[GOOGLE JINGLE]
JAMIE METZL: Thank you so much.
And thank you to all
of you for coming.
If you just open the newspaper
or open any news site,
what do you see?
What do we all see?
We see Trump.
We see the Mueller report.
We see Brexit.
When we look back
at today 10 years
from now, 20 years from
now, 50 years from now
and ask what was the story
of this moment in our lives,
this moment in the history of
our species, it won't be Trump,
and it won't be Mueller,
and it won't be Brexit.
It'll be that, after 3.8
billion years of evolving
by this set of rules we
call Darwinian evolution
of random mutation
and natural selection,
this was the
incredible moment where
we took the reins at our
own evolutionary process.
We took the reins increasingly
of managing and manipulating
biology.
And think about that.
This is a power that, for
our whole recorded history,
we have ascribed to the gods.
But now we are assuming
the power of those gods
that we have imagined.
When Watson and Crick identified
the double helix structure
of DNA in the 1950s,
what they were doing
was recognizing that
there is a book of life.
And the book of life is
structured into the famous DNA
double helix.
And when the Human Genome
Project came to fruition
in 2003, what was
being identified
was that the book
of human life could
be read in the As, and the
Cs, and the Ts, and the Gs.
And now with the advent of
our world of precision gene
editing, we're recognizing
that this book of life
can be written.
And so we're at Google now.
And when we think about,
what are technologies
that are readable, and
write-able, and hackable,
this is the house that
IT built. But what
if we come to see
our biology as being
as readable, and write-able,
and hackable as our IT?
And that is where we are going.
We have this view, which
doesn't really make sense,
that our IT is
variable, which is
why we expect that every
new version of our iPhone
is going to be
better than the last.
But we also have
this strange sense
that our biology is fixed,
that we are biologically
going to be like our parents,
that our kids are biologically
going to be kind of like us.
But when you take a
step back and look
at this from a
historical perspective,
well, it doesn't
really make sense.
Because somehow, 3.8
billion years ago,
we were single-cell organisms.
And then we got to be what
we are now, Homo sapiens.
We've only been this
for about 300,000 years.
And with all the
changes that happen
in an evolution
of any species, it
would be crazy to imagine
that Homo sapien was just
the end of this
evolutionary journey.
So we know that
we are on a path,
that we are going to evolve.
We are not going to stay
Homo sapiens forever.
And yet, it's so hard for
us to internalize that.
And yet, we are beginning
this genetic revolution
that is going to
fundamentally transform
the way we think about all
of life, including our own.
And it has and will have
just tremendous upsides.
We are going to be able to fix
a lot of the bugs in humanity.
And some of those
bugs we call fate.
Right now when people die
of terrible genetic diseases
including little kids, we
say, god, it's terrible,
what a terrible fate,
what a terrible tragedy.
And right now when an
older person gets dementia
or Alzheimer's--
we have a whole
lifetime of investment
in learning and getting wisdom
in building relationships,
and it's just thrown away.
It's this incredible loss.
Imagine if people had five
more years of healthy life
what a tremendous
contribution that
would be not just to
them but to all of us--
how we would make the world
so much better by unlocking
these secrets of our biology.
And that's wonderful.
And we have to embrace that.
And yet, there are some very
real dangers and downsides
of taking this power
that we have, as I said,
attributed to the gods.
Having this ability to
recreate all of life
comes with a tremendous
responsibility.
And the challenge is that
this future is arriving
far sooner than most
people-- most of us,
myself included-- fully
understand or appreciate.
And we're not ready.
And that means everyone, you,
and me, and everybody else,
we need to recognize that
this future is coming.
And we have to prepare not just
for ourselves, but because all
of us have a responsibility
in shaping this revolution
to maximize the upside
and minimize whatever
potential harms there may be.
And it's really up to us.
So as many of you know, my
new book "Hacking Darwin,
Genetic Engineering and
the Future of Humanity"
is out this week.
The reason why I've written the
book, the reason why I'm here
speaking with you today
is I want everybody
to recognize that the
genetic revolution isn't
some crazy sci-fi future.
It's now.
And it's here.
And how it plays
out is up to you.
And you need to see
yourself as an essential hub
in that process.
So this revolution
is going to play out
and is already playing
out in three major areas.
The first one is
in our health care.
We still live in a world of
generalized health care based
on population averages.
And that means that, if you go--
and you're taking most drugs--
you get a drug that is
it is given to you based
on a guess based on
population averages.
Let's say you have a cancer.
For 88% of people in the United
States, you get a cancer drug.
And it's not based
on you individually,
your own individual biology.
