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> But worst case, we can eliminate harmful mutations from being passed on to subsequent generations through screening Are you suggesting that we should prohibi

> But worst case, we can eliminate harmful mutations from being passed on to subsequent generations through screening Are you suggesting that we should prohibit these babies from reproducing when they reach adulthood? If not, how do you suggest we prevent harmful mutations from being passed on with "screening"?

mytailorisrich 7y ago
> Are you suggesting that we should prohibit these babies from reproducing when they reach adulthood? That's currently the only reasonable thing to do.
xvedejas 7y ago
Adults only pass on half of their genes during reproduction. I imagine at least in the case of in vitro fertilization there's a fair amount you can do to make sure the harmful genes aren't the ones passed along, so long as the parent doesn't have two copies of an autosomal dominant harmful mutation. I wouldn't be surprised if more advanced methods exist either; as a carrier for a rare genetic disease maybe I should figure this out.
- wahern 7y ago
  You can't argue with the "but what if" line of reasoning because there's always another hypothetical that could lead to the destruction of humanity or, at the very least, one more mutant baby than anticipated. And that's the problem here: these arguments boil down to "too dangerous", but that's not a characteristic amenable to empirically grounded, reasoned debate. We can only have a scientifically constructive discussion within the context of a concrete, particularized therapy--disease, editing vector, gene, etc. Even then it's difficult, but at least you can reach a point at which you can agree to disagree on an actual, concrete scientific question. Everything else is philosophy and politics. I think what people are trying to justify is an a priori assumption that gene editing (or germline editing if they're a little less cautious) is special and distinct. But I don't think you can scientifically justify that distinction from a harm avoidance perspective. Just because the technique is medically and scientifically distinguishable doesn't mean it's analytically distinguishable. And of course one of the principal drivers of these therapies, at least initially, is stopping the types of mutations that are feared but which already exist in nature. So it's simply a belief that you hold; full stop. It's a legitimate belief, and may even be strongly informed by science, but it's like believing in God or aliens or the utility of Mars colonization--we might as well just put labels on our foreheads so we know where the argument will end up without actually having to argue. Knowing the other person's starting point, and assuming the best versions of their likely arguments, most of us here can arrive at the other person's conclusions independently.
  - vannevar 7y ago
    I think what people are trying to justify is an a priori assumption that gene editing (or germline editing if they're a little less cautious) is special and distinct. Gene editing is special and distinct, in the sense that the genome is a complex and nonlinear system, where small errors can be amplified into large consequences, not only local, biological consequences but social as well. In cases where technology offers such potentially extreme leverage, it is scientifically justifiable to tread cautiously to avoid great harm.
    - wahern 7y ago
      The same debate occurred regarding innoculation nearly 250 years ago. In fact, it's still occurring. Moreover, we're still stumbling--just last week I think someone posted an article to HN regarding how the use of live polio (IIRC?) vaccines has led us to paint ourselves into a corner, perpetually unable to extinguish the last remaining reservoirs. So the original concerns about what we'd now characterize as "complex" and "nonlinear" have been validated. It was the conclusions that were drawn from those concerns that were invalid--in short, that it was too dangerous to be introduced and managed by humans. The benefits outweighed the harms, even though many of the parade of horribles exclaimed by the skeptics did in fact come to pass. Those horribles ended up being buffered and moderated, because that's how complex, nonlinear systems also tend to behave. In Complexity Theory, one of the defining behaviors of "complexity", in addition to nonlinearity, is a tendency to return to a quasi-equilibrium state even though it can never reach, let alone stay, at an actual equilibrium. Absent the dual (dueling?) tendencies of spontaneous change and regression, you have by definition either chaos or stasis.
      - vannevar 7y ago
