The Munk Debates Podcast - Be it Resolved, let’s engineer a better human being

Episode Date: August 8, 2023

We’ve come a long way since DNA was first discovered in the mid 19th century. Today’s scientists are using powerful engineering techniques to edit genes in human eggs and sperm, curing diseases and repairing defective genes before a child is even born. Some scientists are excited about these therapies, championing them as an exciting opportunity to create immunity to viruses, eliminate serious illnesses like AIDS, Alzheimer’s, and cancer, and possibly reverse aging. Like prior innovations in medicine and technology, why wouldn’t we embrace a science that allows people to live longer, healthier, and happier lives? Others are alarmed. They are worried that these new techniques raise a host of profound ethical issues. While eliminating genetic diseases is a worthwhile endeavor, many parents might be inclined to use this science to create designer babies: children who are smarter, taller, or have other supposedly desirable traits. And these tools aren’t cheap. They will surely be available to the rich first, creating a terrifying new dimension to the growing economic inequality crisis. Scientists also point out that ‘playing god’ and editing genes will alter our DNA code forever, and one mistake could inadvertently introduce new diseases into the human gene pool. While the desire to cure genetic diseases is a noble one, the manipulation of our DNA is more likely than not to push humanity towards a dangerous and dystopian future no one wants.  Arguing for the motion is George Church, Professor of Genetics at Harvard Medical School, Professor of Health Sciences and Technology at Harvard and MIT Arguing against the motion is Joyce Harper, Professor of Reproductive Science at the Institute for Women's Health, University College London.   Sources:  ABC News, France24, Today Show, NBC News, VICE, PBS, Gattaca, Critical Past The host of the Munk Debates is Rudyard Griffiths - @rudyardg.   Tweet your comments about this episode to @munkdebate or comment on our Facebook page https://www.facebook.com/munkdebates/ To sign up for a weekly email reminder for this podcast, send an email to [e-mail].   To support civil and substantive debate on the big questions of the day, consider becoming a Munk Member at https://munkdebates.com/membership Members receive access to our 10+ year library of great debates in HD video, a free Munk Debates book, newsletter and ticketing privileges at our live events. This podcast is a project of the Munk Debates, a Canadian charitable organization dedicated to fostering civil and substantive public dialogue - https://munkdebates.com/ The Munk Debates podcast is produced by Antica, Canada’s largest private audio production company - https://www.anticaproductions.com/ Senior Producer: Ricki Gurwitz Editor: Reza Dahya  Become a Munk Donor ($50 annually) to get 72-hour advanced access to the full length editions of Friday Focus and Munk Dialogues. Go to www.munkdebates.com to sign up. Hosted on Acast. See acast.com/privacy for more information.

There are options, and that's why we need to take this opportunity seriously. There's no way you can prevent global warming unless China is part of the solution. This is not normal male behavior. This is predatory behavior. We don't know how bad this bug is. We don't know what this bug does. All of that was thrown away in those eight minutes and 46 seconds, and that's the moment that I became an abolitionist. Extraordinary claims require extraordinary evidence. Welcome to the Monk Debates. Every episode we, We provide you with a civil and substantive debate on the big issue of the day to arm you,

the listener, with enough information to make up your own mind. Today's debate, be it resolved. Let's engineer a better human being. Imagine your doctor discovering that you have a life-threatening disease, but then telling you that there's no reason to panic because they can fix it simply by adding it out of your genes and DNA. It's often referred to as DNA scissors. Chris Bearcast9 is a powerful.

tool that scientists can use to edit DNA and modify gene functions, and it could help eradicate genetically based diseases like Alzheimer's and HIV. While this is a phenomenal scientific breakthrough, it has certainly opened up Pandora's box in terms of all the conversations ethically and otherwise that will be happening. Hello, I'm your moderator, Rudyard Griffith. Well, we've come a long way since DNA was first discovered almost 200 years ago. Today's scientists are using genetic engineering and its advanced techniques to edit genes in human eggs and sperm, curing diseases, and repairing defective genes even before a child is born. Some scientists are excited about these new innovations, championing them as a cutting-edge

opportunity to help people live better lives. Biology is still being transformed by CRISPR technologies. I don't know where it's going to land, but I know there's a huge, huge upside for the good that it could bring us all. Scientists like Neil deGrasse Tyson see the potential to create immunity to viruses, eliminate serious illnesses like AIDS, Alzheimer's, and cancer, and possibly stop or even reverse the process of aging. Proponents of genetic engineering argue that we should embrace these technologies

and their promise to help people live longer, healthier, and more fulfilling lives. Others are alarmed by the rise of genetic engineering. It's not a question of whether we're going to see people try to design their children. It's only a when and then a how far. Once you move past obvious diseases into more preferences about traits, I suspect the biggest ethical issue will be, is there anything that if you had the money or the will, that medicine is going to say no to? That's bioethicist and professor.

