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William Hurlbut on gene editing

A conversation with William Hurlbut on the ethical implications of CRISPR-Cas9 and human intervention in the genetic makeup of life. William B. Hurlbut, MD, is Adjunct Professor of Neurobiology at the Stanford Medical School. After receiving his undergraduate and medical training at Stanford University, he completed postdoctoral studies in theology and medical ethics, studying with […]

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This is KZSU, Stanford.
Welcome to entitled opinions.
My name is Robert Harrison.
We're coming to you from the Stanford campus.
Here we go with another new show, our penultimate one of this season.
We will be airing one more in a few days on Henry David Thoreau to celebrate his
200th birthday on July 12th, after which, in title opinions, will go on hiatus for a while.
We've covered a variety of topics this season.
Everything from Donald Trump to the singularity, from drugs and literature to the great
albums of 1967, and most recently, a show with Eric McLuhan on Marshall McLuhan.
Today, we're going to approach a topic that should induce fear and trembling in all of us.
I'm referring to new gene editing technologies, and in particular to CRISPR-Cas9,
which is the most consequential biotech discovery of our times.
CRISPR stands for clustered regularly inter-spaced short palindromic repeats.
It was co-invented by Jennifer Doudna from Berkeley and Emmanuele Chappantier from France.
It represents to put it mildly a huge game changer for life on earth.
CRISPR promises easy to do inexpensive, highly precise genetic deletions, insertions,
and functional manipulations of genomic processes all across the spectrum of living beings.
This is the kind of technology that would have horrified Hannah Adent,
who 60 years ago warned us about the dangers of acting into nature,
by which he meant provoking natural effects and processes that nature itself would never have brought about on its own.
Adent was thinking in particular about nuclear fission, but now, with CRISPR-Cas9,
we're talking about acting into the genetic makeup of life itself.
When we act into nature, either by splitting the atom or modifying the genome of living species,
no one, and I mean no one, can promise in advance that it's all going to be fine.
Like forgiveness, promise is possible only within the human realm.
Nature does not promise nor can it forgive after the fact a wayward human intervention into its own genetic processes.
We tend to think of technology as a tool to be used by humans for human purposes,
yet in fact it's a dynamic self-propelling system whose imperatives transcend human action and choice.
Technology seeks to augment its means of production, multiply its applications, and expand its capabilities.
Its machinations are not guided by human values or considerations of the greater good, but by technical necessity.
Human behavior must modify itself to fit the demands of technology and not the other way around.
In some, we do not drive our technology, but are driven by it.
That's why in my own humble opinion, I don't believe that we're going to use our gene editing technology judiciously,
but that it is going to use us in judiciously according to its own dictates and capacities.
The guest who joins me in the studio today to talk about CRISPR-Cas9 is William Hurle-But,
from the Department of Neurology at Stanford, where he has taught for 27 years.
He is especially interested in the philosophy of biology and in ethical issues associated with biomedical technology.
William Hurle-But has worked with NASA on projects in astrobiology, and since 1988 has been a member of the chemical and biological warfare working group at Stanford Center for International Security and Cooperation.
He is also the co-organizer, along with Jennifer Dowdner, of a global project called "The Challenge and Opportunity of Gene Editing a Project for Reflection, Delibration and Education."
I was fortunate enough to be invited to participate in a lofty conference held at Berkeley University a few weeks ago.
One of the projects three organizing workshops, where a group of around 20 scientists, bioethicists, theologians and humanists discussed over a two-day period,
some of the ethical and moral issues related to gene editing technologies.
It gives me special pleasure to welcome Professor Hurle-But to the program.
Bill, thanks for joining us today on entitled opinions.
Thank you, good to be here.
Bill, you and I both believe that CRISPR-Cas9 represents a momentous discovery with enormous consequences, not only for humanity but for all life on Earth.
The issues are various and complex, but before we get into some of the more vexing ones, I'm sure our listeners would appreciate a brief description from you about how the technology works and what exactly it is capable of.
So CRISPR-Cas9 is a newly discovered or really invented technology based on a natural system, a protective system deployed by bacteria against viruses.
And this new tool has combined these basic biological mechanisms, a way that can apply some of the same powers of genetic control across a whole spectrum of living creatures.
So CRISPR-Cas9 has been described as a genetic scalpel or molecular scissors, but it's more rightly compared to a Swiss Army knife.
