editing in babies in fact do we approve of gene editing that is already happening to make babies better for example car t anti-cancer therapies involve gene editing
• 05:30 - 06:00 babies as young as seven months astrazeneca and sputnik covet 19 vaccines are adenoviral capsid delivery of dna which via maternal antibodies protect babies note that the cost of these can be as low as two dollars a dose which is a big step towards equitable access which i know is an issue even earlier in life are prenatal gene therapies these have been tested since 2018 for gaucher's disease in which
• 06:00 - 06:30 babies would otherwise die in two years many serious de novo genetic diseases in babies are undetectable in parental genomes for example ret syndrome which also has a gene therapy in testing so we need to do this independent of the parental any one of these four examples car t covered gauchers and rhett should be sufficient to settle this debate but what if we feel obliged to also consider heritable changes or
• 06:30 - 07:00 enhancements despite both topics absent in the debate title if so then consider the scenario of a human specific disease without affected vaccines and with persistent and emerging drug resistance over decades as for example hiv and malaria germline editing of one or more proteins could make our cells more chimpanzee-like and hence make us resistant
• 07:00 - 07:30 with few or no side effects as is seen in nature for hiv and malaria where chimpanzees are resistant to our particular form rather than a ban on fda approved gene editing as we have now in certain cases we need to encourage a culture of whistleblowing on inappropriate use current laws did allow criminal punishment of three people so far but these laws do not necessarily prevent future abuses
• 07:30 - 08:00 of the same nature or prevent covert governmental use so this is what we should emphatically resist while just as emphatically encouraging carefully regulated clinical trials on gene editing to prevent childhood diseases so please vote yes for ethical cautious gene editing to make better babies george for people who don't know the terminology can you please just take a moment to define germline for us
• 08:00 - 08:30 so germline gene therapy would be something that affects not just the individual but affects subsequent generations it's heritable is another term somatic gene therapy would be something that only affects the current generation as far as we know that's the distinction thanks very much george church our next speaker will be speaking against the resolution here is marcie danovsky marcy the screen is yours
• 08:30 - 09:00 thank you and thanks to intelligence square for organizing this important conversation so to be clear i'm going to be talking about reproductive or heritable gene editing which i think is what most people understand when you're talking about making better babies and which is what the policy debate that's been going on is really about so my strong belief is that using gene editing this way in an attempt to make so-called better babies would be both wrong and dangerous
• 09:00 - 09:30 it would be wildly unsafe for those babies certainly that's true now and probably always and it would have the terrible effect of exacerbating our already horrendous social and economic inequalities in fact it would throw open the doors to new kinds of social injustice and on top of that heritable or reproductive gene editing isn't needed for any medical reason that's the justification that's typically given but it's weak at best
• 09:30 - 10:00 let's take a look at that say that you have a harmful gene variant and you want to make sure your children don't have the disease that it causes here's the thing you can already do that and you don't have to muck around in your future children's dna to accomplish it in fact everyone with a disease-causing gene can have children unaffected by it by using donated eggs or sperm and very nearly everyone in that
• 10:00 - 10:30 situation can have unaffected children who are also genetically fully related to both members of a heterosexual couple by using a safe and established embryo screening and selection technique now it's important to say that embryo selection isn't itself ethics free it does raise thorny questions about what kind of people will welcome into our world but using gene editing to create future children and future generations
• 10:30 - 11:00 would amplify these concerns many times over and would carry additional grave social risks and safety risks what reproductive gene editing does make possible is attempts at human enhancement and even if those attempts weren't successful in biological terms the perception that genetically modified children are biologically better than others would make the already obscene inequalities of our society much much worse
• 11:00 - 11:30 and that is the likely societal consequence of attempts to create better babies even if those attempts are well intentioned now some proponents of heritable gene editing like george church for example are open about wanting to eventually use it for enhancements but that would mean we'd be putting our efforts toward building a world of genetic habs and have-nots as geneticist eric lander who is now the top science advisor to president biden has put it the so-called best genomes would go to
• 11:30 - 12:00 the most privileged now to be sure enhancing complex traits like iq or musical talent those are um technically dubious the traits are just too complex but supposedly enhanced children would be perceived differently and they would be treated differently the wealthy parents who invested money and energy in them would would make sure of that and then the advantages that come with wealth would be attributed to genetics