It's just based on the type
of cancer, in many cases,
that you have.
And it's not just a
third, a third, a third.
But let's just
say it is for now.
Let's say, there's a third
of a chance it'll help you,
a third of a chance
it'll do nothing,
and a third of a chance
it'll harm you or kill you.
And so if it helps you, great,
you found the right drug
on the first try.
If it doesn't, then
you have a new drug
with the same percentage
chances of each outcome.
And that's a crazy way to do
medicine if we can do better.
And we can do better.
And we're starting to do better.
And that is leading
us into this world
of personalized or precision
medicine based on each person's
individualized biology.
And what that means is that,
when you go to your doctor,
you will get, for
example, drugs prescribed
based not just on
population averages
but based on your personal
biology understood
through genome sequencing, and
biometrics, and other things.
When you have cancer--
right now, there's
a revolution in how
cancers are being treated.
You will be treated based on the
sequencing of your cancer cells
and your cancer tumors to
get treatments based on you.
When you think of all
kinds of treatments where
there's an n of thousands--
right now, there
are new treatments
called gene therapies, where you
have-- we can call it cancer.
Your cells are taken out.
They are manipulated to boost
your natural cancer-fighting
capabilities.
And those cells are put
back into your body--
those stem cells.
And then they proliferate and
can be used to fight cancer.
And so in all of
these, it's an n of 1.
And that n is you.
And what that means, though,
is that, to gain access
to the world of
precision medicine,
everyone is going to need to
have their genome sequenced.
And we're going to need to have
uniform health and other life
records.
And what does that mean?
Well, it means that,
right now, we are in--
maybe low millions
of people have had
their whole genome sequenced.
But we are moving
into a world where
it will be millions, tens of
millions, hundreds of millions.
And in very short order,
billions of people
will have had their
genome sequenced.
It's estimated that
2 billion people
will have their whole genome
sequenced within a decade.
So what does that mean?
Now you've got 2 billion
people with sequenced genomes.
And you have access
to these roughly--
or uniform-enough electronic
health and life records.
And then humans become a
big data analytics problem.
We're here at Google.
You guys understand
big data analytics.
100 years ago, 200
years ago, people
thought there was this
inexplicable magic in humans.
But I think many of us would
recognize that humans are
just-- "just"--
single-cell organisms gone
wild over a billion years
of evolution.
And just as we can
understand pretty well how
single-cell organisms function
with the tools we have today,
with the tools that people
like you are developing,
we are going to have the ability
to understand much more not
just of our genomics but of the
complex systems of our biology.
And the easy graph or that is
the complexity of our biology
has remained constant
for millions of years,
but the sophistication
of our tools
is on an exponential J curve.
So now we are increasingly
being able to understand
not just the simple
genetics, because we
have a number of diseases,
disorder, and traits that
are single-gene mutation,
meaning it's like an on/off
switch, whether it's Tay-Sachs,
or sickle cell disease,
or Huntington's disease,
so-called Mendelian disease,
or genetically relatively simple
traits, like hair color and eye
color.
But we are moving
into a world where
we are going to use something
called polygenic scoring to be
able to make predictions of
complex diseases, disorders,
and traits.
And that's going
to move health care
from this world of
precision very quickly
into a world of prediction.
And so you are going
to have information--
your parents will have
information from a few days
after your egg is fertilized.
Or people will have information
about their children
from the moment of birth.
And that is going to
include information
about the percentage greater
than average risk of having
some bad things happen or the
percentage greater than average
probability or possibility of
having great things happen,
like having super capabilities,
whether it's health or anything
else.
And so the second change
that that's going to push is
a change where genomics--
which right now,
we think of in the
context of health care--
is going to move way, way,
way beyond health care.
Because our genome isn't
just about health care.
We don't have a
health care genome.
We have a human genome.
And that human genome tells us
about who we are in every way.
You look around the room.
I don't see a bunch
of health care.
I see a bunch of people who have
a different genetic foundation.
That's why you look different.
That's why you are different.
Yes, environment still matters.
But we are primarily
genetic beings.
And we are going to understand
a lot more of the underlying
genetics of what it
means to be human.
So right now, I'm
sure many of you
have done your mouth swabs
through companies like 23andMe.
And you get information
back and certainly
about your carrier status,
which is about these on/off
switch single-gene
mutation disorders.
That's actually relevant.
There's some fun stuff
like your ancestry.
I'm actually 0.01% Yakut.
Shout out to any
Yakuts in the house.
I guess there aren't any.
But in the future, you,
parents and people,
are going to have a
lot of information
about all sorts of traits.
