As I reflected on these talks it reminded me of the Powers of Ten video that Charles and Ray Eames created for IBM. I wondered to myself what a powers of ten video for ethical issues surrounding innovation might look like.

Our first presenter, Lauren Nichols from UW discussed the challenges associated with GeoEngineering or the study of ways to reduce the implications of carbon emissions for climate change. She talked about the perfect moral storm that is occurring as scientists generate ideas for reducing the global warming effects of carbon emissions. Lauren listed the three major categories of changes – global challenge, inter-generational challenge, and the theoretical challenge.

Lauren illustrated several of the Geoengineering Methods that she described in the following diagram:

Geoengineering Methods

Lauren pointed out that the impact of the geoengineering climate change goes well beyond any one nation state, yet some of the ideas could conceivably be funded privately. The ethical questions are staggering:

• Who gets to decide?
• Who sets the thermostat?
• Who bears the burden of shifting rainfall and climate?

Following Lauren, Gwen Ottinger described the massive scale of wind farms as an energy resource that doesn’t emit greenhouse gases. What is new about wind farms is the massive scale both of the devices and of the acreage.  A wind farm in Ellensburg, WA has 149 wind turbines generating 240 megawatts of power on 10,000 acres. Something of this scale requires appropriate zoning and informed consent.  However, how do you do informed consent when you have no idea what the long term implications are for human health of the wind farm?

Next, David Guston from the Consortium for Science, Policy and Outcomes at Arizona State University shared his observations on nanotechnology and the ethical dilemmas. I loved his comment that “biology is the nanotechnology that works.” David started his discussion by comparing nanoscale in nature and what is manmade.  The challenge of nanotechnology is that the properties of materials which are well understood at normal scale are very unpredictable at nanoscale.

Anticipatory Governance is Guston’s proposed solution for dealing with the ethical dilemmas when creating new technologies. Quoting from Detlev Bronk in an article on “National Science Foundation: Origin, Hopes, and Aspirations”, Guston related “competent social scientists should work hand in hand with the natural scientists so that problems may be solved as they arise, and so that many of them may not arise.”

Guston provided an overview of his proposal for Anticipatory Governance with this slide:

Anticipatory Governance

Guston finished his presentation with the William Gibson quote “the future is already here, it is just unevenly distributed.” Anticipating Gayman Bennet’s talk more than he could know, Guston stated “the genie is already out of the bottle, how do we ask the right questions?”

As a UW bioethicist, Malia Fullerton introduced us to many of the issues surrounding the research charge into personalized medicine. She focused her presentation on the implications and ethical challenges of whole genome sequencing.  I was staggered by the rapid rate in the decrease of the costs to sequence a genome.  By the end of 2012, the cost for my whole genome sequence should be $100. She showed the following slide comparing the cost per megabase to Moore’s Law:

Cost Per Megabase of DNA Sequence

Malia went on to describe the ethical challenges in three categories:

1. Inherent uncertainty
2. Incidentalome
3. Individual autonomy

My favorite concept in these challenges is the “incidentalome.”  Now, I have a new favorite term to go along with Life-Wide Learning.  Malia described this phenomena as “you go in looking for one thing and you find something else.” This term is a nice scientific sounding way to describe my blog post title “On the Way to Somewhere Else.” My life is just one big incidentalome.

The fundamental challenge for clinicians is how to communicate with a patient after reviewing a whole genome sequence. It’s a scope issue.  How do you prioritize which of 15-20 risks that are identified with a personal gene sequence should be discussed with the patient? In the Q&A session, one of the audience members asked “who owns the personal whole genome sequence? Does the individual own it, the lab doing the testing, or the third party payer?” Malia was delighted that somebody thought to ask this question as it is another one of those thorny ethical dilemmas with personalized medicine.

