Modern WisdomWhat Embryo Selection Means for Humanity - Dr Jonathan Anomaly
EVERY SPOKEN WORD
150 min read · 30,482 words- 0:00 – 7:08
When Does Health Screening Turn Into Human Engineering?
- CWChris Williamson
I've been advising you guys now for ages, and I think I became convinced that this could be a technology for good probably ever since our first conversation, which was a few years ago now.
- JAJonathan Anomaly
A few years ago, yeah.
- CWChris Williamson
Why do a lot of people still have such an issue with embryo selection, do you think?
- JAJonathan Anomaly
Um, let's see. There's probably a few issues. One is it's still a new technology. Any new technology that hasn't been fully explained to the public, even to doctors, is gonna have some, I think, justifiable skepticism. Um, another reason is people worry about tinkering with the human genome, which we're not doing, but people, um, often, I suppose, confuse embryo selection with gene editing, right? So what we're doing, um, the company Herecyte, is when women do IVF, they, they can already get a bunch of different genetic tests. They could test for, uh, Down syndrome, that's called aneuploidy. They can test for single gene disorders, that's PGT-M, pre-implantation genetic testing for monogenic conditions. We're just doing polygenic conditions. All we're doing is revealing more information about the, the natural genetic variation that exists in your embryos and letting you choose which one to implant. But when we explain that to people, sometimes they think that what you're doing is you're adding new genes or editing the existing genes, and so I think they worry about that. So what's going on? How much do we know about the genome? Um, what are you doing to tinker with it? But in fact, we're not tinkering with anything, so that's probably the main reason people worry about it.
- CWChris Williamson
Scott Alexander did a great blog post on this. He had this wonderful example. He says, "A woman goes in for IVF. She produces 10 embryos. The usual technique for deciding which of these 10 embryos to implant is for a doctor to look them over and see which one looks generally the most normally shaped and healthiest." Is this right?
- JAJonathan Anomaly
It is, and, uh, i- it's not that there's no correlation whatsoever between, let's say, the morphology or the shape of the embryo and its viability, but there's probably not a huge correlation. (laughs)
- CWChris Williamson
Right.
- JAJonathan Anomaly
Yeah.
- CWChris Williamson
But my, my point here is that there is alread- if you're doing IVF, and I think between sort of 1 and 3% of babies in the US are born through IVF at the moment? Is that right?
- JAJonathan Anomaly
Yeah, I think it's at least a few percent.
- CWChris Williamson
Okay.
- JAJonathan Anomaly
In Denmark, it's 10%, so.
- CWChris Williamson
Right. So, you're going through IVF, and currently, if you do IVF, you have this batch of, let's say, maybe 10 fertilized embryos. Somebody's already eyeballing them using some kind of scrutinous ... Like, is, is it eugenics to look at the one that looks the roundest or has the-
- JAJonathan Anomaly
The healthiest, the ... Yeah.
- CWChris Williamson
Yeah, that has the fewest, and, uh, he sort of finishes the example off, and he says, "This time, the doctor tells the intern to make a decision. The intern chooses embryo number five, but a few hours later, the doctor gets nervous, decides to double-check, disagrees with the intern's assessment, and picks embryo number seven. Embryo seven gets implanted, and the woman gives birth to a healthy baby child." Like, that is what we're talking about here, but just with way less information.
- JAJonathan Anomaly
Yeah, although to s- to steel man the other side, I mean, I think what they're worried about is we're taking away some of the mystery of childbirth. So there is something, you know, sort of romantic about meeting somebody and, you know, having (laughs) sex the natural way and having kids the natural way, and I think what people worry about is every step along the way of, you know, you're selecting your partner, your sperm or egg donor, and then you're selecting an embryo, and there are all these dimensions you're selecting on, somehow like removing romanticism. But the truth is, if you have, you know, a really bad disease in your family, schizophrenia, Crohn's disease, et cetera, all we're really doing is saying, look, there's a set of embryos. As you said, there's already a morphological s- score that- that's being given to them. This one's more likely to be viable, less likely, and we're just revealing more information. It's just, it's the kind of information people really want-
- CWChris Williamson
Mm-hmm.
- JAJonathan Anomaly
... specifically to minimize disease, and of course, the, the controversial one, that's not controversial in every part of the world, is intelligence. And of course, we can talk about that, but that probably also scares some people a little bit.
- CWChris Williamson
The Harvard HMS study says 70, 75% of Americans support embryo screening for disease and about 40% for intelligence. So, there's pretty big gap there, almost double the acceptance. Uh, talk to me about the difference between screening for disease and screening for traits beyond disease, not negative versus plus positive.
- JAJonathan Anomaly
Right. Yeah, and it's interesting because if you do the same study in Singapore, and it has been done, it's about the same. It's, it's, it's equal. So, people equally support screening against disease and screening in favor of psychiatric traits, including intelligence or lower risk of various psychological disorders. So, what I like to say is both the winners and the losers of World War II, um, basically took on a set of taboos about genetic explanations, especially for the trait that makes us most human, which is, which is our brain, intelligence. Um, and I think those who were sort of outside of that, you know, Germany, the United States, England, et cetera, those in Asia especially, and South Asia in particular, they just don't seem to draw this distinction between selecting in favor of a positive trait and selecting against, uh, a negative trait, like, like a disease trait. And so, I think what's going on here is there's a set of taboos after World War II. They arose, at least in part, because of the eugenics programs in Germany and this idea that we could rank humans by their relative worth, and the worth was never in terms of, I don't know, how tall, you know, Swedes are versus Bantus are or something. It was how smart they are or how creative they are, and those are all sort of things that have to do with the mind. And so, I think that there's this kind of, this mysterious taboo around mental traits. I don't think it's deserved. I think we can understand the genetics of mental traits just like we can bodily traits, but that probably explains the distinction where some people are uncomfortable selecting for intelligence or against mental health disorders, but they're perfectly fine selecting against diabetes or Crohn's disease. So.
- CWChris Williamson
What is the different? What, i- is it, uh, more of a sense, a judgment on who you are?... on a v- a, a value of your worth?
- JAJonathan Anomaly
I think so. That's probably exactly the right answer. I mean, what, what distinguishes you from another person? I mean, we do look at looks and strength and, you know, how fast you run and all of that. But r- what really distinguishes you, your friends, you know, the people you love, and so on, it's, it's the mind more than the body.
- CWChris Williamson
Mm-hmm.
- JAJonathan Anomaly
And so when you think about it, I mean, as, as people decay, as they get older, maybe they have Alzheimer's degree- d- disease or something like that, and we say, you know, the person is starting to fade away because their mind is. And so I think we attach moral judgments and, and that sort of thing with mental traits more than, than physical.
- CWChris Williamson
Yeah. It's, it's an interesting challenge that people, people do lay an awful lot at the feet of, "Well, what's the landscape of this person's mind?" And you're right. If somebody ages and becomes a little bit more forgetful or senile, they feel less like themselves.
- JAJonathan Anomaly
Right.
- CWChris Williamson
So yeah, there is this sense of self. It's the soul being portrayed through your behavior and your actions and (laughs) stuff
- 7:08 – 14:30
Does Embyro Selection Risk Deepening Inequality?
