You know how today we look back at things like, say, women not being able to vote and we have never unanimous agreement of this being morally wrong? I sometimes like to think what normalized issues do we have today that in the future humans will look back at and think we are being deeply immoral as a society. I'd suggest that not doing extensive genetic testing and aborting those with defects might well turn out to fall in that category. Perhaps the slippery slope here is that we haven't slipped far enough.

You use the word "when" as if it refers to a specific instant in time. I would use the word "when" as if it refers to a process.

You keep using the word "unique" as if it's doing work. I don't see what work it's doing. I also don't believe that "the very beginning" of a unique human life is at that point. I would use the word "potential" in there.

Yes. I don't think it's clear (see language usage) and that "science" doesn't make the exact distinction you're trying to make.

And thus begins the next incarnation of eugenics.

Ok. It would seem something of a shame if we didn't do something like screen for cystic fibrosis among Caucasians not because of other problems but because of a fear of being named into the same category as the horrors of the holocaust.

I've already stated my general perception.

I was merely responding to this:

Hi Folks,

My letter to J. Not sure how this forum works, but I'm a BBV reg, so I don't require a safe space. Comment or don't as you see fit.

Hey J,

I know that you're down about this election, as goddamn well you should be, but I'd like to drop some observations that may or may not help--FFS they're all I have now, basically.

When you went through your Left Behind stage. I recognized it right away, because I went through the exact same thing, though Left Behind wasn't around, same idea. Most empathetic people will flirt with born-againedness at some point in their life. I largely kept quiet about it because I trusted you to work your way through it.

So where did I come out of it? You're an atheist according to what I've heard from you. That is a perfectly logical conclusion, based on the facts presented to us in this world.

So I'm not. I'm a Deist--which is perfectly easy to make fun of, that's fine. I believe in an uncaring God, one who is the wellspring of the universe, and started everything in motion, but one who doesn't give a **** enough to watch in disapproval while we masturbate, or when we make fun of each other, or even when we hurt or kill each other.

Do you care about the bacteria that live in your gut? You should. They're pretty important to digestion and whatnot. Do you care about the individual bacterium in your gut that's having its safe space invaded by a particular amoeba? Why should you? And why should God care about us individually? I believe that God may care about us as a whole, but that doesn't make sense on an individual level. That fact may seem morally wrong to us. So be it.

Jesus, too long. Let me get to the nugget. I think that we're here on Earth to be thwarted. I believe in the spirit, and I believe that you can have whatever you want in the spirit realm....but you can't learn anything from that condition. You need to be thwarted in order to learn something. You need to try something you think will work and have it not ****ing work in order to learn something. This is what this world is for. And this is why Donald J. Trump will be the 45th president of the United States. Let's just take our thwarting--for which I believe we signed up--and try to learn something, and try to come out as better people for it.

ok, not sure how you get from that to "next incarnation of eugenics". That's supposed to be a bad thing, right?

You're really having a hard time with this whole "humor" thing. If the answer is to take the slippery slope...

Sure, there are cases of diseases of such magnitude that the individual in question would barely have a life or functioning brain, but those are very specific cases.

Such screening at the individual level is fairly well covered in science (case to case, depending on what you screen for). But there is very little science that covers the possible outcomes of population-wide screening for "defects".

And there is precedence for my view: Screening for the Sickle Cell trait is possible to do, but science suggests that the genes in question are linked to Malaria resistance, and Malaria is one of the most dangerous diseases in the world. So if you eradicate or greatly reduce the sickle cell trait, it is quite possible that you are greatly increasing the odds of epidemics.

And that's an example of something we know. Very often we don't. To go after "defects" at the individual level as a wide-spread practice can have disastrous unforeseen consequences at the population level.

For the record, sickle cell disease causes hundreds of thousands of deaths per year, is it even clear that it is a net positive? And we've known about the malaria connection for a half century. So sure, it is possible that cystic fibrosis and BRCA and so forth might have some disastrous unforseen consequences we just don't know about today, but my admittedly naive view of the current state of human genetics is that this is somewhat unlikely. We currently have a standard battery of a couple hundred things to test for if people wish, it is just that only a few percent actually go down this route. A lot of horrible, horrible genetic problems in that battery. Many are a complete disaster. I'm not really persuaded by the "maybe there is an even worse disaster we don't know about!" argument. It kinda feels like the handwavy "GMO might be bad because science might not see this horrible consequence even though we currently have zero evidence of that" argument.

From an evolutionary perspective, it's generally a bad thing when the diversity of the gene pool is unnaturally diminished. Whether it's a good or bad thing from a more individualized moral/ethical perspective is a completely different question. But I will suggest that over-selecting for traits is probably a good way to get things really screwed up in a way that's irreversible.

I would liken this to the overuse of antibiotics leading to superbugs or over-sterilization being a probable cause to the increase of asthma and allergies. The illusion of control is very powerful and misleading.

