Transcript: The Promise and Peril of Our Gene Future | Mar 01, 2021

Steve sits in the studio. He's slim, clean-shaven, in his fifties, with short curly brown hair. He's wearing a black suit, white shirt, and spotted gray tie.

A caption on screen reads "The promise and peril of our gene future. @spaikin, @theagenda."

Steve says THE WORK DONE TO MAP THE HUMAN GENOME AND TO BEGIN TO MAKE SENSE OF IT IS, IN MANY WAYS, AWE-INSPIRING. UNDERSTANDING THE POTENTIAL AND PERIL THAT FLOWS FROM IT IS ALMOST UNFATHOMABLE. JAMIE METZL IS A MEMBER OF THE WORLD HEALTH ORGANIZATION'S EXPERT ADVISORY COMMITTEE ON HUMAN GENOME EDITING. HIS MOST RECENT BOOK IS CALLED "HACKING DARWIN: GENETIC ENGINEERING AND THE FUTURE OF HUMANITY."

Jamie is in his fifties, clean-shaven, with short brown hair. He's wearing a black suit and a white shirt.
A picture of his book appears briefly on screen. The cover is white, with a drawing of a blue and orange pair of chromosomes.

Steve continues JAMIE, NICE TO MEET YOU. HOW ARE YOU DOING?

Jamie says THANKS STEVE, GREAT TO BE HERE.

Steve says AND YOU SAY AFTER YEARS OF HUMAN DEVELOPMENT UNDER ONE SET OF RULES OUR SPECIES IS ABOUT TO BEGIN DEVELOPING BY ANOTHER. WHAT ARE THE NEW SET OF RULES.

The caption changes to "Jamie Metzl. Author, 'Hacking Darwin.'"
Then, it changes again to "We are now information technology."

Jamie says THE NEW SET OF RULES IS DRIVING THE EVOLUTIONARY PROCESS FORWARD, WE HAVE BEEN DRIVEN BY RANDOM MUTATION AND NATURAL SELECTION, WHICH IS THE FOUNDATION OF DARWINIAN EVOLUTION, AND NOW OUR ONE SPECIES AMONG THE BILLIONS THAT HAVE EVER LIVED SUDDENLY HAS THE ABILITY TO READ, WRITE AND ULTIMATELY HACK THE GENETIC CODE OF LIFE, AND THAT GIVES US AWE-INSPIRING ALMOST GODLIKE ABILITIES.

Steve says HUMOUR ME. WHEN WE GO DOWN THE ROAD HALF A CENTURY WHAT WILL PEOPLE THEN BE SAYING ABOUT THE TIME WE'RE LIVING IN RIGHT NOW APROPOS TO WHAT YOU JUST SAID?

Jamie says I THINK THEY WILL BE SAYING THAT THIS MOMENT WAS A QUANTUM LEAP MOMENT FOR THE TECHNOLOGIES OF THE GENETICS AND BIO REVOLUTIONS JUST LIKE WORLD WAR II SIGNIFICANTLY PUSHED FORWARD ELECTRONICS AND SPACE TRAVEL. WE'RE SEEING THAT WITH THE, THESE ALMOST MIRACULOUS MRNA VACCINES. WHAT THEY ARE DOING IS INSERTING GENETIC CODE INTO OUR BODIES, INSTRUCTING OUR CELLS TO PRODUCE SOMETHING THAT WASN'T ALREADY THERE, IN THIS CASE THE SPIKE PROTEIN OF THE SARS-COV2 VIRUS, AND THEN TO RESPOND BY CREATING AN IMMUNOLOGICAL RESPONSE TO WHAT WE HAVE CREATED. THIS IS JUST ONE EXAMPLE OF HOW WE ARE, AS ONE SPECIES, HIJACKING THE TOOLS OF BIOLOGY, AND THAT'S GOING TO FUNDAMENTALLY TRANSFORM NOT JUST OUR HEALTH CARE BUT SO MANY ASPECTS OF OUR LIVES, FROM THE WAY WE MAKE AND CONSUME FOOD AND AGRICULTURE TO HOW WE USE ENERGY, TO MATERIALS, AND ULTIMATELY WILL TRANSFORM OUR EVOLUTIONARY TRAJECTORY AS A SPECIES.

Steve says LET ME TAKE US OFF THE PATH FOR A MOMENT HERE. I WANT TO FIND OUT MORE ABOUT YOU. YOU ARE A GUY WHO CAME UP DURING THE BILL CLINTON ADMINISTRATION, YOU WERE ON THE NATIONAL SECURITY TEAM THERE, TERRORISM WAS, YOU KNOW, THE ISSUE OF THE DAY, AND SUDDENLY HERE YOU ARE A GUY INTERESTED IN OUR GENETIC FUTURE. SOMEWHERE ALONG THE WAY, YOU CAME TO A FORK IN THE ROAD. WHAT HAPPENED?

