Interviewing Prof. George J. Annas (Bioethics)

 

Professor GEORGE J. ANNAS (William Fairfield Warren Distinguished Professor, Health Law, Bioethics & Human Rights – Boston University School of Public Health) is a fellow of the American Association for the Advancement of Science, a member of the Institute of Medicine, co-chair of the American Bar Association’s Committee on Health Rights and Bioethics and a member of the Committee on Human Rights of the National Academies.

He is also co-founder of Global Lawyers and Physicians, a transnational professional association of lawyers and physicians working together to promote human rights and health.

He has degrees from Harvard College, Harvard Law School and Harvard School of Public Health, where he was a Joseph P. Kennedy Fellow in Medical Ethics.

Prof. Annas has authored and edited over sixteen books on health law and bioethics, some of which are:

American Bioethics: Crossing Human Rights and Health Law Boundaries (2005)

The Rights of Patients (3d ed. 2004) and Worst Case Bioethics:  Death, Disaster, and Public Health (Oxford U. Press, 2010).

We are on the highway of genetic manipulation, cloning and molecular biotechnology, to the final destination of the engineering of all life.

Today, genetically modified seeds are being promoted to farmers, we have already cloned animals and are, in fact, in the early stages of manipulating human embryos in order to design our progeny.

It would be profoundly unfair to say that all our medical, scientific and technical advancements in this area are being pursued for the sake of power, notoriety and financial gain. The fact is that most of our doctors, scientists and engineers chose their specialties and poured their lives into their particular research because they genuinely wanted to prevent and end human suffering such as disease, physical pain, thirst, hunger, devastation, impediments, desolation, etc.

Still, there are a strong few who love turning these advancements into profit-making schemes, thus tilting the balance dangerously toward destructive tendencies that, ultimately, affect us all. We are all everyday witnesses of how easily and rapidly these destructive tendencies spread.

Imagine if the agriculture of all countries belonged to a handful of corporations.

Imagine if racism, classicism and discrimination were accented by wiping out most of our diversity, instead of being finally eradicated.

Imagine if compassion, understanding, tolerance, surprise, discovery, exploration, learning, thrill, all stopped making sense, all disappeared from our dictionaries because they simply no longer applied.

Imagine if, unfortunately, the above did not require much imagination, but simple observation.

Crossing a threshold that would forever change life as we know it, that would change many emotions as we know them, that would radically alter the human in us… requires careful, constant and consistent in-depth study of information made available globally and thus, a consensus by a vast majority, worldwide.

I had the privilege to interview distinguished Professor George J. Annas, a reputed expert in the field of genetic engineering and its health, social and human rights implications.

SRM:  Professor, thank you very much for taking the time to respond to our questions, we are honoured. Would you please share what your general views are on genetic manipulation and biotechnology with regards to their application to Health?

PROF. GEORGE J. ANNAS:  Biotechnology is a worthwhile endeavour to the extent that it can improve the quality of human life and increase healthy lifespan. This should be all of our expectation of the biotechnology project itself. And it should necessarily also be the goal of the major on-going biotechnology projects. Some that merit specific public attention and oversight include the current iteration of the human genome project – the dream of personalized medicine, organ and tissue transplantation, the development of artificial organs and tissues,  stem cell research for regenerative medicine, and perhaps most importantly, the development of effective vaccines to prevent disease, especially epidemic diseases like the annual flu and HIV/AIDS, as well as new diseases created in the laboratory for use as bio-weapons.

It has also become well-recognized that as a matter of equity and social justice, it is predictably de-stabilizing for society to foster the creation of new biotechnologies that are only affordable and available to a small percentage of the population. That is because this will inevitably deepen the gap between the rich and the poor in ways that are ultimately unsustainable and are inherently unjust.

SRM: What about their application to Agriculture and Food Supply?

PROF. GEORGE J. ANNAS:  My own work has been focused on humans, including what kind of a world we are building for ourselves and our children. This includes most relevantly for our discussion what experiments on humans (including, of course, children) are reasonable, and what level of social discussion and approval we should require before human experiments, including genetic experiments, are permitted. Humans have rights and interests, plants and animals don’t. Nonetheless, to the extent that we try out our ideas about what we think might be appropriate to do to humans on animals, anyone concerned with the future of the human species should be concerned with the types of manipulations we permit and even encourage on animals.