As scientists continue to explore the CRISPR systems many natural variations and selectively engineer clever new modifications in the targeting and operation of this tool, they're discovering a whole new genetic toolkit with functional applications at every level of the system.
The breadth and flexibility and precision of these new tools is opening vast increases in the range and complexity of experimental possibilities, theoretical insights and practical applications. It's a very exciting time in the biological sciences.
So it's exciting in both senses of the word, exciting because it excites a great deal of anticipation, expectation, hopes.
Exciting also because there's a thrill of danger.
For me, in any case, a thrill of an overwhelming potential danger that this new capacity that we have to intervene into the genetic makeup of various species can easily spiral out of control or lead to consequences that were not only unintended, but I would say perhaps even unimaginable.
I think that's true. And it's for that reason that Jennifer and many others agree that we need to have a very serious conversation, deliberation and be very cautious in what we do, whether that's even going to be possible, you might be right.
It may spiral out of control, but at least we have to try.
And the reason we need to try is because this technology addresses very crucial challenges and problems in human life and the life of the planet.
At levels that we all feel kind of imperative for application of our technology, we all know that there are great problems in the ecosystem, balancing natural processes.
There are problems with famine, we all know all too well. The challenges of medicine and contending with the many things that trouble human life and the way of disorders and diseases.
And for some, even death itself seems like it might be a target of our technology. That's another question we should discuss.
But it's a very powerful technology and if we step back we can see why it's being driven by positive goals, but we have to be very, very careful or otherwise it will be very disruptive.
If you like a layout for some way of some of the possibilities implied by this technology.
Okay, positive and negative?
Yes, I think they carry their powers really they can be used like Moses on the mountains said of blessing or curse.
So as most people realize in the mid-century, 20th century we started to develop tools of deeper understanding of molecular biology.
And it also opened real possibilities as we gained more and more knowledge of genomics, real possibilities for actually intervening in life processes.
I was trained at Stanford Medical School in the early 70s and there were very exciting advances in what was called recombinant DNA, most people noticed, gene editing and manipulation of genetics.
There was great hope that we might be able to address the many diseases and disorders that had genetic components.
There are in fact 6,000 genetic diseases with a single gene causes that have no tree of 95% of them have no treatment whatsoever.
And so this is a very big challenge of medicine.
And CRISPR could potentially do away with all of them.
CRISPR could potentially treat them or possibly remove them from the genome.
So CRISPR is so powerful and the reason it's so important is because throughout the last half of the 20th century, even though we had the vision of what we wanted to do, the tools were very limited in their precision, their application, they're very expensive to deploy.
Now CRISPR has changed all that. It's a really big revolution. It's a threshold technology that is advancing us by to use a physical metaphor by quantum leaps.
And basically this is what CRISPR will allow us to do. We can alter individual genes.
We can strategically disrupt a gene or alter the gene all the way to the precision of a single base pair, which is the smallest unit of DNA.
We can study, then we can study the role of those genes in healthy development or in disease.
We can take new genes or make new genes or new regulatory elements by combining different species.
We can insert new powers, new forms of genes into agricultural crops to provide drought resistance, more rapid growth, or enhanced nutritional value of the crops.
Not only that, but CRISPR can do more than replace genes or silence genes.
It can also operate in ways that it can control the expression of genes and a great many differences in both health and disease and indeed similar genes operating at different species are simply the result of different quantity and chronologies of gene expression.
What exactly is gene expression?
Well, the genes in the chromosomes and they are regulated. And so the amount of gene product that's produced, most of your listeners remember from high school biology, DNA codes for RNA, which in turn codes for proteins.
It's a simplified version of what's called the dogma, the central dogma of modern genetics.
So genes code ultimately for proteins.
And when you can control the gene expression, you control the amount of protein produced.
That's one of the products of this new technology to be able to control that.
And we can turn genes off and turn genes on, and control the amount and the timing of their production into their translation into RNA and then into proteins.
So that gives us control over the most fundamental processes and cell physiology, and that determines larger tissue and organ and whole organismal processes.
So it's essentially power over the most fundamental core realities, functional mechanisms of life.
Jennifer Doudna, the co-creator of CRISPR-Cas9 has spoken of this as enabling us to rewrite the very language of life.
She says we're standing on the cusp of a new era, one in which we will have primary authority over life's genetic makeup and all its vibrant and varied outputs.
Yes, and that sentence is one that you quoted during this workshop conference that I attended.