Does substantially reducing the prevalence of BRCA1 in the population fit that "generally bad" example? Do you have a specific argument why that isn't just handwaving "it might become a superbug!'. Like whatever the validity of that as a heuristic (cheetah population was reduced to approx 10k iirc after the last ice age, a problem that affects it now), not sure that really applies here.

In general I think the debate is healthier on a case-to-case basis. Discussing a specific disease or trait makes it tidier.

If we go after "defects" we're suddenly in a different ballpark. Defects often imply something that strays from our cultural ideals more so than our biological knowledge. Just look at how we often view "fittest" in "survival of the fittest" as "stronger, smarter, healthier" - but we know both from ecology and evolution that all of those can be detrimental in some circumstances.

I'm also scared of defects reaching into the cosmetic. As a species we have this tendency to really overreach towards an idealized perfection and be a bit put off by diversity. I'm not saying that this is in any way or form what you suggested, I don't for one second believe that you did. But I do think it's a door that is important to keep shut. Yes, by all means - let us let individuals screen for obviously detrimental diseases where the science is sound, but let's not get lofty and say it makes us "better".

Probably, but that's kind of the nature of "generally bad." The issue at hand is that knowing that some particular set of genes is associated with cancer does not tell us about other things associated with those genes or what else might be impacted.

To put it another way, if we had the option of completely wiping away this particular mutation with the wave of a hand, I'm not sure that it would be wise to do so.

Nope. I have nothing more specific than what one might have been able to say about 50 years ago with the use of antibiotics. We pretty much have super bugs only because we created an environment for them. Here's a just a fun visualization of how that happens.

http://www.vox.com/2016/9/8/12852924...o-mega-harvard

What we do know is that diversity in the gene pool is usually better than homogeneity. So it's probably best not to try to wholesale cancel mutations when they happen.

It applies as a general principle of how evolution seems to work. Just as some evolutionary traits are more "accidental" (in that they don't seem to have evolved specifically to solve some specific evolutionary challenge), we need to accept that evolution sometimes progresses through things that might initially appear to be counter-productive.

This seems like a very weak argument. We know that today there is tremendous suffering due to diseases that are preventable by genetic testing. Maybe your hypothesis is true. Maybe in the future it is discovered there is an even worse consequence of substantively reducing herd prevalence of BRCA1 gene even though current science presents exactly zero suggestion of what that might be and you have nothing but a "hey maybe". If your utilitarian argument is going to work, I think you need a little more oomph than that.

Take drugs, since this is your example. It is true that we now know there are negative consequences of some drugs, thalidomide being a particularly infamous example. The kind of "I have no scientific justification, but hey there MIGHT be a totally disasterous consequence we won't detect for ages" applies in this vague way to every new drug. Yet we would not let this stop us ever using drugs or making new ones.

I'm not making a utilitarian argument. I'm making an evolutionary argument. It's premised on the idea that diversity in the gene pool is preferable. It's not a statement about suffering or specific harm to the individual or the species.

I'm also not making an argument against the creation of drugs. That's a substantively different process than genetic selection. Yes, we only have superbugs because we've overused antibiotics. But that we have superbugs is different from trying to eliminate genes from the gene pool.

I think the antibiotics example is relevant in the sense that it shows how a medical decision that is relatively simple and fairly justified when we only assess the individual case can be very damaging when we don't look at it from a macro-perspective.

Antibiotics are cheap, abundant, effective and directly remove a lot of diseases and disorders, but by over-extending our use of them without sufficient top-down regulation we now risk eventually being worse off, because the reliance on their simple simple and cheap efficiency hinders research into the other approaches that might very well one day be necessary.

Of course it is not comparable in terms of the actual mechanisms at play, but it elegantly portrays that medical ethics can differ when we look at cases from the individual perspective versus the population perspective.

OK, I'm not sure why I should believe that this is universally true. As a sort of vague heuristic, ok, maybe. Genetic diversity is good. But I don't see how you can use this to imply we should never do something like reduce herd prevalence of harmful mutations like that which occurs in BRCA1. Why should I think that having these harmful mutations prevalent in the genetic pool is preferable? Outside of vaguely musing that completely unknown to modern science this putatively harmful mutation in fact benefitial in some magical way.


Sure. It is possible there is some unknown, unspecified way that herd prevalence of BRCA1 mutations is actually a really good thing and that while yes, huge numbers of people suffer and die from breast cancer, there is actually some other bigger harm out there analogous to antibiotics. But do we have any reason to think this is the case here? We have plenty of science on the risks of antibiotics to society. Do we have any on the risk of reducing BRCA1 mutation prevalence?

It's almost a tautology. Genetic diversity is good.

If it's so bad, then evolution will take care of it itself. Again, if I could wave my hand and eliminate this genetic mutation, I'm not sure it would be wise for me to do it.

