Newer Welcome to the Network State podcast.
Thank you so much for having me with all this is awesome.
Awesome, great. So I was thinking we could start
by just giving an overview of what orchard is, what embryo
screening is, maybe what DNA is, just a very, very basics.
People don't know anything about this.
And then also kind of what you're shipping now, let's get
into the moral case, right? Why it's actually important
that, you know, if you're on the left and you believe in my body,
my choice, which I think you and I do, then obviously, you know,
you, you're going to want that to extend to everything.
And if you're on the right and you believe in deregulation,
decentralization, you know, like allowing people basically a
libertarian kind of view, then again, you should come to this
to assist the idea that people's personal choices are their own
business. And certainly a parent shouldn't
be forced to do something that another parent, our person wants
them to do is not really involved in their relationship.
So why don't we, why don't we go start with the the first part
and let's talk about the technology and let's talk about
the morality and then the society.
So you got some slides, got some visuals.
So what Orchid is, is it allows parents to protect their
children in a way that hasn't been possible before.
And what we're able to do is we're able to screen the entire
genome of an embryo, to scan for thousands of diseases that
previously parents didn't have the chance to know about until
after the child was born, after symptoms already developed,
after, you know, a doctor has a really, you know, awful
conversation with the parent that sort of ends with, you
know, there's not much that we can do.
So we basically give all of that information at the earliest
possible stage when there is actually something that you can
do, which is to transfer an embryo that's unaffected.
So let's kind of start at the very beginning of the birds and
the bees, you know, how does an embryo actually form?
So what is an embryo? Embryo is an egg plus a sperm.
You know, each egg, each gamete, you know egg and sperm are
carrying 23 chromosomes that combines to create a zygote, an
embryo that grows. So you can actually see this is
how an embryo develops over those five days that it grows in
the lab. So, So what happens is that you
know, it divides into multiple cells.
On day five, you have about 125 cells.
Five of those cells are sampled from the outer membrane, which
is called the trifecta Derb, and those are the ones that are
actually used in orchids analysis.
So this process of actually biopsying or giving a haircut to
embryos has actually been happening for over 2 decades.
It's just that in that, you know, 5 cell biopsy that only
has 30 pika grams of DNA, historically, you haven't been
able to get very much information off of that.
You only got something called chromosome information, right?
Which you can kind of think of as like chapters in a book
versus what orchids able to do is actually read every single
letter, every single base in those chapters as opposed to
just that. Here's the thing.
The thing is this doesn't look you know, at the at the one or
two or four or 8 or 16 cell or whatever cell stage.
It really doesn't look human, right?
It is very much you can, you can decide you take a continuous
process and every ethicist and every person will have a
different point on that process as to when it's a human being
right. But like probably most would
agree that, well, actually, no, some wouldn't, that the sperm
and egg are themselves, you know, there's there's biblical
injunctions against spilling one seed on the ground and so on and
so forth, right. So if you think it's actually a
quote human at the moment of an embryo, then you'll have one set
of moral intuitions. And if you think it's not really
a human then but it might become a human three months or six
months or whatever months from now.
That's, you know, the whole termination debate or what have
you. Yeah, yeah, I think.
It's important to put this on screen because that what you
just put there, it really doesn't look like a human.
If you were if you told machine learning to ask is does is that
look like a human or not? It's not, you know, it's not
doesn't look like a human, right?
And whether it looks like something is not everything, but
it's something, you know, in the sense of it's a this a
microscopic little cluster of cells that it, you know, legal
systems will differ based on whether or not you consider this
to quote be a human or not, right?
And many legal systems do not consider it to be a human.
This is like one of those things where it's like.
Yeah, yeah. I, I, I, I totally, I totally
agree. I think it's like it's very
clear that, you know, this is not visible to the naked eye.
It's, you know, there's, there's no organs.
Oh yeah, and how small is it you actually?
You haven't indicated that on screen.
Yeah, yeah. It's not visible to the naked
eye, right? So this is under a microscope.
You can't see this without a microscope.
No. If you were to see a Petri dish,
you would not be able to see anything, right?
It's like smaller than a grain of sand.
But I think even separate from that, like the question of is
it, you know, human, is it not like the core thing is that
Orchid doesn't actually change anything about the IVF process,
right? The way that IVF works, the way
that it's worked for 40 years is that you extract eggs, you
create embryos, you create multiple embryos and you have to
choose one to transfer, right? So if you're opposed to creating
embryos, then you should just be you, you should just be opposed
to IVF in general, which is where, you know, 12 million plus
babies have been born, right? The thing that Orchid is doing
is saying that, hey, you have these, you know, 45610, you
know, 15 embryos, however many embryos that you were able to
create during that cycle. And the question is, which one
do you transfer? The previous method is that you
transfer with extremely limited information.
And then with Orchid you have the opportunity to have much
more information. So there isn't actually a new
moral question of should we create embryos or not, or should
we transfer embryos around, right?
That question has already been decided by IVF.
And there this question of, you know, which embryo do we
transfer is just inherent in every single IVF cycle, right?
If you, if you create more than one embryo, then that decision
has to be made. It's just that right now it's
made be a kind of a beauty contest.
So what will happen is that an embryologist will look at these
images and say, OK, this one has a higher morphological grade,
This one has a lower morphological grade.
Or alternatively, they'll use really limited genetic
information. So that's kind of chromosome
testing, what I'm going to get into, right?
So, you know, humans have 23 pairs of chromosomes.
And if you have a abnormal number of chromosomes, then
it's, it's frequently not compatible with life, right?
So chromosomes are organized from largest to smallest,
meaning they know the, the, the number of genes, the number of
bases that are on chromosome 1 is much larger than on the, the
sex chromosomes are much smaller.
So most of you know, if you have a monosomy, meaning a missing
chromosome or an extra chromosome on, you know, most of
these chromosomes are just not compatible with life.
It's sort of unique situation where it is compatible with life
is Down syndrome, Trisomy 21. And I guess kind of the key
point here is really, you know, if someone asked you to
proofread your book and the only thing that they could tell you
is, you know, your book has an extra or missing chapter, you
wouldn't really think that was a very good proofreader, right?
But that's really all that existing genetic testing can
tell you is do you have a on embryos anyways?
Do you have an extra or missing chromosome?
So what whole genome sequencing and what orchid can do is go
much, much further. It goes actually really deep
into every single letter in each of those chromosomes or
chapters, right? So any type of typo, whether
that's an extra base and an insertion, a missing base, a
deletion, those can all be detected.
So there's actually thousands of different genetic diseases that
have been cataloged by geneticists, you know, in the
academic community over the last two decades.
And, you know, what's really powerful is being able to
actually scan for these ahead of time rather than after it's too
late, right? Like, you probably don't know a
lot about, you know, the names, a lot of these conditions, you
know, neuro ocular disorder, like individually each of these
conditions is really rare. But in aggregate, and if you add
them up there, there a lot of people are affected.
So, you know, if you look at like the rare disease community,
they'll say that, you know, 10% of Americans are affected by by
rare disease. And the vast majority of those
are genetic. The vast majority of those who
are affected are are children. And 95% of these conditions
don't even have treatments, you know, much less a cure.
So, you know, what's really cool is that this is already
happening, right? Like babies have already been
born, you know, through orchid that have been screened for this
freedoms had that have had their entire genome screened.
And you know, the reason why this is really powerful is that
if you look at pretty much every single outcome, whether it's
pregnancy or healthy baby, a huge component, a double digit
component is actually genetic, right?