- CWChris Williamson
like that. So what, what do you say about the slippery slope toward eugenics? Like this is a, a term that gets tossed around a lot, and then I've heard you use the word liberal eugenics, whatever that means.
- JAJonathan Anomaly
Yeah. Mm-hmm.
- CWChris Williamson
W- how do you come to... How do you ensure that this doesn't end up being just 1944 all over again?
- JAJonathan Anomaly
Uh, well, I'm not wor- really worried about the terms that we use, whether it's eugenics or genetic enhancement or genetic selection. Um, I think what people worry about, of course, is government control of these kinds of reproductive technologies, or maybe the social pressure that you would feel if everyone else was using it, and then you would feel some pressure-
- CWChris Williamson
Mm-hmm.
- JAJonathan Anomaly
... to use it as well. I think there's just a big distinction we need to draw between individuals making choices, informed choices in particular, to reduce disease risks among their kids and, and governments forcing people to, to do these kinds of things. This is why... I don't know, there's an interesting trade-off here between people worry about genetic inequalities. We've talked about it before. Maybe if, if only the rich, for example, for a generation or two could afford to use these technologies, there would be some genetic gaps that would increase between, you know, the really bright and, and the not so bright and that sort of thing. And one obvious solution to that is governments might, you know, force insurance companies to cover it or subsidize this technology, and I think that's true. We could sort of ensure that there's more equality by doing that. On the other hand, there's a lot of people who don't like technology like this, and I wouldn't want governments to, to basically redistribute their income in such a way that other people, you know, got subsidies to do this.
- CWChris Williamson
Mm-hmm.
- JAJonathan Anomaly
And so I think there's this trade-off between, you know, government's getting more and more directly involved and, and equality, which in that case, I tend to opt against equality. Um, (laughs) and I worry less about equality and more about individual choice and information. Because the more we try to solve-
- CWChris Williamson
Mm-hmm.
- JAJonathan Anomaly
... the whatever kinds of gaps we get between people because of their choices, the more you're going to have to use governments to solve it, right? And that will bring you more toward kind of coercive eugenics rather than against it.
- CWChris Williamson
Mm. What, what is your answer to the concern people have about rich people being able to have smarter, taller, better-looking kids, uh, further worsening the gap? The, not only is the inequality now wealth, the inequality is now genetic.
- JAJonathan Anomaly
Yeah. Well, part of the wealth inequality already is, of course, genetic. We already have strong assortative mating, as you know, and, and we've talked about this as well, but intelligence is one of the main traits that people assortatively mate over. Height, intelligence, athleticism. So I think, um, you know, what we're gonna get is we are, we're already getting more inequalities along various dimensions, and this could ramp it up a little bit. But I think in a generation or two, you know, what can embryo selection get you? It can get you a few points in terms of IQ, it could get you a couple inches (laughs) maybe for height, but it's not gonna lead to dramatic inequalities. Look, over a thousand years, if we had embryo selection plus, you know, IVG, which we can talk about, gene editing, that sort of thing, you know, the world is gonna be a very different place, I think. People are gonna go in lots of different directions, and different states will have different solutions to this sort of thing, right? So some governments probably will, you know, enable people to use this if they can afford it. Others will have a more libertarian approach. So I don't really worry about that too much. What I would worry about is governments really directly controlling the technology.
- CWChris Williamson
Mm-hmm.
- JAJonathan Anomaly
And I mean, I can add, you know, in the Middle East, um, governments already cover, they already subsidize a lot of genetic testing. So it's not really that big of a deal to necessarily just cover genetic testing. What is a big deal is if you're covering a broader and broader swath of this and you're forcing everyone else to pay for it. And so that's what I'm worried, yeah.
- CWChris Williamson
Right. Okay. Just, just to put it into language that I can understand-
- JAJonathan Anomaly
(laughs) Yeah.
- CWChris Williamson
... what you're suggesting is, uh, if only the rich people can afford it, that means that there is an unfair advantage being given to the rich people.
- JAJonathan Anomaly
Sure.
- CWChris Williamson
In order to make it more affordable for the poor people to be able to keep up with the rich people genetically, uh, their, their progeny genetically, uh, one solution would be to have it subsidized or paid for by insurance. But insurance is paid into by everybody, both people who want to use it and people who don't, people who agree with it and people who disagree, people who are rich and people that are poor. And that means that there are people who fundamentally disagree with this sort of technology being forced to pay for it so that people who do agree with it can get to use it.
- JAJonathan Anomaly
Precisely. And whether it's an insurance mandate or a direct subsidy that the government gives you, well they, the government is us. They get their money by taxpayers. And so that's why I sort of say like a lot of people, you know, say, "Well, the obvious solution to inequalities, of anything, genetic inequalities, wealth inequalities, is just give the poor money or give the poor access to whatever." And it's like, yeah, that sounds good, but the money comes from somewhere. And in the case of wealth, wealth redistribution, you know, you're not forcing on people necessarily views they vehemently disagree with. But there are some religious people who really don't like IVF, like they really don't like abortion-
- CWChris Williamson
Mm-hmm. I was gonna say, is this-
- JAJonathan Anomaly
... which is different than IVF and-
- CWChris Williamson
... is this not the s- is this not the case with a bunch of treatments at the moment?
- JAJonathan Anomaly
Yeah. True.
- CWChris Williamson
They're not... You know, there's some people who don't take their kids in when they've got cancer and they're going to pray the illness away and stuff like that.
- JAJonathan Anomaly
(laughs)
- CWChris Williamson
It is surely, this is a situation that we've already encountered or are enc-
- JAJonathan Anomaly
Good. Yeah. Jehovah's Witnesses and blood transfusions.
- CWChris Williamson
What's that?
- JAJonathan Anomaly
So Jehovah's Witnesses, I guess, don't... You know, I don't really understand the religion well, but they don't agree with blood transfusions. They don't want to intervene in, you know, what they regard as natural or God's will or something. And so some of them have refused their children blood infusions when, in fact, their life depends on it.
- 14:30 – 21:13
How Can We Soften the Conversation on Genetic Selection?
- JAJonathan Anomaly
Um...
- CWChris Williamson
Have you thought about a way to make the discussion around the impact of genetics on people's outcomes in life less icky? Now every time that I have a conversation about this, whether it's with Robert Plomin or Paige Harden or you or who, uh, uh, Razib, whoever-
- JAJonathan Anomaly
Yeah.
- CWChris Williamson
... whenever I speak to somebody about this, w- Paige Harden is, like, hardcore on the left, like, she is very, very left-leaning. Plomin, I have no idea, but he was, what, the fifth most cited psychologist in the n- 20th century-
- JAJonathan Anomaly
Yeah.
- CWChris Williamson
... I think? Um, uh, no matter who I speak to, there is always this fucking specter in the back of th- there's this big elephant in the room, this big genetics is eugenics, uh, this is, uh, judgemental, it's breeding, i- it's, it's, uh, determinist, it's reductive, um, it's right-wing, it's Nazi policy, it's overbearing. It- there's always this sort of lurking, and, um, ultimately, anybody that reads a single book on behavioral genetics is going to find out that the raw materials that you're made of is highly predictive of some of the outcomes that you're going to get in life. Not all of them, but some of them. H- have you thought about how to make this message more palatable to the, sort of, wider audience?
