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Doesn't this already manifest in the form of gyms, advanced medicine, proper exercise and nutrition, and various other "improve ourselves" things that require money?

It does, and it turns out that poor people suffering is morally acceptable to those with the means to ease it.

Yes it does, but genetics could take the wealth and power gap to a whole new level. Maybe vanilla humans will just be servants and pets to modified humans.

So? Should we not have cars, planes, antibiotics, computers, etc. because some cannot afford them?

Cost would not be my biggest concern.

Genes are not like points you can spend in a game to upgrade stuff. Editing them is a two edged sword.

Cystic Fibrosis is likely so much more common in Caucasians because having one copy of the gene protects against at least a couple of diseases that were seen a lot in Europe for a time. So being a carrier was protective and made you more likely to survive, similar to how Sickle Cell is protective against malaria.

"Survival of the fittest" doesn't mean the strongest, smartest, etc. Evolution is more about winnowing than about adapting per se. The ones that don't die in the face of unexpected new challenges are the "winners," even if it means they have a defect protecting them from something worse than what the defect does to them.

A fish out of water dies. But gills have a lot of advantages in the water.

Genes just do not work the way comments like this one (above) seem to assume. They just don't.

> Cost would not be my biggest concern.

i believe the comment refers to the way genes get inherited to the next generation. If making gene editing is expensive, the poor will have yet another disadvantage that their children will be less 'capable' than their rich counterparts.

If gene editing is possible - it should also be subsidized so that all of society benefits, not just select few who can afford it.

For now, the rich are more than welcome to keep their idiot choices to fuck with a thing we don't fully understand.

I have a form of Cystic Fibrosis. That's enough horror without it being a thing my idiot parents did to me on purpose in hopes of raiding my IQ.

There is some evidence that some genetic disorders impact brain function and tend to correlate to higher IQs, not lower ones. From what I gather, CF seems to be one of them.

I've made my peace with the hand I was dealt at birth and I'm pretty good at looking for the silver lining. I doubt I could so easily make my peace with it if I learned my parents thought that having a high IQ was more valuable than having functional lungs and a functional digestive tract.

> and a functional digestive tract.

Different disease to yours but I hear that, I never realised how important that was until mine went sideways, it affects everything.

You appear to take an extreme stance.

Try a different argument: If your parents knew there was a high probability that their child would inherit genes making CF an aspect of their lives, would they try to change that even at potential risk.

As a parent myself there is very little I wouldn't do for my child.

I can't imagine the pain CF has caused you and the sacrifices you've had to make. If I were your parent, my desire to not put you through pain would be invariably high.

Isn't that one element of exploration in foundations looking for a cure?

It seems transparency, the longer term impacts, the tradeoffs we will face that we just don't know. There is a cold logic that accompanies that line of thinking. I am not saying one way or another, I just feel it is worth echoing from a purely logical standpoint.

No, I am not taking an extreme position.

Saying that trying to make designer babies comes with potential downside that is potentially horrifying is not an extreme position. It also isn't the same as arguing that people with known genetic defects should be denied the opportunity to try to have children who lack that defect.

Isn't that one element of exploration in foundations looking for a cure?

I've grown vastly healthier while the entire world calls me crazy and accuses me of making that up. I've done so largely via diet and lifestyle.

Based on that, my view is that the obsession with Oo, Shiny! tech solutions expected to create some slam-dunk solution actually hinders real progress. It causes the world to largely overlook more prosaic solutions with more immediate pay-off but less glamor.

The same can be said for generational wealth, education, culture, language, and even names.

   Genes are not like points you can spend in a game to
   upgrade stuff. Editing them is a two edged sword.

Sure... but relative to the objective function that our genes currently optimize. All bets are off once a different objective function gets involved. Given that our genes are currently optimizing something like "reproductive fitness for pre-writing tribes circa 500ky BCE", and that that environment is completely different from what we're dealing with right now - no drug-resistant pathogens or globe-spanning plagues (hell, not even any antibiotics in the first place), low or negative value on longer lifespans, massively lower rewards for cognitive capabilities especially in comparison to the rewards for physical power, no surgery or vitamin supplements or blood testing, surprising (and tragic) lean toward r-selection over K-selection, quite a lot more - I would be surprised if we were unable to find some wins that are, relative to our current objectives, major, obvious, safe, and free.

The objective function currently in effect has kept us going through an extremely wide variety of environmental and cultural conditions.

Will the new one? Suppose the current civilization doesn’t last forever?