• 12:00 - 12:30 instead of to privilege i think it's really far-fetched to think uh that lots of people would be able to afford this in a society where millions of people have no access to basic health care and if you've seen the movie gattaca you know how this turns out a world in which the genes that your parents are able to afford determine where you go to school where you can work even your dating prospects in the real world better babies was the
• 12:30 - 13:00 project of early 20th century eugenics it may have seemed benign when u.s eugenicists had better baby contests at state fairs but we know about the ghastly outcomes of that project reproductive gene editing of course would be different not enacted by government policy or coerced by state violence but driven by commercial dynamics marketing offers peer pressures on parents so the bottom line gene editing is a remarkable scientific
• 13:00 - 13:30 achievement if used wisely it carries enormous promise so let's use it to treat people who are sick not to design babies thanks very much marcie darnowski next up on the screen with an opening statement in support of the motion use gene editing to make better babies here is amy webb amy it's your turn john thank you so much and i would like to appreciate and thank the intelligence square community for allowing us to engage in one of the most important and enduring debates of our time and mercy i
• 13:30 - 14:00 really appreciated your thoughtful remarks in his opening marks you heard george make the case for ethical cautious gene editing and i'd like to venture a little deeper into the reasons why gene editing should not only be allowed but that we ought to champion gene editing right now we are living through an inflection point in humanity we can now read and debug the code of life there are three reasons why we ought to further develop this miraculous technology
• 14:00 - 14:30 first nature is literally full of bugs the natural world is riddled with errors and mutations millions of babies are born each year with errors in their biological code awful mutations that cause diseases like tay sachs disease and cystic fibrosis until recently there was no way to know in advance if an embryo had that mutated code gene editing allows us to make corrections in that code and to prevent
• 14:30 - 15:00 it entirely if we can prevent human suffering we are morally obliged to do so second humans in our current form are vulnerable to external threats like novel viruses it's plausible that sars cov2 which causes covid19 will become endemic like influenza but there are so many other lethal viruses that persist you heard
• 15:00 - 15:30 george explain just a few of them hiv for example there's also mers the middle east respiratory syndrome which has a mortality rate of around 35 gene editing makes us less vulnerable to the 1 500 or so species of patho pathogens to humans that we know today and the billions of pathogenic viruses protozoa organisms that luckily we haven't encountered yet gene editing makes us more resilient
• 15:30 - 16:00 third humankind needs optionality the resolution that we are affirming today is that we should use gene editing to make better babies the survival of our species requires intervention humankind is part of a larger biological ecosystem earth one that's changing faster than we are evolving naturally on our own it's improbable that the world's largest
• 16:00 - 16:30 economies will ever align on co2 reduction geoengineering or other climate mitigation strategies gene editing will at some point give us the chance to make edits and upgrades to enable us to live comfortably in our communities now today you are likely to hear our opponents say some pretty scary things in fact you've already heard some pretty scary things marcy has already talked about wildly scary potential outcomes a future in
• 16:30 - 17:00 which we have gattaca-like haves and have-nots where rich people get to create designer babies the way that you would walk into a build-a-bear workshop in the mall and select all the traits that you wanted uh to include in your baby there is no evidence and you will hear george and i say this over and over again but there is no evidence to support the claim that gene editing will benefit the wealthy specifically in fact there is ample data and ample evidence
• 17:00 - 17:30 to support the contrary i'm here along with george to make the case that gene editing can be safe but i'm not a geneticist i'm a quantitative futurist i'm a social scientist and i use quantitative and qualitative data to build scenarios that model next order outcomes so i'm here to help you understand the dangers of catastrophizing there is no way to predict the future it is statistically and mathematically impossible when we are looking at something with as many
• 17:30 - 18:00 variables as the futures of life where an unknown number of variables under no one person's control are at play we cannot accurately predict the future but that does not give us license to speculate wildly about what might happen like assuming that gene editing will inevitably lead to catastrophic outcomes agreeing with our opponents today is tantamount to robbing our futures simply because we refused to change our mental
• 18:00 - 18:30 models voting yes on this resolution doesn't automatically lead to gattaca to a dystopian future voting yes gives us optionality and a chance to improve our well-being thank you thank you amy webb and now we go on to our final opening statement and it will be against the motion from francoise bayless francoise the screen is yours thank you and i really appreciate the opportunity to sort of share some of my views uh with the audience i want to say at the outset that in the abstract i'm
• 18:30 - 19:00 willing to be persuaded that we should use human genome editing technology to build better humans but the problem for me is i've yet to hear what i would consider to be a really robust definition of better i think what constitutes better in the minds of some is a function of where we are at this moment in time and so in some sense it's a little bit of a fad today this is better tomorrow something else is better the other thing i haven't heard really is a really good argument that actually
