Transcription
It looks completely harmless, but it's one of the most powerful tools science has ever known. The genie is out of the bottle.
In laboratories the world over, scientists are splicing and dicing the very building blocks of life—our DNA. This is the time to talk about it. For the first time in history, we can transform every species on the planet—for better. We can get rid of malaria and tick-borne disease and all sorts of other incredible health problems. Or for worse? What are we really doing? We're meddling about with Nature's blueprint. Are we ready to start stepping across a line? From bulked-up beagles, there will be super leagues with super athletes. To design our babies—you can write the ad copy: choose hair color, skin color, eye color. It's all natural. It's DNA. The possibilities are endless, but whose voice is dictating what should be the design? Genetic engineering could save countless lives, but how do we contain it? There's a whole world out there; you don't know what they're doing. Some boxes should be left closed.
It's happening.
In Dallas, Texas, a groundbreaking experiment is underway that could save millions of lives. It all starts with one volunteer named Ben Dupree. "I have Duchenne muscular dystrophy. It's caused by a mutation, or a problem in the dystrophy gene." Ben has donated a few of his cells to Eric Olson. It was trying to fix the tiny DNA error inside them. Every cell in the human body has 6 billion letters of the DNA code—that's the number of letters in all the words in one thousand Bibles. And think about one misspelled word in a stack of one thousand Bibles. Due to one wrong letter, that one-letter error can put a boy in a wheelchair. My disease causes muscle weakness, along with breathing and eventually cardiac problems. The disease has been eating away at Dupree's muscles since birth. As a young boy, he had trouble walking. At 14, he was in a wheelchair. "All right, come on in here. How much keep you situated?" It was in the mid-20s. Ben Dupree is now 23. His heart muscles are under siege. Without a cure, they'll stop beating. "This is one of the toughest diseases of mankind. It has defied everything that's been thrown at it." One new technology could change that.
It's called CRISPR. CRISPR is like a spell checker for DNA. It has a two-component system. One component is like molecular scissors that can cut the DNA. The other component is like a GPS device for DNA. You can program the GPS device to deliver the scissors anywhere in the six billion letters of DNA. And as soon as the GPS device brings the scissors there, it will cut the DNA. Can CRISPR cut out the single-letter error in Ben Dupree's cells? He's about to find out. "You could call Ben Dupree patient zero. Let me show you these cells, man. Those are Ben's heart muscle cells beating in a dish, and we have been able to correct your mutation in those cells using CRISPR." "It's kind of at a loss for words when you sit face to face with a patient like Ben and you can show that patient that these cells are now producing protein that his body has never been able to make." "Your work is touching humanity. It's amazing to see these cells are basically cured. It's surreal. It's so exciting." "Doesn't seem like it's too far off to start trying this on people." "I hope it's not too far off." "Yeah, moving as quickly as we can." "It's kind of weird to think that the the cells might live longer than I do." There are seven thousand diseases where we know the precise misspelling in the DNA. CRISPR provides an opportunity here we haven't had before, so we're all in a hurry now because we want to see that happen. The potential is enormous, and it goes far beyond curing disease. CRISPR and other gene-editing technologies could literally reshape our world.
In a remote corner of rural China, behind closed doors, one experiment hints at things to come. Two thousand dogs live here, bred for medical research. Two of them have been genetically engineered to look unlike all the others. Geneticist Liang Zhu Lai is on his way to see his laboratory creations. Lai removed a gene called myostatin from beagle embryos—the gene inhibits muscle growth. Meet Hercules. He has twice the normal amount of muscle mass. Putting him beside an ordinary beagle, and the difference is plain to see. This research could also lead to new treatments for muscle diseases in humans, but the CRISPRed dogs have other uses—they could be bred for profit. "Um, we've had selective breeding for a long time, but it's different when we begin to shift genetic inheritance on a permanent basis." Lai wants Hercules and his female cohorts, Tiango, to mate. He believes their puppies will be super beagles, too. "All of these things are unnatural. The science is here; the genie is out of the bottle. It's not going back in, so we are moving from natural selection to design. When you see those beagles, you just know that if you're seeing these individual animals changing and morphing into super beagles, so to speak, next we could be having the same discussion with pictures of humans."
