Up@dawn 2.0

Saturday, February 17, 2018

It's Not Yet Dark

A Memoir by Simon Fitzmaurice - especially relevant to this week's upcoming euthanasia report...


What constitutes a meaningful life? What gives one life more value than another?
Surely only the individual can hope to grasp the meaning of his or her life. If not
asked if they want the choice to live, it negates that meaning. You have ALS: why
would you want to live? ALS is a killer. But so is life. Everybody dies. But just
because you will die at some point in the future, does that mean you should kill
yourself now? For me, they were asking me to commit suicide. Or to endorse
euthanasia ...

Tuesday, February 13, 2018

Report for Feb 15 | Jonathan Cannon & Logan Eley


In our presentation we will look into Conor Friedersdorf's article in The Atlantic. (link below)
Here is a short quiz just to make sure you've read it if you want to claim an extra run for Thursday.
1. Rather than antibiotics, what did 4-year-old Natalie's parents choose to use to treat her infection?
2. What was the outcome for Natalie and for her parents?
3. T/F: Legislative majorities believe that parents should be put on trial for withholding mainstream medical treatment when a child suffers greatly or dies as a result.
4. What was the name of the 2-year-old boy that did of bowel obstruction?
5. T/F: Can scientists use natural enzymes to target and snip genes with unprecedented accuracy?
6. T/F: In future debates regarding "designer babies" gene editing is likely to be the least controversial use.

Here are some supplementary links related to this topic if you're interested in them.

DQs:
-What are your instincts about if or when you would punish gene editing holdouts?
-If the procedures were as cheap as antibiotics, would it be unethical to deny human gene editing to avert a serious disease?
-What if gene editing would reduce the risk of a typically fatal cancer by only 90%? 50%? 5%?
-Would it matter how much the procedure cost?
-How would you define mainstream medicine?
==
Will Editing Your Baby's Genes Be Mandatory?
An ethical dilemma from the near future

CONOR FRIEDERSDORF
APR 14, 2017

Designing a baby, or editing the genes of an unborn child, strikes many as risky, unseemly, unnatural, unethical, or likely to lead to a dystopian future of one sort or another. Still, I predict that within my lifetime, the United States will arrest, try, and convict some parents for refusing to edit the genes of their child before he or she is born.

Consider what is now punished. In The Kindly Inquisitors, Jonathan Rauch’s defense of liberal free-speech norms, the author noted that the liberal, scientific view of knowledge, which he was championing, asserts a unique claim to legitimacy in the modern West. Lest anyone doubt his characterization, he cited the fate of Christian Scientists:

On December 4, 1984, a 4-year-old girl named Natalie died very painfully of an infection. The cause was a common bacterium that is almost always cured by antibiotics. Her parents, however, did not use antibiotics. They used prayer. To many of us, that sounds preposterous. But imagine what it is to believe fervently in the healing power of your Lord. Imagine that your child is sick, and you want the best treatment, the one that is right and most likely to work. That treatment is prayer, or so you believe with all your heart. And that treatment you use. “We say those parents chose the method of care they felt was most likely to make their child well,” a church official said; and unquestionably he was right.

Then the child dies, and the parents are charged with manslaughter and child endangerment. Over the last ten years there have been dozens of such cases. In 1990 a two-year-old boy named Robyn died of a bowel obstruction after a five day illness; his parents, David and Ginger Twitchell, were convicted of manslaughter and sentenced to ten years’ probation. Pictures in the paper showed the mother, after the trial, cowering in her husband’s arms as he faced news photographers. David Twitchell said, “If I try a method of care I think is working, I will stick with that. If I think it’s not working, I will try something else.” By his own lights, he had tried his best for his child. Anyone who did not happen to share the worldview of medical science could only view the prosecution and conviction of the Twitchells as the most blatant kind of scientific imperialism. Sure, in Robyn’s case and Natalie’s the prayer treatment had failed. But sometimes antibiotics and surgery fail, too. When surgery fails, should parents be put on trial for not having first tried prayer?

Almost no one believes that parents should be put on trial for not having tried prayer––but legislative majorities do believe that parents should be put on trial for withholding mainstream medical treatment when a child suffers greatly or dies as a result. And the medical treatments that are considered mainstream will change over time.

Now that scientists can use natural enzymes to target and snip genes with unprecedented accuracy, “it seems likely that gene therapies––eliminating mutant genes that cause some severe, mostly very rare diseases––might finally bear fruit, if they can be shown to be safe for human use,” The Guardian reported earlier this year in an article on designer babies. “Clinical trials are now under way.”

Reporter Phillip Ball quoted one expert as follows:

Because of unknown health risks and widespread public distrust of gene editing, bioethicist Ronald Green of Dartmouth College in New Hampshire says he does not foresee widespread use of Crispr-Cas9 in the next two decades, even for the prevention of genetic disease, let alone for designer babies. However, Green does see gene editing appearing on the menu eventually, and perhaps not just for medical therapies.

“It is unavoidably in our future,” he said, “and I believe it will become one of the central foci of our social debates later in this century and in the century beyond.”

In those future debates, gene editing to prevent disease is likely to be the leastcontroversial use. Some folks will grant that trying to reduce disease is a reasonable course even as they argue against gene editing for cognitive or aesthetic enhancement. Others will remain wary of editing the genes of their child. If early gene editing efforts cause harm past some threshold, the backlash may render my prediction incorrect. Barring that, it seems likely that gene editors will gain the ability to safely prevent some awful diseases, and that the holdouts who fear or morally object to their methods will dwindle more and more with every passing year.