Like, I have a
greater-than-average
possibility of being really
excellent at abstract math,
or sprinting, or having
an outgoing personality.
Anything that is
partly genetic, we
are going to be able
to increasingly predict
the genetic component--
health care, non-health care,
everything that has
a genetic foundation.
That means that the
genetics and genomics
revolution is moving way
way, way beyond health care.
But the third application,
the killer application,
is in reproduction.
Right now, most people--
this is like a test.
Right now, most people on
Earth create babies through--
AUDIENCE: Sex.
JAMIE METZL: Sex.
Good, good, good.
This is why Google has
such a high market cap--
smart people like you--
through sex.
And sex has really worked
well for our species
for hundreds of
millions of years.
It's how we got here.
But there's a risk
that's woven into sex.
And that risk is that
about 3% of all children
are born with some kind of
harmful genetic abnormality.
And we are going to be able
to reduce that risk very
significantly, provided
that we don't conceive
our babies through sex.
Because the way
to do this will be
to use IVF, which is a
technology that's been around
for more than 40 years, and
screen embryos using a process
called pre-implantation
genetic testing.
It's been around for
more than 30 years.
And right now, this
is used to screen
for these simple genetic
diseases, and disorders,
and chromosomal abnormalities.
But as we develop this
greater knowledge of genomics
in very short
order, we are going
to be able to use
this kind of screening
with a lot of knowledge about
very human traits, height, IQ,
personality style, so
many other things that
have a genetic component.
As I said, life has
a genetic component.
And then beyond
that, we are going
to use stem cell technology.
The 2012 Nobel Prize was
given to Shinya Yamanaka, who
developed a process
for creating what
are called Induced Pluripotent
Stem cells, IPS cells.
And what IPS cells are is--
that process allows
us to take adult cells
and induce them into stem cells.
And then those stem cells
can be turned, in this case,
into egg precursor cells and
egg precursor cells into eggs.
And so now with the average
woman undergoing IVF
has about 15 eggs extracted.
Now using IPS
cells, we are going
to be able to have
thousands, tens of thousands,
hundreds of thousands, millions.
So let's call it 10,000.
Because if you're using,
let's say, a skin graft,
there's millions of skin
cells in a skin graft.
The average male ejaculation--
I don't know if this is the
way you guys talk at Google.
But average male ejaculation
has about a billion sperm cells.
So that's readily available.
Fertilize 10,000 eggs.
Grow them all for
about five days.
Extract a few cells from each.
Sequence them.
And the cost of
genome sequencing
has gone down from about
a billion dollars in 2003,
to about $800 today, to
really negligibility in
under a decade.
So sequence 10,000 of these
early-stage pre-implanted
embryos.
And then you have to pick
what you're looking for.
Some of you may have seen my
editorial in "The New York
Times" last week about this.
But in that editorial,
I was imagining,
what will it be like to go to
a fertility clinic in 2045?
And basically, what you're
going to need to do is say,
here are my priorities.
So certainly, health will be at
the top of everybody's priority
list.
I want to have a kid
who's going to be healthy,
who's not going to,
for example, die
of some terrible
genetic disease.
But when it will be an option to
choose healthy lifespan, to say
that we know that there are
genetic patterns that would
allow or increase the odds that
somebody could live a longer
and healthier life than many
of the other embryos that
would be the options might,
people will want that.
And right now, we can
make a pretty good guess.
Of your 15 fertilized
eggs, we can probably
rank them pretty well
from tallest, potentially,
to shortest, provided they
get the necessary inputs
like healthy food.
But in 10 years, in
20 years, I think
it's quite likely we're
going to be able to say,
we can make a pretty
rough but informed guess
ranking your
pre-implanted embryos
based on which is likely to
have the highest to lowest
genetic component of IQ.
And that's a very,
very different way
of thinking about
making babies than what
we've done in the past.
And then beyond that, there is
the technology of gene editing.
Many of you have
heard of CRISPR.
Many of you know what
happened in China last year,
where it was announced in
November that two Chinese twins
had been born the month before
in October whose genomes had
been edited by an
extremely unethical
Chinese biophysicist--
not a biologist, not
a physician, a biophysicist.
But we are in the era of
precision gene editing.
And even had this not
happened last year,
it would have happened next
year or the year after.
It would have been done
much more responsibly
in a much more transparent way.
And it would have been done
to address an actual threat
to these future children,
not to attempt--
and it looks like it
was a failed attempt--
to confer an enhancement
or an advantage.
But we are moving toward the
era of precision gene editing
of pre-implanted embryos.
I don't think
we're going to do--
I'm speaking at a panel
at Harvard later tonight
with George Church.