Arthur Kaplan, voicing a chorus of growing concern over the ethical issues associated with genetic engineering. While eliminating genetic diseases is a worthwhile endeavor, many parents may be inclined to use genetic tools to create designer babies, playing God and editing genes to alter our DNA code forever. On this installment of the monk debates, we challenge the essence of these arguments by debating the motion, be it resolved, let's engineer. a better human being. Arguing for the motion is George Church. He's the professor of genetics at Harvard Medical School

and pioneered the use of the enzyme CRISPR tool to edit the genes of animal and human cells. Arguing against the motion is Joyce Harper. She's a professor of reproductive science at the Institute for Women's Health at University College London. George, Joyce, welcome to the mug debates. Hello.

Great to be here. Thanks. Well, this is a debate that I have wanted to do literally for the last 18 months that we have been running this podcast. The resolution that's got me so interested and energized is be it resolved, let's engineer a better human being. The opportunity to have this conversation with both of you, with your considered opinions, your deep knowledge and insight of this subject area is just a personal privilege and one that are among, members and community really appreciate both of you participating in. So as per standard process, we are going to have you, George, speak in favor of the motion. As agreed, that means that you go first. So I'll put a couple minutes on the clock and turn the program over to you.

Great. So let's engineer a better human being is the proposal here. And I think we all might have a little problem with the word better. I think most people don't like saying that one human being is better than another in some global sense. And engineers typically aim for better in a particular category, not in general. Bicycles aren't necessarily better than jets, for example, or vice versa. So you might ask a physician or a patient whether they feel better today. So health is one of the main categories of what we mean by better. And we also need to recognize that almost all technology is an enhancement over our ancestral state. We would notice that if we went back in time. I think we're concerned specifically about heritable engineering, not engineering in general,

so engineering that passes on from generation, generation, but we should be cognizant that many, many things do, like education, devices, vaccines. They all are transmitted, you know, our English language, our cell phones. My daughter and her daughter have the same of everything. And in fact, the genes are probably the least heritable in a certain sense. If you look at siblings, they often are quite different. I think from an ethics standpoint, we're mainly talking about safety and equity, equitable distribution, low-cost distribution. efficacy, that is to say, working or not, or utility is less of a concern, as long as it's safe and affordable and well explained.

So I'm going to pass it over. I'm sure there'll be lively additional comments. Thank you, George. Joyce, your opportunity now. You're speaking against our motion today, be it resolved, let's engineer a better human being. I'll put a couple of minutes on our show clock and have your opening remarks. Thank you very much. So I'm a reproductive scientist and I've worked in this field for over 30 years and I want to take you on a very short journey through IVF to transhumanism. So in IVF we've been able to create humans in our lab now for just over 40 years. Louise Brown was our first child created in this method. And then we had pre-implantation genetic testing where we could take some cells from the embryo and look at the genes in those embryos. And people have used

this for sex selection, even now for eye color, for diabetes, cancer predisposition. And many say we're heading on the slippery slope in our reproductive genetics. And now we have genome editing. So we had Dr Hay in China in 2018 editing human embryos and transferring them back to people. And we wonder where that will take us. It will probably have a medical connotation so we could eliminate genetic disease from our population, but will we also use this for characteristics because parents want a musical child, a sporty child, a tall child, children with particular eye colour or hair colour? And this leads us on to the transhumanists who really want to use all the technology we can to improve us beyond our basic physiology. And I just wonder where that will take us.