- JAJonathan Anomaly
Sure. I think, I think we all have, people in this domain, but actually, you said, "People who have read a book know about this." The reality is, everyone who's had a family, who's got brothers and sisters or children, know that a lot of what forms their, their personality, the, the differences between them in athleticism, musicality, all this stuff, is obviously involuntary. They grow up in the same environment, same family, same teachers in many cases, and they end up very differently. And so the reality is, most people know this. It's more of, again, back to taboos and kind of public signaling and that sort of thing, um, you know, you're supposed to signal that genes don't do very much, and part of this is, like, we live in a meritocracy and we wanna believe that you can be anything you set your mind to, and, you know, we look like we're kinda raining on the parade (laughs) of, you know, telling people actually, you know, it turns out genes are gonna constrain part of, part of your outcomes in life. But I think actually it's an optimistic message too, because the truth is, the more you know about genetics, the more you realize, like, first of all, they're not deterministic. There's still a lot of space for, (laughs) for what you can do with them, but secondly, we're all good at different things, and so, you know, figuring out that you're, you're better at some things than others doesn't mean that therefore you're, I don't know, inferior, or you should never try to do those other things. Maybe you try to do them precisely because it is a challenge-
- CWChris Williamson
Mm-hmm.
- JAJonathan Anomaly
... but you also, you grow up as a human and you realize you're not equally good at everything, and, and you do the things that you're good at and those become sort of exaggerated. And so, yeah, I don't think it's necessarily a bad message to understand genetics. But, you know, one way to soften it is precisely, especially when we're talking about genetic selection, people spend all this money, resources, you know, selecting a mate, getting married, you know, buying a house, sending their kids to the right schools and that sort of thing, and I think, you know, one thing you can do is you can stack the deck ahead of time, the genetic deck, by just kind of minimizing disease burden, you know, making sure that, to, to the extent possible, they have a, a decent level of general cognitive ability, low level of, you know, psychopathology, uh, uh, um, proneness, that sort of thing, and yeah, that's probably gonna be as effective or more effective than a lot of things parents already do, and I think that's an optimistic message, not a pessimistic one.
- CWChris Williamson
Mm. There's, there's definitely a, a strange sort of duality that I hear in some of the criticisms around embryo selection, um, one being that I, I don't think I've ever heard anybody s- anybody from the embryo selection camp use words like, um, better, l- as in th- the worth of a person, uh, preferable, more optimal, et cetera-
- JAJonathan Anomaly
Yeah.
- CWChris Williamson
... um, which is the outcomes typically that most people are looking to get in life will be predicated by this sort of...... a collection of genes, as opposed to this sort of collection of genes. Uh, you know, if, if you had the choice between a gluten intolerance and no gluten intolerance, like presumably, even if you don't want to eat gluten, it would be better to not be wrecked by it if you accidentally get stealth glutened in a, a restaurant somewhere, for instance, let's say.
- JAJonathan Anomaly
Yeah.
- CWChris Williamson
Uh, or, uh, myopia, right? I don't need to deny the personhood of everybody that needs glasses, which includes both of my parents, by saying it's probably preferable for people to wear fashion glasses if they want to, but to not need them in order to be able to read a piece of paper or a menu in a restaurant.
- JAJonathan Anomaly
Exactly. And-
- CWChris Williamson
But when you hear a lot of the criticisms, they seem to be about, well, what you're saying is that somebody with a higher IQ is sort of more worthy, a better person, better person, more of a person somehow. And, uh, I, I don't think I've ever heard that come out of the, at least anybody that's told me. I'm sure that there's fucking tons of people who actually do.
- JAJonathan Anomaly
(laughs)
- CWChris Williamson
I'm not gonna fucking hitch my wagon to every person that's talking about behavioral genetics, but you understand what I mean.
- JAJonathan Anomaly
Yeah. Most people don't think that someone who is healthier is morally superior (laughs) to someone who's less healthy. Uh, there are degenerate societies where that's true, right? We can think of 1930s Germany and the eugenics laws that they passed, which is, you know, before the Holocaust, something like 300,000 Germans were murdered, um, because they were considered morally inferior because they had psychological disorders or, you know, sexual deviance. You know, some, some homosexuals were killed-
- CWChris Williamson
Mm.
- JAJonathan Anomaly
... by the German regime. So, there are people who have kind of made that conflation in the past, but that doesn't mean we need to make it. And, and the truth is, as I like to say, I mean, we have fewer disabilities over the last 20, 30 years simply because medicine's gotten better. And you could say, therefore, the disabled community, you know, whether it's deaf people or people in wheelchairs, you know, there are fewer of them around, and so they have less solidarity with each other. Um, there's gonna be more discrimination, but the reality is the opposite, right? We have, you know, stronger laws that protect them, we have more tolerance as we've understood the source of their disability, et cetera, so-
- CWChris Williamson
Mm.
- JAJonathan Anomaly
Yeah, I think you said what's basically correct, which is you can, on the one hand, respect disabled people, including intellectual disabled people, and tole- not just tolerate them, but actually say like, "Yeah, they're perfectly fine morally," but nevertheless want your, your own kids to have various advantages. And I guess I should probably say something about, you know, the way in which what we're doing is gonna make this conversation inevitable. So, I probably haven't said much of this to you so far, but, you know,
- 21:13 – 26:56
Inside Herasight: The Algorithm Powering Polygenic Selection
- JAJonathan Anomaly
I'll just give you a quick history, how about that-
- CWChris Williamson
Mm-hmm.
- JAJonathan Anomaly
... of, of IVF and, and how people go about kind of selecting embryos. So, IVF is 50 years old now. It started in your, your home country, right? Uh, um, in vitro fertilization, when you hormonally stimulate women, typically it started with infertile women. They generate a bunch of eggs, and the younger you are, the more eggs you get. Fertilize them with sperm, then you have a bunch of embryos, and, you know, since the 1990s, they've been able to test for Down syndrome and chromosomal problems, test for monogenic disorders. I mentioned that. Um, but here's the thing. I mentioned, okay, now what we can do is we can scan the whole genome. We have these polygenic predictors. Most diseases, most traits we care about, height, diabetes, intelligence, even a big part of eye color is highly polygenic. Hundreds, thousands, even tens of thousands of genetic variants are influencing these things. So, that's a new thing we can do, but the thing that my company is doing, which is not just, okay, we have better polygenic scores than other companies. That's cool, but the really, really fundamental thing that we're doing, which is gonna make this technology accessible to everyone, basically, in the world, there's no blocking this, is we can now take the test for Down syndrome, which basically it's just meant to, to count chromosomes, but it gives you a small snapshot of the genome of the embryo. What we can do is take that data and then whole genome sequence the parents, and because the embryo is just a function of the parental genomes, we can then, we have an algorithm to recreate the entire embryo genome. Each embryo has a discrete genome, right? Different risks, different risk profile, d- different genetic profile, and we can do this using, again, these two sources of common commodities, two sources of data. Anyone can whole genome sequence themselves, any parents. We do it at our lab, but you can do it elsewhere too. Anyone who does IVF can ask for that Downs test and then request the raw genetic data from that test, or we can do it for them, and then we can use that data to understand the entire genome of each embryo. Why is that important? There are lots of countries and lots of clinics within our country where it's completely legal, but some doctors, you know, they don't necessarily want to do it.