The caption changes to "Jamie Metzl. Atlantic Council."

Jamie says YEAH, SO WHEN I WAS WORKING IN THE CLINTON ADMINISTRATION, THANK YOU, WHEN I WAS WORKING IN THE CLINTON ADMINISTRATION TERRORISM WAS SOMETHING MY LITTLE OFFICE WAS FOCUSED ON BUT THE U.S. GOVERNMENT WASN'T, IN A MEANINGFUL WAY, FOCUSED ON TERRORISM. MY BOSS THEN, AND GOOD FRIEND NOW, IS SOMEONE NAMED RICHARD CLARK, AND HE WAS THE CASSANDRA OF THE TERRORIST THREAT. HE WAS TALKING, TELLING ANYONE WHO WOULD LISTEN THERE ABOUT THIS BIG AND FUNDAMENTAL THREAT COMING AND WE HAD TO RESPOND, AND THEN WHEN 9/11 ARRIVED, DICK UNFORTUNATELY WAS THE PERSON WHO HAD SOUNDED THE WARNING BUT THE WARNING HAD NOT BEEN HEARD. AND DICK ALWAYS USED TO SAY THAT IF EVERYONE IN WASHINGTON OR THE WORLD IS FOCUSING ON ONE THING, YOUR VALUE ADD ISN'T FOCUSING ON THAT THING, IT'S TRYING TO SAY "WELL WHAT ARE THE BIG ISSUES THAT AREN'T BEING ADDRESSED AND AREN'T BEING EXPLORED." AND SO FOR ME NEARLY 25 YEARS AGO AS I LOOKED AROUND THE WORLD, AS I CAME TO FEEL VERY INTENSELY THAT THE TOOLS OF THE GENETICS AND BIOTECH REVOLUTIONS WERE GOING TO CHANGE EVERYTHING, I STARTED EDUCATING MYSELF, STARTED DOING WRITING, TESTIFYING BEFORE CONGRESS, I... THEN I WAS SPEAKING AND I WASN'T GETTING THROUGH, SO I WROTE SCIENCE FICTION NOVELS TRYING TO TELL THIS STORY IN WAYS THAT PEOPLE COULD MORE READILY ABSORB, AND WHEN I WAS ON MY BOOK TOUR FOR THOSE SCI-FI NOVELS AND I EXPLAINED THE SCIENCE TO PEOPLE AND THEY, SOME GOT WHAT WAS AT STAKE I COULD SEE THEIR EYES GOING WIDE AND THEY REALIZED SOMETHING BIG AND FUNDAMENTAL WAS HAPPENING, AND THAT'S WHEN I REALIZED I NEEDED TO WRITE WHAT I HOPE IS THE BOOK ON OUR GENETIC PAST, PRESENT AND FUTURE. AND IT'S BEEN REALLY AN INCREDIBLE JOURNEY. I'M NOW,, AS YOU SAID IN THE INTRO, A MEMBER OF THE W.H.O. ADVISORY COMMITTEE ON HUMAN GENOME EDITING, AND WHAT WE'RE TRYING TO FIGURE OUT IS HOW DO WE GOVERN WHAT COULD BE THE MOST POWERFUL TECHNOLOGY IN ALL OF HUMAN HISTORY IN A WAY THAT OPTIMIZES THE BENEFITS AND MINIMIZES ANY POTENTIAL HARMS.

Steve says IT'S INTERESTING THE COROLLARY YOU MAKE BETWEEN YOU AND RICHARD CLARK BECAUSE YOU SHARE A COUPLE OF THINGS IN COMMON AND I WELL REMEMBER HIS APPEARANCE BEFORE THE 9-11 COMMISSION WHERE HE WAS THE ONE GUY IN THE GOVERNMENT TO APOLOGIZE FOR THE FACT THAT... AND HE DIDN'T EVEN NEED TO BUT HE WAS THE ONE GUY TAKING RESPONSIBILITY FOR BEING UNABLE TO GET THE ATTENTION OF DECISION-MAKERS TO THE FACT THAT TERRORISM WAS COMING AND HERE YOU ARE IN A SIMILAR SET OF CIRCUMSTANCES WHERE YOU ARE TRYING TO GET THE WORLD'S ATTENTION FOR WHAT IS ABOUT TO EXPLODE ON OUR WATCH. DO YOU THINK YOU'RE HAVING MORE SUCCESS THAN HE IS?