Once they’re no more numerous or influential than, say, today’s Christian Scientists, the relevant politics will be quite changed. Holdouts who fear that gene editing is putting humanity on a slippery slope to disaster or who have religious objections to the technique or who just prefer “the old-fashioned way” in their gut will conceive a child. If he or she is healthy all will be fine. But some holdouts will give birth to a child with a painful or fatal condition that could have been prevented.

People will get angry at those parents and seek to punish them.

Or at least that is the course I foresee (even though there is arguably an ethical distinction between refraining from editing the genes of a future human and denying essential medical treatment to an already living human, who is understood to have individual rights independent from or not entirely subject to the beliefs of their guardians).

Regardless of whether you agree with my prediction, I’d like to know what you think about the ethics of this matter. A subset of readers will oppose punishing Christian Scientists today for, say, declining to allow the removal of a burst appendix. Such readers presumably oppose punishing the gene editing holdouts of the future, too.

So I am most curious about the views of readers who are presently okay with punishing parents who deny mainstream medical treatment to their children. What are your instincts about if or when you would punish gene editing holdouts? If the attendant medical procedures were as cheap and safe as a course of antibiotics, would it be unethical to deny a potential human gene editing to avert a serious disease? What if instead of a certainty of a serious disease, gene editing would reduce the chance of a typically fatal cancer by 90 percent? How about by 50 percent? 5 percent? Does it matter how much the gene editing technique would cost?

What other confounding factors, if any, should enter into the picture?

Nothing here should be construed to imply anything about my position. I’ve tried to avoid tipping my hand, save my belief that questions of this sort loom ahead for humanity. I’d like to see your stab at answers. Email conor@theatlantic.com if you’re willing to share.

Monday, February 12, 2018

Dan Brown's "Origin"

Looking forward to our report on this book... Post your quiz etc. ASAP, Alex, Kimberly, & Zach.

Not all reviewers were thrilled with it, but what matters to us is whatever important bioethical issues it might raise...

Review Origin by Dan Brown - The Washington Post

https://www.washingtonpost.com/...dan-browns...origin.../85fa064a-a2df-11e7-8cfe-d5b...
Oct 1, 2017 - Dan Brown is back with another thriller so moronic you can feel your IQ points flaking away like dandruff. (Doubleday). “Origin” marks the fifth outing for Harvard professor Robert Langdon, the symbologist who uncovered stunning secrets and shocking conspiracies in “The Da Vinci Code” and Brown's other ...


In Dan Brown's 'Origin,' Robert Langdon Returns, With an A.I. Friend in ...

https://www.nytimes.com/2017/10/03/books/review-origin-dan-brown.html
Oct 3, 2017 - Dan Brown has thrown off the doldrums of “Inferno” with a brisk new book that pits creationism against science, and is liable to stir up as much controversy as “The Da Vinci Code” did. In “Origin,” the brash futurist Edmond Kirsch comes up with a theory so bold, so daring that, as he modestly thinks to himself ...


The World According to Dan Brown - The New York Times

https://www.nytimes.com/2017/09/30/books/dan-brown-origin.html
Sep 30, 2017 - RYE BEACH, N.H. — Anyone who has read Dan Brown's work — and with 200 million copies of his books in print, you know who you are — is familiar with his signature technique of inserting little chunks of expository information into the narrative. Among the topics addressed in his latest thriller, “Origin”: ...


Origin by Dan Brown – a Nostradamus for our muddled times | Books ...

https://www.theguardian.com/books/2017/oct/08/origin-dan-brown-review
Oct 8, 2017 - I used to think Dan Brown was merely a crackpot. Now I wonder if he might not be a prophet. What once seemed to be his deranged fantasy increasingly looks like our daily reality. In our myth-maddened world, we are befuddled by bloggers peddling conspiracy theories and menaced by transactions on the ...

Saturday, February 10, 2018

How your psychology affects your aging



What makes our bodies age ... our skin wrinkle, our hair turn white, our immune systems weaken? Biologist Elizabeth Blackburn shares a Nobel Prize for her work finding out the answer, with the discovery of telomerase: an enzyme that replenishes the caps at the end of chromosomes, which break down when cells divide. Learn more about Blackburn's groundbreaking research -- including how we might have more control over aging than we think. (transcript)
==

Personally I don't think subsequent philosophy has improved on old Seneca's view in "On the Shortness of Life":

“It is not that we have so little time but that we lose so much. ... The life we receive is not short but we make it so; we are not ill provided but use what we have wastefully.”

More Seneca snippets... Maria Popova (Brainpickings) on Seneca...
==
And consider the fate of the Bicentennial Man...