And I remember pointing out that this idea of primary authority means not only power over it also means ownership of.
So the implicit assumption or explicit assumption is that now we are at a point we human beings where we have a presumption of a ownership.
And therefore decision making power over the fate of other life forms.
That's not an assumption I share and it's not one I'm particularly comfortable with.
Yeah, well, I understand your concerns and I share some of them because authorship implies that you are the creator of something.
And it may be right to say that human beings by some mystery are co-creators in the sense that we have unique capacities of comprehension and control unlike any other species.
Really, there's minor degrees of operation on the world by other species, but human beings are a whole different level of reality in the natural world.
And we're the first creature that is able to look back on our own on the source of our creation and say, "We're not satisfied with what we've gotten."
And of course, that raises profound questions as to what we might as co-creators actually want to do.
A Neil's bore of the famous physicist said that we're both spectators and actors in the great drama of existence.
But that, by my thinking, I think with you hers, would come with a huge responsibility to understand and appreciate the nature of that created order.
But there's no question that we're going to continue to operate on the natural world.
At least we have for many, many decades, many centuries actually.
But here the challenge is much deeper because earlier discoveries in our own era, we've been very aware of the advances in physics and chemistry.
But now we're moving on to life itself.
And just to think back over the last two centuries, what advances in physics and chemistry have met, physics, of course, we eventually got not just nuclear energy, but more practically and immediately we got electricity and think, "Oh, that's changed the world."
Think how the discoveries in 19th century chemistry were they, they out the periodic table of the elements and then started playing with them, recombining them, the knowledge and understanding, allowed synthetic chemistry to advance to produce all manner of a...
of phenomenal, unexpected materials and drugs and all sorts of things in the modern world.
Those are now being transcended or added onto by advances in biology, which is the great amazing spectrum of possibility for advancing things at every level from...
from industry to medicine to agriculture and onto perhaps even controlling whole ecosystems and some scientists seriously have suggested the extinction of...
of not just prior animal species, but of actually human ancestors like Neanderthals and Denisovans.
And this is a really amazing moment in the history of life for the first time life is turning back and controlling itself at some level.
Well, there you go, Billy. That word has come up several times now, controlling.
And I actually want to plug Jennifer down in this book that just came out a couple of weeks ago, it's called "A Crack in Creation, Gene Editing and the Unthinkable Power to Control Evolution, Jennifer Co-author,
that with Samuel Sternberg." And that book was published in 2017, just a few...
Just came out. Just came out. Just came out. Two weeks ago.
And I think all of our listeners should probably read it over the summer if they're interested in this revolution in biology that is probably going to determine the fate of our 21st century.
But again, in the subtitle of that book, " Gene Editing and the Unthinkable Power to Control Evolution," I will happily concede that we can affect evolution.
We can intervene in its process. We can screw it up. But the idea that we can control evolution is one that I find overly optimistic and naive and also dangerous.
I suppose being a literary historian, I'm well too aware of all the horror stories in which this kind of presumption of control goes awry.
And I wonder whether when we use the word control, we shouldn't be looking for an alternative because it sets up a false expectation.
Certainly does do that. It's an amazing combination of exaggerated expectation and almost apocalyptic dread that's now encompassing our society.
And you read articles about this stuff, along with articles about robots and AI, this seems to be a major subject now in news.
And I think we rightly need to pay attention to those concerns.
You know, 70 years ago, all this Huxley, who had written earlier, had written the famous novel, "Brave New World."
And if any of your listeners have not read "Brave New World," they certainly ought to.
70 years ago, all this Huxley anticipating the transformation of human life through advances in biology as the final and most searching revolution asserted this really revolutionary revolution is to be achieved not in the external world, but in the souls and flesh of human beings.
And that underscores the significance of this moment. Let me read you a couple of quotes from the recent history and then put it in the context of an earlier quote in the past.
So there's a lot of thought about where this all might go and what we might produce with this.
The National Science Foundation, about 10 or 15 years ago, issued a document that was so awesome of this coming.
And it said, "At this unique moment in the history of technological achievement, improvement in a human performance becomes possible and such improvement, if pursued with vigor, could achieve a golden age that would be a turning point for human productivity and quality of life."
And that's a very aggressive and controlled centered idea.
And we're going to actually intervene not just in disease but in performance.
In other words, enhancements.
Earlier, the Nobel laureate, Herman Mueller, had made similar kinds of hyperbolic anticipations when earlier work in genetics started to suggest there might be way to intervene.