The caption changes to "Watch us anytime: tvo.org, Twitter: @theagenda, Facebook Live, YouTube."

Jamie says I DON'T KNOW. IT'S HARD TO JUDGE BECAUSE SUCCESS IS RELATIVE TO WHAT HAPPENS NEXT. THERE ARE CERTAINLY SOME PEOPLE WHO ARE PAYING ATTENTION TO THESE ISSUES. IT'S MORE THAN IT WAS BEFORE THE PANDEMIC WHATEVER ITS ORIGINS GIVES US AN OPPORTUNITY TO RECOGNIZE THAT SOMETHING BIG AND FUNDAMENTAL IS HAPPENING BUT, AS ALWAYS, THERE'S A RACE BETWEEN AN EXPONENTIALLY ADVANCING TECHNOLOGY AND GOVERNANCE IN REGULATORY INFRASTRUCTURES THAT MAYBE, EVEN BY DEFINITION, ONLY INCH FORWARD GLACIALLY. AND BECAUSE THIS SCIENTIFIC ADVANCEMENT IS ADVANCING FOR ALL SORTS OF REASONS THAT MISMATCH BECOMES MUCH MORE... ALL THE GREATER. AND JUST TO PUT SOME NUMBERS ON THAT, LAST YEAR IN 2020 THE NOBEL PRIZE IN CHEMISTRY WENT TO JENNIFER DOUDNA AND EMMANUELLE CHARPENTIER WHO CAME OUT DESCRIBING THE CRISPR/CAS9 GENOME TOOL. IT WAS A SCIENTIFIC PAPER. SIX YEARS LATER, THE WORLD'S FIRST CRISPR BABIES WERE BORN IN CHINA. THIS SCIENCE IS RACING FORWARD AND WE'RE NOT READY FOR IT. I DON'T KNOW WHETHER I'M MORE OR LESS SUCCESSFUL, BUT CERTAINLY WE ARE NOT SUCCESSFUL ENOUGH AT LAYING THE FOUNDATION TO MAKE SURE THAT WE CAN USE THESE VERY POWERFUL TECHNOLOGIES WITH MAXIMAL APPLICATION OF VALUE IN IT.

Steve says YOU MENTIONED BABIES AND I WANT TO STICK WITH CHILDREN AND PARENTING THERE IF WE CAN HERE. IT IS BECOMING OF COURSE MUCH CHEAPER TO SEQUENCE THE HUMAN GENOME AND PARENTS CAN, IF THEY WANT TO, SOME PARENTS ANYWAY, THEY CAN LEARN A LOT MORE ABOUT THEIR CHILDREN'S GENETIC MAKEUP. DO YOU THINK THIS HAS THE POTENTIAL TO CHANGE PARENTING GOING FORWARD?

The caption changes to "Jamie Metzl, @JamieMetzl."
Then, it changes again to "12 percent more intelligence, 5 percent more extroversion please!"

Jamie says I THINK IT HAS THE POTENTIAL TO CHANGE PARENTING, AND I THINK IT WILL CHANGE PARENTING, BUT WE ALSO NEED TO RECOGNIZE THAT PARENTING IS ALWAYS CHANGING. SO WHEN WE HAVE INFORMATION ABOUT OUR FUTURE CHILDREN, JUST BASIC INFORMATION WE LEARN FROM OUR CHILDREN, FOR EXAMPLE OH MY CODE, KID IS REALLY GOOD AT SPORTS OR MUSIC OR WHATEVER, WE INTERNALIZE THAT INFORMATION AND TRY TO GIVE THOSE CHILDREN MORE OPPORTUNITIES. SO IF WE HAVE THAT INFORMATION AND WE UNDERSTAND THAT OUR CHILD, FUTURE CHILDREN, HAVE A GENETIC PROPENSITY TO BEING REALLY GOOD AT ONE THING OR ANOTHER, WILL THAT INCREASE THE LIKELIHOOD THAT WE EXPOSE THEM TO THAT THING, WHETHER ABSTRACT MATH AND SOMETHING ELSE, IT ABSOLUTELY WILL AND, IN SOME CASES, IT SHOULD. WHAT WE'RE TALKING ABOUT IS SOMETHING EVEN DEEPER THAN THAT, BECAUSE THIS IS NOT JUST GOING TO CHANGE THE WAY WE MAKE BABIES, BUT THE NATURE OF THE BABIES THAT WE MAKE. SO WHEN DOES PARENTING BEGIN? WELL MAYBE IN THE NEAR FUTURE, EVEN NOW, PARENTING BEGINS WHEN YOU DECIDE HOW YOU'RE GOING TO HAVE YOUR OFFSPRING, WHETHER THROUGH SEX OR THROUGH USING THE NEWER TOOLS OF IN VITRO FERTILIZATION, MAYBE EMBRYO SCREENING, AND THAT EMBRYO SCREENING, PRE-IMPLANTED EMBRYOS WILL BE SUPERPOWERED BY THE GENOMES, AND THOUGH THE FIRST APPLICATIONS OF PRE-IMPLANTED EMBRYOS IN CHINA WAS HIGHLY UNETHICAL AND SHOULD BE CONDEMNED, I THINK IT'S IT EXTREMELY LIKELY AND CERTAIN THAT WE WILL BE USING THE TOOLS OF GENOME EDITING ON PRE-IMPLANTED HUMAN EMBRYOS AT SOME POINT IN THE FUTURE.