And George is leading
a process for making
multiple genetic
changes simultaneously.
And that can work
well in plants.
It probably can work
well in animals.
But in humans, I think
that's going to be
risky for a very long time.
But we will absolutely
be able to make
a small number of
genetic changes,
either to reduce
or eliminate risks
and/or to confer benefits.
And that's where we are going.
And this science is advancing
extremely, extremely rapidly.
And it's expanding
in the context
of our humanity and our world.
And it's a world where
people are different.
Communities are different.
And countries are different.
So within any country--
certainly, within this country,
the United States-- there
are going to be people--
and many of you know them--
who are these trans-humanist
biohackers who say,
this is great, no holds barred.
Let's race into this
trans-humanist future.
And there are others
who are going to say,
this is really scary.
We are, quote unquote,
"playing god."
We can't do it.
And there will be differences.
And people are going to try
to do whatever is in line
with their value system.
And the same thing
is going to happen
on an international level.
There may be entire countries--
this may be one of them--
that decide to entirely
opt out, just to say,
this is really scary.
We don't know enough to start
making these kinds of changes.
There are certainly going to
be unintended consequences.
Better we not do
it at all-- better
we forego potential
benefits, because we
think the risk is too high.
And that's a legitimate choice
that some countries will make.
And there will be
other countries
that will say, hey, we recognize
that, using this technology,
we can dramatically reduce,
potentially, health care costs.
We can confer all
kinds of advantages,
whether on an individual
or a population level.
And that's going to be
appealing to some countries.
And this process is going
to be pushed forward
in a very significant
way because we
live in a competitive world.
People are competing
with each other,
and countries are
competing with each other.
I have a good
friend in Korea who
has 12 tutors coming every week
for his 11-year-old daughter--
coming to the house.
In Korea, they have a law now
that national cram schools
have to close at 10:00 PM
because people were having
their seven and eight-year-old
kids staying out
until after midnight
every night,
seven days a week
prepping for exams
that they were going to take
10 years into the future.
And when I asked my friend--
I said, hey, if you could
select among your natural
pre-implanted embryos to try
to pick the one that was going
to have a competitive
advantage by potentially having
a higher-- at least,
genetic component of--
IQ than the others--
he looked at me
like I was insane.
He's like, is that
even a choice?
And when I said,
of the people you
know who are competing for
access to these universities,
if they had a choice,
what would they do?
And just honestly,
he looked at me--
they used to say,
like, I was from Mars.
Now being from Mars is normal--
like, from Pluto.
And that's where we are heading.
There are all of these kinds
of competitive pressures.
And because the
science is moving
so quickly, because there are
all these forces propelling it
forward, now is
the time where we
need to say, hey, what are
the values that we need
to apply to make sure that this
great hope, this great dream
doesn't become a nightmare?
And there's a lot of real
things to be worried about.
Certainly, what
we're talking about
are incredibly complex systems.
The genome is complex enough.
But the genome is embedded
within the multiomic system
biology of what
makes us human, which
is dynamic and interactive.
And then our entire biology
is constantly interacting
with the environment around us.
So nothing is static.
It would be very
difficult if you
understood a human
perfectly in one moment.
In the next moment,
everything would change.
And you would need to
understand the human perfectly
in that next moment to maintain
your level of comprehension.
So we need to be cautious
about meddling with systems
that we don't fully understand.
And equity issues-- right
now, if this technology
is as powerful as I
believe it will be,
what happens if some
communities, and groups,
and even countries have a
lot more access than others?
We need inequality.
There have to be first
movers with any technology.
And that will have
to be the case here.
But we've also seen
what happens when there
are too great of divisions.
It can be very disruptive.
It can be disruptive
internally within a country.
It can be disruptive
internationally
because there are all these
differences, as I said.
So we really need to be
mindful of the equity issues.
Diversity-- I come, and I
look around a room like this.
You say, well, it's great
that we have this diversity.
And I'm sure that
having diversity
makes Google a stronger company.
But that's not
what diversity is.
I mean, it's a one
manifestation of it.
Diversity, in its essence,
is our sole survival strategy
as a species.
If we didn't have
diversity, you could
say we'd still be
single-cell organisms.
But we wouldn't even be that.
Because what we call diversity,
Darwin called random mutation.
And if we were all
exactly the same,
the environment
wouldn't have sustained
this exact same single-cell
organism for 4 billion years.
We wouldn't even be here.
And so we think
about making changes
that even make a
lot of sense to us,
like, for example
eliminating disease risk even
of these relatively simple
Mendelian disorders.
We think we're doing
something good because it's
scary to be a carrier of
some kind of potentially
deadly disease.