"I would rather die a man than live an eternity as a machine." A right to our humanity includes a right to die.
==
Heavens on Earth: The Scientific Search for the Afterlife, Immortality, and Utopia by Michael Shermer-

==
Also of interest:

Heart Stents Are Useless for Most Stable Patients. They’re Still Widely Used. https://nyti.ms/2BoJ0h6

How Artificial Intelligence Is Edging Its Way Into Our Lives https://nyti.ms/2BTH9SJ

Waiting to Treat the Cancer https://nyti.ms/2BLa0IX

U.S. Pays Billions for ‘Assisted Living,’ but What Does It Get? https://nyti.ms/2GJxey7

Thursday, February 8, 2018

"Roadmap to end aging" transcript, slightly more legible




18 minutes is an absolutely brutal time limit,
00:27
so I'm going to dive straight in, right at the point
00:29
where I get this thing to work.
00:31
Here we go. I'm going to talk about five different things.
00:33
I'm going to talk about why defeating aging is desirable.
00:36
I'm going to talk about why we have to get our shit together,
00:38
and actually talk about this a bit more than we do.
00:40
I'm going to talk about feasibility as well, of course.
00:42
I'm going to talk about why we are so fatalistic
00:44
about doing anything about aging.
00:46
And then I'm going spend perhaps the second half of the talk
00:48
talking about, you know, how we might actually be able to prove that fatalism is wrong,
00:53
namely, by actually doing something about it.
00:55
I'm going to do that in two steps.
00:57
The first one I'm going to talk about is
00:59
how to get from a relatively modest amount of life extension --
01:02
which I'm going to define as 30 years, applied to people
01:05
who are already in middle-age when you start --
01:07
to a point which can genuinely be called defeating aging.
01:10
Namely, essentially an elimination of the relationship between
01:14
how old you are and how likely you are to die in the next year --
01:16
or indeed, to get sick in the first place.
01:18
And of course, the last thing I'm going to talk about
01:20
is how to reach that intermediate step,
01:22
that point of maybe 30 years life extension.
01:25
So I'm going to start with why we should.
01:28
Now, I want to ask a question.
01:30
Hands up: anyone in the audience who is in favor of malaria?
01:33
That was easy. OK.
01:34
OK. Hands up: anyone in the audience
01:36
who's not sure whether malaria is a good thing or a bad thing?
01:39
OK. So we all think malaria is a bad thing.
01:41
That's very good news, because I thought that was what the answer would be.
01:43
Now the thing is, I would like to put it to you
01:45
that the main reason why we think that malaria is a bad thing
01:48
is because of a characteristic of malaria that it shares with aging.
01:52
And here is that characteristic.
01:55
The only real difference is that aging kills considerably more people than malaria does.
02:00
Now, I like in an audience, in Britain especially,
02:02
to talk about the comparison with foxhunting,
02:04
which is something that was banned after a long struggle,
02:07
by the government not very many months ago.
02:10
I mean, I know I'm with a sympathetic audience here,
02:12
but, as we know, a lot of people are not entirely persuaded by this logic.
02:15
And this is actually a rather good comparison, it seems to me.
02:18
You know, a lot of people said, "Well, you know,
02:20
city boys have no business telling us rural types what to do with our time.
02:25
It's a traditional part of the way of life,
02:27
and we should be allowed to carry on doing it.
02:29
It's ecologically sound; it stops the population explosion of foxes."
02:32
But ultimately, the government prevailed in the end,
02:34
because the majority of the British public,
02:35
and certainly the majority of members of Parliament,
02:37
came to the conclusion that it was really something
02:39
that should not be tolerated in a civilized society.
02:41
And I think that human aging shares
02:42
all of these characteristics in spades.
02:45
What part of this do people not understand?
02:47
It's not just about life, of course --
02:49
(Laughter) --
02:50
it's about healthy life, you know --
02:53
getting frail and miserable and dependent is no fun,
02:56
whether or not dying may be fun.
02:58
So really, this is how I would like to describe it.
03:00
It's a global trance.
03:02
These are the sorts of unbelievable excuses
03:04
that people give for aging.
03:06
And, I mean, OK, I'm not actually saying
03:08
that these excuses are completely valueless.
03:10
There are some good points to be made here,
03:12
things that we ought to be thinking about, forward planning
03:15
so that nothing goes too -- well, so that we minimize
03:17
the turbulence when we actually figure out how to fix aging.
03:20
But these are completely crazy, when you actually
03:23
remember your sense of proportion.
03:25
You know, these are arguments; these are things that
03:29
would be legitimate to be concerned about.
03:31
But the question is, are they so dangerous --
03:34
these risks of doing something about aging --
03:36
that they outweigh the downside of doing the opposite,
03:40
namely, leaving aging as it is?
03:42
Are these so bad that they outweigh
03:44
condemning 100,000 people a day to an unnecessarily early death?
03:50
You know, if you haven't got an argument that's that strong,
03:52
then just don't waste my time, is what I say.
03:55
(Laughter)
03:56
Now, there is one argument
03:57
that some people do think really is that strong, and here it is.
03:59
People worry about overpopulation; they say,
04:01
"Well, if we fix aging, no one's going to die to speak of,
04:03
or at least the death toll is going to be much lower,
04:06
only from crossing St. Giles carelessly.
04:08
And therefore, we're not going to be able to have many kids,
04:10
and kids are really important to most people."
04:12
And that's true.
04:14
And you know, a lot of people try to fudge this question,
04:17
and give answers like this.
04:18
I don't agree with those answers. I think they basically don't work.
04:21
I think it's true, that we will face a dilemma in this respect.
04:24
We will have to decide whether to have a low birth rate,
04:28
or a high death rate.
04:30
A high death rate will, of course, arise from simply rejecting these therapies,
04:33
in favor of carrying on having a lot of kids.
04:37
And, I say that that's fine --
04:39
the future of humanity is entitled to make that choice.
04:42
What's not fine is for us to make that choice on behalf of the future.
04:46
If we vacillate, hesitate,
04:48
and do not actually develop these therapies,
04:51
then we are condemning a whole cohort of people --
04:55
who would have been young enough and healthy enough
04:57
to benefit from those therapies, but will not be,
04:59
because we haven't developed them as quickly as we could --
05:01
we'll be denying those people an indefinite life span,
05:03
and I consider that that is immoral.
05:05
That's my answer to the overpopulation question.
05:08
Right. So the next thing is,
05:10
now why should we get a little bit more active on this?
05:12
And the fundamental answer is that
05:14
the pro-aging trance is not as dumb as it looks.
05:17
It's actually a sensible way of coping with the inevitability of aging.
05:21
Aging is ghastly, but it's inevitable, so, you know,
05:25
we've got to find some way to put it out of our minds,
05:27