As I listened to Gwen Ottinger introduce the next speaker, I mentally patted myself on the back that in all of the software innovations I’ve built over the years that I never had to worry about the kinds of ethical issues presented today. Then I remembered a conversation in 1986 with Raleigh Awaya who was a Vice President at the East West Center when he came to New Hampshire for a presentation about DEC’s ALL-IN-1. After I finished presenting our current product and our future road map, Raleigh looked me in the eye and said “aren’t you worried that you are unleashing the technology to allow the government to implement George Orwell’s Nineteen Eighty-Four censorship and control vision?” Yes, I answered at the time. And I am still worried about this issue even more so with our development and distribution of Attenex Patterns.

Each of these four panel presentations provided a series of ethical questions, but they did nothing to prepare me for the final presentation by Gaymon Bennett of the Fred Hutchinson Cancer Research Center Center for Biological Futures and a joint initiative of Biological Futures in a Globalized World. At the heart of his presentation was the story of a Dutch Research lab led by Ron Fouchier who had made a highly, contagious supervirulent form of the bird virus H5N1 avian flu.

I was riveted in my seat and leaning forward to be present and focused on Gaymon’s words. The voice in the back of my mind was getting louder and louder – who is watching the scientists?

After the session, I emailed Gaymon to get more background information on the important ethical dilemmas he was raising. He shared three articles. From the first article in the Foreign Policy Journal came:

“When flu scientist Ron Fouchier of Erasmus University in Rotterdam announced in September that he had made a highly contagious, supervirulent form of the bird-flu virus, a long chain of political events unfolded, mostly out of the public eye. Fouchier told European virologists at a meeting in Malta that he had created a form of the H5N1 avian flu – which is naturally extremely dangerous to both birds and mammals, but only contagious via birds – that was both 60 percent fatal to infected animals and readily transmitted through the air between ferrets, which are used as experimental stand-ins for human beings. The University of Wisconsin’s Yoshihiro Kawaoka, one of the world’s top influenza experts, then announced hours later that his lab had achieved a similar feat. Given that in some settings H5N1 has killed more than 80 percent of the people that it has infected, presumably as a result of their contact with an ailing bird, Fouchier’s announcement set the scientific community and governments worldwide into conniption fits, with visions of pandemics dancing in their heads.

“Within government circles around the world, the announcement has highlighted a dilemma: How do you balance the universal mandate for scientific openness against the fear that terrorists or rogue states might follow the researchers’ work – using it as catastrophic cookbooks for global influenza contagion? Concern reached such heights that U.S. Secretary of State Hillary Clinton made a surprise visit to Geneva on Dec. 7, addressing the review summit on biological weapons. No American official of her stature had attended the bioweapons summits in decades, and Clinton’s presence stunned observers.

“Clinton told the Palais des Nations audience that the threat of biological weapons could no longer be ignored because ‘there are warning signs,’ including ‘evidence in Afghanistan that … al Qaeda in the Arabian Peninsula made a call to arms for – and I quote – ‘brothers with degrees in microbiology or chemistry to develop a weapon of mass destruction.'” (Al Qaeda in the Arabian Peninsula is the terrorist group’s Yemeni-based affiliate and perhaps its most aggressive arm today, with connections to a number of ambitious plots.)

“Then, in what has widely been interpreted as an allusion to the superflu experiments, Clinton added, ‘The nature of the problem is evolving. The advances in science and technology make it possible to both prevent and cure more diseases, but also easier for states and nonstate actors to develop biological weapons. A crude, but effective, terrorist weapon can be made by using a small sample of any number of widely available pathogens, inexpensive equipment, and college-level chemistry and biology. Even as it becomes easier to develop these weapons, it remains extremely difficult … to detect them, because almost any biological research can serve dual purposes. The same equipment and technical knowledge used for legitimate research to save lives can also be used to manufacture deadly diseases.'”

The next article from Science echoed more of Gaymon’s presentation:

“Two recently submitted manuscripts to Science and Nature report success in creating mutant isolates of influenza A/H5N1 that are able to be transmitted by respiratory droplet or aerosol between mammals (ferrets). The studies imply that  human-to-human transmission could be possible as well. Shortly after the submission of the papers to the journals, the National Science Advisory Board for Biosecurity (NSABB) was asked by the United States government to address this question. The NSABB recommended that the papers not be fully published; rather, the basic results of the studies should be communicated without methods or detailed results but in sufficient detail to maximize the benefits to society of the studies’ findings. In turn, these recommendations were accepted by the U.S. government and shared with the authors and the editors of Science and Nature.”