• 19:00 - 19:30 tells us why we should spend our time talent and treasure on this particular technology in pursuit of a reproductive goal of building better humans so i want to be very clear about this the time and talent of members of the scientific community and the resources that we have to invest in science are limited and so we actually have to make decisions about where we want to make those investments and that's why i want you to vote against this motion i think
• 19:30 - 20:00 there are better things we could be doing with our time our talent and our treasure so let me just share with you what are the common arguments that are typically brought forward in you know support of the motion one of them is the right to have genetically related children it is said repeatedly that there are people parents prospective parents to be more precise who are at risk of having a child with a serious genetic disease perhaps even a lethal genetic condition
• 20:00 - 20:30 they want to have children they have the right to have children the second argument often brought forward is that we use enhancements all the time why think we should stop here and the third argument which you've just recently heard is that it's important for humans to take over the human evolutionary story in order to ensure our survival well i want to very quickly go through these and show you why they're not persuasive
• 20:30 - 21:00 first of all there is no right to have genetically related children saying doesn't make it so there is in fact no international agreement in support of this claim what there is is a right to reproductive claims but they are very specific so when you hear the words reproductive rights it's actually about the right of women to control their bodies to control the timing the spacing the number of children that will make up their family so it's really about access to things like
• 21:00 - 21:30 contraceptives or termination of pregnancy the second claim about we use enhancements all the time is in one sense very true i mean that's why we send our children to school that's why some parents give them piano lessons because they've heard it helps with their math abilities it's why we have things like cosmetic surgery but i want to suggest that there's something fundamentally different in this context where you're actually tinkering with that which makes human life and that's true whether you're talking
• 21:30 - 22:00 about tinkering with the gametes or tinkering with the embryos and the third point about taking over the human evolutionary story well i understand that in the context of what we're currently doing which is wrecking our planet and so there are people who imagine that there will come a time when we can't survive here because the water's polluted the air is polluted we've got problems with climate change etc and so they really are careful about looking at this as a design project and so we need to redesign the human so that
• 22:00 - 22:30 it can either survive on this planet and would be able for example to drink polluted water and not get sick or it's a design project where we have to get off of this planet and we have to be able to survive on another planet or in a spaceship and i really want to say gosh that seems a pretty extreme response when all we could do is not wreck this planet and so what i want to say very clearly is it's important to understand that this is cool science but we should be using science to build
• 22:30 - 23:00 a better world for all of us and i really worry that this ultimately will be a form of personalized medicine that will really promote the interests of a select few and you and i probably won't be amongst that select few thank you very much francoise and that concludes round one of our intelligence squared us debate and now we move on to the second round and the second round is much more of a conversation where the debaters address one another directly they also take questions from me which is how i'd like to actually start this
• 23:00 - 23:30 round i want to go to francoise because francoise amy is challenging your central claim by saying there is no evidence for it so i'd like you to take that on no evidence for the claim that there would be haves and have-nots in this future well i can actually respond to that very easily because i'm actually the only panelist that lives and works in a country that has government-funded health care and we provide that health care to everyone so we don't even have to talk about fancy technology or enhancement we can just talk about basic
• 23:30 - 24:00 health care we make that available to all citizens that's not the case in the united states and so why would you imagine that this very complicated very expensive technology somehow would all of a sudden become available to everyone they're not hypothetical there's a whole world that has told us and shown us repeatedly that you can't get access to basic healthcare so why would you think that personalized medicine is now going to be readily available now the other thing i do want to say because i think
• 24:00 - 24:30 it's important and some of the other comments that have been made is on the other side you're hearing a lot about safety and efficacy and we may not be there yet but we will be there and then all we need to do is rely on you know appropriate regulations and oversight i think what's really important to say here is that for me this isn't just about safety and efficacy it's about a world view it's about the kind of world we want to build and the kind of humans we might want to have in that world and
• 24:30 - 25:00 so you know i want to say really clearly we already know for example how to safely and effectively destroy the rain forest in the amazon in order that we can have cattle grazing i wouldn't say that's wrong we can already safely and effectively if we wanted to destroy the mona lisa i'd still want to say that that's wrong so we cannot rely just on safety and efficacy getting us to a point where we then assume that all that matters is governance in the strict sense of
