Brews and Views events are moderated discussions addressing fascinating and provocative areas of bioscience and engineering. The series is a collaboration between the Institute for Quantitative Health Science and Engineering (IQ) and the Center for Bioethics and Social Justice that began in the fall of 2017. These casual discussions engage researchers and scholars in considering the implications of innovative biomedical research for patients, people, animals, and populations.
Proponents argue these studies could reveal new ways of treating disabling aspects of autism and improve quality of life for those on the spectrum. Opponents of genetic research raise concerns about eugenic applications of genetic research results and argue that more money should go toward research on services. How do we resolve these tensions? Is predicting autism from genetic data possible or desirable? Are there other potential benefits of genetic research that outweigh the risk of eugenic applications? How much money should go toward genetic research in autism versus research on service provision, addressing societal barriers, and promoting inclusion? As an autistic person, would you feel comfortable participating in genetic research? As a non-autistic person, would you enroll in a genetic study on autism as a "control"? Would you enroll your child?
Generative AI holds tremendous promise for improving healthcare. The future healthcare workforce may be highly dependent on or displaced by AI, considering it can support providers by automating repetitive tasks, providing valuable insights, and improving outcomes. That said, trust in the healthcare provider is paramount to care, rooted in the quality of patient-doctor relationships, effective communication, and shared decision-making. This discussion explores what, if any, circumstances could Chat GPT and other AI tools competently support, or even substitute, for a physician.
There were 610K cancer deaths and 1.9 million new cancer diagnoses in the U.S. in 2022. Roughly 150K cancers were diagnosed with five current screening techniques, mostly in advanced stages when treatment is less effective. That leaves 1.7 million cancers that are diagnosed after a patient is symptomatic. Screening for multiple types of cancer at earlier, treatable stages saves lives. Companies are marketing liquid biopsy tests and claim to have met the lofty objective of early screening for many cancer types. However, if you look at the data, how valid are these tests for early detection? Are they ultimately going to be clinically useful? And, who will pay for the 110 million Americans over age 50 who should be tested annually?
The science of human reproduction is leading to innovations that could dramatically impact reproductive health. Can society and the judicial system keep pace with the technologies of in vitro fertilization (IVF), stem cell biology, artificial wombs, and in vitro gestation? Our expert panelists will dive into the scientific, ethical, societal, and legal aspects regarding the creation, storage, and disposition of embryos and fetuses, and technologies that could change how human gestation occurs.
GMOs (genetically modified organisms) have been the subject of intense controversy for decades. They hold the potential to improve yields, make foods more nutritious, and enhance the resistance of crops to droughts, pests, and diseases. At the same time, critics worry that GMOs are typically associated with centralized, intensive approaches to agriculture that are socially and environmentally problematic. Focusing especially on herbicide-resistant crops, insecticidal crops, and golden rice, we will shed light on the strengths and weaknesses of GMOs from both a scientific and an ethical perspective. What are the most promising applications for GMOs? What are the most serious worries that need to be addressed? How can they be developed in ways that are most beneficial to society?
Since the start of the pandemic nearly a year ago, people in the U.S. have made a concerted effort to support local businesses by shopping and eating locally. The trend to eat local foods and even to become “locavores” has circulated in sustainability discussions for years. Buying local produce, meats, and dairy seems an obvious way to reduce one’s “carbon-footprint,” in addition to supporting local business. But is eating local really better for the environment? Is it an effective way to support the economy? Is it even realistic given the cost of food and limitations on local production? With the global population increase, is local food enough to keep the world fed sustainably? Could the value of supporting one’s community make these questions irrelevant?
As the COVID-19 pandemic continues to ravage people’s lives, societies and economies, we continue to struggle to determine if protective immunity can be acquired through infection or immunization, and whether protective immunity gives you a pass, or an obligation, to participate in “normal” social functions. If there is an effective vaccine on the horizon, how will we determine who will be immunized first, or at all? In this discussion we will describe what is known about immunity to the virus that causes COVID-19, review what vaccine strategies may lead to protective immunity, and discuss the rights and responsibilities for those individuals who have immunity.
The impact of COVID-19 on the health of the world’s economies is as variable as the viral infection is on human health. Recovering from the economic collapse brought about by COVID-19 will take time, money and determination. Just as in healthcare, thoughtful guidance and comprehensive planning is needed to restore the economic health of local, national and global communities. What are the therapies for ailing economies? Is an “economic vaccine” also 12 to 24 months away, or can recovery happen more quickly? What are the sequelae of this pandemic on world economies? In these tumultuous, unprecedented times of global economic upheaval, our panel will address both immediate action and long-term planning strategies necessary to bring back jobs and restore economic growth in Michigan and beyond.
Children appear to be at reduced risk of developing severe COVID-19 disease after infection with SARS-CoV-2 virus, yet they will be dramatically impacted by this pandemic. From changes in education that require at-home learning and how we view human contact, to job loss and economic strain, there are many ways this virus could potentially harm our children. It is our obligation to think through these issues to ensure healthy lives for our children during and after the pandemic. We consider several questions: How will social distancing impact children? How can we use online learning to facilitate education? How can we prepare for the next epidemic? How do we deal with the direct and indirect effects and the social sequelae of this pandemic? How do we effectively communicate information to our children without increasing or generating fear?