So if you look at miscarriage, about 50% of miscarriages are
due to genetic issues in the embryo, right?
So there's people who have recurrent miscarriages due to
genetics that, you know, if they do embryo screening, don't have
to, you know, suffer that same fate.
If you look at infant deaths, you know, over 1/4 of infant
deaths in the NICU, the neonatal intensive care unit, are due to
underlying genetic diseases. Again, this is like a huge
category of sort of the maximum amount of of suffering that you
can imagine for a parent and a child that could just be totally
avoided via embryo screening. And if you look at, you know,
another category like moderate to severe intellectual
disability, about 60%, you know, there's a about a 60% diagnostic
yield for those folks. And you know, a a large fraction
of these are caused by what's called de Novo mutation.
So that means that there's a new or spontaneous mutations in the
embryo that are not present in the parents.
And a lot of these are paternally inherited, meaning
older fathers are contributing more de Novo mutations.
So just interrupt for a second. IVF already exists.
Implantation diagnosis already exists.
Yes, most people who do this, millions of people have done
this. Millions of people are already
screening, and they're already screening for, for example,
moderate to sphere intellectual disability.
Because if you're actually doing it, why would you?
Why would you not, right? So this screening, the moderate
to severe intellectual disability, this is happening in
the pediatric setting, right? So a child will come in and
they'll be affected, right, with, with either, you know,
autism or intellectual disability or epilepsy.
And then geneticists will sequence them and find out what
the cause is, right? The only difference is that
instead of waiting until after symptoms happen, we're we're
moving that timeline all the way up to the embryo because now we
have this new ability which is able to actually sequence the
entire genome of the embryo other than just this tiny
fraction, just the chromosomes, but right so.
Actually that's right. So some fraction things can be
caught preconception or even pre like even before people are
married or what have you because you can get you can sequence or
carrier test them. But many other things that are
de Novo you can only catch postconception but potentially
postconception but pre implementation.
Because exactly. Yeah.
And I think a really important piece here is that right now the
situation is that, you know, we talked about chromosome testing,
right? So via NIPT, pregnant mothers at
10 or, you know, 15 weeks are already getting information
about chromosomes, right? They're already finding out, OK,
my child has Down syndrome. And now they have an option,
right, which is either terminate or have an affected child's,
right? They're already put in that
position, right. And people are already choosing
to terminate. We're already choosing to, you
know, continue those pregnancies, right.
So it doesn't, it's, it's fully sort of more compassionate from
a emotional, physical level to just move that timeline forward
to the to the point of transferring an embryo as
opposed to. Pre implantation rather than
post implantation. Yes, yes, exactly.
So that's what's kind of really surprising.
Just just to define terms, right?
There's like, you know, there's just screening an adult and
giving them their genome before they're, you know, having any
partner of any kind. Then there is what's called
preconception testing, which is similar except the difference
being that now your genome and your partners are being analyzed
together to determine whether or not your children will
potentially have, for example, a chance of having a double
recessive if both parents have a Mendelian disease.
And there is post conception when the embryo exists, but pre
implantation, which is in the context of IVF where you've got
the 9 embryos for example, in your diagram and they're these
tiny microscopic grain of sand things.
And then there is post implantation when you know the
the embryo is actually in the mother's room and it's
developing and then you're screening, you know that and.
Basically at each of those levels, different amounts of
information are being revealed, right?
So correct, that's right. Carrier screening only looks at
recessive disorders, right? But we're saying, hey, you know,
you, you probably care about dominant disorders, right?
You care about cancer, right? But that's just missing from
carrier screening, right? So.
In a sense, if you make a distinction in an embryo and a
three month old fetus, which most people I think do by moving
more testing. Now of course IVF itself is a
procedure and a significant 1 and so on and so forth.
But if someone's doing IVF, then because you can screen pre
implantation, you can catch things so that you don't have to
screen post implantation when there's actually, it's actually
developing in the womb. It's actually a more, as you
said, more compassionate kind of thing.
Yeah. Yeah, exactly.
I mean, maybe it's obvious, but the main cost of that is doing
IVF in the 1st place. And that's a whole separate
topic. But we want to reduce the cost
of doing IVF. We want to, let me see overhead.
A lot of people are working. On that and I think, yeah,
exactly. And I think even to focus on
IVF, right, So we've also already resolved the moral
question of should people be allowed to do IVF electively,
right. So egg freezing and IVF are
identical processes. The question is just, you know,
do you freeze the eggs or do you actually fertilize the eggs?
But essentially women who are perfectly fertile, they have no
infertility issue or already using IVF, using egg freezing
prophylactically, right, proactively to basically, yeah,
preserve their fertility, right. So this idea that IVF can be
used electively without an infertility diagnosis has
actually also already been resolved for the last 10 years,
right? So even that question of, you
know, should people be using IVF who don't have an infertility
issue? I think that question has
already been answered, right? It used to be the case that egg
freezing was only recommended for women who had, you know,
cancer diagnosis, right? They were going to be doing
chemotherapy and then it was it was an option to preserve their
fertility, right? But, you know, over the last
decade, it's sort of advanced beyond that.
It's no longer experimental. Yeah.
You know, millions of people have, have, have done, you know,
that procedure as well, right. And obviously gay parents are,
are using IVF, you know, to form their families too.
So I think it's really sort of I, I think at this point it's
already a personal decision. Do you want, you know, to use
IVF to form your, your family? So again, it's sort of just
like, OK, now once you've made the decision to use IVF, how
much information do you want? Do you want a little bit of
information or do you want sort of the maximum amount of
information that science can provide?
Yeah. So kind of just moving on,
Right. So, so, so I really wanted to
kind of focus on this monogenic case because this is sort of, I
would say, you know, very clinically bulletproof in the
sense that, look, all of these conditions are already screened
for in the pediatric setting. In the adult setting, there's no
debate about, you know, if you have this variant, does it lead
to these disease, right. They're all considered
definitively associated with these diseases.
So it's really just about, you know, moving that timeline
forward. I'd say the second side of the
testing is using what's called, I guess, sorry, just to kind of
like hammer that point home on the monogenic side, right?
So we have users who've had, you know, children who have terminal
disorders, right? So this is a child that has this
brain disorder called less encephaly.
You know, vast majority of children with this condition die
before they're 10 years old. There's no cure.
So I think it's, it's honestly, I think quite cruel to in any
way stigmatize these parents, right?
They've sort of given up their entire careers to be caregivers
for, you know, these very severely affected children.
And now they want the opportunity to have a child that
is healthy, that doesn't have to suffer for conditions in the
same way that their first child did.
And I think that that's an extremely important vulnerable
population to embrace rather than to somehow stigmatize.
And I just feel, you know, extremely strongly about these
families. I mean, this is kind of like the
the reason why I started the company.
So yeah, I just think if if people understood what it is
that they're they're going through, it's like a very human
desire, right? The idea that you know, you want
to, you know, see your child, you know, grow up, grow old
rather than having to bury them, right.
And this is a very this is the reality.
All the people who are like, just roll the dice.
What about the people who didn't want to roll the dice and they
got a very bad roll of the dice and very bad luck, right?
You know, there's no point in, you know, just roll the dice is
just some silly type of thing that people will say without
actually thinking about the consequences of it for people
they don't know, like like Mrs. Crown over here.