and it's rational to do anything that we might want to do, to do that.
05:31
Like, for example, making up these ridiculous reasons
05:34
why aging is actually a good thing after all.
05:36
But of course, that only works when we have both of these components.
05:40
And as soon as the inevitability bit becomes a little bit unclear --
05:43
and we might be in range of doing something about aging --
05:45
this becomes part of the problem.
05:47
This pro-aging trance is what stops us from agitating about these things.
05:51
And that's why we have to really talk about this a lot --
05:55
evangelize, I will go so far as to say, quite a lot --
05:57
in order to get people's attention, and make people realize
06:00
that they are in a trance in this regard.
06:02
So that's all I'm going to say about that.
06:04
I'm now going to talk about feasibility.
06:07
And the fundamental reason, I think, why we feel that aging is inevitable
06:11
is summed up in a definition of aging that I'm giving here.
06:14
A very simple definition.
06:15
Aging is a side effect of being alive in the first place,
06:18
which is to say, metabolism.
06:20
This is not a completely tautological statement;
06:23
it's a reasonable statement.
06:24
Aging is basically a process that happens to inanimate objects like cars,
06:28
and it also happens to us,
06:30
despite the fact that we have a lot of clever self-repair mechanisms,
06:33
because those self-repair mechanisms are not perfect.
06:35
So basically, metabolism, which is defined as
06:37
basically everything that keeps us alive from one day to the next,
06:40
has side effects.
06:42
Those side effects accumulate and eventually cause pathology.
06:44
That's a fine definition. So we can put it this way:
06:46
we can say that, you know, we have this chain of events.
06:48
And there are really two games in town,
06:50
according to most people, with regard to postponing aging.
06:53
They're what I'm calling here the "gerontology approach" and the "geriatrics approach."
06:57
The geriatrician will intervene late in the day,
06:59
when pathology is becoming evident,
07:01
and the geriatrician will try and hold back the sands of time,
07:04
and stop the accumulation of side effects
07:07
from causing the pathology quite so soon.
07:09
Of course, it's a very short-term-ist strategy; it's a losing battle,
07:12
because the things that are causing the pathology
07:15
are becoming more abundant as time goes on.
07:17
The gerontology approach looks much more promising on the surface,
07:21
because, you know, prevention is better than cure.
07:24
But unfortunately the thing is that we don't understand metabolism very well.
07:27
In fact, we have a pitifully poor understanding of how organisms work --
07:30
even cells we're not really too good on yet.
07:32
We've discovered things like, for example,
07:34
RNA interference only a few years ago,
07:37
and this is a really fundamental component of how cells work.
07:39
Basically, gerontology is a fine approach in the end,
07:42
but it is not an approach whose time has come
07:44
when we're talking about intervention.
07:46
So then, what do we do about that?
07:49
I mean, that's a fine logic, that sounds pretty convincing,
07:51
pretty ironclad, doesn't it?
07:53
But it isn't.
07:55
Before I tell you why it isn't, I'm going to go a little bit
07:58
into what I'm calling step two.
08:00
Just suppose, as I said, that we do acquire --
08:04
let's say we do it today for the sake of argument --
08:06
the ability to confer 30 extra years of healthy life
08:10
on people who are already in middle age, let's say 55.
08:13
I'm going to call that "robust human rejuvenation." OK.
08:16
What would that actually mean
08:17
for how long people of various ages today --
08:20
or equivalently, of various ages at the time that these therapies arrive --
08:24
would actually live?
08:26
In order to answer that question -- you might think it's simple,
08:28
but it's not simple.
08:29
We can't just say, "Well, if they're young enough to benefit from these therapies,
08:32
then they'll live 30 years longer."
08:33
That's the wrong answer.
08:35
And the reason it's the wrong answer is because of progress.
08:37
There are two sorts of technological progress really,
08:39
for this purpose.
08:40
There are fundamental, major breakthroughs,
08:43
and there are incremental refinements of those breakthroughs.
08:47
Now, they differ a great deal
08:49
in terms of the predictability of time frames.
08:52
Fundamental breakthroughs:
08:53
very hard to predict how long it's going to take
08:55
to make a fundamental breakthrough.
08:56
It was a very long time ago that we decided that flying would be fun,
08:59
and it took us until 1903 to actually work out how to do it.
09:02
But after that, things were pretty steady and pretty uniform.
09:06
I think this is a reasonable sequence of events that happened
09:09
in the progression of the technology of powered flight.
09:13
We can think, really, that each one is sort of
09:17
beyond the imagination of the inventor of the previous one, if you like.
09:20
The incremental advances have added up to something
09:24
which is not incremental anymore.
09:26
This is the sort of thing you see after a fundamental breakthrough.
09:29
And you see it in all sorts of technologies.
09:31
Computers: you can look at a more or less parallel time line,
09:34
happening of course a bit later.
09:35
You can look at medical care. I mean, hygiene, vaccines, antibiotics --
09:38
you know, the same sort of time frame.
09:40
So I think that actually step two, that I called a step a moment ago,
09:44
isn't a step at all.
09:45
That in fact, the people who are young enough
09:48
to benefit from these first therapies
09:50
that give this moderate amount of life extension,
09:52
even though those people are already middle-aged when the therapies arrive,
09:56
will be at some sort of cusp.
09:58
They will mostly survive long enough to receive improved treatments
10:02
that will give them a further 30 or maybe 50 years.
10:04
In other words, they will be staying ahead of the game.
10:07
The therapies will be improving faster than
10:10
the remaining imperfections in the therapies are catching up with us.
10:14
This is a very important point for me to get across.
10:16
Because, you know, most people, when they hear
10:18
that I predict that a lot of people alive today are going to live to 1,000 or more,
10:23
they think that I'm saying that we're going to invent therapies in the next few decades
10:27
that are so thoroughly eliminating aging
10:30
that those therapies will let us live to 1,000 or more.
10:33
I'm not saying that at all.
10:35
I'm saying that the rate of improvement of those therapies
10:37
will be enough.
10:38
They'll never be perfect, but we'll be able to fix the things
10:41
that 200-year-olds die of, before we have any 200-year-olds.
10:44
And the same for 300 and 400 and so on.
10:46
I decided to give this a little name,
10:49
which is "longevity escape velocity."
10:51
(Laughter)
10:53
Well, it seems to get the point across.
10:56
So, these trajectories here are basically how we would expect people to live,
11:01
in terms of remaining life expectancy,
11:03
as measured by their health,
11:05
for given ages that they were at the time that these therapies arrive.
11:08
If you're already 100, or even if you're 80 --
11:10
and an average 80-year-old,