In 1933, he said that programs of planned genetic intervention "provide the opportunity to guide human evolution to make unlimited progress in the genetic constitution of man to match and reinforce his cultural progress and reciprocally to be reinforced by it in a never-ending succession."
That sounds a lot like we did a show recently on this singularity and artificial intelligence primarily, but also the Kurtzweil notion that there's unlimited progress towards perfection and our own humanity is somehow our own intelligence is going to infect the entire cosmos and we are going to once again become the very center of the whole universe through our own local brilliance.
I think it's a bunch of nonsense from one point of view, but scary that it seems to be the fantasy and driving dream of a lot of scientists that the endless open horizon of human perfectability through what I call artificial means.
I know Rick Kurtzweil personally, and he's a very nice guy, and he's a very, very brilliant guy when it comes to physics and engineering.
But as I've said to him, I don't agree with your projections about human life, and that's because I don't think he has a deep grasp of biology,
and he's needed to make the kind of projections he does. Now he's serving a very important purpose in warning us that some very big changes are possible, but I'm actually the sort of bad guy in his earlier movie, the one before the singularity is near, and it's called Transcendent Man.
I say in that film that I think that challenges are much more complex because of the biological complexity that would be required to manipulate, and I think this comes from some very important dimensions of the way the biology functions which we can discuss here.
But I want to say at this point that these may protect us from some of the greater dangers that at least with regard to human life where we could make terrible mistakes and...
By these you mean what?
Well, what would protect us?
The complexity would make it simply too difficult to do.
Now that challenge of course is that if we try to do them, we may degrade the very humanity that we're trying to heal or improve, and that's a very serious matter.
But let me give you a quote from another kind of futurist Gregory Stock.
He's trained in biophysics and business by the way, and Gregory says this is written about 15 years ago, "futur humans, whoever, whatever they may be, will look back on our era as a challenging difficult traumatic moment.
They will likely see it as a strange and primitive time when people lived only 70 or 80 years, died of awful diseases, and conceived their children outside in laboratory by a random, unpredictable meeting of sperm and egg."
These guys should all take two years out of their lives in order to undergo an education in literature, and maybe scripture and the classics, and learn something about how to improve this space.
We'll prove this really tacky imagination they have of what the good life is supposed to consist in anyway.
We'll leave that aside.
Both some of our listeners at least will be interested in the technicalities of what the challenges are.
So maybe we can talk about that briefly before we go on to issues that are I'm more interested in, which is obviously the metaphysical kind of, if you want to call them moral.
But I gather having read you and other things that if it comes to replacing one gene with another, or if we're dealing on the level of just one or two genes, then CRISPR can actually very likely deliver on his promise.
Yet, when it comes to enhancement of things like beauty, intelligence, and other characteristics that would be highly desirable for people, had they the means to create offspring that were superior to themselves, that you're saying that technically at the biological level, it would at this moment be too challenging to actually control these kind of enhanced characteristics.
Yes, I think that's true and to least to some degree.
So most of our models of how genes work in our current understanding in the popular level, least, are based on genetic diseases.
And there even a single base pair or some disruption in mutation in a single gene at any level can result just a tiny, a little change can result in a genetic disease.
Genetic disease that expresses itself in many ways.
It's most many genetic diseases are syndromes.
They may have a webbing between your toes, cardiac abnormalities.
The eyes may be farther apart than normal, and there may be metal retardation, difference in evident physical form of the body.
And that's because many genes, most genes, do many things in the body.
So if you change, if you mutate a gene, you get many abnormalities.
But that's not the same as trying to produce an improved gene.
If you produce an improved gene, you may be targeting so-called improvement.
You may be targeting some dimension of some aspect of human functioning that you want, and it'll most certainly be,
appearance, intelligence, longevity.
Those are the things people really care about, it seems.
And yet, trying to intervene in those natural traits is far more difficult than correcting a deficiency in a genetic disease.
Genetic diseases are like missing links or damaged links in a chain.
They affect many things downstream.
But trying to change that whole chain and make that gene express an improved trade at one level is likely to affect many different things.
So if you want to understand genes, there are two words you need to understand.
They're little technical, so I'll explain them.
One is polygenic inheritance, and the other is plyotropy.
And basically what they mean is most traits are controlled by many genes.
That's polygenic inheritance.
So traits like longevity, intelligence, that you seem to be affected by, in most cases, hundreds of genes.