Steve says WOW, I GOT TO FOLLOW UP ON THAT, THAT IS FASCINATING. YOU SEE A FUTURE WHERE MORE AND MORE PARENTS, PARENTS TO BE, ARE GOING TO OPT FOR IVF, EVEN IF THEY DON'T HAVE TO, BECAUSE THEY WANT TO GENETICALLY REENGINEER THE CHILDREN THAT THEY ARE GOING TO HAVE? DO I HEAR THAT RIGHT?

Jamie says NOT NECESSARILY BECAUSE THEY WANT TO GENETICALLY REENGINEER THEIR FUTURE CHILDREN, UMM, BUT AT LEAST AT FIRST BECAUSE THEY WANT TO REDUCE THE RISKS INHERENT IN BEING A HUMAN BEING. AND THAT'S OUR ENTIRE HEALTH CARE SYSTEM ARE BASED ON REDUCING THAT RISK. 1 TO 2 percent OF ALL CHILDREN ARE BORN WITH TERRIBLE AND, IN MANY CASES, DEADLY GENETIC ABNORMALITIES. IF WE CAN PREVENT THAT OR FIX THAT BEFORE THESE CHILDREN ARE BORN, SO THAT RATHER THAN LIVING THREE-YEAR PAINFUL LIVES BEFORE A TERRIBLE DEATH, THESE CHILDREN CAN LIVE 90, 100 YEARS, I THINK PEOPLE WILL BE VERY COMFORTABLE WITH THAT. AND WE NEED TO RECOGNIZE THAT WE, IN THE WAY WE'RE LIVING NOW, WE'RE NOT LIVING IN SOME PERFECT STATE OF NATURE, OUR LIVES ARE VERY, VERY DIFFERENT FROM OUR ANCESTORS BECAUSE WE ARE COMFORTABLE USING TECHNOLOGY. AGRICULTURE IS A TECHNOLOGY, MEDICINE IS A TECHNOLOGY, GETTING VACCINATED SO YOU DON'T DIE FROM SMALLPOX IS A TECHNOLOGY. THIS IS ALSO A TECHNOLOGY WHICH, IF USED WISELY, CAN ENHANCE OUR HUMANITY AND, IF USED POORLY, CAN DETRACT FROM IT.

Steve says OKAY. LET ME PURSUE THAT, BECAUSE I SUSPECT THERE'S NOT THAT MUCH DEBATE ABOUT USING THIS ABILITY IN ORDER TO PREVENT A CHILD FROM HAVING A HORRENDOUS LIFE FILLED WITH HEALTH TRAVAILS, ET CETERA, NOT MUCH DISCUSSION THERE.

Jamie says BUT THERE IS.

Steve says WELL...

Jamie says PERHAPS THERE IS. THERE IS A WHOLE COMMUNITY OF PEOPLE THAT ARE SAYING THAT THE GENOME IS SACRED AND ANY ENGINEERING, ANY MANIPULATION OF THE GENOME, EVEN TO MAKE A HERITABLE SINGLE GENE MUTATION TO STOP A DISORDER, A LOT OF PEOPLE FEEL THAT IS CROSSING THE LINE AND, QUOTE-UNQUOTE, "PLAYING GOD." I DON'T THINK SO, BUT I THINK THAT'S WHY WE NEED TO DO THAT CAREFULLY. SORRY TO INTERRUPT YOU.

Steve says NO, BUT I THINK WHERE I WAS GOING WAS THAT'S ONE SET OF ETHICAL CONSIDERATIONS, ANOTHER SET OF ETHICAL CONSIDERATIONS WHERE YOU MAY GET ON TO A SLIPPERY SLOPE IS HOW ABOUT MESSING AROUND FOR... TO TURN AN INTROVERT INTO AN EXTROVERT, HOW ABOUT MESSING AROUND TO HAVE SOMEONE BE MORE EMPATHETIC OR MORE INTELLIGENT OR MORE ATHLETIC OR SOMETHING LIKE THAT. WHERE ARE YOU ON THE ETHICS OF DOING THAT?