For example, cloning (asexual reproduction) has not been (thankfully I think) performed in humans. Nor did anyone seriously propose a human experiment until after Ian Wilmut successfully cloned a mammal, creating Dolly the sheep.  Since then we have witnessed the cloning of a variety of animal species, and this has led at least some fringe groups to endorse the cloning of humans.  Perhaps we have simply been lucky that there is no real gain in cloning humans (because it can’t create anything better than what already exists, only a genetic duplicate), so that even the biotechnology industry came out strongly against human cloning shortly after Dolly was announced (as did Ian Wilmut himself)

SRM:  From your knowledge, how far are we into human genetic engineering?

PROF. GEORGE J. ANNAS: We are not terribly far along at all with humans, but as I have already suggested, work is continuing on animals that, if successful, will tempt at least some scientists to try it on humans. We have seen some stunning developments in primates. Japanese investigators reported on the world’s first successful germline modification of a primate, a New World marmoset. They inserted a foreign gene into the marmoset embryo (the gene coding for green florescent protein, or GFP) and produced marmosets that incorporated this gene into some of their tissues. This part had been done before. What was novel is that sperm taken from one of the resulting marmosets was used to create a new embryo, which was gestated by a “surrogate mother” who gave birth to a transgenic marmoset—the first time a transgenically altered primate had been able to produce an offspring that also exhibited an added gene.

A second experiment involved the transfer of the nuclear genetic material from an egg with defective mitochondrial DNA into an egg with healthy mitochondrial DNA, and the subsequent birth of healthy rhesus macaque monkeys with three genetic parents (having genes from the sperm, nucleus of one egg, and mitochondrial DNA from another egg). Predictably perhaps, an accompanying editorial in the issue of Nature in which this research was published suggested serious consideration to applying the technique to humans because “it has the potential to give more couples the chance of having healthy babies.” The editorial also concluded that complete categorical bans on such technologies might simply “impede programs and encourage unethical practices.” These experiments, although not as dramatic as Dolly the sheep in the public’s imagination, afford us an opportunity to re-open the public debate about what limits we should place on human genetic engineering.

SRM: What major implications do you think that human genetic engineering would have for the majority of people?

PROF. GEORGE J. ANNAS:  That’s a great question, and of course there is some degree of speculation in the answer. First, we need to be specific about what we mean by “human genetic engineering.” Mostly we are discussing genetic engineering on existing human beings with medical problems and trying to solve them with genetic engineering involved in, for example, using embryonic stem cells to create new nerve tissue or new heart tissue. Much more problematic are the issues raised by germline genetic modifications (such as the novel gene introduced into the marmoset embryo) that can be inherited by offspring. Almost every legitimate genetic researcher is categorically opposed to attempting this type of manipulation in a human. This is primarily because it would be an inherently dangerous experiment on the resulting child, and there is nothing we know at this point that could make it a safe experiment that a parent could legitimately consent to on behalf of the planned child.

But there are other reasons to be concerned about inheritable genetic experiments as well. Either such genetic manipulation will produce “better” or even “super babies”, or it will not. If it won’t work, it’s certainly not worth doing. If, on the other hand, there is at least a remote possibility that it will produce what we could term “super babies” that in turn have their own similarly-endowed super-babies, then we are on the road to what I have termed “genetic genocide.” 

This is because these new super humans—sometimes termed “trans-humans”—will ultimately see themselves (or we “normals” will see them) as a new species (or subspecies) of humans who have the moral right (or just the ability) to treat us “normals” as less than human. And even if they do not, the “normals” may come to see the “supers” as such a threat to their own future as to justify killing them in self-defense. One may, of course, find this scenario fanciful, and more science fiction (like H.G. Wells’ Time Machine) than science fact or possibility. Nonetheless, the overall concern that creating a modified human could negatively impact on our concept of human rights remains.

This is because to the extent that our current concept of human rights is grounded in our current views of what it is to be human—and to be a member of the human species—changing the definition of human by changing fundamental human characteristics (such as the necessity of sexual reproduction, which would no longer be necessary, for example, with the introduction of human cloning), could provide new excuses for discrimination at best, and put the survival of the species itself at risk of extinction at worst.

In a debate on this proposition a few years ago at Yale, my opponent stated in frustration, “I don’t care about the human species.”

I think we should.

SRM: Wow… Your opponent did not feel very human that day, I guess. Yes, we should, indeed.

Can you foresee any involvement from human rights organisations in order to inform the general public and bring some control into current proceedings?

