Monday, March 24, 2008|In “Brave New World,” Aldous Huxley described a future in which technology would free us of the pains of life, but at the cost of our humanity. Less than a century later, each week brings us news of technological breakthroughs that rival Huxley’s imaginings. Recent examples, many of which are from San Diego, include:

  • In January, Stemagen, a San Diego biotechnology company reported the first successful cloning of a human embryo.
  • Neuroscientists at the University of California, Berkeley recently reported primitive success in using brain scan technology to determine what someone is looking at. This is the next step in an attempt to “read” visual experience and is crudely an example of “reading minds.”
  • A University of Pennsylvania scientist claims to have regrown a severed fingertip — bone , nerve, muscle, nail, and skin — in just four weeks using a powder made from pig bladder.
  • Genetic testing, once prohibitively expensive, is increasingly available on the open market. One such test, developed by a UC San Diego researcher is now available as a diagnostic tool for people who have or may develop bipolar disorder.
  • San Diego is also at the forefront of regenerative medicine with stem cell research. For example, scientists at The Scripps Research Institute used mouse embryonic stem cells to create beating heart muscle, a feat recently repeated using human cells at the Technion in Israel.

Yesterday’s science fiction is becoming today’s reality. As these and other breakthroughs pass through the stages of research and development to validate results and ensure safety, society must grapple with questions that extend beyond the domain of the laboratory. Clearly we have an obligation to use our scientific prowess to alleviate pain and suffering. The question is not whether to pursue such opportunities but how to do so wisely.

We, individually and collectively, must together seek the best answers to these challenges. Where will such wisdom come from? Scientific leaders, the scientific research community and its professional organizations, governmental regulation and recommendation, and market forces are all possible sources of such wisdom. Leading scientists, many of whom work or have worked here in San Diego, have taken prominent, public roles in both creating and discussing challenging developments in science and technology. These individuals include Francis Collins, Francis Crick, Jonas Salk, and Craig Venter.

Yet wisdom is not confined to scientific leaders alone: religious leaders, politicians, judges and media figures also play prominent roles in these conversations. The unique perspective of leaders is essential for helping us all to make informed decisions, but it is certainly not the final word.

The voice of the scientific research community is most clearly heard through professional organizations and scientific publications. These contributions are also important because these are the people most knowledgeable about the science. These are the people who know best how science is done, what we know, what we don’t know, what is possible, and what is most likely impossible. This also is an important component of informed decision-making, but we need to hear from those who will be subjected to or benefit from new technology.

Some look to the government for wisdom. Federal and state regulation may succeed in preventing certain kinds of research with potential for abuse, such as human cloning for reproduction, but the mere presence of “government” and “wisdom” in the same sentence is certain to raise skeptical eyebrows. Yet when we look more closely, we see that governmental commissions and committees often provide much more nuanced guidance to the ethical thickets created by emerging technologies. Reports of various presidential and congressional committees and councils often offer remarkably insightful analyses of emerging issues, analyses from which we can learn much.

Finally, some believe the market forces will shape the most prudent choices. Products that are beneficial will survive and those that are harmful will be eliminated. But if we rely solely on market forces, we certainly have some tough questions to answer. To what extent will new technologies be available only to the wealthy? Will insurance companies harvest data on our genetic anomalies and adjust our premiums accordingly? Unfortunately, market constraints perhaps best capture the limits within which wisdom is to be found rather than wisdom itself.

Another dimension of market forces is the extent to which we now have a global economy. The problems are often global in character, but the structures for resolving those problems rarely extend beyond national borders. Regulation in one country may simply drive production offshore. Many first-rate U.S. stem cell scientists, including some from San Diego, have moved to Singapore and other countries with more money and less regulation for research. Conversely, the European Union has enacted requirements for clear labeling of genetically modified food, but the United States has few such strictures. 

Avoiding the challenging pitfalls of new technologies is not the sole responsibility of scientists, the market, or government. If the public is not part of an effort to seek wise decisions, we will have given up a role in shaping our own future. The public has a right to be part of this discussion because they will be helped or harmed by such developments and also because that research has been funded in part by their tax dollars. The questions at hand are not narrowly scientific, and they are not out of reach of the average citizen. We can and should make thoughtful judgments on these issues, but first we must be informed. That process begins in the schools and continues with thoughtful and accurate scientific reporting in the media. The Web has greatly enhanced the effectiveness of such reporting and of thoughtful discussion of scientific advances. 

Technology has always carried with it both promise and peril. Our challenge is to reap the benefits of the promises while avoiding the perils. It is both our privilege and our responsibility to educate ourselves, to identify the challenges, and to promote the best possible solutions. We can vote for candidates and ballot measures that define the contours of our technological future. We can use the Web to learn and discuss on a scale not possible as recently as 10 years ago. We can be part of community discussions that include representative voices from all interested sectors, not just the scientists. We know that a brave new world is knocking at our door. Instead of flinging the door open wide, or securely locking it, we should work together and open the door to those choices that are most likely to contribute to a better life.

Mike Kalichman and Larry Hinman are the founding co-directors of the Center for Ethics in Science and Technology. E-mail Kalichman at kalichman@ucsd.edu. E-mail Hinman at hinman@sandiego.edu. Kalichman is the director of the Research Ethics Program and professor of pathology in the School of Medicine, University of California, San Diego. His website on research ethics is here. Hinman is a professor of philosophy at the University of San Diego. He writes widely in the area of applied ethics; he is also the founder of Ethics Updates.

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