        It was not the same debate, because innoculation doesn't have as much capacity for far-reaching consequences. With regard to the notion of relying on the stability of a complex system, they tend to return to a quasi-equilibrium state, not necessarily the state they were in before being 'kicked'. And rate of change matters. Gene editing has the capacity to vastly accelerate the rate of mutation---indeed, that's it's purpose. And even if the overall nature of the genomic system remained recognizably mathematically the same, our experience of it in this accelerated state might be quite different.
- im3w1l 7y ago
  "There are two types of screening that can be carried out as part of the IVF process. Preimplantation genetic test for aneuploidies (PGT-A) screens for any chromosomal abnormalities that may be present, while other preimplantation genetic tests (PGT) checks for specific conditions such as Down’s syndrome, Huntington’s disease and muscular dystrophy, among others. In fact PGT can now be used with IVF to test for nearly 400 rare genetic conditions, including cystic fibrosis and early-onset Alzheimer’s." https://blog.ivf.com.au/embryo-screening https://blog.ivf.com.au/embryo-screening
  - wahern 7y ago
    Many chromosomal abnormalities can be reliably detected at 10 weeks into a pregnancy, if not earlier. 10 weeks is well within the window at which many if not most women would be comfortable terminating. In California these tests are required to be covered by insurance for at-risk women (i.e. 38 and older, etc). I imagine at some point these tests, as well as more precise ones, are likely to become standard procedure for all pregnancies, in California and everywhere else. EDIT: I mean comfortable as in willing; not comfortable as in "whatevs".
    - kabouseng 7y ago
      I understand that these tests require withdrawing amniotic fluid to analise, and / or getting genetic material from the fetus itself. And my understanding is also that to get the amniotic fluid carries fairly moderate risks of infection etc for the fetus so these screenings aren't necessarily done because of the risks not to mention the costs involved.
      - fvncc 7y ago
        I think there are some newer tests which only require maternal blood and can screen for some genetic conditions by filtering extra-cellular genetic material.
        wahern 7y ago
        Correct. I should have been explicit about the technique I had in mind: https://en.wikipedia.org/wiki/Cell-free_fetal_DNA https://en.wikipedia.org/wiki/Cell-free_fetal_DNA AFAIU, if the non-invasive tests turn up positive doctors may recommend (and patients may prefer) amniocentesis for confirmation. I just find it interesting that California would so quickly embrace such new technology. I think it became required about a year or so after the tests hit the market, even before they became widely known (obv still not widely known). But given the rising costs of healthcare, and the incredible amount of public money spent on developmentally disabled individuals[1], it makes alot of sense. For similar reasons, California has had for many years mandatory blood lead testing for all children living in pre-1978 housing. (I think in most states blood lead testing is only mandated through Federal Medicaid regulations, which require testing for child Medicaid recipients.) California's housing and population explosion coincided with peak consumption of leaded paint and leaded gasoline, so California has a uniquely acute lead problem. [1] California has very generous educational programs for the disabled (generous relative to most states), partially as a result of state-based constitutional precedent. By generous I mean a ton of money is spent as a fraction of overall expenditures, relative to most (all?) other states. This is a smallish part of why in-classroom expenditures seem meager relative to other states. Many parents, OTOH, likely have lesser opinions about how generous the programs really are. But school-based speech and physical therapists, for example, can make a very decent living in California, even in the Bay Area. Better to work through a private contracting firm; working directly for the school districts tends to pay less, though benefits are better. I know at least one serial entrepreneur who started, built-up, and sold two school-based therapy contracting firms, and has already started a third.
- dependenttypes 7y ago
  Some genes have a (much) higher chance to be passed on than others.
soulofmischief 7y ago
I think that would make for a good book, exploring the society and problems which result from a genetically modified caste of people who are prevented from breeding with non-modified people. A modern-day Romeo and Juliet.
- imron 7y ago
  The film Gattaca explores some of these themes.
  - TheGallopedHigh 7y ago
    Great film. For those who haven’t yet seen it, I would highly recommended it
anovikov 7y ago
Well that could be a problem in Western countries, but we are speaking of China. Their political system and their culture - their people's intrinsic sense of right and wrong - will be fine with that.