Jamie says SO ALL OF THESE THINGS ARE EXTREMELY THORNY ETHICAL QUESTIONS AND FIRST WE NEED TO, WHEN YOU USE THE WORD "MESSING AROUND,", WE NEED TO DEFINE WHAT WE MEAN BY MESSING AROUND. ONE MESSING AROUND WOULD BE WE HAVE EVERYONE'S GENOMES ARE SEQUENCED AND WE GET A SENSE OF WHO LIKELY TO BE A WORLD-CLASS SPRINTER, THAT DOESN'T MEAN THEY ARE GOING TO BE BUT WHO HAS THE POTENTIAL TO BE, AND WHEN WE TRY TO ENCOURAGE THEM TO STEP THAT DIRECTION. THAT'S THE PLATO'S REPUBLIC MODEL. ANOTHER OPTION, WHICH I'VE WRITTEN ABOUT IN MY EDITORIAL NOT TOO LONG AGO IN THE "NEW YORK TIMES" WHERE I WAS IMAGINING A VISIT TO THE FERTILIZER CLINIC IN 2050, WOULD BE IN THE PROCESS OF IVF. WHEN SCREENING SOME NUMBER OF EMBRYOS, WHETHER IT'S 10 OR 15 IN OUR WORLD TODAY OR LET'S CALL IT 10,000 IF WE USE STEM CELLS IN THE FUTURE TO EXPAND THE NUMBER OF EGGS, AND THEN CHOOSING. WELL, YOU TO HAVE CHOOSE ONE OF THESE EMBRYOS TO IMPLANT IN THE MOTHER, AND MAYBE PEOPLE WOULD WANT TO SCREEN FOR HEALTH AND MAYBE PEOPLE WOULD WANT TO SCREEN IN THE FUTURE FOR CERTAIN GENETICALLY-DETERMINED OR LARGELY GENETICALLY-DETERMINED OUTCOMES. THEN THE THIRD OPTION OF MESSING AROUND COULD BE USING THE TOOLS OF GENOME EDITING TO INCREASE THE LIKELIHOOD OF ONE PARTICULAR OUTCOME OR ANOTHER. BUT BECAUSE OUR GENETIC TRAITS, OR MOST OF OUR TRAITS FRANKLY, ARE SO COMPLEX, MANY DIFFERENT GENES AND THEN INTERACTING WITH ENVIRONMENTAL FACTORS, IT'S NOT GOING TO BE THAT HAVING A BABY IS LIKE GOING TO THE BUILD-A-BEAR SHOWROOM IN YOUR LOCAL MALL WHERE YOU JUST PICK ATTRIBUTES, AT LEAST FOR MANY MANY HUNDREDS IF NOT THOUSANDS OF YEARS. BUT I DO THINK THAT WE WILL INCREASINGLY USE THE TOOLS OF EMBRYO SELECTION, OVER TIME LIMITED GENOME EDITING, BUT THESE ARE VERY, VERY BIG ISSUES THAT COME WITH LOTS OF CRITICALLY IMPORTANT ETHICAL ISSUES WE NEED TO WRESTLE WITH.

Steve says WELL, TO THAT END, I MEAN IF YOU'RE A "STAR TREK" FAN THERE IS A CONTINUITY HAPPENING HERE. DO YOU SEE A FUTURE THAT IS MORE CONCERNING IN THIS AREA OR MORE EXCITING IN THIS AREA?

The caption changes to "A moral maze, but one you must enter."

Jamie says ALL IN ALL I AM AN OPTIMIST. OUR SPECIES HAS BEEN USING ALL OF OUR TECHNOLOGIES TO LIVE OUR LIVES, TO DO THINGS, THAT WE AT LEAST BELIEVE ARE BETTER. WOULD WE HAVE BEEN BETTER OFF WITHOUT HARNESSING FIRE, WITHOUT AGRICULTURE, WITHOUT MEDICINE, WITHOUT AIR TRAVEL, WITHOUT THE INTERNET, WITHOUT ALL OF THESE DIFFERENT THINGS? I'M SURE THERE ARE SOME PEOPLE WHO ARE SAYING YES. THESE ARE TECHNOLOGIES, LIKE EVERY OTHER TECHNOLOGY, THAT CAN BE USED WELL OR CAN BE ABUSED. WE IMAGINE WHAT IT LOOKS LIKE WHEN THEY ARE USED WELL, WE LIVE LONGER, HEALTHIER AND MORE ROBUST LIVES, WE ENHANCE HUMANITY, WE INCREASE OUR CAPACITY TO HAVE MORE HEALTHY TIME TO LOVE EACH OTHER, TO LOVE POETRY AND INNOVATE AND DO ALL THE THINGS THAT MAKE HUMANS SUCH A SPECIAL SPECIES. IF WE ABUSE THESE TECHNOLOGIES WE COULD USE THEM TO CRASH ECOSYSTEMS, TO DIMINISH OUR HUMANITY, AND TO DO LOTS OF TERRIBLE TERRIBLE THINGS. AND THE DIFFERENCE BETWEEN THOSE TWO OUTCOMES IS US, AND THAT'S WHY I'M SPENDING SO MUCH OF MY LIFE ENERGY TRYING TO PUSH FORWARD AND AN INCLUSIVE GLOBAL DIALOGUE ON HOW WE SHOULD BEST USE THESE TECHNOLOGIES IN WAYS THAT ENHANCE THE BENEFITS AND MINIMIZE ANY POTENTIAL HARM.