Will that take us to making a better human being? will we really have a really complicated society where we've got some people who are transhumanists who are edited, who've got technology embedded in them, and are far superior to the other unedited human beings living on our planet? Thank you, Joyce. Terrific opening statements setting up this debate nicely. Now a chance for rebuttal. So, George, this is the part of the program where we again hand it back to you,

another couple of minutes on the clock, you get to react to what you've just heard from Joyce. I'm not a big fan of the slippery slope argument in the sense that we have cars that could go very fast, but we choose not to for a variety of reasons. The idea of having a complicated society, we certainly have a complicated society already, and it's something that we either tolerate or embrace. Some people have access to jets for transportation and other people are stuck at home and everything in between. So I think the key ethical point that I brought up is equity, is if we bring the cost down, help with education, and make sure there's a dialogue that goes on in both directions, then everybody will have access. Some people will choose not to, just as some people choose. is not to have cars today.

Excellent. Well, as the debate goes on, we're going to unpack all these ideas in full. So, Joyce, similar opportunity for you now. You can react to George's opening statement, what you've just heard from him in this instant. Let's move this conversation forward. I'm afraid I don't agree with George's comment

about everyone being able to have access to these technologies. If we look at fertility treatment globally, that it's really not equal. In the UK, depending where you live, some people don't get access to any treatment at all. In the US, the majority of people are paying for fertility treatment. And the list goes on and on in different countries where we do or do not get medical treatment

depending on our salary. So I worry that these technologies will not be accessible to all. and I also worry that people will use them for non-medical reasons. So those are my two biggest concerns. And I feel that we will have a big divide in our population, a rich-poor divide, that will become bigger and bigger as technology advances. Thank you, Joyce. I get to join the conversation now and kind of think up some questions on our listeners' minds.

Before I go to questions, let's just set the stage a little bit more to give our audience an understanding of where you're going to be. these technologies are at at this moment and what both of you think their potential is, both for good and for bads. Maybe George, to start with you, you've really been a pioneer in genetics. That's kind of an understatement. What do you see as the promise and the potential going on in your lab right now or other labs around the world that has you really excited about the potential for gene editing and gene therapies to really transform the human condition? Yes, so my lab has been involved in both the next generation sequencing,

which is increasingly used for non-invasive prenatal testing and other diagnostics, preconception and prenatal. So that's on the reading side and on the writing side we've been involved in the new editing tools, including CRISPR. there's a tremendous amount of excitement about using them in adults and children. I think there's very little case to be made for embryos, but there has been an experiment done on at least three human embryos, which are now three years old.

And as far as we know, they're all three healthy. So that's better than a better track record than some technologies when they're first introduced. The other thing that's exciting is that the costs are being reduced, which somewhat addresses the equitable access issue. So my group has helped contribute to reducing the cost of DNA sequencing by 20 million fold. It's come down from $3 billion to $300, and it continues to plummet. And hopefully it can be made free at some point because it's in the same sense that Wikipedia is free. You do have to provide people with access to electronics.

And then delivering genes is now getting very affordable. In that the two of the main COVID vaccines are gene delivery and very analogous to gene therapy, distinct, however, because they're vaccines. And they cost as low as $15 a dose, which is getting on the low end of vaccines in general, even though it's using a high-tech for the first. time ever, this is how genes are being delivered. So all of those things, I think, move us in the direction of equitable access. And the fact that we could have a big divide is already the case for so many technologies. So, Joyce, you are a professor of reproductive science. So as you said, you've had a long career as these technologies have exploded in your field. And I think it would be interesting for our audience to hear a little bit more about your concerns here, about how

these technologies and your experience are being used now for things that aren't necessarily about health. They're about identity. They're about extenuating cultural preferences. In some cases, cultural preferences that, frankly, are not very friendly to, let's say, an emancipated view of women. We can go on. You understand what I'm getting at. I think it would be interesting for our audience to hear a little bit more about your practical experience and how that is the foundation of these concerns that you have about gene editing and gene enhancement. Yes, certainly.

So it was 1978 that Louise Brown was born. And really, just in those 40 years, it's just incredible how exponentially the field of reproductive science is grown and what we can do now. On July 25, 1978, the birth of Louise Brown in England, gave hope to infertile couples around the world. Known as the world's first test tube baby, the infant was the first child born through the then revolutionary procedure

known as in vitro fertilization. We never imagined back then that we'd be editing human embryos and putting them back and making children. So even when IVF was first started, it was very controversial, and Steptoe and Edwards, who created Louise Brown,

were really criticized for their work and people said they were playing God and it was unethical and the whole slippery slope. I can absolutely see why George doesn't like it, but it's something that we've always talked about in reproductive science. And in the late 80s, the technique pre-implantation genetic testing started. And this was developed to look for inherited disease in these embryos that we could now generate in our laboratory. So we took a few cells from the embryos and then did our genetic tests. and it was designed for a very strong reason to help couples who are at risk of transmitting a genetic disease, such as cystic fibrosis or beta thalassemia to their children.