• 25:00 - 25:30 applying legislation guidelines rules treaties what have you what we really need to understand is that this is about the kind of world we want to build we start off by talking about oh this is so important it's going to allow us to treat and i'm saying that in inverted commas children with terrible inherited diseases and that's not what it gets used for george francois is saying there's already plenty of evidence that the equity maybe to some degree the ethics have
• 25:30 - 26:00 already demonstrated themselves to be slippery and observed only in the breach that that that the story is already quite worrisome and i would like to ask you to take that on i agree but i was pointing out that these are approved um and if they and the if on the other hand um things that that are that we would like to see that would would be equitably distributed would be things that were inexpensive that's why i mentioned that the gene
• 26:00 - 26:30 therapies that that fight covet are as low as two dollars a dose and they could be lower and they could be because there's a gigantic uh economic benefit they can be given away freely and often are that's the sort of thing that would be acceptable uh i think um is something where there's a strong health consequence and it can be distributed globally we're not looking for all the ways this can go wrong as i said we're looking for the
• 26:30 - 27:00 few cases where it could go right well let me marcy hearing what george has to say is there really that much difference between your position on this resolution and his i think there's a huge difference yes well so you know it's it's really interesting to hear you george agreeing that you know germline is such a problematic enterprise and that's not how i've interpreted your pastor mark so i don't know if you've changed your mind or if it's just that for the purposes of
• 27:00 - 27:30 this debate we need to be much clearer about our terms i think it really muddies the understanding if we talk in one breath about making changes to embryos or gametes that will be then present in every cell of every tissue of the any resulting child in all future generations that that child gives birth to that's heritable or reproductive or germline gene editing using gene editing to produce vaccines
• 27:30 - 28:00 or even to produce gene therapies that alter the tissues of an existing patient those are really different things apples and oranges they're considered that way in the debate they're considered that way in policy and in for the purposes of our conversation today i think it's really important to keep that distinction quite clear amy um i'd like you to to jump in and take on a question that has to do with more geopolitical kind of presentation here and that is that while
• 28:00 - 28:30 it has already been pointed out that governments are not the only agents in this whole process governments are agents in this process and we're in a world where um we can certainly imagine that certain governments would commit to improving through gene editing through inheritable gene editing their citizens health their intelligence their resilience their physical strength in order to be competitive in the world stage i want to ask you to take that on do you think that that is a realistic scenario do you
• 28:30 - 29:00 think it is one to be concerned about it is it one that you think that we would want to be responding to um i i think the answer to that is is yes um listen the united states and china are two of the world's largest economies certainly in one of the largest innovation ecosystems where science and technology are flourishing in different ways and unfortunately uh oftentimes the technology and science become embroiled in politics the development of ai is
• 29:00 - 29:30 already part of that um strategic race between the two countries and if we're not careful gene editing is going to wind up in the same place now you've heard mercy and francoise talk about regulatory frameworks that exist around the world but there is still quite a bit of disagreement in different countries on you know how to approach some of this going forward there's also some alignment in unusual places so in germany
• 29:30 - 30:00 um there's uh the german ethics council exists to some degree because of experimentation that took place um under the nazi regime in world war ii you know even they have started to come forward and you know imagine a future in which uh germline editing that's regulated that exists within boundaries so none of us here today are are talking about unbridled experimentation um but a future in which
• 30:00 - 30:30 this might be beneficial so again this isn't about enhancement for enhancements sake or optimizing for optimization's sake we've really left uh you know our our evolution up to serendipity and happenstance and chance uh until this point we have an opportunity to just think a little differently part of what i mean but your opponents are saying that it would turn very quickly into enhancement for enhancements but we don't have yeah john i get it i
• 30:30 - 31:00 hear that and i hear this argument all of the time it's what i call the paradox of the present we use what we have seen or heard previously and assume that that is what's probably that's what's most likely to go forward i model probabilities for a living and at the moment we don't have enough evidence supporting the claim that that this will necessarily take a dystopian right george has already look we all agree that there's a lot of danger here but there's also opportunity and the opportunity comes