Maybe thousands.
And plyotropy means that most genes do many things in the body like I was saying with a genetic disease.
So if you think of the gene products as like the paints on an artist's palette,
and then you think about the difference between the paints and the picture that's painted by the artist,
that's a good analogy.
Because most colors on the palette will end up being mixed with other colors before they produce anything.
Like what's called the phenotype, the expression of the gene.
Most colors will be mixed, and most parts of the painting will result from many colors.
So that's what makes it complex.
If you try to target one trait, you're going to affect many traits.
And if you try to target one trait with just a few genes, you won't succeed because they're controlled by many, many genes that have small effects.
So Bill, let me ask you this question because a young scientist assured me after our meeting at CRISPR, by the way,
that it's in a few decades, it's highly likely that 10% of the human population will have tails.
Not because we need the tails, but because people will want them.
In the same way that some people have tattoos all over their body, the idea that it would be kind of cool to have tails.
Is it absurd to, is that an absurd statement that we could in a few decades be at a point where people could make these kind of decisions on the basis of personal preference,
and something like CRISPR, or an even more advanced, more precise form of gene editing, could enable 10% of our population to have tails,
or 10% of the Chinese population to have blue eyes, kids.
Just fill in your fantasy.
What do you think is a likelihood of that?
Well, why just tails, why not horns, who's antlers, for, you know, as to what people will want to do, I don't doubt that not 10%, but a tiny percent might actually want some kind of exotic alterations.
If you look around at the popular press, you see there are people who's identity,
they're the guy who thinks of himself as a parrot, and he had his ears cut off, and there's a woman who thinks of herself as a cat,
and she had whiskers implanted, and there's all sorts of strange qualities in human nature of concerning personal identity, and a lot of it is think is driven by desire for attention and truth.
Sure, sure.
We have a very well proven track record that when it comes to our desire to distinguish ourselves from our fellow human beings or aesthetic tastes for the perverse.
That if the technology conjugates with human desires, then all sorts of possible results are imaginable, no?
Yes, I think so.
And I think with these tools, some scenarios like that might conceivably be possible, especially if combined with tissue transplantations and the ability to manipulate stem cells and so forth.
And one qualification, what I said earlier about the difficulty of making these changes is that we're realizing more and more that genes are expressed at different times and development and in different body compartments, different body areas.
And if you could control the quantity and chronology of gene expression within specific body areas, you might in fact be able to alter certain aspects of the human body, and it's not inconceivable.
You might be able to grow the tails.
In fact, I would be surprised you couldn't manipulate that if you really wanted to.
And there are other ways you could dramatically increase certain qualities in human beings by affecting gene regulation in specific body areas.
Now, that may or may not be difficult to do, but I suspect we will go on to make some of that possible, but for very good therapeutic uses first, and then people will claim some sort of individual rights to do what they want to with their own bodies.
But you got to bear in mind that everything we do with our body comes with risks.
You know, the fundamental tentative Hippocratic medicine is above all do no harm.
And as a physician, I know that we should never intervene in the body, either surgically or biochemically, frivolously, that the body is a very, very complex balance of purposes and processes.
So, the intervening in it were liable to end up damaging some, it's a lot easier to disrupt in a degrading way than it is to enhance or produce particular types of traits as we might want.
Having said that, we shouldn't be utterly blind to the fact that there might be some things that people would, by some kinds of arguments legitimately want.
That's the cure for existing genetic diseases within a family lineage, but some might argue that human species could be improved by certain mixing of increasing the process of certain genetic traits that are found only in relatively few people.
George Church at Harvard has laid out a series of 12-18 rare protective alleles, which are different forms of genes that are found in some members of our species, but not others.
And there are already talk in certain quarters about making these more common in the human population through intentional germline editing.
Yeah, well, one issue that comes to my mind is the role that evolution has played in getting us to where we are, not only as human beings, but the whole biosphere.
And we know that the vast majority of mutations in different species do not lead to hereditary adoption that they are mostly failures.
Evolution has a way of deciding or filtering what passes through and what doesn't pass through the barrier of what becomes a species or a characteristic of a species.
And you would imagine that just as a single body is incredibly complex in the interaction of all the elements that make up a body, you can imagine how much more fragile, interdependent and complex is the biosphere as a whole.
So let's say that even with our best intentions we say we're going to be very, very, very careful about what we do to ourselves, our human bodies.