We have a responsibility to people a thousand years from now, not just the people of tomorrow.

hell, not even any antibiotics in the first place

No man-made antibiotics. I assure you, Mother Nature was way ahead of humankind there and, in fact, a lot of our drugs are based on things already found in nature.

We have a want center. We tend to like the taste of things that benefit us. There is research on such things.

If you are sick and you respect your cravings, it's possible to find yourself consuming a thing that contains a natural form of medication that addresses your issue, and doing so in sufficiently high quantities as to hit a medicinal dosage of it.

This is likely a root cause of the idea that "god" made someone better: We don't know what they were sick with or what cured it, so it seems miraculous. That doesn't mean there wasn't something in specific that they did or that simply happened that fixed the issue.

We are swarming with billions of microbes at all times. Some are beneficial and we can't digest our food without them. Some are harmful. Low levels of harmful microbes are a routine norm that the body deals with daily. It's only when it gets beyond a certain threshold that it becomes identifiable sickness.

I would be surprised if we were unable to find some wins that are, relative to our current objectives, major, obvious, safe, and free.

When antibiotics first came out, the world announced the end of disease. It's a few decades later and we are dealing with the rise of super bugs instead of living in the predicted disease-free utopia.

You and I fundamentally don't see this problem space at all similarly.

There's a huge difference between "you can give yourself an extra two percent by gnawing on a tree" and "if you follow orders we can wipe out almost every single-celled organism in your entire body within twenty-four hours".

    It's a few decades later and we are dealing with
    the rise of super bugs instead of living in the
    predicted disease-free utopia.

You're cherry-picking, so I'll do a bit of that myself too:

We eradicated smallpox. Tangled bedsheets kill more people than polio. Norman Borlaug saved a billion lives. Malaria will die with Anopheles gambiae.

People once knew that flight was impossible. Not just hard, but impossible, prevented by the laws of physics and not meant for mankind. I flew home from my holiday vacation yesterday. It cost me as much as a good pair of shoes. Less than two days' pay at minimum wage.

"We can never know enough to be safe" is simply and obviously false. Crab-bucket thinking at its finest. We can improve the human condition. We can know enough. Even better, we're getting to the point where we know enough to also recognize that we do or don't know enough.

If you really believe that single bad actors will inevitably ruin everything good and we cannot ever make anything better, well, good luck to you. I submit that, with that point of view, you're better off quitting now so you don't have to experience the doomed future you propose.

We can never know enough to be safe" is simply and obviously false. Crab-bucket thinking at its finest.

Way to go to wildly twist my words out of shape.

I submit that, with that point of view, you're better off quitting now so you don't have to experience the doomed future you propose.

I'm quite open about my struggles with being suicidal. But let's give the benefit of the doubt and assume you don't actually know that.

As kindly as possible, actively encouraging an internet stranger to off themselves because you don't agree with what you imagine they said has got to be one of the absolute ugliest tactics I've ever seen in an internet argument.

So I'm done here. That's not something I consider to be remotely within the realm of a good faith argument.

Note to self: Suggest to my would-be co-founder that such a thing should be a bannable offense on his forum. Cuz: Ew!

Now I'm curious. What did you intend to write? Your post gives equal credence to herbal pseudoscience and modern medicine and, in context, questions whether antibiotics were worth it.

Yes, I should probably find a way to condemn luddite fatalism and anti-intellectualism without pointing out that they are species-wide suicide, exactly as irrational as the personal version and exactly as unacceptable to push for. Maybe I should have simply downvoted you, flagged your post, and hoped nobody saw it. I'll even apologize; I am sorry.

That said, honestly, "disagree" is entirely too weak a word for my perspective on the beliefs your comment helps people believe. I'm going to contest moloch-worship and naturopathy and luddism even when they're unintentional. When they show up on Facebook and Reddit they end with twentysomething mommies deciding not to vaccinate their babies and assaulting Waymo safety personnel. And, well, my real audience are those potential antivaxxers and bucketed crabs, so logos is actively counterproductive and I'm stuck with ethos and pathos, neither of which are anything like good faith. :/

I was diagnosed in my mid thirties with atypical cystic fibrosis. By the time I was diagnosed, I was at death's door. My specialist informed me that people like me don't get well, that symptom management is the name of the game. I informed him that it might be true that I would spend the rest of my life fighting off the next infection, but this one had to go as it was killing me. He physically took a step back as if I had slapped him. He also began scheduling me fewer appointments as I got healthier while expressing zero curiosity as to how I was accomplishing that.