Yeah, exactly. I mean, they're not on the hook
for the for the lifetime, you know, of, of medical bills,
right. And I think that, you know, it's
not diminishing, you know, you know, this this baby's life or
any, anyone's life to, to screen and to say, hey, for my next
child, I don't want them to be affected by that condition.
I think that's kind of one of the tensions that I think people
somehow don't understand that, hey, you know, if I choose not
to drink during my pregnancy, that's not saying all people
with fetal alcohol syndrome should be deleted.
It's saying for me, for my child, I don't want them to be
affected by fetal. Of course, these arguments that
the some of these folks are making are just so silly because
it's like saying, you know, I think we should put on
seatbelts. So I was in a car crash.
Do you think I shouldn't exist? Yeah, exactly.
It's exactly the same as like it just makes no everyone.
Is equally I want people to be hurt by car crashes, you know?
Yeah, yeah, exactly. And, and if anything, it's sort
of like even more unfair than a car crash because, hey, it's
like, okay, there was like a clear human error, you know, 90%
of the time for why that car crash happened, this is sort of
like, okay, you just a random typo just, you know, got added
to your DNA. And then, you know, you just,
you know, your organs don't form, your limbs don't form,
your, your skull doesn't form, right.
That's so it can just be very catastrophic.
It's, it's like the, you know, the, the there's a meme about
like, did you have breakfast today?
They genuinely can't contemplate A counterfactual.
Fundamentally, the the concept really what it boils down to I
think is misery loves company. People who have some form of bad
thing happen to them just want other people to also be
miserable. Some of them, others don't.
Right. Why don't we go to the next
slide Mark? Well, actually, I don't know, I
kind of like basically me saying something and then you doing
your commentary over it. So I actually think that's kind
of good. Like, do you want to do this
summary really quick of like what all this means?
Actually thought that was really good if you want to just like
have one. Yeah, I mean, my summary is, but
we'll add it and pull everything.
Yeah. My summary is, A we've got
Tolman IVF babies. B we already are doing diagnosis
prior to implantation of IVF babies.
C we have the opportunity to improve that diagnosis by simply
adding polygenic scoring on top of monogenic scoring.
D, it's a parent's decision as to whether to do that or not.
E It is not somebody else's decision really, as to obviously
whether those parents got married in the 1st place, how
they choose to have children, whether they choose to have
children. F Much of the hand wringing over
this is based on bizarre, illogical emotionalism that
doesn't encounter the reality of what it is to have a child with
a genetic disorder and to make somebody else roll the dice of
doing that. It's it's kind of like, you
know, I prefer a car without seatbelts.
Therefore you must have a car without seatbelts.
You know, it's kind of like that.
You're literally preventing somebody else from taking a
precaution because you want to roll the dice.
OK, I mean, fine. If you want to roll the dice, be
my guest. Why should somebody else have to
do that again? Why should some other hair and.
I also think it would be if you just did one quick recap of
like, what are the moral questions here, right?
Which is like, OK, should we create embryos That's already
been. Right.
So moral questions, should I, should IVF be legal?
OK, and by the way, we can reverse the same, you know, kind
of argument. Do you hate all the IVF babies?
You hate 12 million people? Do you want them all to be
eradicated because you're so anti IVF?
You IVF hater, you IVF bigot, blah blah blah, right?
Like you can reverse all these retarded arguments on them.
OK fine. So #1 should IVF be legal?
OK, If yes, all right #2 should pre implantation genetic
diagnosis be legal? Which it is, which is basically
like if you've got and by the way, you need that because IVF
embryos often have something wrong with them, employees or
something like that. So you have to screen them
before implantation. So screen them for anemployees,
which are macroscopic chromosomal issues, Why wouldn't
you screen them for microscopic ones, which are like monogenic
discorders? And if you can do that, now that
we've got the technology, why not polygenic?
There's really no or probably minimal added cost.
I assume the amplification step to actually get the DNA from
there and and screen it. It's like minimal biochemical
added cost. So let me put it like that.
There might be fixed cost in terms of doing the data analysis
and so on. So if you if right, so if you're
screening should be able to do Ant plays.
Almost certainly, yes. Monogenic, absolutely.
That's always really standard of care and many parents choose it.
And polygenic? Guess what?
First of all, it's already happening.
And second of all, you can't, you can't draw the line for
somebody else to marry somebody. So they're already picking the
genes of the other partner. If they want a tall partner or a
partner who's good at Frisbee, like that's already their
choice, right? They're already, in a sense.
Right. The biggest impact on air
embryos is going to be your partner.
It's never, it's never going to be the case that your embryo
screening is going to be have a bigger, you know, it's 50% of
the DNA you're you're choosing right there.
So right. Yeah.
So, so you know, like obviously that's not roll the dice.
You're completely intentional about partner choice, you know,
and so this is just really, you know, editing around that
equilibrium. It's like plus minus whatever
percent around that 50% that you've already got in there.
So, you know, many medical procedures, by the way, you
know, heart transplants, there are people who attack that as
necrophilia. Right.
Actually recently, you know, fecal transplants, which sound
gross, have actually been really valuable for people with IBS or
other kinds of things to fix their gut microbiome.
And you know, obviously there's a lot of people who are mad
about not The thing is, it's one thing to be mad maybe
specifically about specific aspect of the COVID vaccine, but
a lot of people have just turned that into being against the germ
theory of disease writ large. Like they generally don't
understand Cox postulates or transmission pathogenesis.
They they just don't just don't understand the immune system or
how vaccines even work. And of course there's like, you
know, stupidity on on both sides, many sides on that on
that issue. But the point being that many
medical procedures, if you're just describe them to like a
medieval peasant, they'd. Be destroyed by.
Them. Yeah, it's like, it's extremely
repugnant seeming right, like boy, like, I mean, so first of
all, just any organ, organ transplant.
You could basically make the argument that, you know, if you
break your leg, then you didn't God want you to be unable to
walk for the rest of your life. Yes, maybe you could.
But you could also say, hey, look, why don't we put a cast on
it and see if you can if it gets better.
That's like the yeah. So like for example, organ
transplants are an obvious 1. Isn't that like defiling the
dead or what have you read? Like, you know, necrophilic?
OK, you know blood transfusions very similar, right?
Wisdom of repugnance would not actually be that wise #3.
Epidural people used to have a huge moral panic around epidural
right that that's. Right.
Actually doctors, also not doctors, used to not tell
somebody tell a patient if they had cancer.
Yeah. Right.
They would keep that information from from patients.
Seems like a big deal. Very very very in local
apprentice, you know type of thing.
I mean, there's, there's so many things like essentially modern
medicine and even hand washing was fought tooth and nail.
Some of these had a huge problem with that.
Like people didn't, didn't, didn't like him.
You know many, many things that are innovations in medicine.
Even. Even the analysis of go ahead.
Oh, I was just going to say yeah, even you.
Know urine samples, stool samples, Blood samples, you know
analyzing all that stuff analyzing all those fluids
there's a disgust reflex with that like a lot of medicine is
gross right like if you. Surgery is gross, right?
The idea of cutting someone open, fixing something.
Surgery is gross. All this stuff.
Of course, you know, you have, I mean, there's all kinds of blood
everywhere in the operating room on a surgery.
If you were just walking on that, you're like, you're
hurting him, stop, blah, blah, blah, blah.
You know, and you know, you wouldn't understand anaesthesia,
you know, basically these are just things where the intuitions
of a medieval peasant can only really get you so far, right?
They really the the caveman mentality.
