Measles: When does Screening, Quarantining and/or Vaccination become Mandatory?

As this linked PBS NewsHour interview between Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, and Judy Woodruff reports, the number of new cases of measles in the US has reached nearly 700, which is the highest number of new cases since measles was supposedly eliminated in 2000. The video is short and provides a quick review of the current causes of the outbreak and suggested steps one can take to mitigate future personal and family risks of contracting the disease. The reason for this being the subject of this bioethics blog is to touch on the ethical tensions between personal autonomy and utilitarian public health calculations regarding the recent measles outbreak.

So what is the problem with getting measles in the first place? Measles is a highly contagious viral respiratory disease. Simply being in the same room with someone with the disease can lead to becoming infected. In its milder form, the disease results in fever, runny nose, ear infection and a classic spotted red skin rash. In its more severe form, it can cause a severe pneumonia requiring hospitalization, deafness, lifelong brain damage and even death. Children under 5 years of age are at particular risk. A common two-stage vaccine called MMR is available that successfully immunizes 97% of those that receive it. It is given at age one and again around age 5.

The benefits of the immunization are two-fold. The first is direct personal protection against contracting the disease if you receive the vaccination and are one of the 97% of individuals who gain future immunity against the measles virus. The second is something called herd immunity. If enough people are immunized (experts estimate “enough” to be between 95-97% of the population), then even people who cannot be immunized, such as infants less than one year of age or individuals whose immune systems are compromised, are still somewhat protected from contracting the disease. This is because new measles cases from “outside the herd” are severely limited in their ability to spread to the small number of non-immunized people within the largely immunized herd. The immunized people effectively act as a physical barrier to protect the non-immunized people. Problem solved, right?

To quote my favorite ESPN College Gameday commentator coach Lee Corso: “Not so fast, my friend”. The measles vaccine is not completely risk-free. Minor side effects include fever, rash and local injection site infections. Much less common but more severe reactions include seizures and rare deaths from severe allergic reactions. In the late 1990s, the British medical journal Lancet published a study by Andrew Wakefield positing a link between the MMR vaccine and autism. This study was later proven to be a completely falsified claim and Wakefield was completely discredited, though some parents still use the original study to argue against vaccinating their children.

If the vaccine were completely risk-free, there would be no logical or ethical reason not to receive the vaccination. If everyone who could take the vaccine did so, herd immunity from a public health standpoint would be at its maximum, protecting the remainder of individuals unable to receive or benefit from the vaccine. The current measles outbreak argues that either we are not properly screening or quarantining new cases of measles at the point of entry to the US or our herd immunity may be breaking down (or some combination of the above).

So, at your next social function, after you have debated your usual political concerns or dismay at your favorite NFL football team’s shocking choice in the recent NFL draft, settle in to a potentially more meaningful discussion around the ethics of personal autonomy versus public health policy regarding mandatory measles screening, quarantining and vaccination. Suggested sub-topics might include:

• Is it fair for those who are able to vaccinate but choose not to vaccinate to freely rely on the herd immunity of those that do vaccinate?
• How public should one’s vaccination or immunity status be to avoid quarantine?
• What reasons are reasonable to choose not to immunize?
• Would it be fair to deny public (or private) insurance coverage for treating the measles if one chose not to take the vaccine?

Physician-assisted suicide, euthanasia, and the World Medical Association

The World Medical Association (WMA) is cogitating on physician-assisted suicide. Their current statement, adopted in 1992, “editorially revised” in 2005, and reaffirmed in 2015, is as follows:

Physician-assisted suicide, like euthanasia, is unethical and must be condemned by the medical profession. Where the assistance of the physician is intentionally and deliberately directed at enabling an individual to end his or her own life, the physician acts unethically. However the right to decline medical treatment is a basic right of the patient and the physician does not act unethically even if respecting such a wish results in the death of the patient.

WMA’s statement on euthanasia, adopted in 2002, and reaffirmed with minor revision in 2013, states

BE IT RESOLVED that:

The World Medical Association reaffirms its strong belief that euthanasia is in conflict with basic ethical principles of medical practice, and

The World Medical Association strongly encourages all National Medical Associations and physicians to refrain from participating in euthanasia, even if national law allows it or decriminalizes it under certain conditions.

Drama has been unfolding in recent months regarding these positions of the WMA. In October 2018, the Royal Dutch Medical Association (KNMG) and the Canadian Medical Association (CMA) together proposed that the WMA change its position to “neutrality.” This Proposed WMA Reconsideration of the Statement on Euthanasia and Physician Assisted Dying was retracted late in the process due to strong opposition.  The German Medical Association proposed a compromise of changes in the language. Those changes included “physician-assisted death” instead of “physician-assisted suicide,” and “physicians should not engage” in place of “unethical and should be condemned.”

The WMA decided to seek written opinions, and revisit the subject at the 2019 Council meeting. In a press release from 29 April 2019, the WMA Council announced that

It was agreed that policy work should continue on physician assisted suicide, augmented intelligence, violence against healthcare professionals and the patient-physician relationship.

