Column: Are there some medical questions that are best left unanswered?


For the Valley News

Published: 04-03-2023 9:54 AM

Here’s a thought experiment. What if, after Roe v. Wade was decided, humanity decided that additional research on birth control was too contentious to explore. In such a world, Roe v. Wade would be the final word on the question of when life began (i.e. after the first trimester) and the ready availability of pre-existing birth control meant that abortion was only used in emergency circumstances.

That wasn’t the world we just lived through in the past half-century. Instead, those who vehemently opposed abortion worked tirelessly to make it illegal and, consequently, legislatures enacted laws that made it increasingly difficult to secure an abortion. Worse, in some cases radical anti-abortionists intimidated those seeking or administering abortions through aggressive picketing, murder threats and vandalism of medical centers. At the same time, pharmaceutical companies, seeing that medical abortions were increasingly under fire, worked to develop means of terminating pregnancies without needing to go to a clinic.

The events of the past several years brought us to the world we live in today, a world where a case before Matthew J. Kacsmaryk of the Northern District of Texas could result in banning the national availability of mifepristone, the “abortion pill,” which is used in half of the legal abortions across the country. It is a world where the question of when life begins remains unsettled, leading legislators in some states to introduce bills that could charge a woman with a potentially fertilized egg with murder. It is a world where jurists can undo scientific advancements for ethical and moral reasons.

It’s too late to put the mifepristone genie back in the bottle. Mifepristone was developed to fill a need in the marketplace, a need to abort a child without requiring the intervention of a medical professional? But mifepristone might be a harbinger of ethical questions on the horizon.

There are several developments in the medical technology area that could have more far-reaching impact than birth control.

For example, early indications are that CRISPR gene editing technology will be able to control sickle cell anemia. Should that be the case, will we take the steps to do so? Assuming we continue finding ways to edit genes associated with medical defects, where do we draw the line? Should we use genetic technology to make it possible to eliminate all genetically linked birth defects? To eliminate all genetically linked diseases? To assure everyone has 20/20 vision?

The research on artificial intelligence (AI) is another area where we need to think through where we are headed. Thomas Friedman’s recent article on ChatGPT-4 in the New York Times describes an interface between genetic research and AI that could have thrilling or chilling consequences. The article reports that latest forms of AI can perform scientific experiments with proteins that it would take scientists years to perform, accelerating research in that area. The article explains that proteins “drive the behavior of the human body and all other living things,” which means that whoever controls the research on proteins could ultimately “drive the behavior of the human body and all other living things.”

Given that very real possibility, I offer this question: who will control the direction AI research takes? Based on our experience with social media the answer would appear to be the private sector. But it’s one thing to allow Facebook and Twitter to censor themselves but quite another thing to allow CEOs like Elon Musk or Mark Zuckerburg to decide how to “drive the behavior of the human body and all other living things.” And if the private sector does not have free rein to conduct research, who determines the limits?

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Over the past several weeks several articles have appeared describing the far-reaching changes that AI will bring to our world, changes that will be occurring at an astonishingly rapid rate. Near the conclusion of his article on ChatGPT, Friedman poses this question:

“Are we ready (for the dawning of the latest developments in AI)? It’s not looking that way: We’re debating whether to ban books at the dawn of a technology that can summarize or answer questions about virtually every book for everyone everywhere in a second.”

To get ready for the forthcoming developments in AI we need to engage in debates about the future we want. Instead of debating the “woke” content in textbooks, legislators should debate how we want AI to transform our way of life.

Instead of debating whether to teach creationism — an issue in play in the West Virginia Legislature — we should be debating the ethics of genetic research. We might have a chance to manage our future if we have these debates now. We missed out on a national debate on mifepristone before it was widely distributed. A national debate on how to use genetic technology and AI would be daunting… but far more meaningful and important than deliberating on the definition of “woke.”

Wayne Gersen lives in Etna.