I've spent time around antivaxxers. Many of them have legitimate reasons for pursuing alternative medicine. Those reasons are rooted in being failed by conventional medicine. Some of those folks gave me useful information after doctors dismissively wrote me off for dead.

There's a lot of information out there on the importance of gut microbes and even how body chemistry fosters biofilm which promotes antibiotic resistance. Antibiotic resistance is potentially reversible.

I had an infection that the doctors never ID'd that was not responding to antibiotics. I went through multiple rounds of antibiotics, some of which had side effects like "kills some percentage of people." I saw zero improvement.

I came up with my own hypothesis as to what was going on, ran it past a friend who happened to be a doctor and he said it wasn't crazy talk. Within two weeks, my condition stabilized and I began gradually improving after talking doctors into giving me certain antibiotics and pursuing specific therapies.

Antibiotic resistance tends to be fostered in developing countries that lack adequate water and sewer infrastructure. There is also research out there on failure to thrive and stunting that I've looked at. Stunting has a component of "probably infection related." Some kids don't respond to simply giving them more food. You also need to add probiotics and address the hygiene issues.

The gut is home to about 70 to 80 percent of the immune cells in our body. So digestion, nutrition, diet, fasting, etc all can have significant impact on immune health and how the body handles infection.

It's possible to use spices, like cinnamon and oregano, to help fight infection.

There's a lot more to it and it's a complicated topic. Also, lots of folks believe I'm insane and telling tall tales, because a former homemaker can't possibly understand anything about health that doctors and scientists can't figure out, no.

So, have a nice day. This is probably a pointless discussion for various reasons.

    talking doctors into giving me certain antibiotics

    a former homemaker can't possibly understand anything
    about health that doctors and scientists can't figure
    out, no.

sigh.

Publish a case study. Please. I beg you.

The people that went into the "people don't get better from this" statistic did not just all lay down and die. I guarantee you they went home and searched for a cure the same way you did. But they aren't here and you are.

Normally I'd say you were lucky, but you claim a testable hypothesis that made sense to an MD and then worked. And you seem rational enough that I don't think you'd be giving "specific therapies" so much credit if they hadn't made the difference.

And you know what we call alternative medicine with testable hypotheses that made sense to an MD and were then proven to work? "Medicine". We went back to leeches and maggots and poop transplants because someone proved that they work. But someone had to prove it. Someone had to brainstorm the principled explanation, someone had to write it down, someone had to add it to the standard, indexed, well-known and searchable body of knowledge. Because there are not enough doctors in the world for them to spend hundreds of hours researching each edge case when they're already massively overworked by the hour per kid it takes to stave off MMR and tetanus and pertussis. It needs to be indexed and searchable, it needs to be in the knowledge base, it needs to be standard.

Getting better from things that "people don't get better from" is by definition novel. Solving something that's common enough to have statistics is similarly valuable. A doctor friend's name will get you past the bigots and a publication will be worth his time. You claim a hypothesis, a principled explanation, and a measure of peer review, so you're good on the fundamentals. If you lead with a technical root-cause analysis and reveal your "specific therapies" with a dramatic flourish you'll even turn the "tall tales" into bonus points for creativity and some word-of-mouth publicity. Your case is entirely publishable.

So prove me wrong. Please. "That which can be destroyed by the truth should be destroyed by the truth." Publish it. Save the lives of all the future people that'll get something that "people don't get better from". If you're right about cinnamon and oregano, contribute some good hard evidence and help bring general beliefs into better alignment with reality, which'll save more lives than just the people that share your exact epidemiology. Strike that "alternative" off the medicine that healed you. I'd damn sure like to live forever and any claim that reproduces can help me do that. Bring everyone up to your level instead of sneering down your nose while handing the antivaxxers ammunition.

I've been doing this about 18 years. I'm no longer friends with said MD.

The piece he said made sense:

I figured my husband brought a parasitic infection back from Saudi, a class of trypanosoma, and was reinfecting me every time we has sex and this was why it didn't matter how many antibiotics I took. I was constantly being reinfected.

So I told my husband "you are never touching me again without a condom" and I stabilized in two weeks.

Then I began asking for standard CF antibiotics that are fairly strong but don't have side effects like "kills some percentage of people."