11:12
we probably can't do a lot for you with these therapies,
11:14
because you're too close to death's door
11:16
for the really initial, experimental therapies to be good enough for you.
11:20
You won't be able to withstand them.
11:21
But if you're only 50, then there's a chance
11:23
that you might be able to pull out of the dive and, you know --
11:26
(Laughter) --
11:27
eventually get through this
11:30
and start becoming biologically younger in a meaningful sense,
11:33
in terms of your youthfulness, both physical and mental,
11:35
and in terms of your risk of death from age-related causes.
11:37
And of course, if you're a bit younger than that,
11:39
then you're never really even going
11:41
to get near to being fragile enough to die of age-related causes.
11:44
So this is a genuine conclusion that I come to, that the first 150-year-old --
11:49
we don't know how old that person is today,
11:51
because we don't know how long it's going to take
11:53
to get these first-generation therapies.
11:55
But irrespective of that age,
11:57
I'm claiming that the first person to live to 1,000 --
12:01
subject of course, to, you know, global catastrophes --
12:04
is actually, probably, only about 10 years younger than the first 150-year-old.
12:08
And that's quite a thought.
12:10
Alright, so finally I'm going to spend the rest of the talk,
12:13
my last seven-and-a-half minutes, on step one;
12:16
namely, how do we actually get to this moderate amount of life extension
12:21
that will allow us to get to escape velocity?
12:24
And in order to do that, I need to talk about mice a little bit.
12:28
I have a corresponding milestone to robust human rejuvenation.
12:31
I'm calling it "robust mouse rejuvenation," not very imaginatively.
12:34
And this is what it is.
12:36
I say we're going to take a long-lived strain of mouse,
12:38
which basically means mice that live about three years on average.
12:41
We do exactly nothing to them until they're already two years old.
12:44
And then we do a whole bunch of stuff to them,
12:46
and with those therapies, we get them to live,
12:48
on average, to their fifth birthday.
12:50
So, in other words, we add two years --
12:52
we treble their remaining lifespan,
12:54
starting from the point that we started the therapies.
12:56
The question then is, what would that actually mean for the time frame
12:59
until we get to the milestone I talked about earlier for humans?
13:02
Which we can now, as I've explained,
13:04
equivalently call either robust human rejuvenation or longevity escape velocity.
13:08
Secondly, what does it mean for the public's perception
13:11
of how long it's going to take for us to get to those things,
13:13
starting from the time we get the mice?
13:15
And thirdly, the question is, what will it do
13:17
to actually how much people want it?
13:19
And it seems to me that the first question
13:21
is entirely a biology question,
13:22
and it's extremely hard to answer.
13:24
One has to be very speculative,
13:26
and many of my colleagues would say that we should not do this speculation,
13:29
that we should simply keep our counsel until we know more.
13:33
I say that's nonsense.
13:34
I say we absolutely are irresponsible if we stay silent on this.
13:37
We need to give our best guess as to the time frame,
13:40
in order to give people a sense of proportion
13:43
so that they can assess their priorities.
13:45
So, I say that we have a 50/50 chance
13:48
of reaching this RHR milestone,
13:50
robust human rejuvenation, within 15 years from the point
13:53
that we get to robust mouse rejuvenation.
13:55
15 years from the robust mouse.
13:58
The public's perception will probably be somewhat better than that.
14:01
The public tends to underestimate how difficult scientific things are.
14:03
So they'll probably think it's five years away.
14:05
They'll be wrong, but that actually won't matter too much.
14:07
And finally, of course, I think it's fair to say
14:10
that a large part of the reason why the public is so ambivalent about aging now
14:14
is the global trance I spoke about earlier, the coping strategy.
14:16
That will be history at this point,
14:18
because it will no longer be possible to believe that aging is inevitable in humans,
14:21
since it's been postponed so very effectively in mice.
14:24
So we're likely to end up with a very strong change in people's attitudes,
14:28
and of course that has enormous implications.
14:31
So in order to tell you now how we're going to get these mice,
14:34
I'm going to add a little bit to my description of aging.
14:36
I'm going to use this word "damage"
14:38
to denote these intermediate things that are caused by metabolism
14:42
and that eventually cause pathology.
14:44
Because the critical thing about this
14:46
is that even though the damage only eventually causes pathology,
14:48
the damage itself is caused ongoing-ly throughout life, starting before we're born.
14:53
But it is not part of metabolism itself.
14:56
And this turns out to be useful.
14:57
Because we can re-draw our original diagram this way.
15:00
We can say that, fundamentally, the difference between gerontology and geriatrics
15:03
is that gerontology tries to inhibit the rate
15:05
at which metabolism lays down this damage.
15:07
And I'm going to explain exactly what damage is
15:09
in concrete biological terms in a moment.
15:12
And geriatricians try to hold back the sands of time
15:14
by stopping the damage converting into pathology.
15:16
And the reason it's a losing battle
15:18
is because the damage is continuing to accumulate.
15:20
So there's a third approach, if we look at it this way.
15:23
We can call it the "engineering approach,"
15:25
and I claim that the engineering approach is within range.
15:28
The engineering approach does not intervene in any processes.
15:31
It does not intervene in this process or this one.
15:33
And that's good because it means that it's not a losing battle,
15:36
and it's something that we are within range of being able to do,
15:39
because it doesn't involve improving on evolution.
15:42
The engineering approach simply says,
15:44
"Let's go and periodically repair all of these various types of damage --
15:48
not necessarily repair them completely, but repair them quite a lot,
15:52
so that we keep the level of damage down below the threshold
15:55
that must exist, that causes it to be pathogenic."
15:58
We know that this threshold exists,
16:00
because we don't get age-related diseases until we're in middle age,
16:03
even though the damage has been accumulating since before we were born.
16:06
Why do I say that we're in range? Well, this is basically it.
16:10
The point about this slide is actually the bottom.
16:13
If we try to say which bits of metabolism are important for aging,
16:16
we will be here all night, because basically all of metabolism
16:19
is important for aging in one way or another.
16:21
This list is just for illustration; it is incomplete.
16:24
The list on the right is also incomplete.
16:26
It's a list of types of pathology that are age-related,
16:29
and it's just an incomplete list.
16:31
But I would like to claim to you that this list in the middle is actually complete --
16:34
this is the list of types of thing that qualify as damage,
16:37
side effects of metabolism that cause pathology in the end,
16:40
or that might cause pathology.