PROF. GEORGE J. ANNAS:  The organizations most involved in attempting to inform the general public about biotechnology and the need for public input and oversight have not generally been the human rights organizations, but rather organizations more specialized in genetic education. One reason I have used the genetic genocide scenario is to encourage human rights organizations—which are extremely concerned with preventing genocide—to broaden their horizons to future threats.

Of course, with real genocides continuing in the world, this is not an easy sell. More direct education work is being done by NGOs such as the Council for Responsible Genetics (which I have worked with) in Cambridge, Massachusetts, whose name very well expresses its mission. We need more such entities, as well as organizations that work specifically on influencing biotechnology corporations to take human rights seriously in their work.

SRM:  Would this be a political or health issue?

PROF. GEORGE J. ANNAS:  It’s not really either/or.  Protecting the health of the citizenry, both nationally and globally, is a political obligation of governments.  Likewise, a healthy population is a pre-requisite to a healthy democracy.  On the other hand, an over-identification of the government or “body politic” with the health of the population can have devastating and deadly effects on individual lives, as National Socialism’s obsession with the superiority of Aryan blood lines and the bio-politics of the body so devastatingly demonstrated.

Governments are obligated to provide the conditions under which people can be healthy (one definition of “public health”), but should not have the power to require people to live up to some ideal of health imposed by government fiat.

SRM:  Clearly and beautifully expressed. Professor Annas, which of your available publications would you specially recommend, so we can acquire more information?

PROF. GEORGE J. ANNAS: Thanks for asking.  Most accessible, I think, is Worst Case Bioethics:  Death, Disaster, and Public Health (Oxford, 2010), especially chapters 1 (“American Healthcare”), 13 (“Global Health”) and 17 (“Genetic Genocide”); and American Bioethics:  Crossing Human Rights and Health Law Boundaries (Oxford, 2005), especially chapters 3 and 4 (“Man on the Moon” and “The Endangered Human”).

SRM: Thank you so much again for your time, your invaluable knowledge and expertise Professor; it’s been extremely informative and a real pleasure.


RELATED LINKS:

´Worst Case Bioethics´ by Professor George J. Annas, at Amazon >
All Books by Prof. George J. Annas at Amazon >

Interviewing Prof. Deirdre L. Barrett (The Science of Dreams)


Professor DEIRDRE L. BARRETT
,
author and teacher at Harvard Medical School, is widely known for her clinical work on dreams and her contributions to creativity and objective problem solving.

She has interviewed many modern artists and scientists on the use of their dreams, and has documented stories that happened to subsidised Nobel laureates and MacArthur geniuses whose ideas originated in dreams.

In her clinical research, she also confirms that we can learn new skills in our dreams, and find solutions to our problems, as well as through hypnosis.

Prof. Barrett has written several successful books for the general public, some of which include the titles The Pregnant Man and Other Tales From a Hypnotherapist’s CouchThe Committee of Sleep, Waistland and Supernormal Stimuli.

She is also the editor of two academic books, The New Science of Dreaming and Trauma and Dreams.

For as long as humanity has dreamt, we have felt a justified curiosity and fascination about the nature of our dreams: why we have them, what they mean or if even they mean anything at all, what they tells us about the nature of our own existence, whether we can control them… etc. This fascination has naturally fuelled many literary and film works, a famous one being Inception (2010) which directed our attention to some aspects of the science involved in attaining the understanding we long for.

So, I was wondering how much we actually know, via science (as the method of inquiry) and its applied clinical observation, and whether those conclusions match the intuition or metaphysical ideas that we all may have about the subject, either totally, partially or not at all.

By the way, you probably already know this, but, ’Inception’, although introducing many elements of fantasy, for the benefit of entertainment, is based on some of said scientific research, although the scientific term for inception is incubation.

An accomplished researcher, celebrated author, and respected faculty member, PROF. DEIRDRE L. BARRETT is also the Editor in Chief of the journal Dreaming: The Journal of the Association for the Study of Dreams and a Consulting Editor for Imagination, Cognition, and Personality along with The International Journal for Clinical and Experimental Hypnosis. I am very grateful for her willingness to take time from her very busy schedule in order to freely share some of her vast knowledge on the science of dreams.

SRM: Professor Barrett, thank you very much for taking the time to participate in this interview.

Is there a scientific and clinical consensus on the mechanism and purpose of dreams or is there still a lot of ground to cover and discover in this particular area of study?