I believe that there's an implicit assumption in your argument, which is that progress is linear. That is, we're somehow supposed to always try to move for "better" in some sense. Sickle cell might have been an evolved response to malaria because at that time and in that environment it was an advantage. But now it's less of an advantage. So was it an advantage or not? There's on a single answer.

With this framework, you're basically making the argument that longer life is always an advantage. That it's somehow always better if we can find ways to get people to live longer. I'm not sure if I believe that. Robustness of life and longevity of life are not the same thing.

This is a very strange argument. Evolutionary time scales are very long. Why should I care if breast cancer BRCA1 mutations will be "taken care of" over the long arc of evolution. People are suffering and dying now. There is no described downside at all (and if there was...wouldn't "evolution take care of" that too?), but a clear immediate upside.


You seem to believe genetic diversity is tautologically good, but what is your argument? Don't get me wrong, as some sort of big picture I agree. Population bottlenecks and inbreeding in small populations are undoubtedly very bad. What you failed to argue is why - tautologically or otherwise - it is bad to reduce the herd prevalence of a known, harmful mutation that disrupts "normal" cell processes, causes cancer in high rates, and has no scientifically identifiable benefit? If you believe that this is tautologically bad, you need to spell out a more sensible argument.


Ok. If I'm discuss health policy, Obamacare for instance, I'm trying to make our society "better" in some sense. So what?

I don't see how I've implicitly made such an argument. While it is true that many of the clearly identified harmful mutations like cystic fibrosis shorten life, people with this disease also have a horrible quality of life.

It is quite hard to try and pull these disparate themes of yours into anything coherent.

Sure, there is a fairly healthy medical concensus that pre-natal testing for mutated BRCA1 genes is a good way of reducing cancer cases. But there is absolutely no consensus that "not doing extensive genetic testing and aborting those with defects makes us an immoral society" (your own words, paraphrased). I will in fact wager that such a view would be vehemently opposed by most medical professionals that work with cancer or cancer research.

And in this case I'm being fair in the sense that I don't take your usage of the word "defects" to mean anything other than mutated BRCA1 genes or very serious conditions.

Right. When the conversation was in the domain of raising possibilities like "maybe it's like sickle cell or antibiotics" where there is either some other benefit, or future harms, I either wanted to point out that we have plenty of examples of mutations where science is pretty clear that they are harmful mutations that cause pretty objective and vast suffering to humans with no benefits in sight. But I'm not claiming any form of medical consensus that it is morally obligatory to abort such fetuses or anything like this. And I was pretty clear here: I began the discussion postulating something people fifty years from now might look back at us. Heck, half the country opposes abortions in general.

Usage here applies to, say, the standard battery of several hundred common genetic defects. Like some small percent of the population already does this.

Perhaps, or perhaps they would say that if it hadn't been for such practices the advances in gene therapy and nano medicine would have come much sooner.

I also think it is a bit too simple to hand-wave cries for caution aside as arguments from ignorance. We know from ecology that severe interference on populations is a very difficult subject to analyze, we know the results of such interference can often take a very long time to show themselves, we know genes often serve multiple purposes and so forth. This isn't saying "we don't know, therefore we know it is bad" this is "we don't know, so we should be careful".

Meh, alleviating suffering today because of a nebulous possibility that some future buzzword wonder cures will have delayed development is really uncompelling. This wouldn't be offered seriously for not doing any medical approach.

Mutations in this gene screw up a normal DNA repair process in cells that most of us have and that leads to these higher cancer rates. Granted, human genetics is an uncertain field. But we have a pretty clear cut negative here (and this is just high profile, many defects are far more dibilitating). And absolutely zero scientific case for a negative consequences of reduced germ prevalence of these egregious mutations. I'm not saying don't be careful, but are we not careful here? Especially when the possible harms you two have come up with seem like pure figments of your imagination (it might delay nano tech! What if it's like antibiotics!) and not any scientific reason of why we might want this gene to have some small mixture in the genetic population. Inaction based on a lack of complete certainty is not compelling,

Because you're claiming that diminishing the gene pool is a good thing. Time scale doesn't really apply to this argument. I'm simply reasserting the hypothesis about genetic diversity.

The same was true of antibiotics. And now look at where we are.

Your assumption is that this gene does precisely one thing and has no other impacts on the overall system. I think this is an erroneous assumption.

There are times and places when one approach is better and times and places when a different approach is better. But this means that what once didn't work might work now or what was working no longer works. This negates the idea of linear progress. Rather, it demonstrates the "progress" is a shifting target that's only a matter of measuring "here" and "there" and not landing on some absolute location on a map of progress.

The idea that by changing this one thing will get rid of it and have no other effects is naive.

Your struggles don't appear to be my problem. I think it all makes perfect sense under the idea the diversity of the gene pool is preferred over homogeneity. It's really not much more than that.