Steve says I APPRECIATE THE RELIGIOUS ARGUMENT THAT SAYS "WE OUGHT NOT TO BE PLAYING GOD AND WE SHOULD NOT INVOLVE OURSELVES IN ANY GENETIC CHANGES AT ALL," PERIOD, FULL STOP. THAT'S A RELIGIOUS ARGUMENT, I UNDERSTAND IT. WHAT IS THE SCIENTIFIC ARGUMENT THAT SAYS IT IS UNETHICAL FOR US TO, IF I CAN USE MY SCIENTIFIC TERM AGAIN, MESS AROUND HERE TO, FOR EXAMPLE, GET RID OF ALZHEIMER'S FOREVER, OR SICKLE-CELL ANEMIA FOREVER OR CYSTIC FIBROSIS FOREVER; WHAT'S THE ARGUMENT THERE?

Jamie says SO FIRSTLY LET ME TALK ABOUT THE RELIGIOUS ARGUMENT. I THINK IT'S VERY LEGITIMATE. THESE ARE POWERFUL TECHNOLOGIES, NO ONE GROUP OF US CAN RAILROAD ANYBODY ELSE. I WAS HONOURED BEFORE THE PANDEMIC TO BE HONOURED TO SPEAK AT THE VATICAN ON EXACTLY THESE ISSUES, AND I WAS A LITTLE SURPRISED BUT VERY HAPPY WHEN THEY COMMISSIONED ME TO WRITE A PAPER ON THE CATHOLIC CHURCH AND HUMAN GENETIC ENGINEERING, WHICH THEY PUBLISHED AND PEOPLE CAN FIND ON MY JAMIEMETZL.COM WEBSITE AND BLOG. SO THERE ARE STRONG RELIGIOUS ARGUMENTS THAT I THINK WE SHOULD CONSIDER. AT THE SAME TIME, THERE ARE SOME PEOPLE, AND I MEET THEM FROM TIME TO TIME, WHO BELIEVE THAT TERRIBLE HUMAN SUFFERING IS FATE, OR SOME PEOPLE EVEN BELIEVE IT'S A CONTRIBUTION TO THE REST OF OUR HUMANITY. I BELIEVE THAT THE HISTORY OF OUR SPECIES HAS BEEN FIGHTING AGAINST THESE KINDS OF TERRIBLE THINGS. WHEN SOMEBODY HAS A CHILD WHO IS DYING OF A TERRIBLE GENETIC DISORDER, I THINK THOSE PARENTS ARE SAYING "WHAT CAN WE DO TO FIX THAT?" IF YOU GAVE THEM A TOOL TO PREVENT THAT, MOST PARENTS WOULD WANT THAT. SO IT'S NOT CRAZY FOR US TO SAY WE'RE GOING TO USE THE TOOLS THAT WE HAVE TO FIGHT AND PREVENT TERRIBLE AND DEADLY GENETIC DISORDERS, EVERYONE SHOULD ASK THE QUESTION IF IT WAS YOUR SPOUSE, YOUR PARENTS, YOUR CHILDREN, WOULD YOU WANT THAT? I THINK THE ANSWER IS "YES." AND SO IF THIS GETS FRAMED AS AN EVERYTHING OR NOTHING DEBATE, WE'RE ALL LOSERS, WHAT WE NEED TO DO IS FIND A SENSIBLE, WISE, MIDDLE PATH THAT CAN BRING US ALL TOGETHER AND ALLOW US TO USE THESE TECHNOLOGIES TO... IN THE BEST AVAILABLE WAY THAT FOLLOW OUR MOST CHERISHED ETHICAL TRADITIONS.