But if you use the classic
case of sickle cell disease,
it's terrible to have
sickle cell disease.
And you will, in most
cases, die very young.
But if you are a carrier
of sickle cell disease,
you actually have increased
resistance to malaria.
So we could eliminate
some kind of thing
that we think is
terrible, but it
could have some kind of
benefit that we don't know,
because it hasn't been
tested in the world
that we have known to date.
But maybe that will be
tested in the future.
So we really need to be
mindful of our diversity.
And the challenge is
that this technology
is moving extremely rapidly.
And we're going to have
to make very big decisions
before we fully understand
the consequences
of the decisions we will make.
And that is a really
big challenge.
And it's a really
big responsibility.
And good news for us, though,
is that, while the technology is
new, the values that
we're going to need
to bring to bear to use it
wisely are, in many cases,
very old.
We are really going to have
to ask ourselves, who are we?
What are our values?
How do we apply those values
in making the huge decisions
that we are going to have to
make over the coming years?
Because the genetics
revolution is not just coming.
The genetics revolution is here.
It's here.
It's here now.
It's happening.
It's changing the
world around us.
But that speed of change
is only going to pick up.
And it's going to touch us
in very, very intimate ways.
And the difference between
having this play out
in a way that does as much
as possible to help us
and bring us together
and having it
play out in a way
that could harm us--
in many ways, for an
unnecessary reasons,
because we haven't done a
good enough job of applying
our values--
the difference between
those outcomes is us.
And so the reason why I've
written this book is I
feel that this revolution
is so important.
We can't leave it
to the experts.
The scientists
are actually doing
a very good job of meeting.
I'm participating in many
of those conversations.
But this isn't an issue
just for the scientists.
This is about our future.
It's really up to all of us.
So on an individual level,
what are responsibilities?
So everybody needs
to be informed.
And everybody needs to
recognize that, if there
is going to be a bottom-up
push to encourage
our representatives and
others to really address
these issues in a way they
can optimize the good stuff
and minimize the
harm, we are all going
to have to be part of that.
So I really want
everybody here to feel
that you are now
informed and that you
can be a hub in this
kind of conversation.
But then on a national
level, we really
need to make sure that
all of our countries
have the regulatory
infrastructures that can
manage these kinds of issues.
The United Kingdom, in my
mind, is the gold standard
for what a well-regulated
country on this set of issues
looks like.
And the US is somewhere
in the middle.
The FDA is actually a
very effective agency
and does a pretty good job of
weighing risks and benefits
of various interventions.
But there are parts
of the world that
are either under-regulated
or have good rules that
aren't well-enforced.
And China is certainly
an example of that.
And then there are places which
are regulatory black holes,
where there's really nothing.
And that can't be.
Because if we have the
kind of medical tourism
that we've had very
dangerously for stem
cell treatments
for this, it could
have very, very
significant consequences
and on an international level.
So on a national
level, every country
needs to have a
regulatory system.
It doesn't need to be the same.
It needs to be based
on best practices.
It needs to be based on each
country's traditions, values,
and ethics, and culture.
But every country
needs something.
And then on an
international level,
we really need to begin a
process of coming together
to develop global rules.
I'm on the World Health
Organization International
Advisory Committee on the
Future of Human Genome Editing.
And we're trying to
think about, what
might an international
system look like?
But we, collectively, are
a long way from there.
And so what we
need to do is have
what I'm calling a species-wide
dialogue on the future
of human genetic engineering.
Everybody needs to
be part of that.
As a matter of fact, my website
is a very humble first step--
hackingdarwin.com-- where
people can go and share views.
But then what we need
to do is to make sure
that those conversations on an
individual level, on a group
level can feed up
through governments.
One of the reasons that my
publisher and I are making
this book, "Hacking
Darwin," available for free
to any member of parliament
of any country in the world
is we think it's so
important that we
have these conversations on the
individual, and the communal,
and on the national level.
What we have to do
is work to make sure
that these conversations
lead to norms which
lead to standards which lead to
regulations which lead to laws.
Because what we
are talking about
here is the future of life.
And it must be regulated.
But it must be regulated well.
And because we are at
this incredible inflection
moment at the beginning
of this revolution
that's going to
change our lives--
because the difference
between the greatest
upside and the most
frightening downside is us--
we all need to feel empowered.
We all need to
recognize that we are
the shapers of this future
in which we and our children
will live.
And I welcome you to
join me on this journey.
So, thank you.
[APPLAUSE]
AUDIENCE: Do you think this
system of-- whatever mechanism
is the thing that is actually
allowing us to choose like, IQ,
better traits, what have you--
do you think it's even possible
to have that exist ethically
in a market economy
or a market system?
