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Slowing things down can be a good thing. I’m not... I don’t have a general position about whether all this should go forward. And in fact in the genetics world I kind of annoy a lot of my friends by being a little more pro-regulation than they are. I do think that... things like direct-to-consumer genomic information are dangerous. And I would like to see people, instead of being able to get genetic information by spitting in a tube and sending their credit card number in the tube to 23andMe or Navigenics or another company, I’d like to see them have to have a learned intermediary, a geneticist, a physician, a genetic counsellor to help them understand that. So there are areas where I think those social constraints are actually useful and good things.
I do think more broadly the social constraints will vary a lot from place to place. The United States will largely be on the libertarian side, I believe, given our culture. Parts of Western Europe much less though. You look at, already technologies like assisted reproduction. Pretty much anything goes in the US. There’s almost no substantive regulation of assisted reproduction. In Europe it varies a lot. In some countries you have to be married in order to get IVF, in others you have to be a heterosexual couple in a long-standing relationship. In some countries you can’t become a mother if you’re over a certain age using technological devices. Lots of variation. Lots of variation within Europe. In general Europe has been more regulated than the United States. I think the real wild card here will be East Asia. South and East Asia, but particularly East Asia, with a different set of historically and culturally derived concerns. Maybe more regulated in some respects, if the party in China thinks that it could be unsettling, but a lot less regulated in other respects. Abortion is not nearly as big a deal in East Asia, culturally, historically, morally, as it is in Judeo-Christian derived cultures.
So I think you’ll see a lot of variation around the world. My basic view is that we’ll never get the regulatory... nobody anywhere will ever get the regulatory side completely right. The question will be: Do we muddle through well or do we muddle through poorly? And I think the world will be complicated. Some things we will want to... Some things should be regulated fairly heavily, some should be regulated fairly lightly. If we’re lucky our actual regulatory systems will accurately capture that and not regulate the ones that should be regulated lightly heavily and the ones that should be regulated heavily lightly. But that’ll take some hard work and some good luck. Because regulatory systems are sometimes arbitrary and capricious.
I do think there are parallels here between the technologies. The long-run consequences are impossible to know. We just I think need to hope to muddle through, but it does give us a sense of... should give us some sense of caution. The way these things will probably play out is there’ll be enthusiasts with money who will be the early adopters. We see that in the genomics world already. There will be desperate people with diseases who will be the early adopters. We see that in the implant and the neuroscience world as well as the genetics world already. How quickly those spread to more ordinary people will be a function in part of the regulations, in part of the culture, in part of the safety and advocacy, in part of whether people feel it’s icky or not, or whether they think it’s cool. So I think we’ll see...
I think all of this is uncertain, in contention, and things will play out differently. You know, a technology might look wonderful and have one terrible disaster early on which can kill it. Or a technology that turns out to be awful in the long run may not... may have no side effects show up in the short run. There was a drug used for morning sickness back in the 50s and early 60s called DES. Women who took it were fine, didn’t cause them any problems, but if they were taking it at a particular stage in their pregnancy and the pregnancy was of a daughter, 20 years or so later when the daughter became of reproductive age she had problems. Serious problems sometimes. There was no way to see that coming. Will some of these technologies have similar long-term time bombs? Does the iPad have similar long-term time bombs? We don’t know. You know, and actually I go back to an example I’ve used earlier. I think probably the technology that most transformed the 20th century was the car. Physically changed the atmosphere, physically changed the layout of our world, how are cities are built, changed sexual mores as people found places they could go and be alone in an easy way. There was no... there were no set of bioethicists or futurologists or anybody else in 1900 that I know of, and certainly no regulatory framework, that thought about what those issues are going to be. Would it have been a good thing or a bad thing if there had been? That’s hard to know. Actually I suppose it’s impossible to know, although I’d like to think we would have been in a little better shape if people had anticipated some of the consequences. If only to lay out roads better or, you know, do other pretty direct things.
So it’s going to be an exciting time, it’s going to be a time of great change and not very much predictability. One big difference though between the silicone world and the carbon world: The silicone world has a long tradition of substantial regulation, particularly in the health area. Most of this will come out of or be affected by the health area, which is heavily regulated. Whereas the silicone world comes from an area, except in terms of its’ telecoms interface, of very, very little regulation. So they start from different regulatory locations. They start also from different cultural locations, because of this assumption that our tools are different... Changing the tools is less important somehow than changing ourselves. An assumption that I think is very questionable, but one that seems to be buried quite deeply.