• 31:00 - 31:30 through thoughtful use regulation and frameworks to sit back and pull the plug on all of this because we're not willing to come to the table and sort out what the regulation should look like is not you know what is dismissive well i'm not sure your opponents are saying to pull the plug on this process but i just want to check in with them francoise or or marcy are you is your argument let's stop this we're not no one is arguing that we stop gene editing we believe i think i can say for everyone here that gene editing
• 31:30 - 32:00 holds promise and yes it does have to be carefully regulated and the many smart people who have thought over decades about how to regulate it have really come to the same conclusion there's not disagreement among between countries there's disagreement within countries yes there's this agreement within the scientific community with many taking the position that is reflected in the motion use gene editing to make better babies
• 32:00 - 32:30 and many equal numbers may be greater we don't know for sure taking the opposite position the position that i taken from swaziland's take that we should vote no on this resolution yeah so if i can just jump in here i think it's really important to acknowledge the following there's a fair bit of diversity between countries right now with respect to using genome editing technology in the lab and there you will see some countries that are actually supportive and have legislative structures and governance in place to carefully
• 32:30 - 33:00 regulate that kind of manipulation but you do not see that diversity with respect to taking those embryos and pursuing a reproductive project we've done that empirical work and it shows very clearly a i want to say unanimous but it's kind of difficult to say that in the context of we were not able to find documents for some countries but for the countries we were able to find documents which is more than half the countries of the world we were unable to find a single country
• 33:00 - 33:30 that actually officially approves endorses this technology so that's just the fact of the world today could that fact change of course so the other thing i would like to say and that's the first time i want to agree with uh my opponents with respect to the debate um i agree we cannot predict the future none of us can do that accurately so in the absence of having that kind of ability i think it is reasonable to look at where have we shown talent before what have we done in the past and what we have done and we
• 33:30 - 34:00 have done it in spades in the last 20 years or so is we have blindly gone along a path which has increased inequity to the point i would say of crisis so why would we think that all of a sudden that's just going to turn on a dime we're seeing right now in equities that you know at a level that are shocking and they've been quite frankly exacerbated by the pandemic we're living through now so i do worry about what i perceive anyhow to be a certain amount of hubris to say
• 34:00 - 34:30 well you know there's lots that's wrong right now with the human genome and we can fix it i'm thinking really how do you get that confidence that you won't make a mess of things and why is it unreasonable to predict that no everything is not going to go right it could really go off the rails it seems to me that both proposals are possible amy go ahead do you look we are shaking your head there yeah listen again i with respect to everybody's thoughtful comments here um there there is no evidence so so the
• 34:30 - 35:00 issue is that the types of inequity that we're talking about are often brought into this debate but there's there is very little evidence um that would show that the future is one in which there's less equity because of this intervention on the flip side if we are in a position which we are nowhere close to being by the way but if we are someday in the farther future in a position to do editing at scale what would it have taken for that to be
• 35:00 - 35:30 true for one thing it would take genomic databases that are orders of magnitude larger than we have today and for that to have happened we would need more people to agree to have their genomes sequenced and to participate in studies at the moment most of the people most of those databases are fairly homogenous so the current situation is that we have mostly caucasian people from mostly wealthy countries who are who are in these
• 35:30 - 36:00 databases to begin with if we but aiming you're making our point this is like i would love to finish my body i would love to finish my thought because i there's something subtle here that i think gets missed in this conversation if we take a much longer view over many more years what we have is an opportunity to bring inclusivity into the current processes and on the other side of that if we have therapies at the moment we don't have structures in place
• 36:00 - 36:30 for who would pay for anything that what we know to be true today is that we have we have a therapy that's been covered by governments and in the united states we don't have nationalized healthcare we have free vaccines the reason that the inequality exists is not socioeconomic there are there are data proving that out it has to do with misinformation um it's because people we're all free to disagree with each other but please somebody show me the data to support those claims data is what i work with for a living oh my goodness amy there's so much data about
• 36:30 - 37:00 social health and economic disparities and there are so many people talking about the covid but you can't take out one one example of free vaccines and have that to be a substitute for equity in health care and health that i'm not i'm saying that it's useful for us to use that as an example george i want to come back to you with the question that circulated around a little bit before because you've been in this field it is your field your you know its potentials and where it's going and it and the realities of working in the science on a day-to-day
