Tag Archives: Health Care

The First Genetically Modified Humans Have Been Born: Now What?

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When the USSR launched Sputnik 1 on October 4, 1957, it didn’t just kick-start the space race. It marked a major technological paradigm shift. From that moment forward, venturing into space wasn’t just some futuristic fantasy. It was real and it had major implications for the future of our species.

On November 26, 2018, a Chinese scientist named He Jiankui announced that the first genetically modified humans had been born. Specifically, two twin girls actually had their genetic code modified at the embryonic stage to disable the CCR5 gene to make them highly resistant to HIV/AIDS. In the history of our species, this moment will likely exceed the importance of Sputnik.

This man may have just upstaged Neil Armstrong.

To appreciate why this is such a big deal, consider the full ramifications of what Mr. Jiankui achieved. The change he made to the genome of those girls was impossible for them to inherent. This particular allele is a result of a mutation within a small population of Northern Europeans and is present in no other ethnic group. It is best known for providing significant immunity to common strains of the HIV virus.

This is of significant interest to China because they’ve been dealing with a surge in HIV/AIDS rates in recent years. Even though AIDS isn’t a death sentence anymore, the medicine needed to manage it is costly and tedious. These two girls, who have not been publicly named thus far, may now have a level of resistance that they never would’ve had without genetic modification.

On paper, that’s an objective good. According to the World Health Organization, approximately 35 million people have died because of AIDS since it was first discovered and approximately 36.9 million people are living with the disease today. It’s in the best interest of society to take steps towards preventing the spread of such a terrible disease, especially in a country as large as China.

However, Mr. Jiankui has caused more consternation than celebration. Shortly after he announced the birth of the two unnamed children, China suspended his research activities. Their reasoning is he crossed ethical boundaries by subjecting humans to an untested and potentially dangerous treatment that could have unforeseen consequences down the line.

Those concerns have been echoed by many others in the scientific community. Even the co-inventor of CRISPR, the technology used to implement this treatment and one I’ve cited before as a game-changer for biotechnology, condemned Mr. Jiankui’s work. It’s one thing to treat adults with this emerging technology. Treating children in the womb carries a whole host of risks.

That’s why there are multiple laws in multiple countries regulating the use of this technology on top of a mountain of ethical concerns. This isn’t about inventing new ways to make your smartphone faster. This involves tweaking the fundamental code of life. The potential for good is immense, but so is the potential for harm.

Whether or not Mr. Jiankui violated the law depends heavily on what lawyers and politicians decide. Even as the man defends his work, though, there’s one important takeaway that closely parallels the launch of Sputnik. The genie is out of the bottle. There’s no going back. This technology doesn’t just exist on paper and in the mind of science fiction writers anymore. It’s here and it’s not going away.

Like the space race before it, the push to realize the potential of genetic modification is officially on. Even as the scientific and legal world reacts strongly to Mr. Jiankui’s work, business interests are already investing in the future of this technology. The fact this investment has produced tangible results is only going to attract more.

It’s impossible to overstate the incentives at work here. Biotechnology is already a $139 billion industry. There is definitely a market for a prenatal treatment that makes children immune to deadly diseases. Both loving parents and greedy insurance companies have many reasons to see this process refined to a point where it’s as easy as getting a flu shot.

Even politicians, who have historically had a poor understanding of science, have a great many reasons to see this technology improve. A society full of healthy, disease-free citizens is more likely to be prosperous and productive. From working class people to the richest one percent, there are just too many benefits to having a healthy genome.

The current climate of apprehension surrounding Mr. Jiankui’s work may obscure that potential, but it shouldn’t surprise anyone. During the cold war, there was a similar climate of fear, albeit for different reasons. People back then were more afraid that the space race would lead to nuclear war and, given how close we came a few times, they weren’t completely unfounded.

There are reasons to fear the dangers and misuse of this technology. For all we know, the treatment to those two girls could have serious side-effects that don’t come to light until years later. However, it’s just as easy to argue that contracting HIV and having to treat it comes with side-effect that are every bit as serious.

As for what will come after Mr. Jiankui’s research remains unclear. I imagine there will be controversy, lawsuits, and plenty of inquiries full of people eager to give their opinion. As a result, he may not have much of a career when all is said and done. He won’t go down in history as the Neil Armstong of biotechnology, but he will still have taken a small step that preceded a giant leap.

Even if Mr. Jiankui’s name fades from the headlines, the breakthrough he made will continue to have an impact. It will likely generate a new range of controversy on the future of biotechnology and how to best manage it in an ethical, beneficial manner. It may even get nasty at times with protests on par or greater than the opposition to genetically modified foods.

Regardless of how passionate those protests are, the ball is already rolling on this technology. There’s money to be made for big business. There’s power and prosperity to be gained by government. If you think other countries will be too scared to do what a science team in China did, then you don’t know much about geopolitics.

Before November 26, 2018, there were probably many other research teams like Mr. Jiankui who were ready and eager to do something similar. The only thing that stopped them was reservation about being the first to announce that they’d done something controversial with a technology that has been prone to plenty of hype.

Now, that barrier is gone. Today, we live in a world where someone actually used this powerful tool to change the genome of two living individuals. It may not seem different now, but technology tends to sneak up on people while still advancing rapidly. That huge network of satellites that now orbit our planet didn’t go up weeks after Sputnik 1, but they are up there now because someone took that first step.

There are still so many unknowns surrounding biotechnology and the future of medicine, but the possibilities just become more real. Most people alive today probably won’t appreciate just how important November 26, 2018 is in the history of humanity, but future generations probably will, including two remarkable children in China.