Steve says JAMIE, TO MAKE THINGS EVEN A LITTLE BIT MORE COMPLICATED, WE'RE COMING TO YOU FROM CANADA TODAY, CANADA IS A SINGLE-PAYER HEALTH CARE SYSTEM, WE THINK EQUITY IS ONE OF THE ABSOLUTE SINE QUA NON'S OF OUR HEALTH CARE SYSTEM, THIS NOTION OF EQUITY. WHAT IF WE WANT TO INTRODUCE THE KINDS OF POSSIBILITIES GOING FORWARD YOU HAVE DESCRIBED TO US TONIGHT BUT IT'S EXPENSIVE, AND PUBLIC HEALTH CARE SYSTEMS OR PUBLICLY-FUNDED HEALTH CARE SYSTEMS, WON'T COVER IT. WE GET INTO A CIRCUMSTANCE WHERE THE RICH WILL BE ABLE TO DO THIS, THE LESS WELL OFF WILL NOT. WHAT ARE THE PROBLEMS AROUND THAT?

Jamie says IT'S A REALLY GREAT AND IMPORTANT QUESTION. FIRST, LET ME SAY THAT I FOR ONE AM JEALOUS OF THE SINGLE-PAYER NATIONAL HEALTH CARE SYSTEM YOU HAVE IN CANADA. THE UNITED STATES IS GREAT FOR SUPER SPECIALIZED HIGH-COST INTERVENTION, BUT IN TERMS OF CREATING A PUBLIC HEALTH INFRASTRUCTURE THAT HELPS EVERYBODY, CANADA IS A GREAT MODEL, ONE... IT'S ONE OF THE REASONS WHY WE'RE GETTING SO MUCH GREAT INFORMATION ABOUT THE PANDEMIC FROM ISRAEL IS THAT THEY HAVE A MODEL AND NATIONAL HEALTH CARE SYSTEM THAT MAKES SENSE. SO ISSUES OF EQUITY ARE ABSOLUTELY ESSENTIAL. EQUITY AND DIVERSITY ARE REALLY THE TWO MOST ESSENTIAL ETHICAL QUESTIONS THAT WE NEED TO CONSIDER. BUT THOSE ARE CHOICES THAT WE ARE MAKING. WE ARE MAKING DECISIONS EVERY DAY ABOUT HOW TO ALLOCATE OUR RESOURCES IN THIS PANDEMIC, WHO GETS WHAT, AND SO I THINK WE NEED TO MAKE DIFFERENT KINDS OF DECISIONS, CERTAINLY, THAN WE MAKE HERE IN THE UNITED STATES. IN ISRAEL, FOR EXAMPLE, ASSISTED REPRODUCTION IS LARGELY COVERED IN NATIONAL HEALTH PLANS. THAT DOESN'T MEAN THAT EVERYTHING, EVERY APPLICATION THAT ANYONE CAN IMAGINE IS COVERED, BUT SOME OF THE MOST IMPORTANT ONES ARE. AND SO IF WE WANT TO LIVE IN A FUTURE WHERE WE HAVE EQUITABLE ACCESS TO HEALTH CARE, INCLUDING THESE TOOLS OF ASSISTED REPRODUCTION, WE NEED TO START BUILDING THAT FUTURE NOW. AND THAT'S WHY CERTAINLY I BELIEVE THE UNITED STATES HAS A LOT TO LEARN FROM COUNTRIES LIKE CANADA AND ISRAEL AND, AT THE SAME TIME, THERE IS A REASON WHY A LOT OF THIS INNOVATION IS HAPPENING IN THE UNITED STATES AND PART OF THAT IS THAT WE'RE FLOODING SO MUCH MONEY INTO THE HEALTH CARE SYSTEM. BUT YOU'RE ABSOLUTELY RIGHT, THESE EQUITY ISSUES, ALONGSIDE THE DIVERSITY ISSUES, ARE FUNDAMENTAL TO MAKING SURE THAT THIS TECHNOLOGY CAN BE APPLIED IN A WAY THAT ENHANCES OUR HUMANITY AND DOESN'T DIVIDE US OR WEAKEN US.

Steve says AT SOME POINT DOWN THE ROAD SOMEBODY IS GOING TO HAVE TO DECIDE HOW THIS IS ALL GOING TO WORK; WHO IS THAT SOMEBODY?

