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Designer babies are a currently hypothetical problem of the future; genetically modified human beings that parents tweak to be a bit better than the average human. As we inch ever closer to allowing gene therapy in sperm, eggs, and embryos, two views of the future are ever more frequently brought up for ethical hand-wringing.

One possibility is that genetic modification will allow for the elimination of diseases such as cystic fibrosis, Tay-Sachs, Huntington’s disease, neurofibromatosis, sickle cell disease, and quite literally hundreds of other diseases. And eliminate them not just from individual children, but from future generations -- a remedy that cures not only the individual, but also their children and their children's children, and so forth...

Also, though, you could make kids big, faster, smarter, stronger, and more beautiful (and also healthier, but in less important ways). While we might not trust parents to always make the best decisions for their children when it comes to rs7412-C, rs429358-T vs. rs7412-C, rs429358-C, the primary issue is that in early days this sort of treatment is likely to be limited by income. This raises the possibility of society becoming even more divided between the rich and the poor, perhaps even permanently, as some cynics have noted that the rich are not always willing to share their wealth and power.

We are probably still at least two generations from this becoming a serious socioeconomic issue, but we are at the point where we could be working on this right now, if we wanted -- and the upside of gene therapy is moving many scientists to think that we should be seriously pushing in this direction.

I messaged Tem42 about Designer baby, that it's too soon and we don't know what the hell we are doing with genetics. That many diseases are adaptations for survival or are attached to adaptation for survival.

He said that I would magically cure diabetes if I could.

No. I would not. Because type II diabetes is an adaptation for survival. The people who survive famines best are the postmenopausal women, often with type II diabetes. And as the world gets smaller, more overpopulated and the anti-vaccine people harass me on Facebook: I think we will need type II diabetes. And I think we will need it in my lifetime.

Infectious disease is alive and well. This winter I have seen influenza, people from teens to 90s. Streptoccus pneumonia and good that I did blood screeens on that one, because a paper just came out saying that 45% of the strep pneumonia is resistant to azithromycin. Azithromycin is what we use for walking pneumonia. One person last week had respiratory syncytial virus, RSV. I called her with the results and she cancelled taking care of the small grandchildren the next day. And I've gotten a positive pertussis IgM blood test on another walking pneumonia: that is an antibody, so it can rise with pertussis (aka whooping cough), chlamydia pneumonia, mycoplasma pneumonia or legionella. Don't know which one that patient had, but so far they respond to azithromycin.

And all of these look pretty much the same. Lung swelling. If they have a strong heart, their heart takes up the slack and they are just really really tired, because their heart rate walking around is 110, 120, 130. If they don't rest, they are liable to get worse. The health department tells me that our county is having influenza deaths: influenza and then the person is already colonized with staphyloccus. The staph invades while the influenza is crashing the immune system and the person dies. And we have multi drug resistant staph. That's right. We can't kill it.

I've been walking them in the hall and then checking the pulse ox. If they are tachycardic walking up and down my short hall three times, off from work. They need to rest until the lung swelling goes down. And they need to avoid getting an additional infection. Don't die, ok? I am writing letters for work. The influenza patient, in their 90s, didn't run a fever. Heart rate of 111 at rest and dropped 8 pounds. The emergency room doc gave me grief for sending the patient in until the patient was there. Hospital admission for four days. The younger influenza patients may run a temperature of 104. Or not. Most of these are not running fevers, but they are sick.

My receptionist is reading my book about the 1917-1918 influenza. Twenty year olds whose lungs were swelling shut. They turn blue and fall over dead. Our county has two ventilators for 25,000 people.

My daughter read The Hot Zone about ebola for school in eleventh grade. During the ebola outbreak. She said, "Mom, I thought you were rather nuts the way you talked about influenza. But now.... I don't think so."

We'll need type II diabetes when we get a really good pandemic. Don't design the babies. They need to evolve....

Strep pneumonia resistance:https://www.magnetmail.net/actions/email_web_version.cfm?recipient_id=2843613455&message_id=13872275&user_id=NFRONTLINE&group_id=3513110&jobid=36247988
Staphylococcus resistance: http://www.smithsonianmag.com/science-nature/factory-farms-may-be-ground-zero-for-drug-resistant-staph-bacteria-6055013/

Of course, my evil side is a bit ok with the superrich designing their children and watching the results of extreme greed and hubris. My good side disapproves and says that the children don't deserve to be punished.

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