Are You Ready for the Genetic Revolution? | Jamie Metzl | TEDxPaloAlto

open any major news source and what do you see we see Trump we see brexit but 30 years from now 50 years from now a hundred years from now people are going to look back at now and they're not going to be talking about Trump they're not going to be talking about Briggs's what they are going to be saying is that now was the moment when after 3.8 billion years of evolving by the set of rules we call Darwinian evolution of random mutation and natural selection this was the moment when our species took increasingly active control of our own evolution think about that for a moment think about how profound that is when Watson and Crick identified the double helix structure of DNA in the 1950s what they were doing was identifying that the book of life had a structure and the structure was the famous double helix and with the fruition of the human genome project in 2003 what we were doing was identifying that the book of life could be read in the A's and C's and T's and G's of genetic code and now at the dawn of the age of human precision gene editing with tools like CRISPR we're recognizing that the book of life can be written when we think about technologies that are readable and writable and hackable we think about information technology as a matter of fact we recognize the variability of our IT so much that we have a built-in assumption that every new version of our iPhone is going to be better and stronger than the last one and yet for some reason we think about our biology as being fixed but why do we think that somehow we evolved from being single-cell organisms almost four billion years ago to this and we've only been homeless a pians for around 300,000 years and yet it's all we know but with these tools of the genetic revolution we are going to be able to fundamentally transform our biology and this is going to create wondrous amazing opportunities for us every time a young child dies of a terrible genetic disease we recognize that as a crime against potential but when a 90 year old gets dementia that's a crime against potential - think of the investment that we have made in people you have a whole life of developing your knowledge and your wisdom and your relationships and when that goes away we all suffer and we are developing tools that are going to expand our humanity expand our potential and we need to welcome that but we also need to recognize that there are dangers associated with developing these Promethean technologies that are giving us powers that in the past we have attributed to our gods the power to make and remake life and that comes with a tremendous responsibility because the genetics revolution is coming very very quickly and we aren't ready and in order to make sure that we optimize the incredible benefits that are coming our way we've got to be so there are three key areas where we are all going to be feeling the impact of this fundamental change the first and probably the most obvious is in our health care when people think about genetics now they think about health care for some very good reasons but if this is genetics is going to fundamentally transform the entire paradigm of health care right now when you go see a doctor you are treated based on the principles of generalized medicine meaning you are treated because you are a human with an N of about 7 billion but that is going to change because as we were able to look under the hood of each individual human your treatment is going to be based on the individual biology of you and that's why when you take a drug it's not going to be a drug that works on average for humans it's going to be a drug that works potentially for you based on specific knowledge of your own biology and the foundation of that biology will be your sequence genome which will be part of your electronic health record so what's that going to mean well as more and more of us have our sequence genome our genomes sequenced as part of this transition from generalized to precision healthcare we're going to have millions then hundreds of millions and within ten years about two billion people will have had their whole genome sequenced and then with the genotypic information what our genes say and the phenotypic information of how those genes are expressed over the course of our lives and using big data analytic tools we are going to be able to decipher more and more of the secrets of the genome and that is very quickly going to transform our healthcare from the paradigm of precision medicine to predictive medicine right now what we call health care is really sick care you go to your doctor with a symptom but maybe that symptom has been germinating in your body for 10 years 20 years maybe your whole life and maybe when you go to see your doctor it's so late in the process your doctor can't do anything but what if when you're taking your child home from the nursery after just being born the doctor says here's your child take him home but just FYI your child has a 70% greater than average chance of getting early onset Parkinson's or familial Alzheimer's or type 1 diabetes right now you say oh my god why are you telling me this this is torture but it's actually really useful information if you knew that your child had an increased susceptibility to tie it to type 1 diabetes wouldn't you want to instill in him or her a sense of how a series of habits of exercise and diet if you were at risk or your child was at risk for some terrible disease wouldn't you want to keep an eye on what progress was being being made in treating that disease wouldn't you want more tests if you knew you had a greater susceptibility to breast cancer at some point in the future everybody is going to want this this information but as we move toward universal sequencing our understanding of genetics and genomics is going to move way beyond the realm of healthcare and that's the second critical application will be through direct-to-consumer genetic information that has nothing to do with healthcare we don't have a disease genome we don't have a healthcare genome we have a human genome and that means that as we understand the secrets of the genome we aren't just going to understand more about our disease states we are going to understand more about the essence of what it means to be a human being our most intimate traits the way our brains function our personality styles anything that has a genetic component and there certainly are many traits that are mostly genetic and partly genetic we will be able to increasingly understand the genetic component of those traits so that's going to mean a lot because remember taking your kid home from the nursery with the information about disease risks what if you have information that your kid has a better-than-average potential at being amazing at abstract math or sprinting or having an outgoing personality will you send them to drama school because you have that information how will that affect how we think about what it means to be a human being how we think about parenting and then the third and most profound application of these technologies will be in a fundamental transformation in the way that our species reproduces right now about 2% of children in the United States are born through a process called in fee and vitro fertilization IVF it's about 10% in Denmark and now when you have IVF when a woman has IVF these embryos the pre implanted embryos can be screened for mostly single gene mutation diseases and disorders things like tay-sachs and sickle cell disease chromosomal abnormalities and simple traits like hair color and eye color and of course gender and all of that is in some certains in some instances controversial but when we have more and more of this information about complex genetics it's not going to be making selections based on just this limited information we already have the ability to rank let's say let's call them 15 pre implanted embryos