BioMedical Sciences and Society
Lecture 1
What makes vaccines a success?
Relevant actors
People: doctors, managers, nurses, developers, administrators etc.
Infrastructure & logistics: cooling, transport, roads, ships, hospitals etc.
Goods and products: needles, liquids, fridges, paper etc.
Systems and structures: administration, finance, government etc.
Knowledge and experience: science, practical experience etc.
What can we learn about vaccine hesitancy from the COVID-19 experience?
People remain unvaccinated for a variety of reasons:
o Some cannot be vaccinated for medical reasons.
o Others struggle to navigate diverse source of information.
o Many hesitate, for example because of specific medical conditions.
o And some are “anti-vax".
Increasing the vaccination rate therefore requires careful collaboration between all relevant
‘actors’: people, infrastructure, goods, etc, and knowledge and experience.
A complex debate:
o Sovereignty over your own body versus protecting public health?
What does “inclusivity” really mean, in this context?
Science, technology and society are intertwined; they emerge through mutual shaping (e.g. passing
a bridge with bus not possible, only possible if you own a car). Interactive view? Adaptive?
Fork-shaped, messy processes of development (unexpected breakthroughs and societal
developments can influence the direction): internet, bicycle, mobile phones, all sorts of medicines
and other biomedical technology such as; Viagra and the HeLa cell line.
S&T is relevant because it pays a role in finding a solution to all sorts of challenges, but it is often
part of the problem or numerous mismatches as well.
Four views on technology and society
- Instrumental view: society develops and uses technology to reach its own goals. So, society
sets a particular goal, and to reach that goal they use technology (goal is NOT about societal
change, rather flat and simple than major goals).
EXAMPLE: fire to eat warm food
- Deterministic view: technological development follows its own trajectory (it just happens),
and technological development has an impact on society. And a lot of technological fear.
EXAMPLE: gene editing of babies (once we have this technology, we cannot steer the
subsequent technological development, we cannot change it)
- Interactive view (designing): society and technology influence each other. “what kind of
world and society do we want to live in and what kind of technology contributes to that
world?”.
EXAMPLE:
- Interactive view (adaptive): society and technology influence each other. “how can society
reinvent itself in the context of its technological development?”. It recognises that society
steers the development of S&T, but that S&T have an impact on society that requires society
to reinvent itself, to change.
EXAMPLE: giving the technology ‘gene editing’, how as a society do we need to change to
make sure that these technologies are not only used by the rich?
,Instrumental view vs designing: designing view recognises that S & T influence each other and that it
really asks the bigger question of what kind of world we want to live in, rather than what goal do I
want to reach.
TUTORIAL 1
Development of the birth control pill:
- Started in the 60’s
- Sexual revolution
- Detachment of sexuality and reproduction
- Women’s emancipation
- Emancipation of homosexuals
Unethically developed because: they used mental patients without their consent, enormous burden.
Will the new, more accurate prenatal screening test affect who we want to live in this world?
What does elimination of Down’s syndrome mean for our society as a whole?
Fewer people with Down’s syndrome > fewer services and less societal understanding > larger
experienced disability.
Are you concerned about ‘societal (ab)normalization’ of Down’s syndrome?
Are parents really free to choose?
o Can and should people defy medical doctors’ authority?
(“if the doctor says so, it will probably be necessary”).
o Cultural pressure (“you chose to have this sick baby, now you take
the responsibility for it”).
They are kind of pressured, so not a 100%.
YUVAL NOAH HARARI [algorithm is going to take us over- deterministic view]
Three lessons learned from, one from each section of the book:
1. Shared narratives are what allow us to collaborate at a large scale and, thus, dominate as a
species.
2. The most prevalent current narrative is humanism.
3. Algorithms could eventually replace us, depending on which future narratives takes over.
Lesson 1: stories are what makes us the strongest animal on the planet.
Because we can all decide what stories we believe in individually, the best stories win. Over time, we
have become more intelligent, which is why, usually, the story that wins in the long run is whichever
one benefits us the most as a whole.
Take religion, for example. Catholicism brought together many European nations after abandoning
the wars they had with one another to fight a larger one. Religion is slowly being replaced by
narratives, in more recent generations.
Lesson 2: today’s dominant narrative is humanism.
Nowadays, we are all aware of the many different religions, political movements etc. As a result, the
story that dominates the world today is humanism. In this view of the world, humans are the central
element and our individual freedom our greatest asset.
Lesson 3: all our future narratives involve algorithms, but if we are not careful, they could replace
us altogether.
Computers have quickly become a big part of our lifes, therefore, it is not really a question of
whether algorithms will be part of our future, just how. Transhumanism argues that humans should
merge with technology to enhance their capabilities and keep up with the power of algorithms.
, Dataism, (deterministic view) on the other hand, suggests we ‘get out of the way’ and let algorithms
become as powerful as they can become on their own. This would also mean giving up parts of what
makes us human, like empathy.
What else can you learn from the blinks?
Why are we okay with standing superior to all other animals?
What unwanted consequence happen due to modern self-expression?
Why is religion still important?
What does science say about the validity of liberalism?
In which fascinating ways are algorithms already smarter than we are?
Computers, internet, vaccines, etc.
Also, what is your opinion on this subject (and the author)?
GENE EDITED BABY [the Guardian]
S&T as part of the solution: how is the gene-edited baby part of the (which? whose?)
solution, and to what problem?
He Jiankui said that the genomes altered to disable a gene known as CCR5, blocks the pathway used
by the HIV virus to enter cells.
Gene-edited baby could eradicate the likelihood of the babies to develop HIV in the future. Gene
editing is a solution of the future for inborn diseases that possibly could be fatal. The doctor edited
the gene that was involved in HIV in the unborn babies.
Mismatches S&T -society
- What mismatches between S&T and society do you observe in the article?
Scientists said that He announced his work without following scientific protocols, including
publishing his finding in a peer-reviewed journal.
Bioethicist Qiu Renzong said He’s decision to work outside established and supervised scientific
protocols could taint the reputation of Chinese science. He said ‘of course it is not ethical’, the
university had rejected his request to perform the experiment. This led He to find a private hospital
outside the academic system which clearly is fraud (where he maybe even fabricated a form to let
people sign it).
A professor of anthropology said ‘there is nothing different in making [genome] edits in adult
humans versus the embryo’. BUT this raised questions: it risks creating a new, genetically modified
elite who cannot get sick but pass it on to other people.
Zhang does not think it was handled in a transparent way, which is incredibly important for new
experimental treatments.
S&T as part of the problem
- How is the gene-edited baby part of the (which? whose?) problem?
The altered DNA of the twins would be passed on to any offspring they have, which creates many
ethical and medical problems in the eyes of several scientists.
The decision about the twin girls was not made by them, but by someone else. These changes will
remain in their offspring for future generations.
The problem that arises on societal level is the inequality that can take place if gene-editing becomes
accessible, since we can only expect the rich to have access to it. This can cause societal inequality
and discrimination. The other troubling aspect is the positive selection of certain human traits while
others are negatively selected for.
