2007 : WHAT ARE YOU OPTIMISTIC ABOUT?

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Chief Executive, Medical Research Council;Waynflete Professor of Physiology, University of Oxford
Chief Executive, Medical Research Council;Waynflete Professor of Physiology, University of Oxford

Things will—er—get better

I'm hugely optimistic that things will be better in 2007 than they have been in 2006. What things, you might ask. Well, lots of things. Let's take a couple of things that are on the minds of many scientists—climate change and stem cells. In both cases, the imperative for action on the basis of scientific evidence is clear. But in both cases, other forces have intervened to frustrate progress.

For climate change, the obstacles are short-sighted commercial interests and short-term political interests—let's call them myopeconomics and myopolitics. Many businessmen still judge that their own fortunes and those of their shareholders are best served by ignoring the doom-mongers and pumping out the carbon dioxide to make money. A few politicians—one in particular—still think that their own political standing, and their place in history, are favoured by denying the growingly obvious. But the consequences of climate change are accruing non-linearly. A point must come at which the impact of change will fall within the near-point of those refractory industrialists and politicians. When that happens, the rules will suddenly reverse. Both business and politics will be better served by response than denial. I predict that the tipping point will come in 2007. Political skeptics will become passionate converts, eager to claim the historical credit for recognising the inevitable. The burners will become preservers.

I should make it clear that what I am optimistic about here is the likelihood of a change in attitude; not, alas, about the probability of rapid success in the monstrous task of reversing the effects of a century of profligacy. We are going to have to live with the consequences of our parents' actions, and our children with the consequences of ours. The issue is whether our children's children will inherit a world worth living in.

For stem cells—or, to be more specific, human embryonic stem cells—the barriers to progress are not economic but moral. On the one hand, biomedical science offers the hope of cellular immortality—the prospect of repairing a damaged brain, heart or pancreas, just as grazed skin or a bitten tongue already mends itself. On the other hand, a substantial cohort of politicians and religious leaders (more exactly Catholic and fundamental Protestant leaders), especially in the United States and some European countries, fiercely oppose the taking of life in the interests of other lives. Although the balance of arguments seems quite different from that for climate change, interestingly, the crux of the problem is again the power of intuition over the cold rationality of science. I have heard a ‘pro-life' lobbyist describe the collection of stem cells from 10-day-old embryos, surplus to the requirements of in-vitro fertilization, as "the evisceration of little babies". Life, it is argued, begins at the moment of conception.

Most scientists would surely argue that a pre-implantation embryo, smaller than the point of a needle, without a single nerve cell, let alone any viscera, cannot possibly be considered a person. Defining the starting point of life is not a matter of dogma but of social consensus. As my friend, Nobel Laureate, Eric Kandel put it: "Life begins when the kids are all through College and the dog dies"!

Then, given these absolutist arguments, why should I be optimistic about a change in attitude to stem cell research in 2007? Because morality is, for all but the most stubbornly impervious to practical evidence, a matter of utilitarian dialectic. Yesterday's moral outrage has a way of becoming today's necessary evil and tomorrow's common good. Just as with climate change, what will cause a swing of attitude is the turning point of a mathematical function; in this case the shifting ratio of perceived benefit to theoretical cost.

Just a few weeks ago, a team of scientists from the Institute of Ophthalmology, the Institute of Child Health and Moorfields Eye Hospital in London (supported, I'm delighted to say, by the Medical Research Council) reported that they had restored sight to considerably more than Three Blind Mice, by transplanting into their eyes immature photoreceptor cells (midway between stem cells and fully formed rods and cones). Rats that have suffered strokes have been vastly improved by the transplantation of nerve-making cells into their brains. The first attempts will soon begin at repairing severed human spinal cords with the help of transplanted stem cells. The evidence of likely benefit is growing fast. No miracles yet, but a trickle of hope, which is likely to become a steady stream in 2007. I predict that the immorality of not helping the undeniably-living sick will soon outweigh the good of protecting the never-to-be-born. Just as with climate change, the angels might switch in 2007.

There we are. That's what I'm optimistic about. The problem is that I'm by nature an optimist. I see the world through those legendary rose-tinted spectacles. My glass is forever half-full. Interesting, isn't it, how many clichés there are for being optimistic. Doesn't that suggest that optimism-pessimism is as much a fundamental dimension of human nature as extraversion-introversion, happiness-sadness, energy-slothfulness?  Being optimistic about a particular eventuality is more a comment on the believer than the belief. So, what I'm really optimistic about is that that I won't be devastated even if my predictions are less than perfect.