JAMIE METZL: Yeah,
it's a great question.
I don't know the answer.
But I do know that
people are going
to be making these choices.
I do know that we
aren't going to want
people to choose anything.
And there will have to be
some kind of restrictions.
And that doesn't
mean that we don't--
there will be all kinds
of very sensitive issues
that will be raised on
issues like skin color.
But also, there will be people--
and there already are people--
who are saying--
for example, deaf parents who
want to have a deaf child.
And this is already happening
in the United States
where this is legal--
who are choosing embryos to
guarantee that those children
will be deaf.
Is that something we're
going to be comfortable with?
When it's a choice, will we
be comfortable with parents
choosing to implant embryos
that will have genetic disorders
or diseases that will kill
those kids at an early age?
I think we're going to be
uncomfortable with that.
There will be all kinds
of other options--
and just as you mentioned
in your question--
IQ, height.
And I think that
people are going
to want to make those choices.
And then the question is,
where does ethics come from?
Does ethics come from law?
Or does ethics
come from culture?
And I think that, in
different societies,
different societies will
have different answers
to that question.
In the places where
it comes from law,
there will be restrictions.
This may be one of those places.
There will be other places
where it will come from culture.
And then there may well
be places like black holes
where people go to do
whatever they want.
AUDIENCE: I was
actually questioning,
do you think the system
at all can exist?
Like, not even
just the mechanism
by which we edit
genes but the systems
themselves could exist
on a bi-nation basis?
Because if you even consider
something like IQ or turning
towards like a certain
trait-- fast running,
or certain pattern
recognition, or what have you--
at that point, we
would have to have
some sort of an international
regulation on discrimination
based on those things.
Because if someone
who is, quote unquote,
"selected genetically" by
their parents to run quickly
or to do something
like that, if they
were to go get a job at
something that wasn't what
they were effectively built
for, is it wrong to say, no--
in my case, if I listened
to what my parents did,
I wouldn't be here right now.
I would be a doctor
or a lawyer somewhere.
But I'm not sure if it's
fully ethical or even
in any way possible for that
to exist ethically in any--
JAMIE METZL: Yeah, I think
it's a very legitimate view.
And there are many
others who believe
that and who will believe that.
And as I mentioned when I was
talking about the diversity,
there will be others
who believe differently.
And in an ideal world--
and I'd love to
live in that world.
And I'm doing my best with
the World Health Organization
to try to do a little
bit toward building it--
we would have some international
standards about what happens
and what doesn't happen.
I had a piece come
out in court yesterday
about how I think
that this issue could
lead to international conflict.
Because a society that's opt
out for exactly the kinds
of ethical reasons
that you describe,
what are they going to do
if another country opts in?
Are they going to make it
illegal for their people
to procreate with people
from that other country?
Are they going to do genetic
testing of every woman who may
be pregnant who's coming in?
These issues are really tough.
There's no easy answer.
But ethics are at the
core of everything.
And either, we're going
to find a way that's
better than what we have
now to apply ethics,
or this could get very ugly.
AUDIENCE: No,
certainly, even in just
in the case you
mentioned, the most
quickly upcoming, which is
the sequencing of genomes
to predict medical maladies
as you go through life--
if you consider that
in America alone--
forget pre-existing condition.
You don't have to show
a preexisting condition
to know that you have that.
JAMIE METZL: Well, everybody
has a pre-existing condition
for something once we
look under the hood.
AUDIENCE: No, of course.
But now it's not that we require
a look under hood to see that.
You don't actually
have to present
that preexisting
condition anymore.
An insurance company can
just know, oh, we have access
to your genetic information.
And we can charge
you a shitload more.
JAMIE METZL: Yeah,
so, yes, right now,
we have the Genetic Information
Nondiscrimination Act, GINA,
which makes it illegal
for insurance companies
to discriminate
against you based
on your genetic information.
But it's still legal for life
insurance companies to do so.
So maybe we'll give a chance for
other people to ask questions.
But these are the issues.
And they're not easy.
And the point is
there aren't answers.
Your question is a great one.
We have to be struggling
with them now.
But we're spending so
much of our time focusing
on these issues that
are less important.
And this is something where
everybody needs to be involved.
We need our leaders
to be involved,
because the exact issues
that you described
are the ones we need
to be wrestling with.
AUDIENCE: So I believe
this is coming.
And human to have a hard time
putting genies back in bottles.
So the first people to do
this will probably be rich.
JAMIE METZL: Yes.
AUDIENCE: And we're
talking about something
that could give crazy advantages
to additional entrants.