In Ianny's world, the potential is obvious. Oh, he's a sports medicine specialist and doctor for several pro sports teams. Nickname Stick. "CRISPR technology has been looked at by athletes, coaches, team owners, management organizations to enhance player performance. Okay, I'm going to flex up this way. Let me know if you feel any of this comfort. No? Okay, good endpoint." Everybody wants a shot at the record, and that makes your career, or you want to win the championship, and as consumers of sports, you want to see people run faster, jump higher. That could be the emergence of super leagues with super athletes. It's not just pro sports, not just adults. The temptation to gain a competitive advantage could start much earlier. "The next sports legend syndrome is that lamina where parents really believe their 10-year-old is going to be the next sports legend, the next Gretzky. Sometimes those parents will stop at nothing." Oh, we all want the best for our children. Gene editing offers a whole new world of choices.
John Zhang is a rock star in the world of fertility, with his own upscale Manhattan clinic. His research alters DNA at the very earliest stage, when egg meets sperm. The application of this technology is limited only by our imaginations. Zhang has developed a technique that combines DNA from two mothers and one father to create a three-parent baby. "Let's say we have two mothers' eggs, just using chicken eggs as an example, as we know chicken has a two-part egg—or white and egg yolk. So you start with two parents who each give one egg—one give egg white, egg yolks—then we get a third appearance of sperm. Now you have a pretty appearance of it. The egg white is host to inherited diseases that cause miscarriage and infant mortality. This taking large potentially can stop or eliminate this mutated gene. Not only they can produce a healthy baby, it can potentially stop in the family trees." "I think we should check from this point on. We know humor reported to medicine is going to change forever. In my family, there is some cases of cancer, and I'm wondering if the work that you're doing would allow me to prevent my future child from being susceptible to such cancers. Certain type of the cancer already can be screened." "Once you open that door a crack, you get the parents who say, 'Well, since we've invested this much money in making sure that our child doesn't have a higher risk of breast cancer, let's also choose whatever hair color, skin color, eye color.'" "What are all of the possibilities that may be open to me in terms of your technology in the future?" "I think we can edit the child; for example, we really like to have an offspring which can be an NBA player." "I think the general public will utilize the design-baby technology, so we can get all this editing and we put together and we're gonna have a design babe." You can write the ad copy for the fertility clinics: You must act now. Give your child the best start in life. It's all natural. It's the DNA. If you have resources to obtain the most cutting-edge technology in the world, this will lead to a separation between the haves and the have-nots. Imagine a world in which wealthy parents purchased expensive genetic upgrades for their children. It's really a science fiction nightmare, but we are trying to design ourselves all the time. "What do you think? We go to plastic surgeon, why do you think we go to beauty salon? Why do you think we're doing prenatal screen? We're trying to prevent all these abnormal genes to inherit the next generation, so why can't we just fix a gene? Why we only can select and throw them away? Why can we fix it? We're taking DNA-based evolution to our own hands." If you want to put a fine point on it, uh, but I think it's all part of cultural and technological evolution. "I think we've always been radical engineers. I mean, I think the person who came up with the invention of fire was—it was probably a very radical technology that—I mean, it was potentially quite hazardous as well."
The hazards of genetic engineering aren't so easy to spot. What exactly are we risking when we cut and paste our own DNA with CRISPR? There are still many unknowns. What if these molecular scissors accidentally go to the wrong place in the genome and cut a gene that you need? Another challenge is that the technology is based on a bacterial protein that's foreign to the human body. What if the immune system mounts a response to try to reject this bacterial protein that's been introduced into it? And what about the DNA itself? Do we know enough about how our genes actually work? Just because we can cut them doesn't mean we should. There are genes that have been discovered 30, 40 years ago, and we still don't know what they do. "It's kind of like a human being—like we don't just stay in our bedroom; we have a job; we interact with other people. And so if you remove any one gene, you're impacting all those other avenues. And if we go snipping and cutting it, then what are we doing?"