- CWChris Williamson
Do what?
- JAJonathan Anomaly
Um, they don't necessarily understand how polygenic, uh, selection works. They don't understand the science of it. And this is totally understandable. I mean, doctors who went to medical school 20 years ago, they can't keep up with all the latest developments in genetics. But now because of this innovation, they don't really need to. I mean, we'd like them to, to know and support, you know, what we're doing, and we have lots of clinics that we work with who are perfectly supportive. But the truth is, you know, it's gonna be really easy for individuals to go to clinics, to request data from, from this test, this Downs test, PGT-A, get sequenced, and then understand the whole genome of their embryos, and that means they can get these polygenic reports that we offer. They thought they were getting a Downs test, but they were also getting a schizophrenia test, a test for intelligence, a test for height, a test for all of the, the kind of disease traits that they care about that we can offer.
- CWChris Williamson
Mm-hmm.
- JAJonathan Anomaly
So, that's of enormous significance because it means that, in a way, there's no stopping this technology, and it democratizes the technology. I think the optimistic point is people worry about inequalities of access. Well, we're giving them access, actually. We're kind of removing the gatekeepers. So, as you started, you know, people worry about eugenics in the sense of governments controlling these things. Well, what we're doing is saying not only can governments and should governments not control it-But actually, clinics and doctors, although we respect them, we respect their choices, they shouldn't be, you know, infinitely powerful to k- to be gatekeepers either. I mean, modern medical ethics is premised on basically informed choice by the patient. You go into your doctor, you get diagnosed with cancer... In fact, one of our star scientists right now, he's only 36, he's a Brit-
- CWChris Williamson
You told me about him.
- JAJonathan Anomaly
... he has cancer. This is Alex, Alex Strudwick-Young, he's at UCLA, and he's the one who, by the way, sort of inspired this, this algorithm I just talked about. And yeah, he d- diagnosed with cancer at age 36. There are people with cancer who are diagnosed much later who don't want to be treated. Why? Because it can be really, really rough. You know, you're 91 years old, stage four cancer, the probability of success is really low, it's gonna be extremely painful, and you just say, "You know what? I understand that what will keep me alive a couple more months is chemotherapy and radiation, but I don't want to do it."
- CWChris Williamson
Mm-hmm.
- JAJonathan Anomaly
And you know what? The law and modern medical ethics says you don't have to do it. Now, if you're Alex Young, you should do it. And, and he did it, of course, because there's a good chance of recovering from it. But anyway, the point is, if we want to take seriously individual autonomy and respect what individuals want to do with their bodies or with their genetics or their embryos' genes, you know, this technology is a godsend, because now we can reveal all this information about embryos. It's no longer a completely random roll of the genetic dice, and all of these kind of, you know, these nannies who want to say, "Oh, no, no, no. You know, you may want to choose in that way, you know, you want to choose whether you get chemotherapy or not, but I know what's better for you, Chris."
- CWChris Williamson
Mm-hmm.
- JAJonathan Anomaly
"Like, I know you should get the chemo even though you're 91 years old. You say that you want to choose which embryo to implant, but, but I say, you know, I, in my academic ivory tower, that's eugenics, so you don't get to." Well, what we've done with this technology is basically liberated people from the nannies, from the people who want to tell them what to do. So I think it's pretty cool.
- 26:56 – 33:09
Should Parents Drive Embryo Selection During IVF?
- JAJonathan Anomaly
- CWChris Williamson
What would happen... I- I keep on thinking about the current process of IVF because it seems to me like this has already happened. It seems to me like there is some sort of selection. There's a, a harvest, 10 eggs, somebody looks through a microscope. If you're the mother or father, or both, can you go to your doctor and say, "Hey, um, before we implant, what d- what did you see over those te-" Is this a conversation that sometimes happens? Will the doctor usually say, "So look, we've got, you know, there's two or three here that I think are, they're non-starters. I don't think that they're going to take, as it's known. Um, they're non-starters. We've chosen this particular one." Could you say, "Well, what did you see?" And then from those, "Well, actually, I feel, I feel a little bit, uh, a little bit more number five than number seven." Is that, is that conversation sort of happening at the moment, do you know?
- JAJonathan Anomaly
Not very often.
- CWChris Williamson
But i- i- is it something that you could have, do you think, if you could ask?
- JAJonathan Anomaly
Yeah, and, and people do. And we've had customers... You know, we, we were in stealth operating for a few years here, so we've had about 80 customers now. We're just kind of coming out of stealth, and we're, we're gonna take on thousands in, in the coming year. But, you know, early days, a couple years ago, what we would do is, because this technology is new, we'd, we'd explain to people like, "This is how it works, and, you know, we can give you various information. You could discuss it with your doctor." And in some cases, clinics, doctors are very open to it, and they say, "Yeah, look, I mean, if you know what you're doing and, you know, y- y- you understand the relevant information, like, you get to choose." But there are others who would just say, "No. Like, we're not going to let you do this. We're going to say this one is morphologically better, so we're gonna put... we're gonna sort of say you have to do that."
- CWChris Williamson
That's them eyeballing it rather than using tests and data or-
- JAJonathan Anomaly
Exactly.
- CWChris Williamson
... algorithms.
- JAJonathan Anomaly
And, and in many cases, this is the bizarre thing, and this actually raises some interesting philosophical issues. Um, they will let you choose based on monogenic disorders. So let's take something like hemochromatosis, Tay-Sachs, um, sickle cell anemia, which is more, you know, West Africans and, and some in the Middle East, right? You know, famously, if you have the one variant, you have protection against malaria, but if you have both of them, you know, both copies, then you get sickle cell anemia. Those diseases have been understood for a long time, and since the 1990s, you could... the parents could get a carrier screening. They get a blood test to see if they carry one of those variants.
- CWChris Williamson
Mm-hmm.
- JAJonathan Anomaly
And they could also do the same for the embryo, and doctors are perfectly fine. If you have that one gene that's known to cause that disease, okay, then you could pick an embryo based on that or based on morphology. But what you can't do is pick based on polygenic diseases, which are the huge majority of the diseases that afflict us. I'll give you an example. Everyone's heard of the BRCA genes. There are these variants, they call them BRAC, but it's kind of like BRCA or whatever, right? B-R-C-A. Um, these, these, uh, mutations that significantly elevate the risk of breast cancer, right? So if you have one of these variants, you're like 60% likely to get breast cancer or ovarian cancer. But yet, that's 3% of all the breast cancers are caused by that. The rest of them are polygenic plus environmental in origin.
- CWChris Williamson
Mm-hmm.
- JAJonathan Anomaly
And so the crazy thing is what these doctors who are acting paternalistically are saying is, "Look, you know, for this 3% of cases, sure, we'll let you choose." And yet even in those cases, it's only probabilistic. They're raising the risk of breast cancer. They're not guaranteeing you get it if you have the BRCA genes.
- CWChris Williamson
Mm-hmm.