I managed to get on zithromax maintenance therapy, a standard treatment for CF. It has a long half life. So I was on it like two weeks out of the month or something and it's good for like another ten days after the final dose. So I essentially had antibiotics in my system all the time, all but maybe four days a month.

Then a med student at the teaching hospital that I had good rapport with put me on Levaquin, another fairly strong but doesn't routinely kill people drug that is commonly prescribed for CF. After that, I mostly went back to needing antibiotics during stress times, like midterms, finals, Christmas. That was my normal for much of my life.

CF doesn't actually make you sick per se. It causes a bottle neck in the processing of certain molecules due to a defective cell channel. Lots of secondary and tertiary and fourth order consequences grow out of that.

I got extremely interested in what do we know about what happens at the cellular level. I talked to a guy with a PhD in Chemistry. I talked to a guy with a PhD in Biology. I asked a lot of questions of a former RN and she told me "You are asking things they don't have answers for. They don't actually know what that drug does at the cellular level."

It's been a long journey and I'm still struggling to survive financially. I've had multiple blogs where I've tried to find the words to express some of it, but I have no audience, I can get no traction. That means I get no feedback for what makes sense to people and what doesn't.

I'm not sneering down my nose at anyone. I've been thrown off of multiple forums. I've been subjected to really ugly personal attacks. Mods on most forums will not protect me. They tell me I'm the problem and the people attacking me are fine and I need to STFU.

So, you know, right after I win the lottery or marry a millionaire I'll get on some attempt to publish something for some internet stranger who initially told me to go kill myself. Sure. Cuz I owe you so fucking much.

Meanwhile, I'm still struggling to make ends meet and try to eat everyday. And that's where my focus needs to remain for the time being because most of the world quite seriously wishes I would drop dead in earnest and has been actively trying to help make sure I die instead of merely being a flippant and lousy argument tactic.

If we can edit, and it's reliable, we (those that can afford it, not I) will. I don't think that's a conversation that we as a society can really have while delivering much impact.

A more salient set of questions to me, is how do we decide what constitutes improvements, and what responsibility do we have to improve those around us once it's economically feasible?

I recently had a discussion with someone who believed that inhibiting genes that correlate with aggression or certain levels of in-group bias should be mandatory for the general population once we as a society are able to do it safely and reliably.

In his eyes, sanding off our rougher edges in pursuit of a social ideal net improvement on humanity.

I personally was appalled by the idea.

I agree that once this is possible, and advantageous, it will happen. Flying out to Thailand or wherever is already cheap compared to any serious medical procedure. Would we arrest people if they come home pregnant? But before we see this for editing, we will see it for embryo selection... which has all the same questions in milder forms.

I'm similarly appalled by your friend's beliefs, although I imagine Beijing will not feel the same way.

Besides worries about individual illness, I worry that self-interested improvements may accidentally remove certain types of people it turns out we need. For example, what if a change protective against autism turned out to weed out the best scientists? For each individual this may be a great choice.

That's an argument against all medical procedures. Costs will come down as technology improves. Some costs can be socialized, e.g. if you want to prevent babies from inheriting CF.

Having neighbours with significantly lower IQ is not something that anyone wants, so if the procedure works rich people would be most interested to apply it to everyone.

But until a working method is found and proven safe, no rich people will be going out of thier way to become test subjects. In fact it is more likely that poor people will be paid for testing improvements on their children.

If nobody wants dumb neighbours, shouldn't public education be really superb?

You can't (yet) buy intelligence.

This is an interesting argument, and it shows that although the public version won't be the absolute best, society will invest significant amount of resources into it.

Considering that unlike education it is one time investment, doesn't need to be applied to all people at once†, naturally propagates through intermarriage, i think it is safe to assume that split of humankind into two species: smart and rich, poor and normal is a very unlikely event.

† it is actually very important to have a large number of unmodified people for several generations for extra safety

It’s going to be an amazing world briefly when poor people are super smart and resistant to measles when rich kids aren’t.

That's a social/political problem and needs a political solution. I rather find myself in a situation where we have the means to improve everyone's lives but don't do it yet than in a situation where we don't have such means at all because we didn't pursue them because we were so afraid that it might only benefit a sub-population.

There will certainly be countries on the world where the benefits of the technology will affect only a tiny elite population, but I think in many other countries it might benefit a much larger chunk. Any country with a public healthcare system should consider doing germline edits if they decrease the risk of very expensive chronic diseases.

I don't understand how the technology works. Could you really in theory edit genes in living people? Or is this more gene editing of the sperm and then let nature do the propagation