Despite the question marks, the research surges on. Pablo Ross is trying something completely different. He's mixing human DNA with farm animals. His goal is to grow human organs inside pigs. "Being able to generate human organs in an animal has the potential to save millions of lives." These pigs—just regular pigs that nowadays are being grown to provide meat and bacon for breakfast—could also provide life-saving organs. The organs would be custom-made, grown from your own stem cells. He starts by injecting a few human stem cells into a pig embryo. "Here we have the embryos; we also put some human cells that are the small dots on the screen, so I'm going to pick up some cells. We're going to use a laser to make a hole in this shell because otherwise I cannot go into the emblem. We can put the cells in there. That's it. Then we just introduce some of these human cells into the area." "What I've seen with emerging genetic technologies is there's an increasing amount of putting things in here and putting things in this species and that species, and we need to make some decisions about what it is we're willing to accept and what we're not." Ross's incubator holds tens of thousands of injected embryos. He grows them for a week, then checks to see if the human cells have divided. The human cells have fluorescent markers, and here they are glowing red and growing in number. "This has never been done before. The first time for me that just by looking at the fluorescence of the embryo you could tell that those are human cells have contributed to development of this membrane, so it was pretty exciting, I would say." In Ross's future world, animal farms will produce an endless supply of human hearts, livers, lungs, and pancreases. If it seems like something in a sci-fi novel, it is. "In 2001, when I started writing the book *The Pig Goon*, it was an imaginary thing. It's a nickname for the larger-than-normal pigs than my novel, growing multiple kidneys and livers were transplanted to human beings, but now that we have CRISPR, this is now something that is happening. In my book, they have also grown some human brain tissue in the pigs—maybe not such a hot idea since pigs are very smart." Anyway, what are we really doing? We're meddling about with Nature's blueprint, and I don't know that we that we ethically should be doing that.
Genetic technologies are transforming our world, and it's not just happening in laboratories. Oakland, California, is home to the world's first CRISPR retailer. "We are shipping out orders to people who have purchased our kits from our website. These are CRISPR and other genetic engineering kits that let people genetically modify organisms in their home." The kits let people play around with DNA—inserting a jellyfish gene into bacteria, for example, to make it glow. Another is genetically altered designer frogs. "We're about to inject some frogs." It's all part of a growing DIY genetics movement—mostly young people who call themselves biohackers. Josiah Zayner is leading the way. "My goal and the goal of my company, the Odin, is like, let's make things open, let's make things accessible. All these people who say, 'Well, gene editing is only going to be available to people who can afford it,' we're saying no, it's not." His starter kit sells for $159. "Last year we made like five hundred thousand dollars, and this year, you know, we're still growing; we're probably going to make a lot more." Along with the piercings, Zayner has a PhD in biochemistry, but many of his customers have no science background at all. "I remember reading one of the first papers on CRISPR, and it's like scientists were trying so hard to make it as obscure and complicated as possible, and I was like, whoa, it's pretty simple." Zayner's success raises questions: Should all this be regulated? And if so, how? "We don't want to democratize guns by passing out AR-15s to schoolchildren. We want rules of the road in place, and the same is true with powerful technologies like gene editing." "I'm packing up the E. coli, which is the host organism of where the CRISPR-Cas9 takes place." It is now entirely possible to genetically engineer, for instance, a disease for which nobody has an incured. It's getting easier; it's more accessible. That's the true challenge. The US government is so concerned about gene editing; it's set up an FBI task force to find out what's being spliced and diced behind all those closed doors. In 2016, there was a U.S. intelligence report that equated gene editing with a weapon of mass destruction. It is an indication of how powerful biotechnology has become, but how do you prevent the misuse and exploitation of a powerful tool? "I'm sure when the first person made electricity, they're like, 'Why do we need something else to candles?' Electricity kills people, like candles are cool, man, and now it's like nobody even thinks about it, like you don't think about being shocked. We're always afraid about unknowns, but I don't think that's a reason not to do it. Planes are okay, but driving planes into big buildings is a bad idea. Sometimes when you don't understand things, you try to regulate the technology, but what you should be regulating is the outcome."