Humanity is at the next frontier—modern technologies have put us all on the same pandemic forefront at the same instant in time—and we are all in this together. The novel coronavirus called SARS-CoV-2 that causes COVID-19 disease presents scientific, communication, medical, societal and ethical challenges and controlling this pandemic will require that we think and act together, but live apart—at least for now. The Brews and Views Forum has taken on challenges across the full biomedical ethics spectrum, but we usually start with a hypothetical—this is no hypothetical, this is real and the instant in time is now. We will use this Brews and Views: At Home Edition to inform and help each other. From our next door neighbor to societies in six other continents, we need to align our goals to address this global crisis. Modern transportation has spread this virus globally and the internet now enables us to manage it globally—we must be up to this challenge. We have assembled a group of experts to address the full spectrum of challenges ahead as we face this new frontier in global society and global health.
Scientific discoveries have the stunning potential to change everything—from how living things survive or thrive on the planet to raising questions of what it means to be human. The impact of related discoveries therefore is profound, with the potential for transforming our lives for the better—or for the worse. Who should govern the practice and application of science? Should those with expert scientific knowledge have explicit or implicit authority over their respective discipline? Alternatively, should those without such expert knowledge have a say in regulating scientific inquiry? Good, or bad, who ultimately is responsible for the impact of what scientists create when their discoveries are put into broad use? Moreover, what is the role of institutional oversight in those decisions?
With millions of human genotypes now determined, our information about human genetic variation is increasing faster than many other areas of science. That pace stokes an appetite for expanded investment. But has this information led to measurably improved, actionable understanding of illness and disease? Genomic medicine is fundamentally a biological and public health topic. Is the genome the major repository of the information we need in health? If so, to what extent might genomic approaches reduce the burden of disease in the community? Will they meet the promise of preventing/eradicating disease and illness? If not, what alternative approaches carry greater promise? What data is most salient/compelling to sway funding sources?
Are we compelled to change consumption habits to ensure a sustainable world? Many are unwilling to give up burgers and steaks yet the resources to produce a pound of beef are 5x greater than a pound of chicken, and 10x greater than a pound of grain. Animal agriculture is a way of life for millions but there are concerns about the processes used to raise farm animals. An alternative is to grow meat in a dish; cultured lab meat will be a reality for consumers in 2019. Would you eat cultured steaks? Might such meat appeal to vegetarians? What are the relative costs of a pound of beef produced in a dish to that produced in the field? Join us as we debate how best to feed modern humans on a shrinking planet.
Our phones know a great deal about us. They collect an impressive amount of personal data, including voice and text correspondences, internet and social media, spending habits, stairs climbed, and geographic location. They already can make assessments about our health, but what additional information can they glean about our mental health? Soon, phones could predict if we’re unhappy, depressed, or even suicidal, and might urge us to seek mental health services. Should your phone then reveal that diagnosis to your doctor, family, boss, or advisor so they might take further action? While such capabilities could effectively address mental health needs, they simultaneously raise ethical questions about privacy, algorithm transparency, and the potential for corporate manipulation of our emotions. Join us in discussing these benefit/burden thresholds.
More than 11 years after the Jurassic Park movie first piqued the public’s curiosity on the process of de-extinction, scientific advances are coming closer to making species revivalism a reality. Is de-extinction a worthy goal? How would we steer clear of negative consequences when re-introducing animals into current ecosystems? Moreover, given the number of living species that are critically endangered, might it not be preferable to focus on extant animals rather than wasting resources trying to resurrect the dead? Who should decide which species are worth resurrecting and which are not?
Artificial intelligence (AI) and robots may seem like science fiction, but in fact the explosion of AI algorithms already has profoundly altered the way we live. AI is deeply embedded in most aspects of modern living including robotics, medicine, cybersecurity, finance, automobiles, online services, and education. With AI’s unprecedented speed capabilities and predictive accuracy, there is room for concern regarding the role of humans in an AI-dominated world. How might society best encourage future development of potentially beneficial AI technologies in ways that preserve what we value about human relationships?
Most of us carry several dozen harmful genetic variants, which affect our health or may be masked by other variants we have, but which could result in more serious disease in some of our offspring. Until recently there was little any of us could do about this, other than becoming informed and perhaps modify our lifestyles. However the recent revolution in genetic engineering through CRISPR/Cas brings into view the prospect of changing these alleles permanently. Do we have an obligation to remove these alleles from the gene pool of humanity?
Some brain implants, such as those for deep brain stimulation, are well-accepted treatments for movement disorders and their use as treatment options for various psychiatric disorders is being explored. However, there are cases where brain implants may influence mental states critical to personality and affect an individual’s behavior and identity. This raises a number of ethical and legal questions. For example, if a brain-implant-induced change in personality results in undesirable or deviant behaviors that cause harm, who is responsible? Is the person with the implant? The implant itself? Or its designer? Who controls the actions of people with these implants? Should we blame the healthcare system, the technology, or the designer? What if the engineer who designed your brain implant had deviant behavior from a faulty implant—are we improving human health or spiraling down a rat-hole?
Imagine you can grow a new heart, or other organ, from your own cells in a pig. If your heart was failing, you could grow a new, perfectly matched heart and have it available when you need it. In order for this to happen we need to humanize livestock. How human should we make livestock? How close to a human is a humanized pig and when would it deserve human rights? While it might address the shortage of human organs, is it fair for the pig to be just a bioreactor for spare parts? What human organs should we produce in pigs: heart, liver, pancreas, skin and muscle? What about a human brain in a pig? Are we going too far, have we already gone too far?