16:42
And there are only seven of them.
16:45
They're categories of things, of course, but there's only seven of them.
16:48
Cell loss, mutations in chromosomes, mutations in the mitochondria and so on.
16:53
First of all, I'd like to give you an argument for why that list is complete.
16:58
Of course one can make a biological argument.
17:00
One can say, "OK, what are we made of?"
17:02
We're made of cells and stuff between cells.
17:04
What can damage accumulate in?
17:07
The answer is: long-lived molecules,
17:09
because if a short-lived molecule undergoes damage, but then the molecule is destroyed --
17:12
like by a protein being destroyed by proteolysis -- then the damage is gone, too.
17:16
It's got to be long-lived molecules.
17:18
So, these seven things were all under discussion in gerontology a long time ago
17:21
and that is pretty good news, because it means that,
17:25
you know, we've come a long way in biology in these 20 years,
17:27
so the fact that we haven't extended this list
17:29
is a pretty good indication that there's no extension to be done.
17:33
However, it's better than that; we actually know how to fix them all,
17:35
in mice, in principle -- and what I mean by in principle is,
17:38
we probably can actually implement these fixes within a decade.
17:41
Some of them are partially implemented already, the ones at the top.
17:45
I haven't got time to go through them at all, but
17:48
my conclusion is that, if we can actually get suitable funding for this,
17:52
then we can probably develop robust mouse rejuvenation in only 10 years,
17:56
but we do need to get serious about it.
17:59
We do need to really start trying.
18:01
So of course, there are some biologists in the audience,
18:04
and I want to give some answers to some of the questions that you may have.
18:07
You may have been dissatisfied with this talk,
18:09
but fundamentally you have to go and read this stuff.
18:11
I've published a great deal on this;
18:13
I cite the experimental work on which my optimism is based,
18:16
and there's quite a lot of detail there.
18:18
The detail is what makes me confident
18:20
of my rather aggressive time frames that I'm predicting here.
18:22
So if you think that I'm wrong,
18:24
you'd better damn well go and find out why you think I'm wrong.
18:28
And of course the main thing is that you shouldn't trust people
18:31
who call themselves gerontologists because,
18:33
as with any radical departure from previous thinking within a particular field,
18:37
you know, you expect people in the mainstream to be a bit resistant
18:41
and not really to take it seriously.
18:43
So, you know, you've got to actually do your homework,
18:45
in order to understand whether this is true.
18:46
And we'll just end with a few things.
18:48
One thing is, you know, you'll be hearing from a guy in the next session
18:51
who said some time ago that he could sequence the human genome in half no time,
18:55
and everyone said, "Well, it's obviously impossible."
18:57
And you know what happened.
18:58
So, you know, this does happen.
19:02
We have various strategies -- there's the Methuselah Mouse Prize,
19:04
which is basically an incentive to innovate,
19:07
and to do what you think is going to work,
19:10
and you get money for it if you win.
19:13
There's a proposal to actually put together an institute.
19:16
This is what's going to take a bit of money.
19:18
But, I mean, look -- how long does it take to spend that on the war in Iraq?
19:21
Not very long. OK.
19:22
(Laughter)
19:23
It's got to be philanthropic, because profits distract biotech,
19:26
but it's basically got a 90 percent chance, I think, of succeeding in this.
19:30
And I think we know how to do it. And I'll stop there.
19:33
Thank you.
19:34
(Applause)
19:39
Chris Anderson: OK. I don't know if there's going to be any questions
19:42
but I thought I would give people the chance.
19:44
Audience: Since you've been talking about aging and trying to defeat it,
19:48
why is it that you make yourself appear like an old man?
19:52
(Laughter)
19:56
AG: Because I am an old man. I am actually 158.
19:59
(Laughter)
20:00
(Applause)
20:03
Audience: Species on this planet have evolved with immune systems
20:07
to fight off all the diseases so that individuals live long enough to procreate.
20:11
However, as far as I know, all the species have evolved to actually die,
20:16
so when cells divide, the telomerase get shorter, and eventually species die.
20:21
So, why does -- evolution has -- seems to have selected against immortality,
20:26
when it is so advantageous, or is evolution just incomplete?
20:30
AG: Brilliant. Thank you for asking a question
20:32
that I can answer with an uncontroversial answer.
20:34
I'm going to tell you the genuine mainstream answer to your question,
20:37
which I happen to agree with,
20:39
which is that, no, aging is not a product of selection, evolution;
20:42
[aging] is simply a product of evolutionary neglect.
20:45
In other words, we have aging because it's hard work not to have aging;
20:50
you need more genetic pathways, more sophistication in your genes
20:52
in order to age more slowly,
20:54
and that carries on being true the longer you push it out.
20:57
So, to the extent that evolution doesn't matter,
21:02
doesn't care whether genes are passed on by individuals,
21:04
living a long time or by procreation,
21:07
there's a certain amount of modulation of that,
21:09
which is why different species have different lifespans,
21:12
but that's why there are no immortal species.
21:15
CA: The genes don't care but we do?
21:17
AG: That's right.
21:19
Audience: Hello. I read somewhere that in the last 20 years,
21:24
the average lifespan of basically anyone on the planet has grown by 10 years.
21:29
If I project that, that would make me think
21:32
that I would live until 120 if I don't crash on my motorbike.
21:37
That means that I'm one of your subjects to become a 1,000-year-old?
21:42
AG: If you lose a bit of weight.
21:44
(Laughter)
21:47
Your numbers are a bit out.
21:50
The standard numbers are that lifespans
21:53
have been growing at between one and two years per decade.
21:56
So, it's not quite as good as you might think, you might hope.
22:00
But I intend to move it up to one year per year as soon as possible.
22:03
Audience: I was told that many of the brain cells we have as adults
22:06
are actually in the human embryo,
22:08
and that the brain cells last 80 years or so.
22:10
If that is indeed true,
22:12
biologically are there implications in the world of rejuvenation?
22:15
If there are cells in my body that live all 80 years,
22:18
as opposed to a typical, you know, couple of months?
22:20
AG: There are technical implications certainly.
22:22
Basically what we need to do is replace cells
22:26
in those few areas of the brain that lose cells at a respectable rate,
22:29
especially neurons, but we don't want to replace them
22:32
any faster than that -- or not much faster anyway,
22:34
because replacing them too fast would degrade cognitive function.
22:38
What I said about there being no non-aging species earlier on
22:41
was a little bit of an oversimplification.
22:43
There are species that have no aging -- Hydra for example --
22:47
but they do it by not having a nervous system --
22:49
and not having any tissues in fact that rely for their function
22:51
on very long-lived cells.