Finally, the baby was delivered. "My arm and the feeling is—it is amazing. It's brilliant." John Zhang's first ever three-parent baby raises questions, too. The parents chose to be anonymous, and much follow-up research will be done on the child is unknown. With these new technologies, we simply don't know what we don't know, and that in and of itself is a risk. This has been an intense ethical debate about are we crossing a line there? Or that certainly is not something that would happen in nature. Is it safe? That would be a good thing to know. Genetic technologies are advancing so fast, governments are playing catch-up. In the U.S., it's legal to alter a human embryo in a lab, but illegal to implant it in a patient, so Zhang traveled south to create his three-parent baby. "Dr. Zhang went to Mexico to implant the embryo because he said there were no rules there. It's not okay to flout the rules of your own country. Dr. Zhang is willing to do that. I think he's dead wrong and should be condemned for it." Zhang is undeterred. He now offers his services from a clinic in Ukraine. "We are carefully selecting a patient and we are actively engaged with a clean book trial in Ukraine, and in a few months, I hope I can share some good news with you all." And more three-parent babies are on the way. The UK has given approval for women with similar diseases to use a technique similar to Zhang's. There's no world government, so how are these decisions going to be made, and who's going to make them? Science has gotten way ahead of any form of legislation, and anyway, how would you police that? If we have countries competing to develop a technology because it's a technical advance, that's not the kind of competition between countries that is going to benefit humanity. "I think the most likely people to go rogue will be American billionaires. We saw what happened in prohibition—alcohol verboten—people made it in their bathtubs. When the tools exist and when there's a will, there's all sorts of ways people get around things."
"I'm Tristan Roberts. I have had HIV for around five or six years. I'm excited about the possibility of potentially curing this—maybe for a few months, maybe for a few years, maybe indefinitely, but it's only one way to find out." I lost my health insurance through Washington State because they said I wasn't a resident; I didn't have enough money, so it's just like, yeah, you're a citizen, but if you don't have a house, you're not really a citizen in this country. Medication could control his HIV, but Roberts wants a cure. "I'm afraid of giving it to anybody. The barrier that I feel between other people, it's like the expression in my physical love could potentially kill somebody, and yeah, that's that weighs heavily for sure." Tristan Roberts is completely within his rights, according to the FDA and the rule of law in this nation, to uh, self-experiment in any way that he deems medically appropriate. And Tristan Roberts and his friends aren't scientists or doctors; they're biohackers who've concocted a homemade gene therapy. So, um, it wasn't made with a CRISPR kit, but still, this has even desire Zayner thinking of the treatment. "I get this thing that pops up on Facebook, and I was like, what? Like somebody's gonna do a Facebook Live gene therapy injection? That's crazy." What Roberts is doing here falls into a legal gray area. The FDA prohibits the sale of treatments that haven't met strict testing protocols, but Roberts isn't selling; he's experimenting on himself. "You're genetically modifying yourself today to be immune to HIV." Imagine some biohacker who really doesn't understand, you know, contamination, how to notice it, how to test for it, is injecting themselves with stuff that they make in their house or garage. "Panda, the possibility to get pretty hurt is is significant. That isn't gonna work; you haven't thought this through; you haven't actually even read the literature to know what is necessary if you're going to have any hopes of this being useful." This is complicated stuff; it isn't like, you know, just writing the latest app for your iPhone. "What do your medical doctors think of you doing this? Do they—do they—" "Yeah, I haven't—I haven't talked to them."
New technologies have given us unprecedented power to manipulate DNA, and it's not just human genes—the entire natural world can now be engineered. "I think there are much bigger problems than what human beings are doing to human beings. The big question to me is what are we doing to other life forms." CRISPR opens the floodgates to modifying the genomes of everything. This is a tidal wave of technology that is going to consume and touch every aspect of biology.