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Health Care, Politics, And The Impossible Paradox

As a general rule, it’s my policy to ignore major political issues until after the protests have died down and people have stopped trying to strangle each other through computer screens. Politics is rarely sexy, unless it involves Monica Lewinsky and whoever John F. Kennedy was screwing. In my experience, nothing kills the mood faster than a heated political debate.

I know I’ve spoken on certain hot-button issues before. I did a quick response to the Women’s March earlier this year and the March for Life that quickly followed it. Those weren’t debates, though. Those were protests with simple, clear messages that were easy to break down. Debates aren’t just a little trickier. They’re downright infuriating.

There was a time when I used to enjoy engaging in such debates. I would even go out of my way to find people who disagreed with me, try to understand their position, and then try to argue my own. It was a good mental exercise, but that’s all it ever was.

At no point did I ever change anyone’s mind about anything. At no point did anyone change my mind either. Like debating creationists, they might as well have just been glorified shouting matches. They weren’t meant to actually persuade the other person. The debate was just a spectacle and nothing more.

The fact remains that people don’t like to change their minds about anything. I’ve mentioned time and again how rigid and stubborn the human brain is. Changing an opinion about something is a last resort. Before that happens, people will do the kinds of mental gymnastics that would make a Russian gymnast cringe to justify their opinion.

That brings me to the ongoing health care debate in the United States. I know everybody has an opinion on it and they want to shout that opinion from the highest hill over a bullhorn while Uncle Sam and Lady Liberty give them a back massage. It’s one of those issues that a lot of people are sick of, which is kind of ironic when you think about it.

It’s a frustrating debate to have in the first place because most other industrialized countries have resolved it. The United States of America, despite all the flexing it does of its patriotic nuts, is one of the only industrialized countries that doesn’t have universal health care.

It’s been argued over endlessly by politicians and presidential candidates. Every now and then, one will even build a platform around it. There have been any number of initiatives and policies, some of which do result in meaningful legislation. However, the debate still continues and so does the whining.

Now, I’m not going to take a position in that debate. That’s not the purpose of this post. I’m writing this because someone needs to point something out in this debate that nobody seems to recognize. It’s something that both sides of the debate need to understand, if only to maintain a sense of perspective.

It’s not a thought experiment. It’s not an opinion. It’s not even an argument or a policy idea. It’s a cold, unambiguous fact that is at the heart of the health care debate and others like it. This is a hard truth so whether you’re a card-carrying liberal or a die-hard conservative, you might want to brace yourself.

What we’re trying to accomplish with our health care system is physically IMPOSSIBLE.

Let that sink in for a moment. I don’t usually write in all caps, but this is something that’s worth shouting. If you’re reading this out loud, please read it over again and shout it as loud as you want because it needs to be belabored.

Health care, be it universal or reserved for rich people with decent insurance, is an impossible endeavor that tries to account for infinite possibilities with finite resources. There are over seven billion people on this planet. There are hundreds upon hundreds of diseases that afflict the human body. Treating every person to the utmost just requires too many resources with too few people qualified to administer them.

That’s why the answer to the health care debate isn’t as simple as adopting the same universal health care policies as Europe. Contrary to what Bernie Sanders fans might believe, health care in Europe faces some pretty huge challenges for the exact same reasons. There are too many people who need health care, but there just aren’t enough resources to go around.

Go to any country with any type of health care system you can think of. Don’t be like Michael Moore and focus narrowly on one particular part of a system. No matter where you go and no matter what system you encounter, be it universal or administered by wizards, you’ll always find cases of people not getting the care they need.

Within those cases, you’ll find plenty of unusual cases, such as people who resort to do-it-yourself dental care. You’ll also find plenty of tragedy about people suffering horribly due to their inability to get the care they need. So long as demand outstrips supply, they’ll always happen. That’s just basic economics and dispassionate logic.

In the end, whatever health care policy or reforms get enacted, it won’t be enough. There will still be people who suffer because of it. There will also be people who end up paying more for both their care and that of others. There’s just no way around it. Health care requires resources and people. When there aren’t enough of both, you’re going to get people who get screwed over.

It doesn’t help that many countries, including the United States, face a shortage of qualified doctors. Despite the generous salaries and sexy nurse fantasies, the actual process of becoming a doctor is extremely costly and very difficult. No matter how sexy Hugh Laurie makes it look, becoming a doctor is hard and laborious.

It also doesn’t help that pharmaceutical companies and insurance companies are for-profit companies whose incentives aren’t always in line with providing the best of care. There are people in this world who will risk doing real harm to sick people in order to turn a profit. These people aren’t super-villains or sociopaths, for the most part. They’re just working within a system with flawed parts.

This is not to say that the health care debate is hopeless. For the moment, the situation is impossible. There really isn’t a way to provide adequate care to everybody. However, there are some rays of hope that should keep everyone’s panties from getting too dry.

To combat the doctor shortage, companies like IBM are using Watson, their Jeopardy champion, to help diagnose disease and research treatments. Major biotech companies are using tools like CRISPR, which I’ve talked about before, to alleviate diseases that were once fatal and expensive.

Further into the future, advances in technology like smart blood or brain implants will improve overall efficiency in determining appropriate care. However, there will still be a cost. There will still be a bureaucracy, which both sides of the political spectrum find inherently unsexy. So long as that process is determined by humans and for humans, there will be flaws.

Remember this the next time someone debates health care. No matter what side they’re on, the issues they’re highlighting are literally impossible. It’s still a debate worth having. We should still strive to give the most amount of quality care to the most amount of people. That’s good for society, the economy, and even politicians.

Let’s just remember that there’s a difference between a solvable problem and an impossible situation. Health care, at the moment, is an impossible situation. We shouldn’t lose sight of that, no matter how the debate unfolds moving forward.

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