Yeah. So sometimes there's a utility
to it, right? Where sometimes there's
something that's that feels weird and actually is bad or
what have you, right. But the problem and, and one of
the issues is that much of the modern scientific establishment
has said, for example, like XX and XY don't exist, right?
Like chromosomes don't aren't functional and so on.
So I actually understand where the sort of medieval peasant
mentality came from or why it came back because they just went
back to extreme basics and just relied on their intuitions as a
caveman. But those intuitions are going
to be different from person to person also, right?
So they're not scalable across the site.
They're very tribal. Yeah.
Anyway, so it's coming back. So basically I think what
what'll eventually happen with all of this by the way, and
let's go back to your your slides.
But I think what's going to start?
Yeah, yeah, go. No, no, no, you.
Should yeah, yeah, I think I just have like 5 more minutes
and then we can like get into it.
So basically, you know, if you, I think a lot of people really
underestimate what the power of a base pair is, right?
You know, you have ATCG people are like, oh, you know, maybe it
doesn't really matter if you swap an A for AT, right?
So I'm going to try to really illustrate and show you kind of
what the impacts of a single base pair are are, right.
So this is, you know, the tallest man in the world, this
is the shortest woman in the world.
And, you know, these conditions, you know, gigantism and
achondroplasia are, are really caused by, you know, a single
letter change, right? So you're talking about a single
letter in a single gene that results.
In a very good slide. Green leads.
You know, dramatically different, you know, you know,
essentially what happens in, in gigantism is that, you know,
your pituitary system goes into OverDrive and sort of a, a
massive amount of growth hormone gets dumped and you become, you
know, extremely tall. And, you know, conversely in
achondroplasia, you know, people who are who are, who are much,
much shorter, you know, they have a, a critical protein
that's broken that doesn't allow, you know, normal growth.
And actually if if I recall correctly on that particular
variant is something that's more common among sperm of older men
that it's like a hypermutable region or something like that
that tends to tend to see more achondroplasia in children of
older men that there's some sort of that part of the genome is
actually more susceptible to mutation in that particular.
Way I actually don't know of like the, the full ideology of
both of these diseases. I just think that, you know,
when you, when you're looking at that previous slide where we're
talking about, you know, these thousands of, of, of different
diseases, A lot of these are honestly are, are, are fatal or
extremely serious. People don't have an emotional
reaction to it because they don't know someone with, you
know, arterial calcification or any of these, you know, sort of
diseases that have strange names are not very relatable.
But I don't know, I guess what I'm trying to get across here is
like, you know, it, it really matters, right?
It could be the difference between your child having a
terminal condition or not. It could be the difference
between, you know, someone, you know, being, you know, very, you
know, you know, 3 standard deviations from the norm in
terms of height in either, in either direction, right?
So these changes do matter. And, you know, it's very
reasonable for parents to want to scan for this information
because it can have, you know, a, a very significant impact on,
you know, their, their health trajectory.
So we kind of already talked about monogenics and I'm going
to get into polygenic. So again, monogenic is sort of
that, you know, single gene, single variant is a specific
disease. Polygenic is trying to
understand conditions like heart disease, schizophrenia, bipolar,
where it's not just driven by a single gene, but rather it's the
cumulative effect of many, many different variants across the
genome. So, you know, the study
designed, the way that they actually, you know, build these
models is, is pretty simple. They're looking for a sequence
variation. They have sets of people who
are, you know, unaffected controls and then they have
people who are affected. So, you know, folks who have
schizophrenia, folks who have bipolar, and then they're
looking for enrichment. So you know, basically which
variants are, you know, more common in the in the cases as
opposed to the controls and in terms of the performance, this
is what the shape of these curves often look like, right?
So you're looking at, you know, how often do people get heart
disease and what is the percentile of their risk score?
So in the 50th percentile, that's about average.
And then what you can see is that there's a really strong
risk increase when you get to the the much higher percentiles,
right? The 95th plus percentile of
risk, right? So that's kind of what the type
of risk that we highlight. It doesn't really matter if you
know the 30th versus the 70th percentile because a very small
increase in risk. But if you're at the tails of
these distributions, there is a very strong signal from that
genetic component. So that's kind of what parents
can learn. Is that OK?
Is my embryo in that low risk or average risk category or is my
embryo in that high? Risk, the thing about it is
there's N variables on which you've got curves like this,
whether they look exactly like this or not because that is
coronary artery disease, you've got N more that are like that.
Yeah. And so how do you how do you
think about the multi variable aspect of that because some an
embryo that's high on some of these will be low on others?
Yeah, yeah, yeah. That's actually a great.
So I'll actually get into that. So basically one one thing that.
Because you're doing best of N across a vector of K variables,
or K is usually much greater than N.
Yeah, yeah, yeah. So I think one of the things
that people are really trying to understand is that, you know, if
I'm, you know, selecting an embryo that's low risk for for
one condition, does that mean that they're going to, you know,
conversely be higher risk for another condition?
And they've actually already built what's called correlation
matrices where they'll say, OK, is heart disease correlated with
atrial fibrillation? Is it correlated with
schizophrenia? Is it correlated with bipolar
results? They've done this, Yeah, but.
You wouldn't. You wouldn't need to do it that
way because you actually have. If I'm not mistaken, you have
actually the raw underlying ACS, GS and TS.
So you can form, let's say you have N embryos and you have K
conditions on which you're screening for.
And then each of those K conditions has M sub K
underlying loci, right, That contribute to it, which is a
ragged list for each of them, right.
Then you can, you don't have to do the calculations.
You can actually go to the exact loci and you can say, let me
calculate the PGS for this N by K table.
And then you can just see, you know?
How many shared variants are there?
Yeah, right. Yeah, yeah.
So basically I guess what I'm getting at is like what you see
is there's there's an aggregation with diseases that
have that are related. So basically heart related
conditions, you know, heart disease, atrial fibrillation,
those aggregate together. They have a shared architecture.
Mental health conditions like bipolar disorder, schizophrenia,
they aggregate together, right? So what ends up happening is you
get to actually reduce risk for multiple conditions at once,
right? So an embryo that's, you know,
high risk for schizophrenia is also, you know, likely to
there's a there, there is a shared genetic architecture for
other mental health conditions. So rather than there being a
trade off, what what actually happens is that a lot of these
conditions that are for similar systems end up actually having
those those shared variants. So anyways, I think that's I'm
trying to kind of just kind of respond quickly to what people
usually they're, they're sort of immediate.
And how many conditions are you looking at there besides
coronary artery disease? We're looking at about 12:00.
I'm going to give you the, the full list, but kind of thinking
about this, you know, sort of from like the South Asian
standpoint, right? If you roll the dice, you might
get an average outcome, right? So what if the average outcome
is chronic disease, right? So all S Asians, we get heart
disease at, you know, 4 * a higher rate than any other
ethnic population, right? We're twice as likely to to die.
You know, 25% of heart attacks occur under 40 for South Asians,
and 50% occur under the age of 50.
So we're getting heart disease 10 years earlier than the rest
of the population, right? So I don't want that to affect
my child. Just because that's something
that, you know, a lot of South Asians have, that doesn't mean
that I want that to, you know, automatically be a part of, you
know, these are one of the biggest causes of death, right?
Like, and especially in terms of, you know, reducing the
quality of of life, right? A heart attack, even if you
survive it, it's sort of, you know, you, you, you are able to
run as a lot of consequences of this, right.
