Archive for April, 2008

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Wednesday’s Words of Wisdom

Wednesday, 30 April, 2008

Today’s Words are in Latin, truly the wisest-sounding language of them all. These words are attributed to the the Roman philosopher Seneca (the Younger)

“Nemo liber est qui corpori servit” (No one is free who is a slave to his body)

Although it is likely Seneca was using these words to admonish those hedonists who let their bodily urges control them, these words are nonetheless a strong statement for bodily autonomy/morphological freedom.

Our rights to freedom and autonomy should extend to our own bodies and DNA. If a person wants to go for a run, we let them because they have the right to freely do that. So, if a person wants to have cyborg legs in order to allow them to run faster or wants to insert a few genes into their muscles so that they can run faster, they should be allowed to do that too.

It’s my body, my brain and my genome. To forbid me from changing those characteristics is violating my right to liberty.

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GINA + effective genetic predictions = no health insurance

Tuesday, 29 April, 2008

The United States Senate has recently passed the Genetic Information Non-discrimination Act. This bans insurance agencies, and workplaces, from using information obtained from predictive genetic tests to discriminate against their clients (or workers). They can still use existing symptoms to adjust their premiums, but tests that suggest you might get cancer or a similar condition in the future will be off limits to insurers.

But this could provide some very serious problems if genetic tests become very good at predicting disease risks (and they will). If people know they will likely get a genetically-influenced disease in the future, they will take out comprehensive private health insurance. And if people know they very likely won’t get that disease, they will opt for a basic private health insurance plan to cover accidents and contagious diseases. (Those who don’t know their genetic disposition will probably stick with their moderate, employer-provided health plan – and most people say they won’t want to test their genome if GINA wasn’t there).

The effect of this is that insurance becomes less viable, because insurees are now cherry-picking their insurers rather than the reverse. Why would an insurance agency offer cancer cover, if the only people who opt for that will be people likely to get cancer? Offering such cover would be a net drain on the insurer! Therefore, private health insurance, though very profitable in the short term (before the diseases present themselves and claims start being made), will not be able to survive in the long run. No more private health insurance.

There are ways to avoid this. The obvious ways are to allow genetic discrimination (so premiums could be raised for the genetically at-risk), or to ban good genetic testing (not nice). A more likely prospect would be for insurers to be legally required to cover all genetically-determined or influenced conditions under all plans. This would, however, result in many people paying money for health care they will never need, but is arguably better than people going without.

The best (in my opinion), though also unlikely, would be for the United States to accept the death of private health insurance and move to a totally public health system, where all medical expenses are paid for by taxpayers. Taxes not used for health care each budget would be a surplus to cover previous/future deficits or create more facilities (instead of into the pockets of insurance company executives). Plus, genetic discrimination (typical or ‘reverse’) would be impossible.

Although I figured this out on my own, what I have said here has been, of course, said by many others. Here is the best one:

Personal genomics and the end of insurance

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Gene therapy fixes (night) blindness

Monday, 28 April, 2008

Those bionic eyes I blogged about have some competition – from genetic engineering. A form of blindness known as Leber’s congenital amaurosis is caused by a lack of a key gene, RPE65, in cells of the pigment epithelium cells. These are the cells just behind the photoreceptors, and they produce a key pigment molecule called 11-cis-retinal. This pigment is used primarily in rod photoreceptors, because the cones can make a similar molecule known 11-cis-retinaldehyde without relying on the pigment epithelium cells. However, the cones degenerate, meaning that Leber’s congenital amaurosis can cause blindness by middle-age.

Gene therapy was trialled on young adults (17-23), who still have reasonable colour vision thanks to functional cones. However, cone cells require more light to be stimulated, so the rod cells (which only show light and dark, or shades of gray) are used primarily in low-light conditions (and in peripheral vision).

The researchers used the common viral vector AAV (adeno-associated virus) plus an adeno 5 helper virus. This vector contained the DNA of the human RPE65 gene, including its promoter sequence (the terminator sequence was different though – bovine growth hormone polyadenylation sequence was used). They injected these into the subretinal space of one eye.

Unfortunately, though three patients underwent the surgery (at least, three were included in the study – I think it has been trialled on others), only one showed improvement. It was a dramatic improvement though – improved visual mobility, as measured by a navigation in a simulated street scene in low-light conditions – from 77seconds to 14 seconds, without bumping into the wall eight times like he did before the surgery. The researchers believe this lack of improvement in the other patients was due to their retinal degeneration being more severe, which if true would mean that this therapy should be targeted at children with the condition.

View full article in the New England Journal of Medicine.

Now the race is on. I wonder which will end up curing blindness first – bionics or genetics. This race is going to be in many areas aside from vision research, such as in giving mobility back to amputees (can we regrow limbs before we get fully functional prosthetics?). Personally, I’m willing to let both fields work, so that those who want it can be enhanced from both directions.

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I’ve bought Bill McKibben’s book

Saturday, 26 April, 2008

For some reason, I’ve actually bought a book by one of the crazy people in this arena of human enhancement – Bill McKibben’s Enough: Staying Human in an Engineered Age. If you don’t see any blog posts from me this week, it’s because I’m outside screaming at the sky or possibly burning the book in a fit of rage against the status quo bias present throughout the book.

I’m not looking forward to reading this one, but as Francis Bacon said: Knowledge is power.

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Bionics eyes are everywhere!

Friday, 25 April, 2008

Everywhere I look, I see some mentions of bionic eyes. Well, ok not everywhere, but there are stories this week about visual bionics coming from the US, the UK and from here in Australia.