- JAJonathan Anomaly
But for all of these other cases, you've got significantly elevated risk of breast cancer or schizophrenia or Crohn's disease. We know it runs in your family. We know this genetic data is real. We know that you validated your results, but you know what? You don't get to choose based on that. It's kind of insane actually. And I'll give you another example that's kind of in between these. We're offering for the first time something that we're calling neuro risk, and it's an interesting thing. Basically, a significant portion of the population has genetic variants that interfere with neurological development. They don't guarantee that you're gonna have a really bad outcome, but they're often associated with things like dyslexia and even low functioning autism. And these are just rare genetic variants. We can track them, and we can give you a score and say-Look, some of these embryos have these variants known to cause neurodevelopmental disorders and some don't. And, um, you know, again, these doctors, because they haven't kept up on the science and, you know, fair enough, it's hard to keep up with this stuff, they're gonna say, "You can select against a monogenic disorder, but this neuro risk thing or these polygenic disorders, we're uncomfortable with that." But the real question is why? And, you know, again, it may be just like, well, the latter, you know, polygenic disorders, they're probabilistic, they're not guaranteed-
- CWChris Williamson
Mm.
- JAJonathan Anomaly
... you know, to produce these outcomes whereas the others aren't. But it's like, no, they're not actually because again, these monogenic traits like, like the BRCA variants, all they do is you have this one gene, it elevates the risk of breast cancer, ovarian cancer, it doesn't guarantee that, right? And so what we're doing is we're just introducing complexity, and what I found interesting is doctors don't like dealing with probabilities yet they're already dealing with probabilities. Every treatment that you go in... Actually, you know this as well as anyone. You go in for a diagnosis and they say, "Based on your symptoms, we think it's X." And you're like... Two months later you go to another doctor and it's like, "No way, dude. It's Y."
- CWChris Williamson
Mm.
- JAJonathan Anomaly
And then it's like, okay, now we've got three doctors who believe it's Y and you're like, "Okay, cool, I'm pretty sure it's Y. Now how do we treat it?" And then you go (laughs) to two or three more doctors and they disagree about how to treat it. All of medicine is probabilistic, and indeed all of life is, right? Should you take a driverless Uber or a Waymo or you should take the one with the driver? And it's like, well, let's weigh up the probabilities, right? People do this all the time, but I think what's happened is there's this illusion that medicine is about... There, there's truths, there's facts, and what I want is the doctor gives me the facts and then the doctor tells me, "Do I have the disease? How do I treat it?" And doctors have gone along with this illusion in a way, but it's an illusion. It's just false. And so what we're doing, I think, is we're introducing a little bit more complexity and a little bit more in terms of probability, and they worry that it's just, it's just too much to explain to people (laughs) and they don't want to do it.
- 33:09 – 46:45
How Can We Tell If Genetic Screening Companies Actually Know What They’re Doing?
- JAJonathan Anomaly
- CWChris Williamson
That doesn't feel like a particularly moral stance, but it is moralized. What's going on there?
- JAJonathan Anomaly
Yeah, fair enough. (laughs) You know, you made the criticism, not me. I mean, that is... Yeah, it's... In, in, in some ways, they really are projecting. I mean, not all of them are. Some of them have legitimate worries. Um, I, I will say this, for example. There are some companies out there that are doing polygenic prediction either to give you health scores for yourself so you can diagnose, "What's the chance I'm gonna get Alzheimer's when I'm older," right?
- CWChris Williamson
Mm-hmm.
- JAJonathan Anomaly
There's a polygenic risk score.
- CWChris Williamson
Yeah, I've done one of those. Uh, Intellx DNA.
- JAJonathan Anomaly
Yeah.
- CWChris Williamson
They're based here in Austin. They're great.
- JAJonathan Anomaly
Yeah, so there are many companies out there, and I'm not gonna name-name-names because some of them are actually pretty good and some of them are horrendously bad.
- CWChris Williamson
Okay.
- JAJonathan Anomaly
Like, like, no better than chance. This is astrology, what they're doing. And shockingly, moving from the academy to, to the, the private market, you know, I used to be a bit more of, like, a kind of libertarian economist. Like, markets will eventually get, you know, the right information, and so, you know, the best companies will get the best investors and the most money. And what (laughs) I found in this, in this realm, oh my God, some of the worst companies are the, the best capitalized. Like, people who have been good at... you know, maybe charismatic CEOs are, are often good at raising money even when they have a shit product.
- CWChris Williamson
Mm.
- JAJonathan Anomaly
And because there's so much, um, what we call in economics asymmetry of information, they can often con both customers and even venture capitalists.
- CWChris Williamson
Well, I mean, look-
- JAJonathan Anomaly
Um...
- CWChris Williamson
... the, the world of health and fitness is replete with this, right?
- JAJonathan Anomaly
Yeah.
- CWChris Williamson
Like, how many, how many, uh, products are superfluous in claims, not clinically backed, not tested for-
- JAJonathan Anomaly
Exactly.
- CWChris Williamson
... contaminants and all the rest of the stuff. I suppose the difference is one dose of a, uh, slightly over-caffeinated pre-workout, it doesn't have lifelong implications.
- JAJonathan Anomaly
Exactly.
- CWChris Williamson
A company coming in and saying, "You should choose embryo three instead of embryo five," uh, or, "You have a, a disposition for this or that," results in literally an alternate human being born or you adjusting your entire lifestyle for the rest of your days.
- JAJonathan Anomaly
You just hit on the most important point, and this is what I want to stress because, you know, of course I have a product to shill or whatever, but don't believe me. I mean, you should... You know, science is science, and so for any company that's offering polygenic scores, whether it's for your own health prediction, there are lots doing it, you just mentioned one, or for, you know, embryo screening, the first question you should ask is, "How did you get your polygenic scores? How did you create these scores?" You know, "Have you accessed various biobanks and so on? And mainly, how do you validate these scores? How do you know they work? How do you know how much predictive power they have and how do you justify that claim?" And then finally, and I can tell you how this works, but finally, how does this work across different ancestry groups? And this is of fundamental importance. And I- I'll just tell you an anecdote and then I can get into how, how these claims can be validated because you should, anybody should ask these of these companies, right? Including my own. You should challenge us and say, like, you know, seriously, skeptically, like, "What are you doing here and how do you validate this?" So let me give you an anecdote which is, we had one couple come to us in early days and they had done some genetic testing on themselves and they had polygenic scores for schizophrenia, and they were really worried about having a kid. They actually had some embryos in the bank already, and they were worried about whether they should have a kid at all because they both scored, according to this company, really high in terms of risk for schizophrenia. And schizophrenia is a highly heritable condition. If both parents have it or if neither parent has it but they have a high, high polygenic score for it, uh, meaning, you know, a high risk for it, there is a decent chance their kids are gonna have schizophrenia, right?
- CWChris Williamson
Mm-hmm. Mm.
- JAJonathan Anomaly
What did we do? We retested the parents and then we simulated embryos based on parental DNA-
- CWChris Williamson
Mm.
- JAJonathan Anomaly
... and what we showed is, you know, based on our predictors, and our predictors do work better than this other company, I can say how that works, I'm not gonna name the company-... they actually had very low risk in terms of their polygenic risk scores for schizophrenia. That is fucking wild, right?