Wednesday, February 7, 2018

Report for Feb 8 | Kimberly Edwards, Kyle Jameson, Vincent Lehman

Hey everyone! We'll be giving our report on Dr. Aubrey de Grey. We chose to use one of his earliest TEDTalks instead of a book, so I've included a transcription of that presentation below. If you would prefer to read it in a language other than English, you can find alternative translations here. Just click on "Transcript" under the video, and it will give you the avaliable options. It's also avaliable (in English) for download straight from my Google Drive in the event that you'd prefer to have it saved electronically to consult during our discussion.

If you'd like to go straight to the video on YouTube instead of watching on this site, here's a direct link: "A Roadmap to End Aging".  

We've chosen to include our discussion questions in our PowerPoint to better faciliate conversation in the moment, but if anything in the video inspires you to share, please do so in the comment section and we'll bring it up during our presentation!

Please bring your cell phones with you to class!
Of course, most folks already do, but we will be doing polling via text message during our presentation, and would love for everyone to be able to participate!

We hope you enjoy our topic, and good luck on all of yours!


Kimberly, Kyle, and Vincent

==

Dr. Aubrey de Grey, "A Roadmap to End Aging"



==

English Transcript of "A Roadmap to End Aging"



==

Quiz
  1. What tiny organism allows for genes to be placed (or reverse transcribed rather) into the human genome: bacteria, viruses, archea, or "my friend bob?"
  2. T/F- Metabolic byproducts accumulate over time, eventually causing pathology.
  3. What is the study of Gerontology?
  4. T/F- The "robust mouse rejuvenation procedure" allows for mice typically living an average of 3 years to their 5th birthday. This therapy is adminstered at year two of the mice's life span (tripling their remaining life).
  5. What does "LEV" stand for?
  6. List one ethical concern that comes to your mind personally with regards to the extention of human life.