What worries me even more than, for me there's a certain poetic justice if we screw up our own human species by a kind of wanton use and hubris regarding this kind of technology.
What really bothers me is what the other life forms on earth, what fate awaits them at the hands of the United Kingdom Technologies.
Yeah, that's a very, very important point.
And I have a certain concern about that sense that you mentioned about wanton use and hubris.
And many of the things that we hope to do would be positive and without being cruel or disruptive.
But the possibilities for doing things frivolously and even with a certain disregard for the, which might call the existential reality of the creatures that we're dealing with is a very great concern.
I don't think we're, we have absolute hegemony over the natural world.
And if we do and do it in a wanton way with hubris, we are really going to suffer and we're going to cause the whole of the created order to suffer.
Now, you can already see there's a human proclivity for this kind of stuff.
I don't know if this really hurt the animals especially, but there've already been projects where people produced monkeys that glow in the door.
Rabbits that glow in the dark, rabbits that glow in the dark by putting a fuss for us and gene in.
And that probably didn't hurt anything, but you can imagine by recombining genes and by combining that technology with the capacity to manipulate tissues and in chimeric creatures.
So, you know, our children, children's children at least might go to a whole different zoo, a kind of a doctor's zoo and practically speaking that could be very degrading to the animals that were produced.
You know, when they were first doing genetic engineering on animals, there were some real horrifying tragedies where pigs were produced and with terrible arthritis and other unmentionable disgusting qualities.
And people have gotten a sense of that, that's not the right thing to do with this.
But if done very carefully, I think that the positive changes in agriculture could be useful of both animals and plants and that would help feed people who were starving and are in very bad malnutrition and that's a positive use of this technology.
Well, I have to say, two days, two and a half days at the conference, my own dogmatic skepticism, I had to reconsider when I was exposed to how much actual good that no one would want to contest could be imagined in terms of the use of the technology.
On the other hand, I was, the more I read about CRISPR in preparation for the discussions, I was imagining that if the animal world were capable of rumors, if it were capable of being informed about this discovery, and if they were capable of spreading the word, I have no doubts that the entire animal world would be in a sheer panic and funk.
And that it would be on the edge of hysteria, because we do not have a good track record with other species, and there would be absolutely no reason for them to trust us to use this new power responsibly and not to their own detriment.
I think they're already quite suffering if you really look out on it that one of the great scandals of our age is the level of species extinction and the kind of torment we've subjected animals to.
And I think that it just comes down to the centrality of the, both the basic knowledge that's essential for this and the basic ethical disposition that is essential for it, because without those two, and it can't be just knowledge, it has to be a right ordering of our attitudes, our relationships within the natural world.
Otherwise, the whole creation is going to grown under this weight of intervention, that's the eye-degree.
Well, yeah, and there you're alluding to this verse from Paul's letter to the Romans, where the whole creation has been groaning as in the pains of childbirth right up to the present time.
And if the other creatures would be aware of what's in store, I mean that groaning probably would be getting a lot louder right now.
You've written an interesting piece on St. Francis, where St. Francis being the befriender, I mean he is the fellow creature of all other creatures.
His brother, Wynn, and sister, Moon, and sister death, and all the other creatures, the mythology surrounding Francis is very much that of a creature among creatures, right?
And this is something that I found in the group discussion that almost everyone, whether we're still anthropocentric, or the sense that if we can make this work for us, then it's perfectly fine.
Without very much concern about what the other creatures, I don't know if you and I agree on this fundamental principle that the human is one creature among others.
I agree with what you said earlier that there's an abysmal gap that separates us from other creatures when it comes to our intelligence and our power and our ability to make decisions and so forth.
But I'm not at all convinced that we are co-creators or are intended to be co-creators, I do find it mysterious.
That somehow, let's call it evolution, it's not even call it creation.
Somehow creation has allowed us to discover something like CRISPR-Cas9, because it would seem to be from one point of view, you could say it's one of the biggest mistakes evolution could have made.
Which is to give us human beings one creature among others, somehow the perverse intelligence in order to create that kind of technology.
On the other hand, you can say that, well, no, there's something special about the human that justifies the anthropocentrism by which all other creatures are some, it's justified as long as we treat them humanely and so forth.
But they're there really under our stewardship and under our tutelage.
Well, those are very profound reflections on difficult problems.
You know, so much depends on what one sees as the source and significance of the natural order.