As one might imagine, this article set off an ethical controversy in the scientific community about censorship. Science Magazine also interviewed the researcher Ron Fouchier who had this to say:

Q: How do you feel about the moratorium yourself?

R.F.: It’s a pity that it has to come to this. I would have preferred if this hadn’t caused so much controversy, but it has happened and we can’t change that. So I think it’s the right step to make. It’s comparable to what happened in 1975 at the Asilomar conference. But I think that was driven more by the scientists themselves; this time it’s mostly the public controversies that drive it.

Q: Did the NSABB recommendations take you by surprise?

R.F.: Absolutely. This was something that was unprecedented, and something I wasn’t counting on at all.

NSABB has said that the risks outweigh the benefits, and now many people are saying: In that case, you shouldn’t do this research at all. That’s a very logical response. But the infectious disease community doesn’t agree with NSABB on this. What NSABB should explain better is what the risks are exactly. How much bioterrorism have we seen in the past? What are the chances that bioterrorists will recreate these viruses? And is it really true that publication of this research would give bioterrorists or rogue nations an advantage? That’s what I would like to hear from the NSABB.

After the session, I talked with several colleagues about the staggering implications of this flu research. My research scientist daughter sided with the scientific community on this one and quickly forwarded me a pointer to an article from Nature by Peter Palese:

“The recent arguments over the creation of a transmissible form of the bird flu virus (H5N1) feel very familiar. My colleagues and I were at the centre of a similar controversy in 2005, when we reconstructed the 1918 flu virus, which had killed up to 50 million people worldwide. News stories around the globe debated the merits of our research and television pundits argued opposing viewpoints. Naturally, the US government was concerned — as it is now. Yet our research was published in full. So why are similar concerns being used now to demand unacceptable censorship of the H5N1 scientific papers?

“I have spent my career studying potentially dangerous pathogens — 20 years ago, my lab developed the technique that has enabled the H5N1 researchers to insert the mutations that render the virus more easily transmissible. In the 1990s, researchers discovered degraded samples of the 1918 virus in lung tissue from US soldiers who had died from the ‘Spanish flu’. Using polymerase chain reaction technology, they amplified and sequenced the virus’s RNA. We then took an existing influenza virus and, one by one, swapped its genes with those from the 1918 virus, eventually recreating a live version.

“As we prepared our results for publication, the US government convened the National Science Advisory Board for Biosecurity (NSABB), which advises the community about research using agents that pose threats to national security or public health. Our experiments had made some people nervous.

“During our discussions with members of the NSABB, we explained the importance of bringing such a deadly pathogen back to life. Although these experiments may seem dangerously foolhardy, they are actually the exact opposite. They gave us the opportunity to make the world safer, allowing us to learn what makes the virus dangerous and how it can be disabled. Thankfully, the discussions were largely constructive — within a week, the NSABB recommended that we continue to study the virus under biocontainment conditions, and publish the results so that other scientists could participate in the research. After we published our full paper in 2005 (T. M. Tumpey et al. Science 310, 77–80; 2005), researchers poured into the field who probably would not otherwise have done, leading to hundreds of papers about the 1918 virus. As a result, we now know that the virus is sensitive to the seasonal flu vaccine, as well as to the common flu drugs amantadine (Symmetrel) and oseltamivir (Tamiflu). Had we not reconstructed the virus and shared our results with the community, we would still be in fear that a nefarious scientist would recreate the Spanish flu and release it on an unprotected world. We now know such a worst-case scenario is no longer possible.

“This experience has made the NSABB’s latest recommendation — that the H5N1 researchers not reveal the mutations behind the virus’s transmissibility — all the more frustrating. I make the same argument today that we made in 2005 — publishing those experiments without the details is akin to censorship, and counter to science, progress and public health. Why did the (different) members of the committee come to a different conclusion in this case? I can only hope that they take a more sensible stance and change their minds, or that the scientific community at large convinces them to do so. Certainly, the authors of the papers, as well as the journals considering them for publication (including this one), should resist the committee’s unworkable compromise that the full information should be released only to approved experts, and insist on full disclosure.