from likely tallest to likely shortest within about 10 years we're going to have the ability to rank them from likely highest genetic component of IQ to likely lowest genetic component of IQ we'll be able to rank likely most outgoing again it's not an entirely genetic trait to likely least outgoing you see where this is heading we are touching the core of what has been the mystery of what it means to be a human being with these technologies but right now our ability to select embryos is limited by the number of eggs that a human female produces I mentioned 15 which is the rough average but what if you could have more and there is a technology that is already being applied to animals of taking in any adult cell but a skin cell is often the easiest one and so you take a skin graft you induce those skin cells into stem cells using a process for which Shinya Yamanaka won the 2012 Nobel Prize so now you have let's call it 10,000 cells that have been turned skin cells into stem cells stem cells then induced into egg precursor cells and egg precursor cells into eggs so now you have 10,000 eggs and you fertilize them with the male sperm because there's about a billion sperm cells in every male ejaculation and now you have 10,000 fertilized eggs and in a machine you grow them for about 10 days after about five days you extract a few cells from each you sequence those cells and the cost of genome sequencing has gone down from about a billion dollars in 2003 to about $800 now to negligible 'ti with a decade so that doesn't cost anything and then you get a spreadsheet and in the spreadsheet you have all of the options for your 10,000 embryos and when you're starting with 10,000 you have a lot of options how far can we go with this well our ancestors who knew nothing about genetics took proud wild wolves and turn them into yapping chihuahuas imagine how far we can go with the knowledge that we have about how genetics works and how biology works we can go a very very very long way and on top of that then we have these unbelievably power tools of precision gene editing like CRISPR many of you know that in 2018 a Chinese scientist an unethical Chinese scientist in my view was the first person to genetically engineer two little girls to any humans and those children were born in in October 2018 in China and this was a rogue scientist but had he even not done what he did still two years from now three years from now we would anyway have had the first application of precision gene editing to a pre implanted human embryo that would would have been taken to term we aren't going to be starting from scratch and creating babies out of a computer but we will be making small numbers of Jo gene edits whether it's 1 2 3 yet it's 5 edits maybe 10 of its I don't think that we're going to be making one thousand two thousand ten thousand gene edits to a pre implanted embryo within the next couple of decades and what is that going to mean because we are going to make changes in most cases to eliminate terrible and perhaps deadly risks and people have a gut feeling well it's okay to eliminate risks but we don't want to do things that feel like enhancement but there will not be a clear boundary between those two poles all of life will be in that gray area because it is all about perception and these incredibly powerful tools will exist in the context of us of our community of communities of our cultures and we are all different within our societies people have all kinds of views ranging from extreme people with strong religious views who have a strong aversion to quote/unquote playing God to transform inist biohackers who think it should be all systems go and everything in between and how will societies figure out how to balance those different desires and interests we're all so different now internationally that there are countries that have strong judeo-christian backgrounds that may have one view about the permissibility of messing with nature other societies may have different views how do we think about sinking these different views and if that isn't hard enough we're doing it in a world driven by extreme competition we have extreme competition within our communities I have a friend who is Korean and lives in Seoul he has 12 student I'm sorry 12 tutors coming to his house every week to tutor his 11 year old girl Korea has a law making it a requirement that cram schools close every night at 10:00 p.m. because so many people were having their 7 and 8 year old kids stay out past midnight 7 days a week preparing for exams they were going to take a decade in the future when I asked my friend if you could sort your pre implanted embryo embryos to give your future child a 10 to 15 point IQ boost would you do it he looked at me like I was insane like why would you even ask that question obviously and then I said how about everybody else who are the parents of kids in your school and the look on his face didn't change and that maybe culture of specific subculture specific but we have all of these different cultures and people will have different desires and if that's not complicated enough what happens when different countries have different entire approaches to using these technologies imagine one country call it the United States decides to opt out another country let's call it China decides to opt in because it perceives an economic or competitive or other benefit what would the opt-out country do one thing you could one thing is you could imagine they would say well we've made our decision you've made your decision let's see how it plays out and we don't know how it would it would play out but people will be afraid of that because what if that other society has some kind of big advantage that the SIA tea the society that's opted out doesn't have what do you do so you could try to say well we'll try to build a global standard which is a great answer but it's hard to do but what if you try to pressure that other country and they don't change do you make it illegal for your citizens to procreate with people from that other place do you use force to try to get them to stop imagine all the crazy things humans have gone to war over in our history is this one I don't know it could be and the ethical issues around this are so deeply profound that they they hit us all we are talking about is messing with very complex systems we don't remotely or fully understand there are equity issues who has access and every technology has a first adopter that's the nature of technology but we've seen what happened when European powers for example had slightly better weapons and slightly better ships than everybody else it led to the colonial colonial era what will happen if there are real or perceived differences between people and diversity we think about diversity as a great way to have better workplaces and universities and school but it's something much deeper from an evolutionary perspective from a Darwinian perspective diversity is just random mutation you could say if it weren't for diversity we'd still be single-cell organisms but you'd be wrong because if we didn't have diversity those single-cell organisms could never have survived once the environment change because there's not good or bad in evolution there's just suitability for a particular environment and diversity is our investment in being ready for a future scenario that we can't predict and we're going to have to make big decisions before we fully understand the long term implications of the decisions that we are going to have to make we now have a tremendous responsibility but also a great opportunity to bring our best values to bear in shaping this technology that is going to shape us and I invite you to join me thank you [Applause]

Channel: TEDx Talks

Views: 25,618

Rating: 4.652174 out of 5

Keywords: TEDxTalks, English, Global Issues, Ethics, Future, Genetics, Law, Medicine

Id: FgGtlLjHMgM

Length: 19min 6sec (1146 seconds)

Published: Fri May 24 2019