Kevin Esvelt broke open the floodgates with an idea so powerful, science is still catching its collective breath. "I was walking through a park, looking at all the different organisms. I saw a turtle that day in the water, and I wondered, 'Are any of these ever going to be edited?' If we were to edit that turtle, then it wouldn't reproduce as well as the wild turtles. Then I thought, 'Well, wait a minute. What if we, instead of editing the genome, we teach the genome how to do genome editing on its own?'" Called an engineered gene drive, and it does much more than slice into DNA; it gives animals a set of genetic instructions so their genomes can edit themselves and their offspring. Now humans have the ability to change the course of evolution. Wouldn't it be lovely if we could tweak mosquitoes so they don't spread disease? The key to the gene drive is that it's self-replicating. The edited mosquito always passes the altered gene to its offspring, even when it mates with an ordinary mosquito. The next generation will inherit the new gene, and so on and so on until the new gene takes over a population. No one had imagined that we would be able to edit entire wild species—that concept was absent even from science fiction. We could get rid of malaria and tick-borne disease and all sorts of other incredible health problems, and it could all start here, off the Atlantic coast, on the island of Martha's Vineyard. It's paradise, except for the ticks. "Multi nasty little bug as well is going to infect the whole world." My four brothers and a sister and my mother and father and my wife—she's had Lyme disease like three or four times every summer. As vacationers arrive, so do the ticks, ready for a blood meal. They're everywhere; they love to hang out in the beach grass just as people are coming through, and so it's all done stealthily, surreptitiously. You can't feel the tick bite. They actually rest, waiting for something hot to come by, and then they jump, and then they dig in, and then they start sucking. The ticks carry more than a dozen diseases that make us sick—the most common is Lyme. "Relax, you can be two months old or you can be 98 years old, and if the tick gets on you for a blood feast, then you can have Lyme disease." "I'm sorry, are you doing in general?" "I'm having a harder and harder time walking." Yeah, every year 300 000 Americans are infected with Lyme disease. "Something that was so tiny I couldn't even see it makes me lie on the floor gasping for breath and almost kills me." "I'd love to see it just as eradicated. Good luck on it though. I mean, what a monumental task." Esvelt's team is game to try. Their target is not the tick; it's the white-footed mouse, the primary carrier of Lyme disease. "I think there's a mouse in there." The mice pass it onto the ticks, and the ticks pass it on to us. "Yep, yep. Look at that." Esvelt wants to engineer disease-free mice in the lab, then release them and let the gene drive go to work. "If you talk to people who are suffering from Lyme disease, you want to do something about it, but there are people on the island who say, 'Oh, you don't know what you're doing. This is Frankenmouse. He's gonna—he's gonna, you know, could become a monster. What's going to happen when they get out in the wild?' We'll see. I don't know." Frankenmice to the east, Frankenpigs to the west. In California, Pablo Ross is pressing forward. He's implanted his genetically engineered embryos into surrogate sows. "We transfer 40 to 50 embryos in each pig with the cold that we're going to obtain, you know, 10 to 15 fetuses from them. There is one right here, and so that one is pregnant. Very exciting." The embryos grow to 28 days, then he checks if the human cells have survived. Evolution would not let this happen, but engineering does. The white fluorescent specs are all human DNA. What are we creating? What sort of porcine characteristics might creep into the human who's being treated with a heart grown inside a pig? "Thank you. People who aren't in my situation, they would not understand. Mills has waited four years for a kidney. For me to have the tree of my life, it came from a pig. I don't care; give it to me. It came from a cow, so what? Give me that organ. I want the kidney." The pig-grown organs aren't ready yet. Ross won't let the embryos grow past 28 days. "We are stopping early in case some unexpected things happen with the human cells in this early embryos. What if the human cells give this embryos human characteristic, like if they go to the brain and they increase the intelligence of the animal or let's say they make five fingers instead of two? We don't expect that's going to happen, but we do have to determine and measure that because that could blur some of the lines of what it is to be human." Nobody wants a talking pig. "These unknown things involving animals—there's—there's something quite terrifying to us about that, and I—"
Think it probably goes way back to our deep, deep distant past, when you never knew what you might run into in the jungle. [Music] Till now, the mixing of human and animal DNA was pure fiction, but CRISPR is making it happen with a growing number of creatures, including other primates. China is a hotbed for genetics research on monkeys; they've had human genes edited into their DNA, genes that cause human disease. Western researchers often collaborate, running their own experiments on these transgenic monkeys. China has better funding, and the animals are less expensive. So I single out the Chinese scientists and government, seeing this as the opportunity to be the best; this is their chance. Everything comes down to money. [Music]
I run genetics labs in China and at Emory University in Atlanta. [Music] They were part of a team that created the world's first transgenic monkey model for Huntington's disease, a hereditary neurological disorder. We find that the pathology in the monkey brain is just like a human brain, so that was very exciting to see that kind of result. In 2008, it was groundbreaking. Now, with CRISPR, primates are given any number of neurological disorders. Here, they're looking at a monkey brain given Parkinson's. These monkeys are born with a human gene associated with autism; their parents have the gene too and pass it on to them. They are developmentally delayed, and they're less social than their peers. The thinking, feeling beings have their own personality; they're really highly social creatures. I am ethically so against doing it. The monkeys are already similar to humans, not having the feeling, emotions you can you can you can tell right, because the nurse, the monkey can mimic some very important human diseases like depression, like schizophrenia. We cannot use the mice.