- CWChris Williamson
Mm-hmm.
- JAJonathan Anomaly
That means people are making decisions about, as you said, their health, if they're going to have kids at all, let alone which embryo to implant based on-
- CWChris Williamson
Or if they're gonna have, stay with this particular partner.
- 46:45 – 51:38
Does Herasight’s Algorithm Work?
- CWChris Williamson
Okay, so what's the efficacy like? Does this work? Does your thing work?
- JAJonathan Anomaly
Yeah, um, yeah. It's, it depends on the trait. So, all of them work well that we offer. I mean, we have, like, an endless list of traits we don't offer, and that's because we wanna be sort of... We wanna be extremely scientific rig- scientifically rigorous. What we don't wanna do is offer a trait where we're barely better at chance at predicting this. We want these to work robustly. And I can give you examples, but basically, you know, when you think about something like, let's just take schizophrenia, because it's a bad disease, it's something nobody would want, right? Um, you know, the predictors work reasonably well, but they're gonna be more effective in a sense for people who have a family history of it, right? It is true that a random person could get it with no family history. But if you have... And we do this when we, when we give, um, parental reports to people. First, we give a simulated report based on their DNA. "Here's what you can expect your embryos to look like." We actually do 500 simulations. And the idea is let's, like, recombine their DNA 500 realistic times, give them a sample of what their embryos probably will look like on average.
- CWChris Williamson
Mm.
- JAJonathan Anomaly
And then when they do IVF, they might, they might have actually gotten genetically lucky, and everything shifted a little to the right, or unlucky and to the left, and this will guide them. Do you wanna do another round or not? Um, et cetera.
- CWChris Williamson
Oh, how far or close from the bullseye did you get? Or did you beat your odds based on our prediction?
- JAJonathan Anomaly
Exactly.
- CWChris Williamson
Or do you undersell them, yeah.
- JAJonathan Anomaly
Yeah, and if you just want one kid and you've already got a couple of embryos that are doing pretty well, like, yeah, why do another round of IVF? If you want three or four kids, and we've got a lot of pronatalist customers that wanna have a lot of kids, you know, maybe they wanna, you know, do, do more rounds of IVF based on that. Um, but the other thing that tells you is, you know, there may be risks you didn't know you had. But based on your DNA and your partner's DNA, we can reveal kind of new information. And whether or not you know your family history, that can show up in those scores. But if you do know your family history, what you can really see is, like, you know, something like schizophrenia, for example, depending on the number of embryos you have, you could reduce risk by, by half, right? So, it really depends on what your family history is, how many embryos you have. But I'll tell you what we can do for intelligence, and maybe we can talk about some of the correlates 'cause they're pretty cool. Um, you know, for intelligence, if you have 10 embryos, we can predict about a 15-and-a-half-point spread, which is about a full standard deviation. So, the average IQ of, of the population is gonna be 100.... not by magic, because we just define the average IQ as a hundred, and so any deviation from that is going to be above or below average. But think about the difference between someone that has a hundred IQ and 115, or 100 or, uh, or 85 or, if you want to really go down, 85 and 70. The Army will not let you serve if you're below 85, and for good reason, right? You can't learn quickly, you can't process data, and you can't be relied on to fight a war effectively. If you're below 70, you can't be executed in, I think, the state of Texas, because you're considered basically incapable of making rational decisions. So, think about that. A- a 15-point spread is big. Now, the- the real spread between 10 embryos is about double that, it's about 31 or 32 points. We can predict about half of that if you have 10 embryos. And that's wild because, you know, think back to, uh, you know, I don't know about your grandparents, but you know, I have an Irish Catholic side, and my- my grandmother had 12 brothers and sisters. And if you- if you see a big family like that, you really do see differences-
- CWChris Williamson
Mm-hmm.
- JAJonathan Anomaly
... in- in height, in intelligence. You know, "This guy, he's gonna stay on the farm." You know, everyone kind of accepts that. You know, you might not talk about why, but you know, he's a- he's a great guy. He's athletic, he's good-looking, but you know, this is gonna be a farm boy. "This guy over here, you know, he's, you know, maybe not so athletic, but he's- he's heading to Yale." And everyone kind of understood that. You've got big variation between siblings, and all we're doing is we're saying, "Look, if you have a bunch of embryos, we can reveal a- a large part of that variation," in the case of intelligence, about half of it-
- CWChris Williamson
Mm-hmm.
- JAJonathan Anomaly
... and you can choose accordingly. And- and a lot of people, by the way, we have a customer who, you know, she has type 1 diabetes, she's really bright, she went to medical school, and she decided not to be a surgeon in part because of type 1 diabetes. She doesn't want to pass out. I mean, you know, you've got a- a good patch now that regulates bl- blood sugar, but there are certain limitations. And she went through and she looked at her report, and some of her embryos were really shifted high on diabetes and some were lower, and she had a real dilemma, which is the smartest one, projected smartest anyway, was also highest risk of diabetes.
- CWChris Williamson
Mm-hmm.
- JAJonathan Anomaly
What's she gonna do? She's not gonna ... she's not so obsessed with one or two points of intelligence that she's gonna impose that risk on it, and so she chose a- you know, one that's a little bit shifted to the left on intelligence, but also on diabetes risk, so ...
- CWChris Williamson
Yeah, I've got- I- I think this is a really good point.
- 51:38 – 1:01:20
Is Buyer’s Remorse a Risk of Embryo Selection?
- CWChris Williamson
What about buyer's remorse-
- JAJonathan Anomaly
Yeah. (laughs)
- CWChris Williamson
... with regards to this? I had-
- JAJonathan Anomaly
Yeah.
- CWChris Williamson
... a dude on the show, Finn Taylor, he does this great podcast, Finn Versus the Internet, and another one called Finn Versus History. And I- I briefly mentioned this topic in this conversation to him, and he's a father of two, I think, and he brought up, "Well, imagine the strange kind of regret, or resentment, or what-if-ism that a parent might have if they choose from a harvest of 10 eggs," and they say, "I'm not gonna get the one that's got diabetes, that's got the high diabetes risk, even if they're not gonna be quite so clever, I'm gonna pick another one," or whatever. Any outcome that that child has in their life, the parent is going to feel even more culpable for. Not only are parents already swimming in this, "Well, if you don't raise them right, and what about attachment theory, and what about nutrition, natal nutrition, fetal alcohol syndrome, and it was because you- the house had mold in it," and so on, and then, "It's the way that you raised them," and it's, you know, "They cried out" or the nod, all of these things. Parents are already overloaded and burdened with this guilt-
- JAJonathan Anomaly
Yeah.
- CWChris Williamson
... and now, the guilt of, "I chose wrong." P- partner, child, right? Wh- how do you think about that? That seems to be a unique problem that we've never had before.
- JAJonathan Anomaly
I agree. Although, actually, the never had part I don't agree with, so I'll give you an analogy. But first, I'll start by saying, you know, several people you've interviewed are customers. (laughs) I can say that now.
- CWChris Williamson
Mm-hmm.
- JAJonathan Anomaly
Um, well, I can only ... obviously, we don't reveal names of customers unless they really want to be revealed, and I can say, you know, Diana Fleischman and Geoffrey Miller, who you've interviewed-
- CWChris Williamson
Mm-hmm.