JAMIE METZL: Yes.
AUDIENCE: And we could--
I was listening
to an NPR article.
And they were saying, we could
have two different species,
the rich-person species and
the poor-person species.
JAMIE METZL: The Eloi
and the Morlocks.
AUDIENCE: And so, what is
the World Health Organization
doing about this or
thinking about this?
JAMIE METZL: Yeah.
I'm working with the
World Health Organization.
The answer is something.
But nobody is doing enough.
I mean, this is such
an important issue.
And it's just being
massively under-addressed.
So there will be first
adopters of this technology,
like every technology.
But we've seen what
happens when there
are first adopters
of the machine gun.
You can really skew the
way the world looks.
And on one hand, there will
be some democratic pressures,
just in the sense
that there will
be huge savings to at least
rational health care systems
that these
technologies can bring.
And from a theoretical
perspective,
in a country like the UK where
you have a national health
system and a rational regulator,
you can think about, well,
if we're going to eliminate
lots of genetic diseases
that cost hundreds of billions
of pounds per year or more
to treat and we distribute that
benefit across the population
by providing free IVF and embryo
screening to everybody who
wants to have a baby,
that is a rational thing.
But even in that system,
there are going to be people--
because we are humans,
and humans are crazy--
who want more.
And again, it's a
very, very real issue.
What I will say about
these equity issues,
which are so serious,
in the future--
that if we care, if
those are our values
that we don't want to
live in a world that's
divided genetically in
the future, the best
way to fix that is to
look at our values now.
If we're perfectly comfortable
having an average kid born
in the Central African Republic
being born with brain damage
because his mother
is malnourished--
and so that kid's brain will not
function as well as our kids'
brains will function.
Even though it's not
based on genomics,
if we're comfortable
with that world,
and that world is OK
for us, how can we
expect that there's going to be
a different us in the future?
But if we say our values are to
live our principles of equity
today, when we get to the
future, we'll know who we are,
and we'll be able to
apply those values.
Yeah?
AUDIENCE: I just want to start
by saying this conversation
made me super uncomfortable.
But that's exciting
because I like
when things sort of disrupt
my expectations of what's
going to come.
I live for those moments.
I live for that moment where
you walk into the water,
and you take a
couple extra steps,
and then you're floating.
So what I think is
kind of interesting
is you're talking about
this continuum of stuff.
You've got your genome.
And if we can edit it to
make you more healthy to live
longer, that's one definition.
That's a belief system for
saying, that's a better life.
I think, when you talk about
making someone more intelligent
or making someone run
faster, it's pretty clear,
this is a superlative.
You're making them better.
But what about the lens
of not the IQ but the EQ?
What about the
emotional quotient?
What about the
space of creativity,
the space of cultural
norms, the fact
that forgetting things means
the things you remember
are meaningful?
And certainly, this is less of
a technology-driven question--
more of a question about
what makes us human.
And I guess, just at a
high level, I'm curious,
how does that work its
way into your thoughts
as you start to extend
beyond medicine?
JAMIE METZL: Yeah.
It's such an essential question.
Because if we--
any of us-- think
of this as a conversation
about science,
we've missed the whole point.
This is a conversation about
humanity's values and ethics.
And it's set in the context
of a revolutionary technology
and revolutionary science.
So we have to be
focusing on those things.
But the challenge for us is that
diversity for the last almost 4
billion years has just been
something that happens to us.
I didn't say, oh,
I want to be born
looking like
whatever I look like
or having whatever genetic
inheritance that I have.
My parents didn't say that,
other than in the process
of meeting each other.
But now these things
that have just happened
are going to increasingly
become choices.
And that's essentially the
point that I was making
when I talked about diversity.
We are going to have
to articulate something
that just happened to us.
And if we think that the only
way to have value in this world
is to have 15, or 20, or 50
higher points on an IQ test,
we are going to
destroy our humanity.
And not only that,
we're going to become
less good at a lot of things
that we collectively do.
And as a matter of
fact, what I am saying
is, if everybody starts
making the same choices based
on our cultural biases of
things that seem perfectly good
and we don't have a
conversation about diversity--
which is essentially the core
point of what you're making--
and how we value
it and how we're
going to realize that in a world
where biology is manipulable
and a choice, we are
going to drive ourselves
into potentially even an
evolutionary cul-de-sac.
And the drivers won't be
authoritarian governments.
The drivers will be the
most well-meaning parents
who are trying to give
advantages for their kids
in the world as they see it.
And so I totally agree with
the premise of your question.
And I'm sorry that I have the
same answer to every question.