PROF. DEIRDRE L. BARRETT:
As brain imaging techniques have advanced, there is a rapidly growing body of knowledge of what the brain is doing during dreaming in terms of brain waves, changes in the group of biochemicals known as “neurotransmitters,”  and which areas of the brain are more and less active compared to the waking state. So there is a good consensus on what the physiological mechanisms of dreaming are. However, there is still huge disagreement about their meaning or purpose. Some theories have posited that dreams have one function—wish fulfilment, threat simulation, memory consolidation—or no function at all.

I believe that dreams are simply thinking in a very different biochemical state. We’re still focused on the same things as when we’re awake—worries, hopes, and fantasies.  The major concerns of dreaming are obviously our personal issues–childhood slights, current moods, and how we get along with significant others.  However, objective and professional concerns also show up in our dreams, and sometimes find useful new direction there. We’d never ask what one thing waking thought is for, it’s obviously for a huge range of purposes. I think the same is true for dreams.

SRM: You are widely known for your interviews with successful artists and geniuses, some of them Nobel Prizes, spurred by that theory. Could you, please, tell us a bit about how often these personalities used their dreams or practiced lucid dreaming and what were perceptible common factors amongst them, if any?

PROF. DEIRDRE L. BARRETT: The frequency of using dreams in one’s work varies by discipline. Well over half the visual artists I asked about this said they sometimes used their dreams in their work. Just under half of novelists, playwrights, poets, and film professionals do. It’s higher in sciences which involve inventing devices than ones which deal with abstract relationships. But help from dreams occurs occasionally in every field, even music or math, even though these areas are rare in dream.

During dreams, the visual cortex is more active, verbal areas of the brain less so, and the prefrontal cortex, which makes fine judgments about appropriateness, is greatly damped down in activity. This is very likely why research on problem solving in dreams finds that problems which benefit from vivid visualization or from abandoning conventional wisdom and “thinking outside the box” are the ones likeliest to be solved by a dream. Most of them either had their problem solving dreams spontaneously, or had simply told themselves they wanted to dream about the problem.  Only a few developed techniques for “lucid dreaming”—knowing they were dreaming while dreaming—to solve problems.

SRM: Which one would you say is the technique that both proves most effective and is easier to master, when applying it in our daily lives: incubation, lucid dreaming or hypnosis? What are each best at solving, by the way?

PROF. DEIRDRE L. BARRETT: Incubation is the technique which is easiest to master. In one weeklong study I did with college students incubating dreams about homework and other objective problems, half dreamed about the problem and a fourth solved them. They were practicing a very simple version of dream incubation for a few minutes at bedtime only.

Dream incubation is a very effective way for most people to get inspiration, guidance or problem solving from their unconscious mind. It takes much more time and effort for most people to learn to become lucid in their dreams. And hypnotizability varies greatly between people—for some, it’s a great way to learn to change problematic behaviors, control pain, or solve other problems, but for others it is only modestly effective and, for this later group, it’s useful mainly for relaxation, stress reduction, or reinforcement of habit change which one is achieving mainly by some other means.

SRM: Who are hypnotizable and not hypnotizable individuals? What are the characteristics of these groups?

PROF. DEIRDRE L. BARRETT: It’s a continuum, not sharply defined groups. Characteristics which predict being hypnotizable are essentially trance-like experiences of everyday life: having had an imaginary playmate as a child, daydreaming a lot, and a knack for blocking out real sensory stimuli such that someone may have to call your name very loudly to get your attention when you are absorbed in a good novel.  High hypnotizables find images trigger physical sensations -they may shiver at a film about the arctic even though the theater is warm.

There are two subtypes of people who are the most hypnotizable. One group are the “fantasizers”: they report frequent and vivid daydreams which they remember in detail and often report their imaginations were every bit as vivid as reality. Their earliest memories are often of ages 2 and earlier. The other group “dissociaters” tended to have amnestic experiences easily. They report “daydreaming” a lot also, but by that term they mean that they know their mind wanders as they may be called on in class or at work and have no idea what’s been going on, but they also have no idea where it has been—just “off somewhere.”  They often have first memories which are latter than most people age 8 or beyond.

SRM: Do you believe that astral projection is only one class of lucid dreams or, on the contrary, do you perhaps believe that clear differences can be established between both experiences?