- JAJonathan Anomaly
... they haven't used us yet. Um, you know, they've- they're- they're- they're good friends of mine. They are planning on using us, but they had two kids the natural way first, and now they've got embryos they'll probably use in the coming year or two.
- CWChris Williamson
Mm-hmm.
- JAJonathan Anomaly
Not surprising that they would, (laughs) they would be customers-
- CWChris Williamson
Mm-hmm.
- JAJonathan Anomaly
... or that they would be open about that. But Diana's actually the one who first posed that question to me, like, two years ago. And I thought, "That's a good question. Um, I'm gonna write something on our website." We have, like, an ethics FAQ.
- CWChris Williamson
Mm-hmm.
- JAJonathan Anomaly
FAQ, you know, it's kind of a '90s term, but you know, are we playing God, you know? And, uh, well, what about buyer's remorse or, you know, her question, the way she put it, uh, "What- you know, what if I feel guilty that our- our original kids didn't have the advantage of being selected, you know, for low disease burden or high intelligence than our later kids?" And I mean, the answer that I came up with, you know, maybe it's satisfiable, maybe not, is first of all, like, you know, there's only so much you can do with embryo selection, right? We're not creating the perfect kid, there's- every kid's a trade-off, every embryo's a trade-off. But also imagine, you know, that the polio vaccine was invented, you know, after you had your second kid, and you're about to have your third kid. And, you know, the kid has grown, and you know, you didn't vaccinate the first couple of kids, and you know, they grew to adulthood. One of them got polio and they've been crippled, and now later, you have a kid and you could vaccinate it in time, right, before it gets polio. Would you say, like, "I'm not gonna vaccinate because I feel guilty, like, giving this kid an advantage that the first one or two didn't"? And it's like, that would be morally insane, right? You would actually be a moral monster if you chose not to vaccinate your kids when, you know, just because the vaccine wasn't available to the first one, but it is to the second. I think the same thing goes with this. You're giving a slight to maybe a potentially large advantage, but even if the advantage is large, as it is with the vaccine-
- CWChris Williamson
Mm-hmm.
- JAJonathan Anomaly
... or maybe, um, you would have implanted an embryo that had really bad prospects because you were doing it blindly, um, and you did it blindly when you just had sex and had the kids the first time. Does that mean you shouldn't give the next kids advantages? And I think nobody really thinks that.... you know, there might be an irrational, and I will say, it's irrational guilt that you might feel over it, but I do think you should just push that aside. I don't think it's really a legitimate guilt.
- CWChris Williamson
I understand Diana's question. I don't think it's precisely the same as the one that I was asking.
- JAJonathan Anomaly
Okay.
- CWChris Williamson
I think the one that I was asking was, you choo- it's not the comparison between the natural child and the selected child that you have, let's say-
- JAJonathan Anomaly
Yeah.
- CWChris Williamson
... that you've done it in the way that Diana and Jeffrey have done it. It's more the outcomes that my child gets in life, I am more culpable for than I already was.
- JAJonathan Anomaly
Yeah.
- CWChris Williamson
And, and that is because of the choice that I made, and I chose wrong.
- JAJonathan Anomaly
It's a good point. I mean, in a sense, you could say that, um, about any of this. Did you choose to do IVF at all? And then if you chose to do IVF, did you choose which embryo? And in a sense, that is true. I, I suppose the more you take control of any domain of life-
- CWChris Williamson
Mm-hmm.
- JAJonathan Anomaly
... um, and, and in this case, it's another person's life-
- 1:01:20 – 1:05:15
Where Do We Draw the Line with Trait Selection?
- JAJonathan Anomaly
- CWChris Williamson
What should you not be selecting for?
- JAJonathan Anomaly
Yeah, good. Um, I'm glad you asked. Uh, I, I got asked this by a journalist yesterday, and, you know, are there, are there lines that you draw? Are there things you wouldn't select for?And the, the, the first thing that came to mind is, think of the worst in humanity. Sadism, psychopathy, the combination of those dark triad traits, right?
- CWChris Williamson
Mm-hmm.
- JAJonathan Anomaly
Machiavellianism, you know, dark triad basically. Sadism, psychopathy, Machiavellianism. If we had a good predictor for those, which we don't now, but I think that's coming in the future, would you allow people to select against those things? And I think the answer that I would give is yes, and I would be happy if they did. Would you allow people to select for those things? And my answer is no. And that any company that allowed that should be shunned. And should it be illegal? I'm not so sure. And the reason I say I'm not sure, even though that's the most extreme case, is I think social norms are more powerful in many ways than government regulations.
- CWChris Williamson
Yeah, they are.
- JAJonathan Anomaly
And if people were shunned for doing that, and furthermore, if we look at the, the psychology of a psychopath, or a narcissist, do they really necessarily want to invest a lot of resources in (laughs) I don't know, doing IVF and embryo screening and all the other things? Probably not, right? They wanna get away with petty crime, you know. They want sex, drugs, and rock and roll. That's why they always end up in prison, right? They, they tend to be normal levels of intelligence, but sort of fast life history strategy. They're always committing crimes (laughs) and, you know, getting momentary pleasures. I doubt they'd even wanna use IVF, but if they did, I think that we should, as companies, basically not let them select in favor of those kinds of traits.
- CWChris Williamson
Wow.
- JAJonathan Anomaly
Um, but here's, I mean, do you wanna talk about the complexities? Because I think this is more complex, you know, there's the sort of PR angle where I could say, like, "Well, this is wrong and this is right," or whatever. But I mean, more interesting is stuff like, well, you know, these are all spectral conditions, just like height, just like intelligence. There, there's a spectrum, right? There's not just tall and short, and there's not psychopath and not psychopath. The truth is, probably some degree of some of these traits are, are both adaptive and even good-
- CWChris Williamson
Mm-hmm. Yeah, yeah.
- JAJonathan Anomaly
... for either the individual or society.
- CWChris Williamson
If you had zero Machiavellianism, I don't know whether there's a scale of Machiavellianism, uh, if you had no Machiavellianism, then you're not particularly shrewd or canny.
- JAJonathan Anomaly
Right.
- CWChris Williamson
You're not able to play the game when you need to. You're probably gonna get walked all over at work. And yeah, there's a bell curve, right? There's an optimal zone, and maybe there's a couple of little bumps in it. There's a little bit here, "Oh, that's good, but this is not, so, oh, but there, again, we go-"
- JAJonathan Anomaly
Yeah, yeah, exactly.
- CWChris Williamson
... and then it falls off the end. Um, that's really interesting. I, I, I looked on, uh, a bunch of announcement posts that have been going on on Instagram. I think I sent you one of them a little while ago.
- JAJonathan Anomaly
Mm-hmm.
- CWChris Williamson
Uh, and a few of these are trended because this world, your world, Parasite plus a bunch of other companies, it, it seems like this is kind of the space race now, kind of the, the starter pistol. Is, is it fair to say that?
- JAJonathan Anomaly
Absolutely, yeah.