But very soon it's been used probably by thousands of couples every year, and probably most of them fertile couples that don't even need to go through fertility treatment, but they're using it to choose the sex of their child. And there are some countries where you're not going to be surprised, the majority of people in that country are choosing a boy. So we don't have data, unfortunately, on how often this is done. It's illegal in the European Union to choose the sex of your child if there's no medical reason, but certainly it's done outside Europe, the US and other countries, with huge regularity.

It's probably thousands a year. There's also a company now offering for you to check the eye colour of your child, depending on the genes that the parents carry. And there is another company also now looking at multifactorial diseases such as predisposition to diabetes and cancer and heart disease. So in the UK, we're governed by the human fertilisation and embryology authority. And they say that we can only do pre-implantation genetic testing for a serious disease. But how you define serious is really as long as a piece of string.

And we have done testing on an embryo for inherited deafness and for cancer predisposition. But where we would take these things in the future and these genetic testing is once we can sequence the human genome from an embryo, just from a few cells from an embryo. I always tell everybody if they haven't seen Gattaca yet, now's the time, because we are unfortunately here. Ten fingers, ten toes. That's all that used to matter. Not now. Now only seconds old, the exact time and cause of my death was already known. Neurological condition, 60% probability. Manic depression, 42% probability. Attention deficit disorder, 89% probability.

Heart disorder. We can almost now sequence the genome from our few cells and then find out everything about that future child. And then the parents could choose from the embryos that they have in their lab in the dish in the lab, which embryo would be the one that they would choose preferentially. Maybe they're very sporty and they want the embryo that's going to produce the child with the most predisposition to sport or their musicians. And they want the embryo that's got absolute pitch.

So those things can be done now. And then I think I'll leave it there and wait to go on to talk about genome editing and where that can take us following on from that. Hi, Rudyard Griffiths here, your host and moderator. I have a favor to ask you, please consider becoming a monk member. Membership is free and you get access to a series of great benefits, including a 10-plus-year library of some of our best debates, dialogues, and podcasts. You also get a free monthly newsletter featuring the debates that we're watching around the world.

And you get a specially curated Friday weekly monk members-only podcast that focuses on the big international events, and trends shaping our world. All of that, again, free at www.w.com. I hope you'll consider joining and becoming part of our community. Now, back to our program. So, George, can you respond to some of these interesting points Joyce raises? Because it's, you know, we're all familiar with the, you know, the phrase, you know, kind of ruling from beyond the grave.

Well, this is parents kind of ruling from pre-birth, creating, let's say, a selection, Joyce just mentioned music to give an embryo and a child a musical ability or a sporting ability. In a sense, this just, I don't know, it strikes me and maybe people listening to this program as somehow just deeply wrong. It's undermining free will. It's undermining the wonderful randomness of life that in no small part, surely George, comes from our genetics, comes from the mixing of peoples and genes in ways that create unpredictable consequences and patterns and the lovely diversity that is humanity. Yeah, I agree with most of what Joyce has said, but it doesn't address the question

of whether we should engineer healthier humans by the means. It's simply questioning whether every thing. that we do has to do with health. It is definitely the case that many of our technologies are not focused on health. Our technologies have to do with fashion or sports or so forth. They're really not But, George, just because this is fascinating and just to interject here, just briefly, intelligence. But if you're more intelligent, are you healthier? I don't know. I mean, I would, I mean, there's an attribute possibly that we could select embryos on a basis for. Is that something we should consider? If we reframe that as cognitive ability, I think there's going to be a great, big industry

on preventing cognitive decline because we have an aging population, and therefore inadvertently possibly one of the mechanisms would be enhancing cognition among people that are not yet senile. That's not necessarily a negative thing, but it is getting a little bit away. away from standard health care, but it is an unintended consequence. But it's not something that's specific to germline human editing. It's pervasive throughout many technologies that they're heritable. So, for example, we could have random choice of language, but we don't. You know, for I don't know how many generations back, my family has spoken English.