PROF. DEIRDRE L. BARRETT: I think that the two experiences are related and that at least most experiences of astral projection occur during dreaming sleep (few may occur in a waking trance or even be seizure-related).

People experiencing astral projection are usually aware they have a physical body sleeping in the bed. However, they often see that sleeping body from the other one or they may experience a sense of both their traveling “astral” body and their physical body simultaneously. Lucid dreamers are usually fully in just the dream world experientially, they just know it is a dream, and if they bother to think it through (most don’t), they realize they must have a physical body asleep in bed, but they don’t usually experience the real, physical body.

SRM: What elements in the movie I mentioned in my introduction, ‘Inception’, would you say that are speculative, for dramatic effect?

PROF. DEIRDRE L. BARRETT: Being able to influence someone else’s dream with the drug devices is speculative. We can potentially influence other people’s dreams with pre-sleep suggestions and even with sensory stimuli and whispered words once the dream is underway. But these techniques are imprecise and uncertain. There is no way we are going to share a dream or specify someone else’s dream with anything like the precision the film depicts, that’s clearly for dramatic effect.

SRM: So, what specific elements in ‘Inception’ are actually based on scientific and clinical data?

PROF. DEIRDRE L. BARRETT: There are three main premises in ‘Inception’ which are accurate and which call people’s attention to aspects of dreaming of which they might not have been aware:

1) Dream control—influencing the content of your dreams as opposed to influencing other people’s dreams, which as we’ve just discussed, is greatly exaggerated in the film. But it is possible to influence your dreams by dream incubation. The simple version is if you want to dream about a particular person, or topic or problem, you should think about the topic once you are in bed, and form an image of that topic—because dreams are so very visual, and let it be the last thing in your mind before falling asleep. Equally important, don’t jump out of bed when you wake up; almost half of dream content is lost if you get distracted. Lie there and reflect on your dream, or better yet, write it down.

2) Lucid dreaming—many people have occasionally had a dream in which they knew they were dreaming, but you can greatly increase the odds of this happening with a similar bedtime dream incubation combined with periodic daytime reality checks: of whether you are dreaming—a habit which will eventually carry over into your dreams.

3) The occurrence of dreams within dreams—this really happens, and like with Inception, they can even embed as a dream within-a-dream-within a dream . . . or chains of one false awakening after another. False awakenings like the ones depicted in ‘Inception’ also occur but you don’t necessarily always have a dream-within-a-dream precede a false awakening symmetrically as they depict —either can happen alone.

SRM: Talking about becoming aware… your book Supernormal Stimuli is based on evolutionary psychology. What are the main conclusions reached on it?

PROF. DEIRDRE L. BARRETT: Animal ethologist and Nobel Lauriate Niko Tinbergen coined the term “supernormal stimuli” to describe imitations that appeal to primitive instincts and exert a stronger pull than the real thing. In Tinbergen’s research, song birds abandon their pale blue eggs dappled with gray to hop on black polka-dot Day-Glo blue plaster eggs so large they constantly slide off and have to hop back on. Biologists have constructed supernormal stimuli for all basic animal instincts —comically unrealistic dummies which an animal will try to mate with or fight with in preference to a real individual if color, shape or markings push their buttons.

In my book I applied this concept to explain most areas of modern human woe. Animals encounter supernormal stimuli mostly when an experimenter builds them. We make our own, from candy to pornography, from stuffed animals to atomic bombs. Most modern problems, from war and grossly unfair distribution of wealth to inane television and our obesity epidemic, can be explained by this phenomenon. We’ve reversed the relationship between instinct and object to manufacture a glut of things which gratify our basic desires with often-dangerous results

SRM: What would we need to do in order to regain our stimuli’s balance? Is there a possibility to regain balance without eliminating the causes for supernormal stimuli?

PROF. DEIRDRE L. BARRETT: Humans have one stupendous advantage over the bird on the egg —a giant brain. This gives us the unique ability to exercise self-control and override instincts that lead us astray. We are actually quite good at resisting ones we recognize as abnormal, most people know shooting heroine would feel good but resist doing it. Once we recognize how supernormal stimuli operate and learn to identify them readily, we can craft new approaches to modern predicaments.

SRM: It’s within our power, that’s for sure. Thank you again, Professor, for sharing your wealth of knowledge and expertise on this subject, it’s been extremely interesting and very informative.


RELATED LINKS:

All books by Prof. Deirdre L. Barrett at Amazon >
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