- CWChris Williamson
Right, okay. So starter pistol's been fired on polygenic risk scores for embryo selection, and, uh, I was having a look through the comments. I, I was finding out what, what people's thoughts were, and there was some of the sort of boilerplate stuff that I thought was perhaps unsurprising. There's a couple of really interesting ones. "Diabetes and cardiovascular disease run in my family, and if I could select an embryo that had a reduced risk of it, of getting it, I 100% would." I thought that was really interesting, this sense that if you knew... I, I, I thought about the potential of that woman, I think it was,'s kid-
- JAJonathan Anomaly
Mm-hmm.
- CWChris Williamson
... uh, knowing, "Mom, you had the option to select against this, you didn't, and I got it." That's the first one. Um, well, do you have a moral obligation to sort of give your kids... That's an interesting question, but the second one being, uh, where was it? (sighs) Um,
- 1:05:15 – 1:13:07
Could Genetic Selection Lead to Wrongful Life Lawsuits?
- CWChris Williamson
"Suppose that you got cancer and your mom admitted that she selected you for pretty eyes and didn't even check the cancer column of the embryo selection report. How would you feel?" Um, so this potential, we talked about, uh, buyer's remorse, but what about birther's remorse, right? The potential that you feel like you were born, and we get into the question of personhood, which I wanna get into in a second.
- JAJonathan Anomaly
Mm-hmm.
- CWChris Williamson
But, um, yeah, these, these, these two worlds, the one where somebody knows that they've got family history and they think, "I would love to do this for my kids," uh, and if, as a kid, you realized that you had the opportunity for this thing that you're now suffering with to be selected against and you didn't, again, it's so, it's so novel and messy, and I don't... I- I'm struggling to navigate the ethical landscape here. I feel like I'm sort of clunky. I'm trying to learn a new dance and I'm clunky and falling over my own feet as I try to work out what I think about this.
- JAJonathan Anomaly
Good, yeah. Well, yeah, this is a bit mind-blowing. Back when I was a s- philosophy professor, I, I had written a couple papers on this topic and I encountered a little niche of, of law, of legal doctrine, and it's called wrongful life. You know, there are wrongful death-
- CWChris Williamson
Mm-hmm. Mm-hmm.
- JAJonathan Anomaly
... lawsuits, right? Obviously someone is killed or-
- CWChris Williamson
David Benatar is a big part of this, right?
- JAJonathan Anomaly
Yeah. Well, and, and there's a woman at UCLA Law School, Seana Shifrin, who wrote an article called Wrongful Life, and it's about someone who sued their parents, but, you know, because or somebody-
- CWChris Williamson
Never asked to be born.
- JAJonathan Anomaly
Exactly, or somebody sues on behalf of the kid, but in this case because they have severe disability, like the, the, the, the kind, like think of Tay-Sachs. So, you might not know what it is-
- CWChris Williamson
I don't know what it is.
- JAJonathan Anomaly
... but it's a, it's a protein folding disorder, and basically if you have the two copies of th- of that gene, that variant, um, you're either going to die in the womb as a, as a fetus, or if you are born, your, your life is typically very short, extraordinarily painful, just deformities. Think of, you know, proteins are basically what constitute your, your body, just like cells. And so imagine if you have generalized protein folding disorder. You, you just basically-
- CWChris Williamson
Body can't make a body very well.
- JAJonathan Anomaly
No. And, and you're just going to die a miserable, painful death. It's horrific. And so this disease is actually going away because people are screening for it. It is one of those monogenic diseases, and people are either coupling up, they're not marrying if, if you're, you're known carriers, if both of you are, or if you are, they're screening for it in terms of embryos. Um, but imagine if you, you knew...... that you had this risk, and maybe even deliberately implanted it. I don't know who, who would do that, but-
- CWChris Williamson
Yeah.
- JAJonathan Anomaly
... strangely enough, there are these wrongful life, you know, lawsuits. It's kind of strange, but-
- CWChris Williamson
If the kid dies-
- JAJonathan Anomaly
... you know, better never to have been born kind of thing.
- CWChris Williamson
Y- yeah, if the kid dies so young, who's doing the lawsuit?
- JAJonathan Anomaly
Yeah, yeah, exactly.
- CWChris Williamson
Right.
- JAJonathan Anomaly
It's gotta be on behalf of someone else doing-
- CWChris Williamson
Right. Okay.
- JAJonathan Anomaly
And this, this is an extreme case, and, and, yeah.
- CWChris Williamson
I, I understand on that. Uh, would you let somebody select for Tay-Sachs or something like that?
- JAJonathan Anomaly
No, I don't think so. So any- anything that's clearly and demonstrably antithetical to a healthy life or that's antisocial. So I think the antisocial one's easy, like, again, extreme sort of sadism, psychopathy. If somebody told us they wanted to select for that-
- CWChris Williamson
Hmm.
- JAJonathan Anomaly
... we would say no.
- CWChris Williamson
Just to interject, uh, uh, desktop DNA printers have a similar sort of system in that, uh, red, green, yellow sys- I'm-
- JAJonathan Anomaly
Yeah.
- 1:13:07 – 1:25:36
How Genetic Selection Impacts Personhood and Identity
- CWChris Williamson
to me about the problem of personhood when it comes to this.
- JAJonathan Anomaly
Ooh, yeah, that's, that's a good question. Um, getting deep here. So, um, a Brit named Derek Parfit, a famous philosopher, wrote a book in 1984 called Reasons and Persons. And part of the topic that he was, he was going on about, this was a really, really big topic in the '70s, is, you know, what makes you the same person across time? And this goes back to David Hume, John Locke, these old British, Scottish philosophers, they were d- you know, debating, is there a thing? Is it, is it your body? You know, is it the same body over time? And they'd say, "Oh, no, but a baby is very different than a, you know, a middle-aged man or pre-pubescent, post-pubescent, the old man that you become. You know, your, your body's different. Your cells are changing. So, like, is there anything that unites you over time?" And-... you know, guys like John Locke, David Hume, and then eventually Derek Parfit, they would say, "Actually, what makes a human the same person over time, if there's anything at all, it's psychological continuity." But then they would have all these, these interesting thought experiments, like, yeah, but what if you had amnesia, you know, you had a head injury or something like that? And, and they would just bite the bullet and say you're actually not the same person, you're quite literally a different person in the same body, right? Because what makes a person uniquely a person is, going back to our earlier discussion, you know, there's so much based around our brain and our psychology, right? 'Cause that's what we identify as. You know, and Derek Parfit even said, you know, a brain transplant is the only, the only operation where, you know, the, the donor, you'd rather be the donor than the recipient, right? You are the donor, right? (laughs) Because you are the brain, essentially, in a new body, if, if, if you could do that. And so, so Parfit had all these really interesting puzzles, and they are ultimately ethical puzzles that revolve on this kind of metaphysical discussion about personhood and identity. And, you know, he starts with some cases of, you know, you imagine a teenager who gets pregnant, you know, accidentally, and she thinks to herself, "Man, I could have waited and maybe had a career or whatever else. And if I did wait, maybe I would have found a better, a better guy," right? You know, he had lower risk of disease, or he was smarter, or he had some other advantage. And he asks himself, you know, from an impersonal standpoint, would the world be better had she, had she waited?
Episode duration: 1:59:26
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