In 2018, Chinese researchers cloned monkeys. Cloning combined with CRISPR will give researchers an endless supply of identical primates with human genetic mutations edited into their brains. When you start doing brain cells, there's so much that we don't know. Could there be some potential for some element of consciousness that's human in a non-human animal? What were the moral status B of that animal? But recent history has shown that shocking new technologies quickly become per se. The same concerns have been raised before, for example, when these two babies were first made, since this blurs the line of what it is to be human. If we can make a human in a lab, and nowadays it's widely acceptable, so much of what's happening in genetics is being pushed to the future; you know it's coming, but we're not there, we're not there, and that's often what you hear in science. What I would say to that is this is the turning point; yes, the final details are still ahead of us, but the turning point is now.
On Martha's Vineyard, the focus is not the monkey but the white-footed mouse. Kevin Esvelt's team is trying to engineer a solution into mice. So I'm gonna grab them gently by the leg and put them on the ear. It turns out a small percentage of white-footed mice are genetically immune to Lyme disease. When a tick attaches, it does not get infected. I discovered the mechanism of action of immunity against Lyme disease. With this aspay protein, we can, using CRISPR, insert that DNA into the reproductive cells of mice so that their offspring will inherit that immunity. If all goes well, hundreds of thousands of crisped mice will be released to mate with the wild population. [Music] I have no qualms about changing a species; we've been modifying nature ever since we've known how to do it. We've selected for dogs with short faces, plants that give us more food, and Kevin is simply being the agent of selection. When you're in the rainforest, you absolutely get the feeling of the interconnectedness of all life, where every single species, no matter how insignificant it seems, can actually be playing a very important part. And now we want to mess about with the genetics of species before we really even understand the complex nature of the ecosystem itself.
Esvelt knows the stakes are high; he wants every island resident to know too. He sees community awareness as the most important part of his work. Would that like give a nicer ecological advantage, and like with that, what problems would that cause in like the environment? It's a great point, and that's sort of the number one concern when you're thinking about engineering something for the wild. As far as we know, the answer is is no. So when I first told my mom we want to release, first she's like, "There's no way," but then I told her all the key points and how it wouldn't be dangerous, and then she was excited about it. So I think when it comes from the kids, I think that's also important. I think it's more important coming from you than it is coming from us. I don't think we have the moral right to do this kind of research in the traditional closeted way. If at any point the community says stop, that's it; project stops; we walk away. Speaking as someone who invents new technologies and is terrified of things going wrong, I appreciate all of you keeping an eye on us. You are in charge of this project because you're the people who live here. I am responsible for whatever comes of CRISPR-based gene drive, and that is tremendously challenging because we can't always anticipate what those consequences will be. Every human tool has a good thing you can do with it, a bad thing you can do with it, and it's something that you didn't anticipate that people end up doing with it.
As word spreads in the absence of regulation, people will find their own reasons to give gene editing a try. So I know why most people come see me; you're coming to see me because you're interested in talking about having a baby. So why don't you tell me your stories? Scott and I met each other about 13 years ago; we worked in the same office; we started dating; we fell in love; and then we met Chloe. Her and I were working very closely together and immediately became friends, and over time, uh, this whole thing organically happened. We just feel that creating a child with all three of our DNA could just complete the family and make it whole, and so we're just kind of curious to see if that would be able to work and if so, how. We're hearing about this type of technology called three-parent IVF, and I joke and I say it's not an orgy, people. As soon as people hear that, they think that it's something sexual, and there's three people in a room. No, it isn't. From a technical standpoint, that is something that theoretically is possible. Three-parent IVF is used to literally cure extremely debilitating diseases. The critics, I can just hear them talking right now and say, "You have three selfish adults; this is completely elective, right? Like no one needs this," and that is a little frustrating because we are three consenting adults, and and that's a lot of what it should be about, the fact that we're all here and committed and wanting to love, give love to a child, should be all that matters.