It's if it all has just kind of been produced out of nowhere with no reason, if it's just a random collocation of chemicals, just matter and information processing itself out against the constraints of survival, then maybe it doesn't mean much.
Maybe the transhumanists have an argument that we should intervene against the cruelties and contingencies of the natural order.
But if one sees some mystery operating within the whole of the cosmos, then one steps back and says, well, maybe it's not so meaningless and maybe it's not ultimately as cruel.
It's definitely got sufferings and sorrows in it, but maybe it has a higher meaning in the way it's been unfolded to us, or maybe it can be both that and have meaningfully altered at some level but not at its most core level, then that's a different view.
So when I was in training in medical school, I sat in the classroom and listened to the people who were bringing the biological revolution into existence.
My teachers included Paul Berg, who got the Nobel Prize for recombinant DNA, Arthur Cornberg, who got the Nobel Prize for discovering DNA polymerase, the fundamental enzyme that operates at the most basic level of
biology. And these great scientists and many others in Stanford were setting the foundations for the revolution in biology.
And I pondered this, I could realize in fact, maybe we in the other side of the classroom, the listeners realized more imagination where it could go than some of our professors.
And I said, well, Paul Berg tells me, he didn't imagine some of this stuff, but I certainly sat there and realized great powers over life are coming.
And I got more and more interested in the life of St. Francis, because I had not been raised in a religious family, but I became a Christian when I was an undergraduate at Stanford.
And during those years I was trying to figure out what does that mean in terms of our relationship with the natural world? How can it be both a creation and yet have suffering it? How can it be made by a good and loving God, yet have suffering, just written right through it?
And I started reading about St. Francis and what an interesting person he was. He was profoundly engaged with the world in the sense that he saw the realities before him.
He was the son of a wealthy cloth merchant, and he kept noticing the sufferings around him. And finally one point he came to a leper on the side of the road.
And although he had a great dread of leprosy, he got down from his horse and he gave them out of coin, he probably threw it at him.
And then recognizing that he too was a creature of the world, and that God loved him. Francis went over and embraced the leper.
And he said that from that moment all that he dreaded became for him, the source of a great sweetness.
So he went out into the world, he gave away all of his goods, and he went and served the poor, and totally in loving, humble disposition.
And in the process he rediscovered some of the positive realities of the natural world that had been neglected until that point in the early early dawn of the Renaissance.
And among the other things, the reason why I'm telling all this is because Francis was not just the simple, sentimental individual like we see in the statues and gardens and stuff with his handouts, handouts stretched in the birds on his hands.
He recognized the suffering that it's racks the natural world, and yet he did not see that suffering as meaningless.
And if we make the argument that all of these transformations should be done only to combat suffering, that is not an adequate argument in and of itself.
I'm a doctor, I know how much suffering afflicts both humanity and the natural world around us, but I also know that it's about something.
That it's not suffering is not the only an ultimate evil. There's something going on that is important for us to recognize.
Suffering is an opportunity for love, but love is always guided by a higher sense of purpose, not just to relieve the suffering.
And that's what is provided by the purposes of existence itself, healthy existence included.
Right, and that's where one statement that I made in our discussion there is that a lot of people in this field believe that the human condition is a disease for which we need to find a cure.
And I'm not sure I share that assumption along the lines that you've been describing that if we are human to the degree that we belong to a human condition, by condition it means that we are conditioned by certain irreducible realities or facts called it facticity.
I think one is mortality. It's part of our condition. Suffering is another.
We are with others. This is we are conditioned by our being in relation to others, our dependence on others.
And suffering is certainly part of that condition as well.
So I think God better come to you and others understood, but they were thinking more along the political revolutions,
but that understood that this spirit of rebellion in the modern age is really one of rebelling against the human condition as such.
As if it can be cured of its death, its morbidities and certain kinds of things that we might associate with pathologies.
But if I understand you, what you're saying about Francis is that what he understood is that that love of the world is part and parcel of the acknowledgement of the suffering that goes with being embodied.
And that suffering is not necessarily an objection to existence. And here we can even invoke the supreme rebel under God of the atheist in Nietzsche, who said that all of our problems in the modern world are really about what kind of attitude do we have towards suffering?
And those who would consider it as nothing but something to be rid of, to be overcome, he called him nihilists, whereas a tragic affirmation of life, which would be in the spirit of saying yes to life, would be saying yes to life in virtue of the fact that it does come with these conditions.