Quiz Feb 8




We wrap up our reading and discussion of Bioethics: The Basics with ch.6 on justice. Anticipating Eula Biss's On Immunity next month, we might pay particular attention to this chapter's discussion of vaccination/immunization. If you're interested, also see Seth Mnookin discussing his book Panic Virus:
  1. But first, on "enhancement": awhile back I saw a chilling fictional representation of how future mental/cognitive enhancements might lead to dystopia. It was episode three of the British series "Black Mirror," in which everyone is equipped with an implant called a "grain" - it's kind of a subcutaneous Google Glass, with instant access to one's entire archival memory (and with f/forward and rewind). The late David Carr on Black Mirror, MicroSoft's HoloLens, and our dwindling experience of "actual unencumbered reality"...
    And if that's not chilling enough, check out "The World of Tomorrow"...
    1. What are the two major spheres of justice discussed by Campbell? 
    2. (T/F) Vaccination/immunization and restricted mobility are two of the measures used by preventive medicine to counter the spread of disease. 
    3. Another name for the micro-allocation of health care, concerned with prioritizing access to given treatments, is what? (HINT: This was hotly debated and widely misrepresented ("death panels" etc.) in the early months of the Obama administration.)   
    4. What "perverse incentive" to health care practitioners and institutions do reimbursement systems foster, as illustrated by excessive use of MRIs?
    5. What is the inverse care law?   
    6. What is meant by the term "heartsink patients"?
    7. How are Quality Adjusted Life Years (QALYs) supposed to address and solve the problem of who should receive (for instance) a transplant?   
    8. Who propounded a theory of justice that invokes a "veil of ignorance," and what are its two fundamental principles?   
      9. Under what accounts of health might we describe a sick or dying person as healthy?
    10. Name two of the "capabilities" Martha Nussbaum proposes as necessary to ensure respect for human dignity?


    DQ:
    1. Do you agree that health care providers are ethically obliged to promote a fair balance between the rights of the individual and the welfare of society as a whole, and a fair distribution of benefits and burdens in society? Would you say that ethos is widely shared among physicians?

    2. Reflecting on the present measles outbreak and the ebola quarantines of last summer, how would you rate the current strength and effectiveness of vaccination and restricted mobility as tools of preventive medicine? How might they be improved? Do you agree that most anti-vaccers lack a degree of social conscience?

    3. Are you aware of examples of unjust "queue jumping"? 150 (Does the name Mickey Mantle ring a bell?) 
    4. Are there better alternative payment systems than reimbursement? Is it possible to reign in excessive tests and costs while retaining a reimbursement system? 
    5. How would you resolve the Lifeboat Scenario? 153f.

    6. Do you agree that justice requires us to remove the social disadvantages caused by ill health and disability, and support a universal right to those health care interventions that will allow everyone to pursue their "normal opportunity range"? Would you be more or less likely to agree, if you found yourself behind the "veil"? 159

    7. Are there any "attainable human capabilities" on Martha Nussbaum's normative list you'd not include on yours? 163

    8. Elaborate on how bioethics overlaps with environmental ethics. 165
==
==
Dr. Victor Sidel, Public Health Champion, Is Dead at 86
Dr. Victor Sidel, a leading public health specialist whose concerns ranged from alleviating the effects of poverty in the Bronx, where he worked for many years, to raising alarms about the potential impact of nuclear war, died on Jan. 30 in Greenwood Village, Colo. He was 86.His son Mark confirmed the death.

As a founding member of Physicians for Social Responsibility and International Physicians for the Prevention of Nuclear War, which won the Nobel Peace Prize in 1985, Dr. Sidel voiced his apprehensions about nuclear proliferation as a public health issue for more than 50 years. He served as president of the former organization and co-president of the latter.

In a paper in The New England Journal of Medicine in 1962, Dr. Sidel, Dr. H. Jack Geiger and Dr. Bernard Lown painted a grim picture of fatalities and injuries in the Boston area from a nuclear attack and posed ethical questions for surviving doctors.

“Does the physician seek shelter?” they asked, adding, “If the physician finds himself in an area high in radiation, does he leave the injured to secure his own safety?”

And in speeches beginning in the mid-1980s, Dr. Sidel (pronounced sy-DELL) used a metronome to stress what he described as the imbalance between worldwide spending on arms and health care. With the metronome set at one beat a second, Dr. Sidel explained that with every beat, a child died or was permanently disabled by a preventable illness, while $25,000 was spent on weaponry... (continues)
==

==
    Mother Jones (@MotherJones)
    We are this close to "designer babies" mojo.ly/1W5QtTe pic.twitter.com/KTO0VDpNHl

    New Republic (@NewRepublic)
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    The USDA abruptly removes animal welfare information from its website
    http://wapo.st/2kBZkTy

    Measuring the wonders of an empathetic ear in the doctor’s office
    http://wapo.st/2k4JHTO

    Turning the Tide Against Cholera
    Two centuries ago, a global pandemic rose from the swamps of Bangladesh. Now researchers there may have found the tools to stop it.
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Trump’s Travel Ban, Aimed at Terrorists, Has Blocked Doctors

Across the United States, over 15,000 physicians are from the seven affected countries. Many work in small towns, poor urban neighborhoods and V.A. hospitals.