So the idea that parents shouldn't have access to
mitigating the biggest vector in terms of mitigating risk for
disease. Yeah.
I just, I just think it's insane, right?
Because what you what you can see, right?
You're just talking about. OK, You know, what are, you
know, you're trying quantify like from from like the math
perspective, how much risk reduction is actually possible.
And it's, it's really remarkable how much you can get with a
really small number of embryos. So this is looking at kind of
the worst, worst case scenario, right?
So let's say you have two parents, both mom and dad are at
high risk. And what you can see is that you
can get a 30% risk reduction with five embryos with, you
know, a pretty, you know, poorly performing model.
And if you're in and this analysis, by the way, you know,
wasn't done by Orkut is done by an independent physical
geneticist who just published this paper that I just love
these these figures that that he produced.
So then, you know, if you use a slightly better model, you get a
40% risk reduction with five embryos.
And then with an even better model, you get a 55% risk
reduction with just five embryos, right.
So this is. Interesting to start stopping
out. Wait a second, So the software
again is the difference between the triangles, the circles and
the squares? Yes, yes.
OK. So just and then once you get to
about 9:00 or so embryos. Yeah, right.
Yeah, yeah. So yeah, you're seeing this this
behavior where it starts to flatten out, right, Because you
sort of sampled from the distribution in terms of how
much risk you can reduce. On on one condition.
Yeah, this is on one condition. Right.
But multivariate, the problem is if you're optimizing the minimum
risk on one of your 12 things, the other 11 are loose and can
have higher risk, right? So you have some weighted sum of
them that you're doing this on. Well, this one, this one is not
looking at all. We can look into the methods,
but this figure specifically is talking about reducing risk for
one condition. No, I know, I know.
But basically you'd have this kind of figure for each of the
12, but stopped reducing risk for let's say you picked the the
best of five that got you the lowest risk on condition one,
right? Then conditions 2 through 12,
you might have higher risk. So you have to sort of spend
your optimization budget. Yes, yes, exactly.
So, so, so the thing you want to think about is that probably for
those other conditions, if you're playing in this realm,
it's not going to make a big difference.
So you really want to be focusing on what is the
condition that your embryos are at high risk for where there's a
really big delta, you know, right, You want to just get them
out of that like 97th plus percentile, which usually for
for 12, you're not going to have multiple where you have embryos,
like you're not going to have for multiple diseases that
you're in the top three percentile of risk.
If that makes sense, right? Because if you're playing that,
that that's kind of does that make sense to explain that with
us? Yeah, totally.
Keep going. Yeah, yeah, yeah.
So, yeah, so basically this is kind of like the worst case
scenario, right? You have, you have you're pretty
constrained because both mom and dad are high risk and you still
get this pretty massive, right, 30 to 55% risk reduction, right?
So people don't really have, again, a good way to
conceptualize how massive this risk reduction is.
So what I'm trying to compare it to you is, you know, this is
more powerful than the most successful drugs on the market,
right? Drugs that are making, you know,
a billion install year, right? So here's here's 2 drugs you
have, you know, drug for COPD. There's just basically one
obvious point of this is there's just massive healthcare savings
from this potentially if we can get IVF and so on out there
because just like many. Yeah, usually what I'm trying to
get people to grok is like, medicine is not very good,
right? It costs a billion dollars and
10 years to get a drug to market.
Or you you prefer to be fixed at the genome level rather than
ever? Yeah.
But even more than that, I mean, it only has a 30% relative risk
reduction. That's what we're comparing,
relative risk reduction to relative risk reduction, right?
We'll talk about absolute risk reduction later.
But the point is, is that some of the best drugs on the market
only get a 30% relative risk reduction.
Then you're leased to that drug for life and there's side
effects, right? If you do this for your embryos,
there are no side effects, right?
Like you already decided to do IVF, you're picking an embryo.
The question is just do you want the embryo to be at higher risk
or lower risk? And then that that risk level is
the same for life. You don't have to like take a,
you know, continually take a drug every single day, right?
Because the other thing is that when they do these studies,
right? Like you don't actually get the
benefit if you're not perfectly adherent to the medication,
right? And there's entire companies
that are built around how do you get someone to actually remember
to take a drug every day, right? That's also not trivial, even if
you get, you know, a drug to work.
OK. So yeah, then if you kind of
look across the other situations, right, like you
might not be in that most constrained situation where both
mom and dad are at high risk, right?
If you're in the situation where mom and dad are average risk,
you know, you're getting up to an 80% risk reduction, right?
If you're in the situation where one is high and one is low,
you're kind of, you know, topping out at maybe 70%
depending on, you know, what the power of that predictor is, how
well understood it is. So yeah, all of this is to say
that this is like a huge area where people can potentially,
you know, massively change the trajectory of their child's life
with really kind of a like surprisingly minimal cost for
like how big of a component the genetics is.
And kind of this is kind of what I was trying to talk about
earlier, which is, you know, what are the genetic trade-offs,
right. So you can do.
You can build these correlation matrices where you look at you
know which conditions are are correlated to which other ones.
And you can see that, you know, psychiatric conditions, you
know, kind of are, are the most correlated with each other.
You know, cardiovascular conditions are correlated with
each other. But you know, schizophrenia is
not correlated with height. It's not correlated with type 2
diabetes, right. So it, it's not the case that,
you know, you're necessarily trading off risk for one thing
for another thing. And, you know, people, again,
not just work it, but the entire physical genetics community has
done a ton of work to look into this and to, and to see, you
know, what are the potential, you know, trade-offs or, or, or,
or or shared architectures between these conditions.
Yeah, this is kind of the the take home point, right, is that
having lower genetic risk at birth is, is likely more
powerful than almost anything else that you can do later in
life, right? There's no diet, there's no
exercise that's going to, you know, mitigate risk for
schizophrenia, right? There's nothing that can, you
know, change, you know, the chance that your child has
pediatric cancer, if they have a specific variant that makes it
extremely likely for them to have it, right.
So I, I don't know, I think it's sort of like this massive
benefit that's hiding in plain sight that people are, you know,
instead of embracing, they're kind of, you know, coming up
with these really. Yeah.
Illogical arguments for why it should be stigmatized.
Yep. Basically, The thing is, go
ahead. Oh, I was, I think, sorry, I
think this is the last point, right?
So it's sort of like people have actually already surveyed the
public and said, you know, what is their opinion about embryo
screening for, you know, childhood onset, adult onset,
polygenic, monogenic. And the American public is
really strongly in favor of this, right?
72% either strongly approve or approve of embryo screening.
And here's a number that I think is actually even more
surprising, right? So 30% of Americans would either
definitely consider or. That's a random sample.
Yeah, Yeah, it's, it's, it's OK. This is a random sample and it's
also older folks. So I actually think that if you
like, I think the average age was I think like 40 or 45, which
I think is is older than. Fascinating.
Article you know the set of folks who are actually going to
be considering having kids so if anything I think this is an
underestimate of how many people would consider you know doing
IVF and I think it's. Actually, 2024 paper.
Yeah, yeah. So I think that I think people
should be really shocked by this number, right?
The fact that 1/3 of Americans are considering, hey, I would
not have babies the old fashioned way.
I would rather have babies consider using using IVF in
order to mitigate risk for these conditions that I've been
affected by. I think that that's extremely.
Interesting nationally representative sample.
Yeah. At least for, yeah.