“Giving the full details to vetted scientists is neither practical nor sufficient. Once 20–30 laboratories with postdoctoral fellows and students have such information available, it will be impossible to keep the details secret. Even more troublesome, however, is the question of who should decide which scientists are allowed to have the information. We need more people to study this potentially dangerous pathogen, but who will want to enter a field in which you can’t publish your most scientifically interesting results?”

Then another colleague, Geoff Bock, forwarded several articles from the New York Times that the full details of the recent experiments would be released:

“The full details of recent experiments that made a deadly flu virus more contagious will be published, probably within a few months, despite recommendations by the United States that some information be kept secret for fear that terrorists could use it to start epidemics.

“The announcement, made on Friday by the World Health Organization, follows two months of heated debate about the flu research. The recommendation to publish the work in full came from a meeting of 22 experts in flu and public health from various countries who met on Thursday and Friday in Geneva at the organization’s headquarters to discuss “urgent issues” raised by the research.

“Most of the group felt that any theoretical risk of the virus’s being used by terrorists was far outweighed by the ‘real and present danger’ of similar flu viruses in the wild, and by the need to study them and freely share information that could help identify the exact changes that might signal that a virus is developing the ability to cause a pandemic, said Dr. Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases, who represented the United States at the meeting.”

On March 3, 2012, the New York Times provided the following editorial on “The Truth about the Doomsday Virus?”

“Two months ago we warned that a new bird flu virus — modified in a laboratory to make it transmissible through the air among mammals — could kill millions of people if it escaped confinement or was stolen by terrorists. Now Ron Fouchier, the Dutch scientist who led the key research team, is saying that his findings, which remain confidential, were misconstrued by the press.

“He says that the virus did not spread easily and was not lethal when transmitted from one ferret to another by coughing or sneezing, and that it became highly lethal only when big doses were injected into the animals’ windpipes.

“That is hard to square with his original assertions. Experts who read his original manuscript say it reported that the new virus spread through the air and remained as virulent as the natural virus, which has killed 60 percent of the humans it has infected.

“Dr. Fouchier’s new claims are only the latest bizarre twist in a global health debate that badly needs an objective, independent arbiter. The public needs to know whether this virus is a potentially big killer, and if so, how it should be contained. It needs to know what details can be published without giving terrorists a recipe for a biological weapon. And it needs to know that a mechanism will be put in place to assess all the risks and benefits of such research before it is approved — not after a new virus has been created. . .

“These issues need to be resolved by experts who do not have institutional biases or turf to protect. The World Health Organization should be in the best position to oversee a response to what is a global problem. Its first effort was one-sided and disappointing, but it has pledged to convene further meetings with a much broader range of experts and interested parties. It must ensure that these forums are not rubber stamps for what the narrower special-interest group just concluded.

“These are complicated issues, and the stakes are enormous. Governments and scientists have a clear responsibility to get this judgment and future efforts right.”

As I staggered from the presentation and wandered down the hall of UW1, I visited Professor Alan Wood’s office to thank him for his work in arranging the Innovation Forum. I shared with him my synopsis of the panel discussion and the sobering implications of Gaymon Bennett’s presentation. I laughed and said it was so sobering that I was going to have to go home and have a bottle of fine wine to drown the implications. Alan shared that he was in a similar state of mind preparing his lecture on the Great Famine for his Chinese history class. He lamented “to imagine that one single beating heart, Mao Zedong, could have caused this famine that killed 30 million people and to this day most Chinese people don’t really understand the magnitude of what he did.”

As I turned and walked out of his office even more depressed than when I walked in, Alan asked if I would raise a glass of wine in memory of the Great Famine as well.

As I immerse myself in the intersection of the humanities and innovation, I begin to wonder if Detlev Bronk had the right idea of getting the social scientists more deeply involved with scientific researchers.

Who should watch the scientists? They are right before us – the deeply committed, deeply thoughtful and deeply caring humanities professors.