mytailorisrich 7y ago

> Are you suggesting that we should prohibit these babies from reproducing when they reach adulthood? That's currently the only reasonable thing to do.

xvedejas 7y ago

Adults only pass on half of their genes during reproduction. I imagine at least in the case of in vitro fertilization there's a fair amount you can do to make sure the harmful genes aren't the ones passed along, so long as the parent doesn't have two copies of an autosomal dominant harmful mutation. I wouldn't be surprised if more advanced methods exist either; as a carrier for a rare genetic disease maybe I should figure this out.

wahern 7y ago
You can't argue with the "but what if" line of reasoning because there's always another hypothetical that could lead to the destruction of humanity or, at the very least, one more mutant baby than anticipated. And that's the problem here: these arguments boil down to "too dangerous", but that's not a characteristic amenable to empirically grounded, reasoned debate. We can only have a scientifically constructive discussion within the context of a concrete, particularized therapy--disease, editing vector, gene, etc. Even then it's difficult, but at least you can reach a point at which you can agree to disagree on an actual, concrete scientific question. Everything else is philosophy and politics. I think what people are trying to justify is an a priori assumption that gene editing (or germline editing if they're a little less cautious) is special and distinct. But I don't think you can scientifically justify that distinction from a harm avoidance perspective. Just because the technique is medically and scientifically distinguishable doesn't mean it's analytically distinguishable. And of course one of the principal drivers of these therapies, at least initially, is stopping the types of mutations that are feared but which already exist in nature. So it's simply a belief that you hold; full stop. It's a legitimate belief, and may even be strongly informed by science, but it's like believing in God or aliens or the utility of Mars colonization--we might as well just put labels on our foreheads so we know where the argument will end up without actually having to argue. Knowing the other person's starting point, and assuming the best versions of their likely arguments, most of us here can arrive at the other person's conclusions independently.
- vannevar 7y ago
  I think what people are trying to justify is an a priori assumption that gene editing (or germline editing if they're a little less cautious) is special and distinct. Gene editing is special and distinct, in the sense that the genome is a complex and nonlinear system, where small errors can be amplified into large consequences, not only local, biological consequences but social as well. In cases where technology offers such potentially extreme leverage, it is scientifically justifiable to tread cautiously to avoid great harm.
  - wahern 7y ago
    The same debate occurred regarding innoculation nearly 250 years ago. In fact, it's still occurring. Moreover, we're still stumbling--just last week I think someone posted an article to HN regarding how the use of live polio (IIRC?) vaccines has led us to paint ourselves into a corner, perpetually unable to extinguish the last remaining reservoirs. So the original concerns about what we'd now characterize as "complex" and "nonlinear" have been validated. It was the conclusions that were drawn from those concerns that were invalid--in short, that it was too dangerous to be introduced and managed by humans. The benefits outweighed the harms, even though many of the parade of horribles exclaimed by the skeptics did in fact come to pass. Those horribles ended up being buffered and moderated, because that's how complex, nonlinear systems also tend to behave. In Complexity Theory, one of the defining behaviors of "complexity", in addition to nonlinearity, is a tendency to return to a quasi-equilibrium state even though it can never reach, let alone stay, at an actual equilibrium. Absent the dual (dueling?) tendencies of spontaneous change and regression, you have by definition either chaos or stasis.
    - vannevar 7y ago
      It was not the same debate, because innoculation doesn't have as much capacity for far-reaching consequences. With regard to the notion of relying on the stability of a complex system, they tend to return to a quasi-equilibrium state, not necessarily the state they were in before being 'kicked'. And rate of change matters. Gene editing has the capacity to vastly accelerate the rate of mutation---indeed, that's it's purpose. And even if the overall nature of the genomic system remained recognizably mathematically the same, our experience of it in this accelerated state might be quite different.
im3w1l 7y ago
"There are two types of screening that can be carried out as part of the IVF process. Preimplantation genetic test for aneuploidies (PGT-A) screens for any chromosomal abnormalities that may be present, while other preimplantation genetic tests (PGT) checks for specific conditions such as Down’s syndrome, Huntington’s disease and muscular dystrophy, among others. In fact PGT can now be used with IVF to test for nearly 400 rare genetic conditions, including cystic fibrosis and early-onset Alzheimer’s." https://blog.ivf.com.au/embryo-screening https://blog.ivf.com.au/embryo-screening
- wahern 7y ago
  Many chromosomal abnormalities can be reliably detected at 10 weeks into a pregnancy, if not earlier. 10 weeks is well within the window at which many if not most women would be comfortable terminating. In California these tests are required to be covered by insurance for at-risk women (i.e. 38 and older, etc). I imagine at some point these tests, as well as more precise ones, are likely to become standard procedure for all pregnancies, in California and everywhere else. EDIT: I mean comfortable as in willing; not comfortable as in "whatevs".
  - kabouseng 7y ago
    I understand that these tests require withdrawing amniotic fluid to analise, and / or getting genetic material from the fetus itself. And my understanding is also that to get the amniotic fluid carries fairly moderate risks of infection etc for the fetus so these screenings aren't necessarily done because of the risks not to mention the costs involved.
    - fvncc 7y ago
      I think there are some newer tests which only require maternal blood and can screen for some genetic conditions by filtering extra-cellular genetic material.
      - wahern 7y ago
        Correct. I should have been explicit about the technique I had in mind: https://en.wikipedia.org/wiki/Cell-free_fetal_DNA https://en.wikipedia.org/wiki/Cell-free_fetal_DNA AFAIU, if the non-invasive tests turn up positive doctors may recommend (and patients may prefer) amniocentesis for confirmation. I just find it interesting that California would so quickly embrace such new technology. I think it became required about a year or so after the tests hit the market, even before they became widely known (obv still not widely known). But given the rising costs of healthcare, and the incredible amount of public money spent on developmentally disabled individuals[1], it makes alot of sense. For similar reasons, California has had for many years mandatory blood lead testing for all children living in pre-1978 housing. (I think in most states blood lead testing is only mandated through Federal Medicaid regulations, which require testing for child Medicaid recipients.) California's housing and population explosion coincided with peak consumption of leaded paint and leaded gasoline, so California has a uniquely acute lead problem. [1] California has very generous educational programs for the disabled (generous relative to most states), partially as a result of state-based constitutional precedent. By generous I mean a ton of money is spent as a fraction of overall expenditures, relative to most (all?) other states. This is a smallish part of why in-classroom expenditures seem meager relative to other states. Many parents, OTOH, likely have lesser opinions about how generous the programs really are. But school-based speech and physical therapists, for example, can make a very decent living in California, even in the Bay Area. Better to work through a private contracting firm; working directly for the school districts tends to pay less, though benefits are better. I know at least one serial entrepreneur who started, built-up, and sold two school-based therapy contracting firms, and has already started a third.
dependenttypes 7y ago
Some genes have a (much) higher chance to be passed on than others.

soulofmischief 7y ago

I think that would make for a good book, exploring the society and problems which result from a genetically modified caste of people who are prevented from breeding with non-modified people. A modern-day Romeo and Juliet.

imron 7y ago
The film Gattaca explores some of these themes.
- TheGallopedHigh 7y ago
  Great film. For those who haven’t yet seen it, I would highly recommended it

anovikov 7y ago

Well that could be a problem in Western countries, but we are speaking of China. Their political system and their culture - their people's intrinsic sense of right and wrong - will be fine with that.