• 37:00 - 37:30 basis do you have any concern to you know a version of what your your partner amy said that we're we're uh sort of holding ourselves back i want to put in another way that we would be left behind competitively in the world market in being able to develop and and and control and use this uh technology i'm i'm not concerned about the competitive market because i think that i i would like to believe that if any
• 37:30 - 38:00 nation leads the others will follow and i don't particularly care who leads and who follows i want us to float all the boats um i am concerned that we if we that inaction is not a uh foolproof strategy we can really screw up by being slow or inactive in in the prop as which is exactly what happened with cover 19. we were slow to adopt net mass vaccines distancing tests
• 38:00 - 38:30 and we could do that again with a in a whole variety of emergency cases and the gene therapies that were used for vaccines um were dirt cheap because billions of people benefited um and i think that's where the the future lies is helping the poorest people and helping people is that is that is that helping for better babies is is a vaccine part of the art yes it is better babies it it it is because of francoise asks
• 38:30 - 39:00 for a robust definition and i can't give the most robust but i can the definition i gave is that they are healthier they are healthier than our ancestors babies were they are healthier than they would have been otherwise but it's really important both for this conversation and for our conversation about vaccines to be very clear the vaccines do not change the genes of human beings yeah so i'm afraid by finding the water you're getting us into very deep water church yeah sir i just wanted to jump in
• 39:00 - 39:30 and say that i think one of the things that's highlighted there is something that i've written and spoken about a lot which is the difference between wants and needs and one of the things that i think is important is to understand that we can't always respond to what everybody wants we do have moral responsibilities to respond to needs and so i think the thing that's really interesting is where does family making fit in that kind of a conversation so i think a lot of people want to become parents a lot of people want to have genetically
• 39:30 - 40:00 related children i don't think we have a moral obligation to respond to that want and let me explain it this way if somebody needs food of course i should give them food if they turn around and say they want a croissant it's like well no you have a need for food you may want some other kind of food but that's not where i have a moral obligation to respond and so in that context i think it's really important to think about ways that you might offer therapies perhaps even you know genetic therapies to your child
• 40:00 - 40:30 who's born and perhaps has a genetic condition that could be treated as contrasted with selecting in advance traits that you think are desirable and then putting this together to try to make what you think is the better baby and i want to make one more point which is that there are places that have already started to advertise this there's a couple of clinics i think unscrupulous clinics and i'm quite convinced that they can't actually provide anything that they say they would provide but they're proposing to use crispr to do things like
• 40:30 - 41:00 change skin color change hair color and increase breast size i'm sorry that's crazy i don't friend but friends was interesting in this debate i don't think your opponents are endorsing at all those sorts of enhancements i i totally agree that's meant to talk about what might the future look like so we've been hearing whether or not we can predict about the future and i'm saying well here's an example about the present and the ways in which that technology is being marketed so i think that does
• 41:00 - 41:30 speak to what i might anticipate happening in the future which is that more unscrupulous clinics might offer these kinds of interventions under the guise of building better babies and if there were a the ability to genetically edit out a risk for alzheimer's which challenges cognitive cognition would that be a good thing to go for george i i i think this nicely illustrates first of all there's plenty of
• 41:30 - 42:00 we're not usually interested in uh all forms of intelligence we probably should be uh it's very often a very narrow thing that that people would want and their very narrow types of intelligence have been shown to be fairly easily manipulated in in animals i think the place where we should be drawing the line is where francoise was saying about world view and what we actually want to do and outcomes rather than mechanism by which
• 42:00 - 42:30 we achieve those outcomes so what worries me is that we will develop drugs and gene therapies that will address alzheimer's in adults and they will be used off label for enhancing inheritance intelligence in adults and then we will truly have the invalids in the social divide that we're trying to avoid with this arbitrary line in the sand uh i totally applaud the the the avoiding of avoiding uh inequities and in fact
• 42:30 - 43:00 straightening out the inequities we have right now but i don't think that saying that you can only fix it if you have enough money to to to cure alzheimer in in somatic cells and you can't do it in germline so can i just interject because i actually would like to offer a response to both formulations um of your question the first one was you know about increasing intelligence and iq and at the time in response i thought the only way i would have to answer that question is to refer people to jonathan
• 43:00 - 43:30 glover a philosopher who when asked that kind of question said of course yes we need to do that why because we're too stupid to stop wars and so what that already tells you is that the focus is on what's the goal what's the objective and so in that context it wasn't about getting a competitive advantage it's about how we make the world a better place and we're not doing a very good job of it right now and then you reframed it in terms of alzheimer's and one of the things that you know i wanted to share is that my mother passed away of alzheimer's