Well, that's the way I see it, and my experience in medicine tells me that this is not a meaningless journey we're going through with our frailty and finitude that in fact there is good in it in spite of the suffering of it.
When you deal with patience, you realize that suffering becomes an opportunity to kind of wash the windows of your soul to seed more deeply into the very heart of life.
Oftentimes people who suddenly find themselves afflicted by something, perhaps even a terminal illness, will wake up to the people in the world around them in a way they had not before.
We have a great proclivity to go down these rabbit holes of appetite and ambition and dissuade ourselves from the central purposes that are so prominent in the natural life of humanity.
I see medicine as a very positive, of course we want to relieve people's pain and if possible cure diseases, but I don't see that as a process that is more than it is.
As not the ultimate goal of existence, we have to frame that within the context of individual lives of purposeful existence which includes that mature interaction and engagement with the realities of their own suffering and their own death.
I was in Rome a month ago and I went to visit a Franciscan Capuchin home and there was a quote on the wall by a saint named Crispin and it essentially is a little bit worded a little differently but it said essentially who could be so insane as to want to ultimately escape death itself.
And I do not see the purposes of our technology as overcoming the condition.
This condition and yet I remember about 10 years ago I heard quote from William Hazelton in the founding of the Society for Regenerative Medicine.
He said that the real goal is to live forever. We use our technology to live forever. I don't see that as the real goal. I see the real goal as the healthy natural lives which brings us to the profound question of how do we intervene.
And in Galen the first century Roman physician said the physician is only nature's assistant but that's so different than what Hazelton said and the whole attitude that we are going to remake our basic existence seems to me to be off base.
It's strangely disturbing and it couldn't end up very tragic. Now with regard to the role of medicine I don't see that the same. I see it as a restorative profession which allowing people to live good and healthy natural lives.
That's great because it puts you on this side of the futurists that you were quoting earlier.
I'm certainly on that side of the line. I think Aldous Huxley quotes Alatin saying in one of his books I think it's the art of seeing where he says
the food at Natura Sanat the physician treats nature heels. So that is a healthy concept of the vocation of the physician of medicine and biotechnology that if you can treat but you treats by bringing the sick body to the point where nature will heal.
It has a natural healing power within itself. I think that you quoted is a Galen who said it's just the assistant of nature.
So that is a very much more humble and understanding of what the vocation both of medicine as well as biotechnology is than the other Kurt's vivian futurists who think that we're on the way to a kind of immortal perfectability of the
species. So I appreciate everything that you've shared with us today, Bill.
I think your emphasis on the word humility is very appropriate. It's very fascinating because that word humility comes from a Latin root. It's the same root as the word human.
And we are the creatures of the earth. We've been framed and constrained by the earth itself. And we ought to be humble within it.
Well, right. And there are many of us. Let's, you know, let's be frank and honest with ourselves, the earth has cost us a great deal of suffering.
Human beings as well as other creatures. There's no doubt that there's something to the biblical stories of there being a curse to the fact that we we're on earth, the toil, disease and so forth.
And yet humility and is also related to the to the humid, the earthly, the humus.
And our humanity is rooted there. That's actually if we want to be human, we can't deny that. And I think that in some cases it's not so much a curse that we are born and have to die and have to suffer.
I think that the real curse of the condition is in the various ways in which we attempted to deny that somehow or refuse to acknowledge it.
And any kind of use of crisper that involves an open acknowledgement of these conditions, these basic conditions of our humanity, I'm in favor of it's when we start fantastically about overcoming the conditions entirely that I start to get.
Well, I think we're very much on the same same place on that larger issue. I think there will be very good uses for this technology, but that as I said earlier, all that needs to be framed in a larger vision and larger context of the meaning of human existence.
And if I had to sum up the meaning of that, it goes way beyond technology to something much more encompassing and significant that summed up in the word love.
Very well said, behind our listeners, we've been speaking over this hour with Professor William Hober from the Stanford Neurobiology Department.
And he and Jennifer Doudna, one of the co-inventors of the CRISPR-Cas9 technology, are involved in this global project in order to bring to the public a much greater awareness of what CRISPR is all about and what the potential benefits as well as dangers are and wish you luck in that endeavor to increase public awareness about this whole thing.
In our own little humble way on entitled opinions, we're trying to do the same thing in the last hour of conversation we've had.
So thanks again, Bill, for coming on.
Thank you.
I'm Robert Harrison for entitled opinions. Thanks again, Bill.
Thank you.