Yeah. So I think that this idea that,
you know, IVF is somehow like IVF is very different if you
are, you know, fertile and you're not struggling with
infertility, right? It's sort of like, hey, it's
like this inconvenience that you have to be on medication for two
days and you know, it's like AI mean for a lot of people.
It's like a bad period, right. I'm, I'm not trying to diminish,
you know what it's like to fight infertility.
It is extremely difficult. You know, if you, you know, have
PCOS, endometriosis, a lot of these other conditions,
infertility is like equivalent to a cancer diagnosis.
But for fertile people, you know, it's an extra, you know,
two to three weeks of discomfort compared to, Hey, you're going
to have a nine month pregnancy. You're going to raise this child
for life. You know, do you really want to
risk, you know, a condition that you've been affected by or kind
of these random genetic typos affecting a child?
And I think that a lot of parents are going to say no,
right? I mean, even just if you think
about miscarriage, right? I mean, it's extremely, yeah,
it's, it's extremely, you know, emotionally costly to.
Oh, they're here. I can.
Yeah, I can share the screen for a second myself.
So here is the article that you're just mentioning, just
pulling it up while you're talking.
Here is the on approval of interest in polygenic ambient
screen by this is a 2024 article.
And so actually this is a great figure. 45% approve, 30%
strongly approve should be allowed. 80% This is an amazing
graph. It's just for the just for the
Twitter bubble, just for just for people to know.
Just FYI, it's like 80% should be allowed.
OK #1. And it's even higher idea,
right? The idea that.
Like there's like yeah, very for the purpose of PS us exactly.
And then approval for various outcomes.
So you know, for health conditions, it's like
overwhelmingly there, right. But even for and psychiatric
conditions like mental illness, overwhelmingly there.
But even here it's like close to 5050, right.
Like, you know, these are these are looking like, you know, in
the sense of no opinion. If you delete no opinion in a
sense, right, these are close, you know, so it's like maybe
it's 5 to 1 ratio or something like what's that like 80 to 10,
eight to one ratio for some of these bars.
And here it's like a one to one, right, in the sense of close to
5050. But that's actually that's,
that's what I'd call this is non controversial and this is
controversial, but in the sense of 50% support and 50%
opposition, which means on the order of 50% of states or
jurisdictions may actually legalize it, right.
So, and then, you know, if you look at what conditions and
traits and so on, so cancer, heart disease, Alzheimer's,
diabetes, just basically overwhelming like this, you
know, and you get to obesity and that's actually still pretty
high over here. And it's only only when you get
to skin color that's like extremely negative, even like
intelligent. So again, this is, this is
close, right? It's, it's more disapproved than
approved, but it's not orders to magnitude.
You add up the red and the yellow versus the blue and the
other blue over here, neuroticism and so on.
So BMI is basically very similar to obesity.
So it's interesting that it's different.
The phrasing of the question sometimes matters, and then, you
know, concerns. Interesting, interesting paper.
Good. Paper yeah, so so I think it's
just people don't you're you're totally right There's like a
Twitter bubble and people don't realize that you know, the vast.
Majority of the FYI 80% of people support embryo screening
in a toy 24 seti. Yeah, it's just important.
Actually send me your deck also because I will preview this.
I will preview this pod with the with both that and the one base
pair, right? Like is 8 foot 3 versus 2 foot
7. You know, literally 1D
alteration. Because just I want to give you
just one asterisk on that one, so I don't have those people's
genomes. I just looked up for gigantism
and achondroplasia. OK, No, no.
So. Yeah, so.
Basically, we're not giving them a diagnosis.
I'm just saying for gigantism and achondroplasia, this is
these are the single base pair of causes of it.
So just I'll give you like exact copy if you want of like how
what those mean, but I just want to give the caveat.
It's like we're not giving them a diagnosis.
We're saying for people who have gigantism, right, controplasia.
So I think I want your commentary on like the moral
necessity of this and then maybe a little bit of your commentary
on the scientific side too, because I think I might have
gone too deep. So I'd rather I would like for
you to like summarize it because.
Well, well, first is I mean on the left.
The entire thing for the last 50 years has been my body, my
choice. So how could I possibly do not
extend? How could you?
How could you define reproductive choice so narrowly
as to say it only extends like you can only turn me in some
cases or not others or screen and survey.
That doesn't make any sense at all, right?
So just reap just choice alone. So basically everybody who's in
favor of reproductive choice on the left should obviously be in
favor of embryo screening or certainly not pushing to ban it,
even if they don't do it themselves.
If it, you know, as they used to say, if if you don't want it,
don't have one right. As to the right, I do understand
the social conservative argument.
I disagree with it because I think that the quote wisdom of
repugnance could be applied to many, many, many, many things,
right. And what we think of as normal,
like circumcision could be considered really bizarre and,
and is considered bizarre. And in some historical cultures
or what have you, heart transplants would be considered
bizarre. In some cultures, certainly past
culture, surgeries like the screening of blood, you know,
urine samples, fecal samples, all the stuff that's like
completely normal in any biomedical clinic.
If you just go by, oh, that grosses me out, you wouldn't do
it. And we have millions of IVF
babies and we have millions of IVF procedures and we have
existing screening for an employees and monogenic
disorders. We have all the infrastructure
set up. We have 80% support from people,
as your paper shows, for screening even in the West, and
it's almost certainly higher in the East, just given, given the
numbers I've seen. And the whole point of the Human
Genome project, billions and billions and billions of dollars
was to use the genome for human health.
Like all these taxpayer dollars went into this.
So that's yet another argument. That is, if you were a taxpayer
on this, it's your right to use that information, right?
And then you're also choosing your partner.
That's 50%. And that certainly wasn't a roll
of the dice. And this is like an edit around
that. Then moreover, for many
populations like S Asians, chronic disease is actually
unfortunately the average outcome because in the modern
environment, modern nutritional environment, we have very high
rates of, of heart disease and of type 2 diabetes and other
kinds of conditions. And she put all that together
and it is really something where people are, some people are just
reacting in this really stupid emotional way.
And you know what? That's their right for
themselves, you know, for themselves, whatever.
You know, I'm not certainly not saying they should do it if they
don't want to do it, but they definitely can't stop somebody
else. Because at some place, you know,
some point on the face of the earth, there will be given,
given that it's controversial, not in a 99 one way, but at most
a 5050 way, there will be 50% of jurisdictions that do it.
And then what are you going to do?
You can reverse the argument on them.
You're going to discriminate against that IVF baby.
Oh, huh. You know what?
You think they shouldn't exist, right?
And so in general, I think one of the most interesting things
about this, by the way, is a dog that didn't bark, which is that
tech is in favor of this, right? And that is that is a huge thing
where the builders are in fear of this because we know life is
hard enough. Life is there's a lot of
difficulties in life. And you know, if, if somebody
has chronic disease, heart disease or something at 50 and
they could have not had it, why, why would you, You know, it's
this weird thing where life expectancy, by the way, as you
know, was quite low in 800 average life expectancy because
all kinds of infant mortality had not been solved, right?
So infant mortality was very high in the past.
And as a consequence, some, you know, people used to write and,
and even adult mortality was high, depending on how far back
you go, right? And I mean people within our
not, I mean great grandparents generation, all kinds of modern
conveniences from electricity, running water, all kinds of
things were just not present. And so you know really what it's
related to. I think the resistance, not, I
mean the resistance to embryo screening is part and part I
think of a broader anti tech thing within the West, which is
like people setting self driving cars on fire, right?