racism is unfortunately goes through families without the aid of genetics. You know, like I said, we all, you know, everybody in my family has the same cell phone and and so forth. These are heritable, but somehow we put them in a separate category. Hmm. Interesting. They're not random. They are very intentionally transferred from generation to generation. So I, you know, I just think, I think that I would.

certainly join everybody on the side of we should legislate or arrange in some way that everybody treat each other better, that they not, that they not stigmatize people that are different morphology and coloration and so forth. But that's a separate issue than whether we should develop the technology for making people healthier in general. Thank you, George. Just a reminder to our listeners, our debate resolution today, be it resolved, let's engineer a better human being. So, George, I want to come back to you on what you just heard from George there and a kind of interesting idea that there are all kinds of inherited things that we pass on from our children that transmit through culture. So are we really are we really being fair here to genetics and genetic engineering and manipulation by somehow separating it out as something different and therefore potentially dangerous or bad for society? Well, how I see the near future is that we now have the technology here definitely to test our embryos for probably their whole sequence and very soon to edit the embryo if it's not quite how the parents would want it to be.

And that can be related to health, but it's going to throw up everything about that potential person as well, their characteristics and anything that's heritable. So if we have the technology to do that, should we do that to make a healthier person? And if we should, so do we stop then any normal, good old-fashioned reproduction and get everyone to go through IVF, get every potential person in our lab, in our dish, biopsy them or edit them to be the healthiest person we could create? That to me is the million dollar question. And I think the answer, even though it makes me feel uncomfortable, is that at some point that's where we will be.

So I'm sure we all know, Aldous Huxley, Brave New World, written almost 100 years ago. And that was his scenario, was that we don't have a family. We aren't carried, just stated in our mother. We're kept in a lab. And the lab decide how we're going to be. Are we going to be an alpha, beta, gamma? What level are we going to be at?

And it was the embryologist who worked. in that clinic, the embryologist who works in IVF clinics now, who are the ones that also would do the genome editing, they're the ones that are deciding the fate of the embryo. And I think it's inevitable, but it's a little bit scary. And I'm not sure whether it's utopia or dystopia and Bravely World obviously goes the wrong way. But I think we need to talk about it. And just because we can do it, should we do it, I think we will. But then will everybody really do it? Will we really stop normal reproduction and all reproduction will be assisted? There's lots of questions there but I think it's going to happen. Maybe not in my

lifetime. Depends how much I get edited for my longevity, but it's something that we have to think about because I think we're at an absolute turning point in reproduction. I think it's here now and we need to talk about it and that's why so many people have. George, your thoughts on that? Huxley's Bravener World, is this what awaits us? I mean, you're an engineer as well as a geneticist. I mean, you more than most people understand the dual uses of technologies and how historically, technologies with incredible promise, nuclear power, suddenly also produces a catastrophic dual use capacity. Why maybe are you more optimistic that genetic engineering isn't going to, collapse into one of those sharp kind of binary distinctions as a technology, throwing off incredible potential social goods, but also potentially catastrophic social and cultural consequences. Well, I think I actually agree with Joyce that there is a possible inevitability, although I think we shouldn't give in to inevitability arguments, because there are some things that we have

avoided and mentioned the speed limits on cars. So we can regulate very attractive technologies, and I think we will and should in this case. We already have the FDA that keeps us out of trouble in many ways, but we'll have to extend it to this particular category. I think the Brave New World was more dystopic than we will actually have because they intentionally made Epsilon, which were not as healthy, by our current definitions anyway, as they could have been. And so I don't think there's going to be a temptation for us to make disabled individuals. I think the focus will be on enablement. And we might be able to do it outside of IVF clinics.

Part of the stigma here is IVF is somewhat invasive, hormone treatments and so forth. But Joyce is absolutely right. It could result in more and more in vitro work. Almost every technology we need to guard against the dual use. Almost everything new that's powerful does have that possibility. We just need to anticipate it, and that's why I agree with Joyce that we should have conversations, partly because you never know who's going to think out of the box to come up with a negative scenario that we want to avoid.

A short time ago, an American airplane dropped one bomb, on Hiroshima and destroyed its usefulness to the enemy. That bomb has more power than 20,000 tons of TNT. With this bomb, we have now added a new and revolutionary increase in destruction. I think if we had had an open discussion about nuclear weapons before we fired the first ones, or if it had, it had, the discussion that happened before World War II rather than after it might have been a different world. So I think the discussion is a very key component of all this. Joyce, I wonder if I could, again, just put you in service of the audience a little bit and explain to the layperson what CRISPR is and why you have some concerns about that.