• 43:30 - 44:00 disease and our family lived with that through a period of about 10 years it was very difficult it was very challenging it was hurtful my mother was a very strong and powerful woman and i thought this is a terrible way for her to exit this world and yet at the same time i think i'm a better person for having lived through that experience and i wanted to say that in the context of having challenges that we have to face and overcome and sometimes they're very deep and hurtful but they make us who we are and they make for the rich diversity and i think
• 44:00 - 44:30 we ought to be worried about trying to always massage things in the world so that we're better off in some sense and again it's that question what does it mean to be better well very very profound way to finish round two i want to thank all of you for the conversation we just had and now we move on to round three and round three will be comprised of opening statements by each debater in turn they will be two minutes each and first to speak in support of the resolution is george church george once again the screen is yours thank you i i want to
• 44:30 - 45:00 make sure that we're not confused between somatic and germline i'm i'm using vaccines as an example of something where we can create equitable healthcare not as an example and and some of them do involve gene therapy but somatic gene therapy the germline i i consider that there is a possibility that that that we have not ruled out that germline could have a similar uh equitable uh response to an
• 45:00 - 45:30 emerging and an emergency use to that point all humans since 1978 are enhanced relative to our ancestors with respect to smallpox all of us not just the rich our parents immune cell dna was altered not the germline one person in a million vaccinated did die of side effects subsequent generations were not consented
• 45:30 - 46:00 but are we grateful for this arguably the only equally distributed technology in history yes i think most of us are grateful um would we do the same for malaria or another disease like it yes i think we would even if it involved germline sorry gene editing yes germline i think the jury is out would we use or continue to use gene editing for car t covered gauchers rhett etc i would say yes germline
• 46:00 - 46:30 you decide but please vote yes there are reasons to use gene editing to make better better healthier babies thank you george church our next speaker will be making her closing statement against the motion here is marcie darnovsky marcy your turn again thanks john so the motion today is use uh use gene editing to make better babies and what do we mean by better babies how do we imagine what better babies would
• 46:30 - 47:00 look like well i have a collection of magazine covers that feature pictures of so-called better or designer babies and these magazines include mainstream weeklies like time women's magazines like cosmopolitan and popular science magazines like mit technology review and the babies that they used on their front covers are supposed to sell magazines of course but they do that by illustrating what the
• 47:00 - 47:30 imagination today of heritable gene editing looks like and all these babies have some things in common every one of them has blonde hair blue or green eyes fair skin and i think that reflects a likely future if we allow gene editing to make better babies and it's why we should keep the door shut finally i want you to imagine a world where newborns are labeled as
• 47:30 - 48:00 good or bad better babies or not better babies based on the dna that was sold to their parents at the fertility clinic this would be a world where the wealthy buy genetic privileges for their children and pile those on top of their other advantages and now we can imagine a really different world where children are all born with an open future with their lives full of possibility where society's resources go for providing all children with clean air clean water
• 48:00 - 48:30 basic health care so please vote no on this motion voting no is a vote against opening the door to a new form of high-tech market-driven eugenics voting no is in favor of using our social resources to develop new medical treatments for people who are sick let's use gene editing to treat patients not to make supposedly better babies thank you marcie darnowski our next speaker will be speaking in support of the resolution use gene editing to make
• 48:30 - 49:00 better babies here is amy webb today's debate was not about designer babies it was about improving health and health outcomes in a safe future way now mercy said earlier that we don't have evidence in some cases because we're talking about the future which i deeply appreciate and agree with but you also just heard marcy describe a probable future of aryan super children blonde hair blue eyes we keep seeing them over
• 49:00 - 49:30 and over again on magazine covers and what we know to be true is that that's not a foregone conclusion it's simply artifacts from what already existed we can develop guardrails to prevent against the future that she's describing in fact we do have data and we can build out models this is what i do to explore next order outcomes i asked you at the beginning to avoid catastrophizing so that we
• 49:30 - 50:00 could have an open dialogue not to use the past to predetermine what the future might look like and i think we've succeeded today in helping unlock probably how you are thinking right now about what the futures of gene editing might look like we have to be willing to think through alternative futures not using a utopian lens but rather pragmatism until now powerful stories about the futures of gene editing gattaca eugenics experian experiments they take up a lot