A US company, Second Sight, working through the University of Southern California, has a nice bionic eye called the ‘Argus II’. Two blind patients in the UK have received the implants, which sends information from a camera worn on the head to a retinal implant featuring 60 electrodes on a 1mm2 chip. Now 60 electrodes isn’t much, considering that the retina contains about 160 million photoreceptor cells. Each of those electrodes is likely to be stimulating large portions of those. So it’s only rudimentary sight at the moment – only able to distinguish between large objects. But it’s only a matter of time.

The Prime Minister of Australia, at his 2020 Summit this week, thought that research into further bionics was a good plan for Australia, seeing as the University of Melbourne were the leaders in developing bionic ears (cochlear implants). The cochlear implant has a similar problem as the bionic eye – it uses a mere 22 electrodes to stimulate a few thousand receptors. One other Australian design, a bionic eye developed at the Sydney Eye Hospital, has a cost-effective design featuring only 30 electrodes, but differs from the Argus II in that it is fitted on the extra-ocular surface of the eyeball, rather than on the internal surface of the eye.

The Australian researchers at The Bionic Ear Institute in Melbourne have learned from this, and their bionic eye design features a total of 1000 electrodes. It also stimulates the optic nerve, rather than the retina itself. I’d imagine this would have the advantage of allowing more of the visual field to be stimulated at once, rather than just the part of the retina where the chip is.

Only a matter of time now before we have bionic eyes like Steve Austin (Six Million Dollar Man) or Jaime Sommers (Bionic Woman – the 2007 one). Or Batou from Ghost in the Shell. And if you really want to stretch for it – John Silver from Disney’s Treasure Planet.

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Wednesday’s Words

Wednesday, 23 April, 2008

I’m unsure as to whether these words are wise or not. They are not words of worry in that they were not written in fear or anxiety, but they have certainly caused enough worry by others. These are pretty much guaranteed to be quoted in some form in a book critical of human enhancement (and published after 1997). Some of these words are those of molecular geneticist Lee M. Silver, in his book Remaking Eden (first published in 1997, but I only have the 2007 reprint):

  • [A]ll people [belong] to one of two classes. The people of one class are referred to as Naturals, while those in the second class are called the Gene-enriched, or simply GenRich.
  • The GenRich – who account for ten percent of the American population – all carry synthetic genes.
  • The GenRich are a modern-day hereditary class of genetic aristocrats.
  • The GenRich class are anything but homogeneous. There are many types of GenRich families, and many subtypes within each type.
  • All aspects of the economy, the media, the entertainment industry, and the knowledge industry are controlled by members of the GenRich class
  • Naturals work as low-paid service providers or as laborers.
  • [B]y the end of the third millennium, the GenRich class and the Natural class will become the GenRich humans and the Natural humans – entirely separate species with no ability to crossbreed, and with as much romantic interest in each other as a current human would have for a chimpanzee.

I don’t really know why Silver wrote about a seperate human species. I don’t think it is likely to ever happen. Silver refers to the evolutionary process of speciation occurring as the two classes become less genetically compatible due to reduced breeding. But I suspect that enough GenRich will fall in love with the “lower” tiers of society (who will probably have some genetic enhancements, as they become cheap enough to afford) to keep the gene flow going, and thus prevent sympatric speciation.

And besides, Silver is talking about the third millennium here! Did he not think that by that stage, geneticists would have worked out how to overcome any genetic incompatibilities between two closely related species? Even if this reproductive incompatibly is caused by differing chromosome numbers (the objection often raised to human artificial chromosomes), at the current rate of advancement in the science of ‘reprogenetics’, there will be a way to make them compatible.

As I said at the start of this entry, Silver appears to have worried more people than he comforted with the Prologue of Remaking Eden. And without good reason, in my opinion.

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Positive feedback loops in bioethics

Wednesday, 23 April, 2008

There are some situations in bioethics were people use a prior action has justification for further actions. I like to call these positive feedback loops, as they remind me of the positive feedback mechanisms of the body; an increase in one property (say, the level of a hormone) causes a set of signals to be releases that cause that property to change in the same direction as the initial perturbation. In economics, such loops are called ‘vicious circles’, such as where lack of education leads to a lack of income which leads to a further lack of education leading to a further loss in income and so on.

The most obvious loop is that involved in the debate about human embryonic stem cell research. These were banned or restricted (by limiting funding) in many places around the world, and many researchers no doubt shied away from the field due to the funding or legislative insecurity. Unsurprisingly, there have been far more treatments developed that involve adult stem cells than those using embryonic stem cells. Detractors of embryonic stem cells claim this lack of results is due to the inferiority of embryonic stem cells, and without the push for therapies, the restrictions on embryonic stem cell research are not likely to change, and could even be increased.

Similar examples involve agricultural biotechnology, where harsh restrictions GM crops causes them to be far more expensive and less efficient to grow, which weakens claims about solving the food crisis, which removes the major reason for allowing the research, which causes restrictions to increase.

I’m worried a similar problem of this sort could arise with human enhancement technologies, like genetic modification. They will first be banned for ethical problems or safety concerns. Then a few researchers will begin their research in other nations where there are no safety concerns or clinical trials, leading to horrible experimental disasters unrivaled in sci-fi films. Then those experiments will be exposed to the public, leading to mass panic. This social pressure will leading to even harsher restrictions on the research, driving the research even further underground, thus restarting the cycle again.

We need to watch out for these loops. It is entirely unscientific for people to claim that stem cells are better derived from adults than embryos if both are not on equal footing. It is entirely illogical for people to claim that growing GM food is more expensive if their concerns about GM food are what made it so expensive in the first place. And, it is especially bad to force research underground where it will be carried out in a manner unsafe to both the researchers and the research subjects, and illogical to believe such research would be equally dangerous if carried out in approved facilities under regulatory oversight. These loops can quickly spiral out of control into a land of very, very harsh restrictions on scientific research. And I, for one, would much rather have too much science than too much legislation.