So let's maybe move beyond the editing of embryos to our increasing ability in terms of technology to edit the soma, the body, through some genetic techniques and engineering that actually George was a pioneer in half. helping create. Absolutely. I'd hate to describe CRISPR when I've got George on the other end, who as you say is one of the pioneers of the CRISPR technique. But correct me if I'm wrong, George, I believe that CRISPR is a transient technique, as often these technologies are, and they do evolve very quickly. And we've got very wrapped up with CRISPR, but there are other techniques that are coming in that will edit the genome, which are going to overtake it and have started to overtake it now. My main interest has always been around the embryo, and I mentioned how at the moment we can test the embryos for these diseases. And the big words that people always use to describe this

was design of babies, but pre-implantation genetic testing was never designing babies. It was just selecting the embryos from their genetic status. But CRISPR, or or any genome editing technique applied to a human embryo would absolutely be designing them and editing them to make them very different. And it's something I have a concern about. And my big concern is about the safety of this. How can we be sure that whatever technique we use to edit a human embryo, that we have not harmed that human embryo?

And I have asked many fertility experts and IVF experts around the world if they can tell me what tests we could do, or a series of tests we could do in the short term, to be sure that we haven't harmed the embryo with any of these technologies. And unfortunately, we don't have one. We need generations of studies. And yes, we can do every animal study known to mankind, but we're human and humans are different.

George, do you want to come back on that just on the safety. aspect. I mean, how do we know? Because the problem here is the effects of the edits and how and when they show up in terms of illness or disease and potentially the very long timescales or even illnesses that are hereditary that are the result of genomic editing that we'd have to wait until the next generation came along to fully assess. I mean, this practically makes the FDA look like a racing train in terms of the ability to approve and assess whether medical interventions are in fact safe. Yeah. Well, I'm glad you brought up the somatic alternatives in your point to Joyce.

And to me, the safety is classically handled by the FDA. And I think that, I think that what this indicates is not whether or not we should engineer a better or healthier human being. It's what stage we should do it at. And I think the tendency is going to be to do it at a later stage than embryo for a variety of reasons. One is that there simply are a lot of people that have made it past the embryo stage, and they want to be healthier and better than they were earlier. So there's a large market as a way you can think about it. For example, whether it's health or cognition or avoiding cognitive decline, big markets for that for dealing with graceful aging, healthiness for a longer period of time.

That's all most relevant to people that are already born. It is quite problematic to assess the safety risks. to something that could affect someone 70 years later or could affect the next generation 100 years later, that's something the FDA has no mechanism to deal with. I think the question is not whether we should engineer ourselves to be healthier, it's at what stage, and I would guess that it's going to be mostly

in people that are already alive. And we can see that the price of doing that is plummeting. The technologies are happening, exponentially. They're improving exponentially cost and quality. We still have to pay attention to long-term safety. It's just it's less long-term if you're already, say, 70 years old. Thanks, George. So, Joyce, we're going to do all this possibly in a capitalist system. George mentions markets here. You know, there is a scramble net right now, multi-multy, multi-tens and hundreds of billions of dollars scramble around genetic engineering and

and life sciences. Do you have some particular concerns in that regard? I mean, to the extent to which this is technology that doesn't simply exist in a lab or in a, you know, in a kind of necessarily in a government regulated, contained space or processes. I mean, they obviously impinge upon whatever therapies or drugs are developed. But do you have a particular concern about this moment in our culture? you've talked about inequality at the beginning of this debate. Maybe you could say a bit more on that. And unfortunately, I do have concerns. And I really love George's optimism that this will be

available for all and the price will go down. But in my field, in IVF, the IVF market itself is just a multi-billion dollar business. It's, in every country, it's literally million, million dollar business. I think the latest prediction was that in about five years, the global fertility market was going to be worth $36 billion. Where is all this money coming from? Most of it is coming from patients who are paying for this treatment. IVF cycles now in the UK, as I said, most of it's not offered on our health service. And it's about between £7,000 and £10,000 for an IVF cycle. go privately so people can't get access to it. And it's the same for pre-implantation genetic testing. So unfortunately, because of the fields I've been in for the last 30 years, I really worry about

these technologies being totally available to all. And I just see the divide already of fertility treatment and where we're heading with that. And seeing, for example, the pre-implantation genetic diagnosis testing companies are being. sold left right and centre for millions of dollars. So unfortunately in my field, things aren't getting cheaper and cheaper. They're cheaper to do, but the prices don't change and the patients pay for those prices. So I really hope that we can have a change of this. And it's really great to hear George say that for treatments, for those of us that are already here, it's looking so positive and optimistic. I just wish that in my field it was going to be the same.