But that's why we have a
little bit of a head start now.
Imagine if we could have
had an open conversation
at the beginning of the
Industrial Revolution
or the beginning of the
nuclear revolution about,
well, we know this
stuff is coming.
What are the values that we
want to weave into everything?
And we have a little window
before everybody retreats
to their barricades.
And that will happen.
And it will happen soon.
So this is that window.
And one of the
reasons why I like
speaking with groups
like you is that I
feel like this is a conversation
that we're all part of.
And we all need to be
hubs in that conversation.
Yeah?
AUDIENCE: Do you see
abortion laws today
that we have in this country
in the world as any indicator
of how the World
Health Organization
rules are being laid out?
Because I feel, like
you aptly mentioned,
that there's always
going to be two sides.
JAMIE METZL: Yeah.
AUDIENCE: And how
do you see your work
being compiled into that?
JAMIE METZL: So that
the debates that we've
had over issues like abortion
and genetically-modified crops
are highly relevant to
where we may be going.
And they're also a warning that,
with abortion in the abortion
debate, there are people on the
various sides who have staked
out extremely rigid positions.
And here in the United States,
the politics of abortion
makes it much more
difficult to have
these kinds of conversations
on a national level
than is the case
in other places.
And again, the United Kingdom
is a good example of that.
But when we look at abortion,
you have to ask yourself,
if you believe that life
begins at conception, why is it
that we have picketers and
protesters in front of clinics
where abortions
are taking place,
but we don't have them in
front of fertility clinics?
Because if life
begins at conception,
the place where abortions
are happening, that's retail.
But the fertility clinics,
that's wholesaling.
If you think that's murder,
that's where it's happening.
But why aren't the
picketers there?
And the reason is because this
technology has normalized.
And people in those
communities, they
see these parents
who have benefited
from the miracle of life who,
otherwise, wouldn't have.
And they don't like to admit it.
But they recognize that there
is a cost and a benefit.
And genetically-modified
crops are another example
where the scientists actually
did a pretty good job
of setting ground rules
and behaving responsibly
since the 1970s.
But the general
public, on average,
didn't feel that they
were part of that process.
And so now you have pretty much
all of the science Nobel Prize
winners alive who are
repeatedly saying,
GMOs are safe for human
consumption-- which they are.
And yet, people have this
gut feeling, particularly
but not exclusively in
Europe, that there's something
wrong with GMOs, because
it's not "natural."
And now, millions
of people need to be
harmed in Africa and
South Asia, because they
can't grow GMO crops.
Because if they do they won't
be able to export to Europe.
And agriculture is
their main industry.
And I keep coming back
to the same points.
So if we want to have a
meaningful conversation that
can guide us and lead
us toward optimizing
the benefits of this incredibly
powerful and, in many ways,
wonderful technology,
we all need to engage.
We need to see
ourselves as shapers
of this information
and ultimately
regulatory environment.
Yes?
AUDIENCE: I was
very happy to hear
the piece about skin cells--
being able to turn
those back into eggs.
Because the undertone
of a lot of this
is medicalization and control
for how women reproduce--
not as a goal but
as a consequence.
And it ties back to
the comments about,
why don't people
pick at IVF clinics,
has a lot more to
do with control--
one can always argue about that.
And then you take this also--
you tie it to what
we already see
happening across
Asia in terms of sex
discrimination, abortion, which
is warping the population.
We already have experience
that this has done poorly.
And so one of my
concerns, as you
go in the world
working on this, is
that there are actually women.
And there's work going
the reproduction side.
You said, toss IVF off.
Oh, yes, this is here.
It's standardized.
And we have a lot more multiple
births, which are hugely--
JAMIE METZL: Well,
that's going down.
Yeah.
AUDIENCE: Yes.
But they're riskier-- the chance
of it, the medicalization.
This all has huge implications.
We talk about, oh,
wouldn't it be lovely
if your kids are smarter?
I have three smart kids.
And asynchronous
development-- there's
all of these societal
implications that are embedded
in the culture assumptions.
Oh, this must be great.
But getting there is
hugely challenging.
JAMIE METZL: I totally
agree that there
are huge issues of women's
health, reproductive health.
And we are moving into
a new world of biology
and how biology works.
So I've talked about
how egg cells will
be created from adult cells.
We already have--
in the last year,
two male mice have had their own
100% related biological child.
Two female mice have
had their own 100%
related biological child.
We are moving into a
world where biology
is fundamentally different
than what we have known.
And the possibilities that that
will bring are, in many ways,
beyond most of our imagination.
Thank you so much.
It's really been a
pleasure speaking with you.
[APPLAUSE]