Jamie says SO I'M SPENDING A LOT OF MY TIME TRYING TO ADDRESS THAT QUESTION. AS YOU MENTIONED IN THE INTRO A NUMBER OF THE HEALTH ORGANIZATIONS, ADVISORY COMMITTEE OF HUMAN GENOME EDITING, WE'RE TRYING TO DO IT, RECOMMEND AT LEAST WHAT A GOVERNANCE FRAMEWORK FOR THESE TECHNOLOGIES MIGHT LOOK LIKE. AND IT'S REALLY COMPLICATED BECAUSE OUR WORLD TODAY, IT'S NOT JUST GOVERNMENT, NOT JUST THE U.N., GOVERNANCE HAPPENS AT SO MANY DIFFERENT LEVELS. SO, AS I SEE IT, WE NEED TO HAVE A TOP-DOWN/BOTTOM-UP APPROACH. FROM TOP DOWN, GOVERNMENT, WE NEED TO MAKE SURE EVERY GOVERNMENT HAS A REGULATORY STRUCTURE IN THEIR OWN COUNTRY THAT REPRESENTS BOTH INTERNATIONAL PRACTICES AND THE UNIQUE CULTURE AND HISTORY OF THAT COUNTRY. WE NEED TO MAKE SURE THAT, WE NEED NEW TREATIES ON AN INTERNATIONAL LEVEL. BUT PERHAPS MOST SIGNIFICANTLY, WE NEED WHAT I CALL A SPECIES-WIDE DIALOGUE ON THE FUTURE OF HUMAN GENETIC ENGINEERING THAT CAN BEGIN A PROCESS OF DEVELOPING NORMS OF BEHAVIOUR THAT CAN UNDERPIN ALL OF THOSE OTHER THINGS. AND SO THAT'S WHY THERE IS A RACE, THERE IS A RACE BETWEEN THE EXPONENTIALLY GROWING TECHNOLOGY, AND OUR ABILITY TO USE ESTABLISHED GOVERNANCE SYSTEMS TO USE IT WIDELY.

Steve says WE KNOW WHAT MUTUALLY ASSURED DESTRUCTION WAS IN THE COLD WAR, I WONDER, GIVEN THE SCENARIOS YOU DESCRIBED, IF WE HAVE DIFFERENT COUNTRIES PURSUING DIFFERENT APPROACHES DO WE HAVE A MUTUALLY ASSURED GENETICALLY ALTERED FUTURE COMING OUR WAY SOMETIME IN THE FUTURE?

The caption changes to "A superbaby arms race?"

Jamie says I WRITE A LOT ABOUT THAT IN "HACKING DARWIN," I CALL IT THE ARMS RACE OF THE HUMAN RACE. AND IF WE'RE NOT CAREFUL WE'LL HAVE THAT KIND OF ARMS RACE SITUATION. I WRITE ABOUT THIS IN THE BOOK, BUT IT'S NOT COINCIDENTAL THAT THE WORLD'S FIRST THREE CRISPR BABIES WERE BORN IN CHINA, AND THE CHINESE BIOPHYSICIST WAS AN EXTREME NATIONALIST, AND EVERYTHING HE WAS WRITING HE TALKED ABOUT BRINGING GLORY TO CHINA. SO THESE TECHNOLOGIES EXIST WITHIN THE CULTURAL CONTEXT OF US, OF HOW WE HAVE ORGANIZED OURSELVES. AND IF WE AREN'T CAREFUL, IF WE DON'T TRY TO BUILD, FIND THE RIGHT BALANCE BETWEEN LOCAL, NATIONAL AND GLOBAL GOVERNANCE ETHICS AND NORMS, WE WILL BE IN THAT KIND OF SITUATION, AND WE WILL BE, IF THIS TECHNOLOGY WORKS AS WELL AS SOME PEOPLE THINK, IN A SITUATION WHERE ONE COUNTRY IS DOING INTERVENING AND WHETHER IT'S THROUGH EMBRYO TESTING OR GENOME MANIPULATION, TO GIVE A COUNTRY AN ADVANTAGE, OTHER COUNTRIES HAVE TO DECIDE HOW DO THEY RESPOND, DO THEY DO NOTHING, DO THEY TRY TO STOP THE ONE COUNTRY OR TRY TO MATCH IT? THAT IS A PLAUSIBLE SCENARIO FOR THE FUTURE WHICH IS WHY WE HAVE AN INCREDIBLE URGENCY TO TRY TO DO EVERYTHING WE CAN NOW.

The caption changes to "Producer: Eric Bombicino, @ebombicino."

Steve says HMM. THE NAME OF THE BOOK IS "HACKING DARWIN," ABSOLUTELY FASCINATING STUFF AND IT HAS BROUGHT JAMIE METZL TO OUR VIRTUAL STUDIO FROM VAIL, COLORADO. JAMIE, IT'S GREAT TO TALK TO YOU. STAY SAFE AND BE WELL, OKAY?

Jamie says ALL RIGHT, THANKS SO MUCH STEVE.

Watch: The Promise and Peril of Our Gene Future