• 50:00 - 50:30 of space in our minds so what i'd like to leave you with is a different type of story a story of a family that i used to babysit for the father was a lawyer mother was an economist they were really really hard they were super successful and they loved their children more than anything their youngest daughter was born with cystic fibrosis they tried to live normal lives but it was difficult they had to paddle her back every day she was on a strict schedule took a half hour to clear her airways and she was on a breathing machine there
• 50:30 - 51:00 was a ton of different medications they did this out of love for her even knowing that she was unlikely to live into adulthood that little girl died before she turned 12. i remember i was at her funeral and it was awful who among us would force a family to go through the pain of losing a child if gene editing safe ethical planned gene editing within boundaries gives us the ability to screen and edit embryos to remove the mutation causing cystic
• 51:00 - 51:30 fibrosis why would we deny parents that choice voting yes on the resolution is a vote for hope hope for parents who know what it's like to suffer and hope that future generations will be resilient living healthier and happier lives than even we are today thank you thank you amy webb and finally with our last word our last argument against the resolution to use gene editing to make better babies here is francoise bayless thank you i want to end by asking everyone to sort
• 51:30 - 52:00 of pull back a little bit from the conversations we've had today which has focused very narrowly on genome editing in the context of a reproductive project and asking you to vote as to whether or not this technology should be used to make better babies and i'm asking you to vote no not simply because of what i've said thus far and marcy has contributed also to that argument but because it's important to think about the world in which we're
• 52:00 - 52:30 living and the world we want to use technology to build you know you've just heard a very dramatic example about cystic fibrosis and yes it would be wonderful if children were not born with this but we've made great strides so that actually now very few children die of cystic fibrosis they're typically older adults and as we continue to offer therapies they do better and better and one of the things that's really important if we're actually looking about the data with respect to genome editing in a heritable context for cystic fibrosis the data as provided by
• 52:30 - 53:00 the international academies commission that just published its report it could be used in the united states for one case every 15 years so let me take you back to a point i made over and over and over again what do we want to use our time talent and treasure for these are limited resources we are social interdependent relational beings and i worry about us focusing on our genetics and perhaps unwittingly embracing a certain kind of genetic
• 53:00 - 53:30 determinism that's not who we are we are persons and ultimately all persons are second persons we become who we are in society through those relationships finally we are all fail and frat fragile we're fallible and in that context we really i think need to embrace the project of building a world that embraces diversity and tolerance and i worry that this is not the technology
• 53:30 - 54:00 that will do that for us if it's used in the context of a reproductive project we all want all kinds of technology to help those amongst us who are living with challenges when we have opportunities to be helpful please vote no thank you francoise bayless and that concludes round three and our intelligence squared debate that was the final round and now it's time for our second vote remember it's the side that changes the most minds between the first and the second vote that will be
• 54:00 - 54:30 declared our winner second vote goes the same way as the first one did please go back to iq2us.org you'll have the same choices for against or undecided and as i mentioned earlier we're going to be keeping this vote open for seven days and at the end of those seven days we will announce the winner on our website iq2us.org the competition is over i want to say to all four of our debaters i think that you uh set such an example of bringing a technical complex nuanced topic um to
• 54:30 - 55:00 you just brought more light to the conversation for all of us i'm not sure that anything was resolved here but i don't think this is at the moment the moment for resolution at this issue at all as we're talking about a future for which there is no evidence that we will we'll have the evidence in the future and perhaps we can have you all back in that future time of future generation for another debate but george amy marcy and francoise for an excellent conversation and for doing it the way you did i want to say thank you so much for joining us at intelligent squared
• 55:00 - 55:30 thank you thank you yes thank you and i want to thank all of you for tuning in we appreciate your support and your commitment to the kind of discourse we bring at intelligence squared i want to remind you that we are a a non-profit we are a philanthropy we do these debates to raise a level of public discourse to show that it can be done that it we can have conversations like this this way we would love your support at any time by going to our website iq2us.org and you can make a donation to
• 55:30 - 56:00 keep us going there because we would love to keep going we're now past 200 debates and we want to at least double triple quadruple that all right to all of our debaters and to all of you who have watched thank you so much for joining us for yet another i think pretty good iq2 intelligence square debate please tell your friends and watch the rest of our debates they're all online for now i'm john donven and i'll see you next time
• 56:00 - 56:30 [Music]