One of the things that we're seeing in society is that there's more and more genetic information available to women and families. We're beginning to see this might be associated with this; this could be associated with autism; this could be associated with something else. Ours that was diagnosed when he was five with high-functioning autism, and so we're wondering what the possibility of screening for that is, just so that we can make sure that any child that we bring in would have less of a chance. And also, is it a possibility to like pick and choose characteristics of like say Chloe's eyes or my hair or um his metabolism, his metabolism kind of thing, like is that going to be a possibility at all? The question is becoming not just, "Do you want to have a child?" but it's slowly morphing into, "What kind of a child do you want to have?" The line between what's a medical situation and what's just a physical characteristic can be blurred quite easily. Once the tools are there, people will play with them. There's a lot of couple-oriented stuff here, stuff here being at this or couples. I don't think you run into too many. No, that's true. I imagine that there are hundreds of other people that are talking about this around their kitchen table. The fact that they're even asking the question, let me tell you, we need to start coming up with these answers as a society. This is the time to talk about it. The present penetrates the future, and that is why we have to make decent decisions now. Where is the umbrella of thoughtful oversight that we need to be sure these wonderful new developments, which are incredibly promising for healing terrible diseases, don't get misused in a way that makes us all regret having had that skill in the first place?
With no binding international agreements on gene editing, each country is finding its own way, which makes for a hodgepodge of legislation. Canada does have laws on their books: you can use gene editing to treat people who are sick; you cannot use it to alter the traits of future human beings. This isn't going away; it's not really something you can stop, and we're going to have to like come to terms with like, how do we do this in a way that is ethical? Tristan Roberts' homemade gene therapy raised eyebrows around the world, but it didn't cure his HIV; luckily, it didn't harm him either. He is now deciding whether to inject himself again. [Music] People already have access to this stuff; arguing over whether people can and should do it is pointless. We should figure out how do we help people do it safely; how do we make it available in a manner that's effective and doesn't hurt people? Eric Olson must clear several regulatory hurdles before he can attempt a clinical trial to test the safety of his CRISPR therapy. He's now cured Duchenne muscular dystrophy in dogs, but a dog is not a person. Not a day goes by when I don't receive an email or a letter from a desperate mother or family from somewhere, any corner of the earth. There's so much hope; there's so much desperation. The letters typically say, "Dr. Olson, please work harder; we're working against the clock; we know where this is headed." The reality is it's not likely that Ben will see the benefits of this technology in his own body; it will still take us a few more years to bring this to the finish line.
Olson sees a future in which all children are spared the effects of muscular dystrophy. I have worked my entire career on muscle disease, but I have never been more optimistic about anything than I have been about CRISPR. The impact of CRISPR could be huge in bringing us great benefits, but it also could be huge in bringing us into a world that we really don't want to live in. We're essentially changing the human story right at this very point. What's the worst thing that's going to happen? Let's think: people are going to be cured of diseases—that sucks; people are just going to be really healthy and really athletic and really attractive, and it's like, is that bad? I don't know; I don't know. Our private corporation is going to be offering "design your baby" services unless that's outlawed. Yes, who's determining what's the best human trait? Is it someone that's blue-eyed, someone that's brown-eyed, someone with dark hair, someone with black hair? What I'm concerned about is not so much our hair color but our neural diversity. There would be a great tendency to have everybody behave the same way, to cut off the extremes where actually many of our most creative and most productive individuals come from. Who's going to make those determinations? [Music] Who is the god with all-seeing wisdom? In a way, I think we're not playing God; we are helping God; sometimes God is too busy.
Esvelt is so wary of the powers of his gene-drive technology; he's now developing an undo button in case it all goes wrong in the wild. Until it's ready, he's urging scientists not to use his own creation. Some boxes should be left closed; some boxes should stay closed. But you do not have the power to determine who can or cannot open that box. There's a whole world out there; you don't know what they're doing. And what keeps me up at night is a question of what's next. The future of our civilization will primarily be determined by the technologies that we invent and the wisdom with which we choose to use them. More than technological power, it is wisdom that we need. [Music]