The Biotech Revolution, the second episode of the BBC4 Visions of the Future series, continues to describe ways in which humanity is making a “historic transition from the age of scientific discovery to the age of scientific mastery”. Presenter Michio Kaku suggests that unlocking the basic code of life will allow us to “predetermine the destiny of life itself” and to manipulate it at the most fundamental level (Start-00:02:00).
The programme begins with Kaku having his “medical future rather than history” diagnosed via a series of genetic tests for complex diseases such as heart disease, diabetes and Alzheimer’s. He describes this as an “owner’s manual” which will enable him to have greater control of his health, and to allow others to perhaps prolong their life by decades (00:02:20-00:06:20 and 00:20:05-00:23: 20). As a scientist, he is eager to discover what secrets his genome may contain however, as a person, he says “wait a minute, this could be a Pandora’s Box… I’m looking at a side of me I have never seen before, a side that has potential medical problems lurking there”.
Some of the issues raised here mirror those found in the ITV1 broadcast The Killer in Me, which illustrated particularly well the anguish associated with having such tests and the way actions could be taken in light of the results. In this programme, in contrast, there is greater emphasis placed on the potential impact on relatives and wider society that may result from taking the tests. “We really want to respect your privacy and the privacy of your relatives” the physician emphasises to Kaku. Much of the future of this testing, if not the present, relies upon “the last great discovery of the 21st century, the Human Genome Project”. Kaku believes that this event holds such significance that we will look at the history of medicine in two eras, “before genome and after genome”. “Having unravelled the fundamental code of our biology the stage is set for us to manipulate it” he adds (00:06:25-00:09:20).
Picking up on a different application of this genetic revolution, the programme moves on to consider gene therapy. The impact of genetic knowledge on the family of a child with Severe Combined Immune Deficiency (SCID) is discussed (00:09:25-00:14:37). SCID or ‘bubble-boy disease’ is a disease of the immune system, which renders sufferers susceptible to all manner of infections. It is possible to treat the patient with a bone marrow transplant, but finding a correct match is often difficult. Pioneering work, in which stem cells are removed from the patient and genetically modified ex vivo before re-injection into the body, has seen some measure of success. The parents of a child who received this treatment describe how the “benefit was very quick… we got our life back and our little boy”.
Despite success stories such as this one, gene therapy has not been without its problems. Several patients, including one at the London clinic featured in this programme, have developed leukaemia as a side-effect of the gene delivery process (see BBC news report), and Jesse Gelsinger, a volunteer in an unrelated American trial, sadly died as a result of complications (see BioethicsBytes post Gene therapy – Horizon ‘Trial and Error’).
The episode is rich with other bioethical themes. For example, Kaku describes how one day there could be a “human body shop”, where each of us could have a series of replacement organs, biologically exclusive to the individual, grown from our own cells. “For some, these replacement organs foreshadow a Frankenstein future, but for me they are an example of our mastery of life” (00:24:40-00:34:55). This potential evokes differing responses. ‘Regenerative medicine’ of this type may provide a fantastic future where parts of our bodies could be replaced as they become old or damaged through disease or lifestyle. On the other hand, there is a school of opinion, voiced here by Oxford Professor Susan Greenfield, who is concerned that if people have a life without hardship, pain, and suffering or serious challenges they will have lived life without truly exploring their humanity.
The potential for cloning is also discussed (00:35:50-00:42:40). The current implications of animal cloning are illustrated and possible future uses of human cloning are explored. This raises many concerns, ranging from accusations about “scientists playing God” to worries that we are tampering with evolution. More generally, this illustrates a range of questions people are asking about new development in biomedicine: How far will this science go? What applications of this science should we embrace? In what circumstances should a development be permitted (or not permitted)? Once a technological know-how, such as the ability to make clones, exists how can you realistically enforce a ban? Kaku suggests that you cannot, he believes “you are just going to have to get used to the fact that a tiny fraction of the human race will be clones”.
Genetic enhancement may give us abilities beyond our biological heritage (00:42:40-00:49:00). From memory enhancement for the classroom to stronger muscle mass, speed and coordination on the sports field, genetic technology could potentially divide the human species as we know it. Kaku is an enthusiast: “society is built on maximising performance… why should we let people’s lives be determined by the throw of a dice?” Human Genome Project director Francis Collins believes that “it raises the question about who decides what is an improvement? Is that improvement going to be available to all, or will it be another example of separating between people who have resources and people who don’t?” (00:47:32-00:48:16).
Questions of this kind illustrate how the technology might generate a two-tiered society. As Kaku observes “in the worst case scenario the society begins to fracture, on one hand you have a race of super-beings and on the other, the rest of us”. Ann Corwin, a transhumanist, takes the view that evolution is an unfinished piece of work and that genetic enhancement is just an extension of nature (00:53:15-00:55:53). She too can envisage people separated into ‘genetic tribes’.
This programme is an exceptional resource for teaching bioethics. The breadth of subjects covered is beyond the scope of this one post. The programme as a whole, or any number of shorter sections, could readily be used as discussion starters. These include the following:
Complex disease diagnosis (00:02:20-00:06:20 and 00:20:05-00:24:40),
Human Genome Project (00:06:25-00:09:15),
Gene therapy/GM (00:09:20-00:14:33),
Organ transplants (00:24:40-00:29:25),
Issues surrounding ageing (00:29:27-00:35:24),
Animal/human cloning (00:35:50-00:42:40),
Genetic modification, genetic enhancement/GM (00:42:40- 00:49:00),
Designer babies (00:49:00-00:50:02) and
Visions of the Future – The Biotech Revolution is a 60 minute programme and was first broadcast on Monday 12th November 2007, BBC4, 21:00, TRILT Identifier 0074CDCC. It was also repeated on BBC4 on 13th November 2007, 00:25am and 14th November 2007, 20:00pm.