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Matt Ridley on the New World of Medecine The following is an adaptation of a BBC interview with science writer Matt Ridley, conducted last December. Q: What medical discoveries lie around the corner in the next century? A: I think one of the most far-reaching discoveries in the current century will be the discovery of the genes that cause us to age. Once we’ve been able to understand which genes those are — and we know they're there, there’s no question about it: We’ve found them in mice, we’ve found them in flies — we'll be able to counteract them. Then we will slow down the aging process dramatically. My great-grandchildren might well live a very long time and might not look very old at the end of it. Q: What will the social and economic consequences of that be? A: Dramatic. Careers would go on potentially forever, since there’d be no particular reason why people should retire. More than that, I think people would delay having children. They already delay it pretty well as far as they can, in order to keep their options open in economic and mating terms. If you could quite happily have your first child in your fifties or sixties, then I think a lot of people would do that, and that would have a very depressing effect on population growth. In fact, population would start to fall very rapidly. Q: Have we more to hope for or to fear when it comes to health and disease? A: Well, if I wanted to be pessimistic about infectious disease in the next century, I could make the argument that a lot of viruses and other bugs have jumped into our species from animals, and there's good reason to think there are more to come. There are a lot of creatures which we’ve only just come into contact with at a concentrated level. Moreover, we’re living in very crowded cities and we’re communicating round the world, we’re travelling very far, so the whole globe is now the germ pool, as it were, for the germs. It is very different from a century ago. But I don't think we need to worry too much because I think we’ll keep one step ahead of these diseases, and because, on the whole, most infectious diseases are getting less virulent, not more virulent. The reason for that is because the virulent ones tend to be the ones communicated by insects, not communicated directly. Directly communicated diseases don’t like to lay low their victims, they actually want the victim to be pretty healthy so that he can spread the disease more. Q: Just give me an indication of how dramatic medical changes might be by 2100? A: Somebody looking back from the end of the 21st century will be amazed by how many things we didn’t understand. We didn’t understand what schizophrenia was caused by. We didn’t really understand what heart disease was caused by; we thought it was caused by diet, but didn’t take into account other factors like infection or social pressures and so on. The other thing that person will be surprised by is how many things were incurable. Just as we look back at 1900 and say what a lot of things were incurable then, someone will look back and say, “They really didn’t have a cure for cancer; they really couldn’t do anything about colds.” Q: What effect will our understanding of our own genetic makeup have on medicine? A: The main effect of our genetic understanding on medicine, I think, will be to individualize, then personalize, medicine. At the moment, medicine treats the population, it doesn’t really treat the individual. So it gives the same remedy for everybody and it says to everybody, “Lower your cholesterol,” for example. That’s good advice for some people but bad for others, because some people already have dangerously low cholesterol and they end up very depressed if their cholesterol goes down even further. In the future, I think you’ll go to see your doctor and you’ll have, on a chip, [a list of] all your genes. And the doctor will literally say, “Ah, for you, with this particular complaint, the best solution is this drug.” For somebody else it might be a different drug. In that sense, we’ll all at last be treated as the individuals that we are and not as the statistical parts of a population. Q: How will we reproduce in the future? A: I think most of us will go on reproducing the normal way, but there will be an increasing number of people who will use in vitro reproduction. The reason for that is partly because there’s going to be an increase in infertility. We know that simply because we're already allowing the infertile to breed [in test tubes] and, on the whole, that kind of infertility is heritable, so it’s bound to increase as a proportion of the population. Moreover . . . homosexuals who want to have their own children will probably use in vitro techniques. Q: What other choices will rich people have about how to breed? A: By 2100 I think if you're rich enough and you can travel, you will be able to have your future children genetically modified. Whether that will be legal in most countries I don’t know, but I think it will be technically feasible. It will be simple things at first, like correcting short-sightedness and before that, of course, debilitating diseases that you will be able to avoid by genetic modification. That will be pretty uncontroversial. It will get much more controversial when people start doing cosmetic things, when people start trying to make their children more intelligent by genetic modification. The question is whether we’ll consider that to be something that we should leave to the individual, or something that society should take a view about and, indeed, legislate about. Q: Is cloning viable and if so what might its consequences be? A: One of the interesting things about cloning is that you could actually do it in secret. I mean, you could actually produce a complete replica of yourself, with the right help from medical doctors, and nobody would know that it wasn’t just another baby that you’d had by normal means, because nobody knows what I looked like when I was a baby. By the time it is grown up to my age, it will, of course, look like me; but by then I won’t look like that any more, so I could go through my whole life bringing up my clone and pretending it was my child. Nobody would be any the wiser. Of course, the psychological effects on a clone of the parent's expectations that the child should behave in the way that they behaved might be very frightening. Q: What does cloning actually mean? A: The fundamental shift involved in cloning is to abandon the idea that there are two parents of each child. A clone literally has only one parent, and it’s genetically identical to that parent, just as an identical twin is genetically identical to its twin. It happens already: a lot of plants clone themselves and if you take a cutting from a plant, that is cloning the plant. There’s a lizard in Arizona that only reproduces by cloning, so it’s not unknown in the animal kingdom. But it is unknown for mammals like ourselves to do it, with the single exception of Dolly the sheep and her successors in the farm world. The problem is: how to reset the aging clock so that [the clone] doesn’t start, as it were, with its biochemistry already at the age of the parent; [otherwise, the clone] would age very much more rapidly. Q: Will there be a moral burden on the parents by 2100 in terms of pre-birth choices for their child? A: I think parents will come under more pressure, perhaps, to produce perfect children, and that could be unfortunate. Just as today's parents, particularly in large cities, come under pressure to get the best schooling for their children; in a way, it’s analogous to that. But the one thing I think that we misunderstood 100 years ago and therefore are probably misunderstanding again now, is the extent to which there is diversity in human beings and the extent to which individuals will want to do different things. For example: Halfway through the 20th century, people started thinking about in vitro fertilization. One of the things that they said was that the problem would be that people would rush out and try to have famous people’s babies instead of their own babies. Lenin was mentioned as someone who everybody would want to have as the father of their child. Well, of course, it is exactly the other way around. Q: What are you most looking forward to in the 21st century? A: Understanding the entire human genome. I think that’s a fantastic intellectual advance on the part of our species, really. What I most fear about the future is that we haven’t really done anything to improve human competence and human nature. The technology gets better and better but people don’t get better and better, and the potential for individuals to wreak havoc on their fellow members of the human race is still as great as ever. [ARTICLES] |