People getting mad about AI, people getting mad about crypto,
people getting mad about immigrants taking their jobs,
people getting mad about, you know, data centers and their
electricity consumption or something like this.
People just getting mad about tech at all because tech is
changing a lot of things and they just want, you know, no
more stop. You know, I want to just, I just
want to stop. I want to reverse the world and
so on. This is similar emotion in the
late 1800s, early 1900s around the industrial revolution and
you know, because the big belching factories, all the
pollution and so on. And to be clear, I'm not saying
that there aren't some, you know, like we developed cars and
then we developed walkable societies and we took away
highways from some parts and so and so, so we developed the
thing and we realized we'd over developed it somewhat.
So we removed some developments, but we kept developing cars
because we still did electric cars and self driving cars and
now flying cars, but we also had walkable communities.
And so there's a balance between them.
And you know, my view is life is difficult enough.
Why roll the dice doesn't matter.
Why roll the dice when you'd have to?
There's going to be 5 1000 more dice rolls.
Yeah, you could just hit by a car.
Why do you want to also have to go blind?
Yeah, you can. You can already get hit by
lightning, you get hit by a car, you can, I mean, there's,
there's 5 million other things that can go wrong, right?
Why you want to, you know, again, this is this is the kind
of person I think who maybe they don't want to put on their seat
belt, but why are they preventing you from putting on a
seat belt you. Know yeah So what do you think
is the steel man like what do you think is the most like I
think we talked a lot about the arguments that kind of are just
nonsensical they they they they just result from ignorance of
not understanding how the genome works how IVF works, how you
know genetic screening works right.
So what do you think are maybe even the most, oh, sincere?
Arguments. Yeah, sure, the steel man would
be that far. Leftists have abused science to
call it capital S science. And they said masks don't work
before they do. And they said that the during
the BLM riots that racism is a real pandemic after telling
everybody to stay inside and they people ran outside and they
call a paper that was published a day ago in Nature, they call
that science, capital S science as if it has the same number of
replications as Maxwell's equations.
Because they equate prestigious citation with and they they
basically substitute prestigious citation for independent
replication, independent replication of sciences.
Yeah, go ahead. Oh yeah, Just to say yeah, like.
Yeah, and by. The more than Yeah, the
replication matters way more than just a journalist.
Yeah, exactly. And so The thing is that the
peer review basically means like two or three thumbs UPS.
It's like if you imagine acting, you need to be a social network
where people post papers, two or three likes from someone in that
social network. It's a peer reviewed paper.
It's not like they're, it's rare that someone goes and replicates
the result where they replicate the result is on GitHub where
you get clone and then you try to compile it or build it,
right. So that's actually where you get
replications. And that's actually the future
of what academia is. It looks a lot more like GitHub
and reproducible research and so on and so forth.
But so, so because of that, there's and of course
universities are like 99% Democrat or something like that.
And a lot of people have not gotten a share of all this
technological progress. And of course, we're also
demographically different from a lot of people.
You know, we are. So tech is in the US, it's
focused on the West Coast, it's focused in cities.
It's got a lot of immigrants, got a lot of Indians,
Pakistanis, Chinese, Koreans, Japanese, gays, Jews.
That's that's how, you know, the right, we consider it foreign.
And then for the left, it has too many white men, capitalists
and you know, so on and so forth, right.
And, and so both the far left and the far right look at it as
alien and different. And the far left emphasizes the
capitalism and the right emphasizes the immigrants.
And the left doesn't like the economic change and the right
doesn't like the cultural change.
And they basically just wanted to go back to the way it was
very roughly right. And that is just an.
Overlying. Go ahead.
Status quo bias is what you're saying.
More than SAS quo bias, Unabomber bias, right?
What I, what I actually think is going to happen, just to digress
for a second, is not even digress many years ago, I mean
five years ago ish, I realized, and I wrote about this at the
time, that after all the Sturman drawing that after everything is
said and done, the final political axis will be, let's
call it futurism versus primitivism, right?
They will call it humanism versus transhumanism because
they'll say, Oh my God, transhumanism, it's all bad,
blah blah, blah. So and we're just being human.
We're being normal right now. The thing is being a normal
human minions, no electricity, no running water, no light
bulbs. And so it's over in their heads.
OK. And and so like, there's no way
that that societies, cities could could have the carrying
capacity to to have a Unabomber lifestyle where he's literally
living in the woods. But we do have that as part of
our DNA in a literal sense because we, you know, our common
ancestors were similar to chimps.
And so we do have millennia of, you know, the outdoors and and
so on in our DNA in a sense. So there's some, you know,
genetic yearning for that, I'm sure.
However, there's another interpretation, which is that
humanity is actually defined by technology.
For example, Richard Rangam is this book, which is like cooking
made as human. Why?
Because the fire allowed us to externalize metabolism, so you
could spend less energy on your gut and put more to the brain.
And then if you you take fire, you take weapons like the spear,
you take clothes, right? The spear, you don't need fangs
with the clothes. You don't need fur with a fire,
you don't need gut enzymes. And all three of them freed up
more calories for the brain. And so encephalization quotient
just rose across hominids. And you know, I posted that a
while ago. It's like the first singularity.
Did you see that? The original singularity.
Oh, this? Is a good one, yeah.
So basically it's like it's like basically it took, you know,
millions of years for, you know, the human brain to evolve.
So it's sort of like if you compare that to, you know, GP US
and CP US, it's like the time scales are very different.
Yeah. And by the way.
Elon agrees. True, right?
But this is the original singularity, right?
And the thing about this is what that means is since humans
began, we have been pushing it into software.
It's the same process that took all of the, you know, took fangs
and threw them into Spears and took fur and turned into clothes
and that took gut enzymes, turned into fire and pushed
everything into the brain. To manipulate all these tools is
the same thing that's taken all kinds of devices from a camera
to a recorder and so on and push them into software in the phone.
The same kind of thing that's taken all kinds of tools and
just pushes them into AI, right? That takes all kinds of stuff
and pushes into the screen and into software and you have less
hardware and it's more done in software, right?
So we have been doing this concept of push everything into
general purpose software has actually been a winning strategy
for 10 million years, right? And this also says actually what
makes ACMN is the use of technology, because an ape can't
use a spear. It can it can jump, you know,
along the woods or whatever, right.
But it you know, or maybe they can use some basic tool use.
We understand my point. They can't, they can't.
Animals, unlike humans, basically can't use technology,
certainly not advanced technology.
So actually technology is what makes us human and reversing
technological progress, you know, stopping to let alone
reversing it actually makes us unhuman.
It's anti human, right. So that's why I called them
primitivists. Because they want to regress to
something in the name of doing something natural.
They're doing something unnatural, and they're stopping
the singularity that actually defines humanity, right?
So that's actually the crucial reversal because it's actually,
you know, the primitivism is essentially the new version of
communism. Because communism also appeal to
kind of the natural small group sharing and so and so forth.
Primitivism has enough changes to its genetic code that
conservatives don't recognize it as communism even though it's
the same thing. If communism was against
capitalism, primitivism is against technology.
OK, but of course techno capitalism is a very correlated
thing, right? So we have antibodies to
communism because that and that's against capitalism.
So instead of targeting capitalism dark, they'll target
technology. The left will be against the
capitalists and the right will be against the immigrants and
the center. A lot of well meaning Jonathan
hate type guys will be against the phones.
The problem is I understand why they're against the phones, but
basically moderated use of phones works in many other
cultures around the world. The problem with the West is
they don't have any moderation of use of phones for kids and so
on and so forth, right? So what what happens is you have
a collision of values that just don't have any sense to them.