but I fear it's not. George, you're involved with a number of companies. You've been, in addition to a geneticist and engineer, a bit of an entrepreneur in this space. So give us an argument for why we should be kind of, again, possibly optimistic about the role that, you know, private capital and an entrepreneurial system can bring to the development of these technologies and their role out globally. Well, I think we don't want blind optimism. I think that, and we don't want pure capitalism without regulation, we greatly benefit from the FDA. I almost never worry about the FDA making things tougher and stricter. I sometimes worry about when a patient Avisky group might make them a little softer for a moment. But I think that we have the potential of even for almost everything that's currently expensive, there is a very positive slippery slope towards complete affordability. I mean, probably the best example in history is the smallpox. That is now $0 to everybody on the planet. You don't even have to

vaccinate people anymore because it's extinct. That should be our guiding light. That should be are gold standard, is we want to bring the price down to zero. I think there are ways that the technology will improve within IVF, and there will be ways that technology improves completely outside of it. I want to go to closing statements. This has been a fascinating debate today, one that I've wanted us to do on this program for really since its inception, and that resolution has been, be it resolved, let's engineer a better human beings. So, Joyce, I'm going to put a couple of minutes on the clock, let you wrap up this debate from your perspective.

You've been arguing against the motion. What are the key points that you want to leave our audience with? Well, I'm really happy to hear George's optimism and his lab have been doing the most amazing work, which I am absolutely sure are going to help us engineer a healthier human being. So I hope that work continues, and we're going to see a real difference to the health of the global population. But from my perspective, as a reproductive scientist, there is hesitancy around using some of this technology on human embryos and where we go with that.

And I think we need to think carefully about how we use these technologies on a human embryo and the safety of these procedures. and what it will mean for the future of humanity and access of this technology to all. So I think there needs to be a little bit of hesitancy about applying this across the board. Thank you, Joyce. George, we're going to give you the last word in our debate today, be it resolved, let's engineer a better human being.

So I think we've kind of converged on a lot of points. I think there is maybe consensus that embryo may not be the ideal place, at least in the near term, because of the problematics of doing long-term safety evaluation and the attractiveness of doing it either preconception or in adults is much more possible of being regulated with more confidence. We should worry about these technologies in advance, and it's great that we have conversations like this one. Thank you. And thank you both on behalf of the Monk Debates community. It's been a fascinating discussion. I've learned so much about the science, the ethical, moral issues.

And I always love debates where we get to think big ideas about our collective future. So, Joyce, George, thank you so much for coming on the program today. Thank you. Thank you. Enjoyed it. Well, that wraps up today's debate. I want to thank our participants, George, and Joyce for a terrific conversation. they gave us so much to think about.

We love your feedback and reactions to what you've just heard. Please send us an email to podcast at monkdebates.com. Here's a note from listener Rob about our recent podcast debate on Athens versus Rome. Rob writes, dear Rudyard, having just listened to the debate on Greece versus Rome and which is the greater contributor to our current society, I'm struck by the virtue of listening to ideas presented with clarity without the just of visual images. It was an articulate, enjoyable, and thought-provoking debate. Hey, Rob, thanks for that feedback. We're going to keep our great debates coming for you.

And also just a reminder that if you're listening to this podcast of the Monk Debates, we have a whole other podcast series we'd love you to check out. That's my weekly conversations every Friday with Janice Gross Stein, one of Canada's leading international affairs experts. Each week we analyze the big issues and ideas in the news, hopefully leaving our listeners with some new analysis and insights. Our Monk members podcast, as it's called, is free as part of our basic monk membership, which is also free at www.com forward slash membership. Thank you for lending your time and attention to our efforts to restore the art of public debate in our time. I'm your host and moderator, Rudyard Griffiths. The Monk Debates are produced by Antica Productions and supported by the Monk Foundation.

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