What do you think is how this is going to play out for
reproductive technologies? Like, do you feel like it's
going to fall along these similar lines of like, you know,
primitivist versus? Absolutely, primitives versus
futuris will be the axis and going to be legal in some
important jurisdictions probably certainly in tech 4
jurisdictions around well the same kinds of places probably
that are pro crypto and have digital nomad visas will
probably have you know legal embryo screening and so and so
forth. In the same kind of places that
are falling to primitivism of the blue or now the red
varieties will probably be against them or we don't know.
It's unpredictable. It can be very.
The future is fragmented and you will have a lot of different
combinations of ideologies that make sense to those individual
people versus just a clean left and right.
And so at least some of those tribes, some of those
jurisdictions will be in favor of technology and those will
probably be some of the best places to be.
Usually they'll probably be the places that are prosperous
enough that and not just prosperous enough ascending,
ascending jurisdictions are also ascending at the same time the
Internet is ascending. So they have a positive
association with the advance of technology.
The West minus tech is descending while tech is
ascending. So even if they're rich, they're
descending world. And whereas for let's say India
or you know, the Philippines, even if it's poor, it's
ascending world, right? So that's why I like developed
and developing world is the wrong way of talking about it,
because that implies a static developed world and the
developing world's mean moving towards it.
Instead, it's the descending world and the ascending world.
Yeah, Yeah, I know. Yeah, that's a great point.
Yeah. So I guess the.
Ascending rule will be pro all of this.
Yeah. So do you want to kind of like
just summarize what you feel like sort of the like the moral
cases, sort of like what, what do you think?
Like how do you think people are going to see this like today and
maybe like how do you think that's going to that's going to
change over the next couple of years as it becomes more
popular? Yeah, to reduce it to known
moral principles in the West, For the left, it's just
reproductive choice, point blank.
For the right, it is small government.
And why interfere with, you know, somebody's personal
decisions? That's like that's a very short
secular political case for it, right.
Then you can go and you can quote, you make the religious
case in terms of doctrine and scriptures and and so on and so
forth. I don't think many, you know, it
may turn out that there's some people who can quote
Christianity and so on against this.
I can certainly quote Hinduism for it.
I'm sure I could probably find someone who could quote Islam
for it because there's many people in the Middle East who
are very pro embryo screen, many people in the Jewish community
who are pro embryo screen because of, you know, carrier
testing. So you could probably find
scriptural arguments I'm sure are usually for or against
something. But in general, I think maybe
the major faith groups could be for it.
Yeah, I, I think that that'd be my, that'd be my concise moral
argument for it. And then, you know, The thing is
one of the issues is some of the arguments put forward against
this are just based on genuinely stupid reflexive, like an AI,
you know, like association like this, right?
And they just get mad for the sick of getting mad, you know,
and they they associate like a grain of sand.
Embryo is the same as a human is the same as this is the same as
that. And these rhetorical equations
simply don't map to the reality. And it's like, oh, isn't it nice
to have some chance? The pitter patter of poems.
And I think there's a great tweet that you had, which is
like, this is like a guy talking about how great it was to pick
berries that didn't like the rise of agriculture.
You know, it's just I The thing is that kind of argument is to
them very convincing because it just feels, you know, but feels
can't build feels can at best for them ban, but feels like
doesn't know an A from AC from AT from AG usually, right?
So they can try to ban in those jurisdictions and then they just
won't be able to do it globally because you can show the poll
numbers and so on and so forth. So so long as the fields no.
Yeah, I think. The primitives he, he.
Made a great argument right around that, right?
Because it's sort of like, hey, we traded electricity for
candles, right? We traded cars for horses,
right? We traded, you know, organ
transplants for for for death, right?
We treated epidurals for having, you know, a pregnancy.
But they. Soldiers for guns were
considered really cowardly relative to like soldiers with,
you know, Knights with, with swords who'd actually go up and
see you and chop you and so and so forth.
Like, you know, today we think of a soldier with a gun as
brave, but in the past they were thought it was cowardly because
they wouldn't just go up to you and hit you with a sword, right.
So moral intuitions do change over time based on the baseline
of what people think is, you know, the right thing to do,
right? Yeah, exactly.
I think basically pointing out like, hey, what is lost, you
know, from, from, you know, having, having, you know, babies
through sex is like it's basically kind of like the most
standard cliche for anti progress, right?
It's like if you only look at what's lost and you don't look
at what's gained, I mean, you can make that argument for, you
know, why don't we, you know, hunt our our own food with the
bow and arrow and putting it at the grocery store.
It's like something's lost, sure, but what is gained, right
like. The macro argument I'd actually
say is not even really the moral argument.
It's a correlational argument. If people feel that their
fortunes are just in general declining, which they do in the
West outside tech, they'll just be against any kind of change
whatsoever, especially from the tech guys.
If you're in tech and change is generally being good for you,
you'll generally be neutral or positive on change.
And if you're in the East or more generally the ascending
world, then you're also going to be more positive on tech.
So we should look to tech and the ascending world to legalize
this stuff, and we should not look to the descending world to
support it. And we just need to divide
jurisdictions on that basis. And then they just kind of, you
know, like I'm not saying everybody in the descending
world will support it and everybody in the descending
world will oppose it. But that's the way that you, you
should expect things to to play out, right?
That's actually the macro above, even the moral intuition.
Yeah. So what do you think is is so
threatening to people about it? Like why is it like I've, I am
genuinely surprised by like the amount of activation.
So I don't know, I'm just kind of curious if you feel like you
have any? I mean, you know, well, first is
people have been inculcated to they literally don't understand
what genes are. Like they got mad at the Sydney
Sweeney has great genes ad right.
Huge numbers of people got mad at this.
It's just a pun because they're like, I can't believe you're
saying genes could do something. Oh my God, right.
So like it's, you know, in many ways American Society is like
twisted into knots over genetics over all kinds of things.
You know, it's, it's this bizarre kind of thing where
they're, I mean, look, there's a lot of wars that kill a lot of
people and they're much less, you know, I don't know, I, I, I
feel that the concern is one other thing about it is the
concern is like, it's like, it seems like extremely angry on
the day that it hits and then they just move on to the next
thing two or three days later, right?
It is very much a passing storm. And if you just keep building,
they just don't have the attention span or anything like.
That yeah, I mean, I think that's that's the thing that I
think is most, I don't know, I guess makes me feel the best
about it actually. It's like basically the the
benefit to each individual parent is so great that like
random, you know, negativity is is not enough to to convince
them, right. It's sort of like for each
individual parent, it's the difference between is their
child, you know, going to be able to meet their developmental
milestones, be able to walk, be able to talk or not.
And then for these other people who are kind of, you know, being
negative, it's like, you know, they don't really have anything
at stake, right? So it is, it does feel like
that's like really unique part of, you know, you know,
healthcare decisions where people actually get to, you
know, vote with their feet and then decide, hey, like, this is
the thing that's going to make a difference for me and for my
family. And, you know, they'll, they'll
be willing to do that even if, you know, there's a lot of, you
know, loud voices on the other side.
Yes, ma'am, I agree. OK, cool.
All right, so let me wrapped there and any last words, any
other things you want the audience to come away with?
No. No, I think it's great.
I'll send you the the slides and I'll even send you the slide
notes too. And then you if you want to like
AI, re trigger them to we whatever content that you want,
that'll be great.