With the next WMA Council and General Assembly scheduled for 23-26 October 2019 in Tbilisi, Georgia, observers should note the jockeying for position by various medical associations. It seems unlikely that those medical associations in jurisdictions where physician-assisted suicide or euthanasia are embraced would decrease pressure on the WMA. Yet we can hope that the World Medical Association will not succumb to such forces. After all, the WMA was formed in the shadow of World War II – a time when the raw wounds of incredibly inhuman acts by some humans against others had been recently seared into the minds of millions. The WMA needs to stay the course they set in 1946, for, to paraphrase George Santayana, those who do not learn from history are condemned to repeat it.

Men without chests

One thing that is essential for us to be able to think well about bioethics is an understanding of who we are as human beings. One aspect of that which has been discussed on this forum is the concept of human dignity, the idea that all human beings have inherent value which impacts how we interact with each other ethically. For Christians that is grounded in the idea that we are all created in the image of God. John Kilner has expressed so very well how our being created in the image of God is the reason why people matter.

C. S. Lewis wrote about another aspect of how we understand ourselves as human beings back in 1947 in a little book titled The Abolition of Man. The first chapter of that book is titled “Men without Chests.” As a medieval scholar he was using a medieval image to express a concern that he had about how the tendency to deny the existence of objective moral truth in his day was leading to a problem with how we function as human beings. In the image that he is using the head represents intellect or reason, the chest (or heart) represents sentiments or values, and the stomach represents the appetites or desires. He says that if we believe that statements about morality or values are simply statements about how we feel and are not statements that can be considered objectively true or false, then the chest has lost its ability to mediate between the head and the stomach. Without objective moral values humans become beings whose intellect is used to achieve their desires without any means of controlling those desires.

What Lewis predicted is where much of our society is today. We are told that our identity is based on our desires, and that if we do not fulfill our desires then we are denying who we really are. Anyone who would suggest that our desires might be wrong or that we should not fulfill those desires must hate us and is attacking us and making us unsafe. Our desires define who we are, and our intellect is given the task of fulfilling those desires.

This is in stark contrast with a Christian concept of who we are as human beings. We understand that as human beings we are created by God in his image and with a purpose. We also understand that we are fallen. This world is not how it ought to be and we are not how we ought to be. Because we are fallen, our desires are frequently wrong. Our identity is not found in our desires, but in our relationship with our creator. We understand that our creator has given us the capacity to understand which of our desires are right and which are wrong. He has enabled our intellect to comprehend objective moral values that are grounded in the goodness of God’s nature. Those moral concepts allow us to distinguish right from wrong desires. That is what ethics is about. Those moral concepts also help us understand that we fall short of what we ought to be. We need help. That is what the gospel is all about. That is why Jesus died and rose again as we just celebrated at Easter.

The idea that our desires define who we are and must be fulfilled creates men without chests who are incapable of distinguishing right from wrong and can only express how they feel about a moral issue. We must have chests which hold to objective moral truths to think ethically and be complete human beings who are not simply ruled by our appetites.

Brain resuscitation (?) in pigs

The latest mind-blowing (seriously, no pun intended) report from the science literature is that a team of scientists at Yale Medical School have been able to use an artificial preservative solution to recover electrical activity in some of the cells of the brains from the severed heads of pigs that had been slaughtered for food.  This is absolutely stunning because the understanding—so widely accepted that the term “conventional wisdom” is trite in this case—that the brain’s need for oxygen, nutrients, and the blood flow that provides them is so massive, so constant that an interruption of even a few minutes means irreversible death of brain tissue.  This can be in part of the brain (as in a stroke), or the whole brain (as in brain death).  Your correspondent is not a neuroscientist, but understands that recent research is showing the human brain, anyway, to be more adaptable than historically understood, meaning that after an event like a stroke, function can be restored over time with rehabilitative efforts that support the remaining, undamaged brain tissue adapting to the damage.

In this case, it was four hours after the pigs’ deaths that the researchers isolated their brains and put them into the solutions.  Besides the electrical activity in some nerve cells, the researchers also found evidence that blood vessels could support circulation, and that there was metabolic (energy-using) activity in the isolated brains.  Evidence that the whole brain was working, and able to, for example, “feel” pain or detect stimuli, was not evident, but the researchers were not trying to do that.  Their immediate goal was apparently to understand how long brain cell function might be preserved.

Before we rush to invoke the immortal Viktor Frankenstein, it should be said that the researchers in this case appear to have carefully followed existing ethical guidelines for the research use of animals.  And it is tempting to speculate about this work leading to new treatments for brain injury.

Still, many ethical issues are raised.  What constraints should proper ethics of experimentation on animals put on future, similar experiments?  Is it acceptable to pursue a model for whole animal or even human brains preserved outside the body to study preservation and restoration of function, perhaps even to the point of trying to “jump start” the whole brain, as the current researchers speculate might be necessary.  Or, such a recovery might be impossible; they say they might just be observing an evitable process of brain death and decay.  Maybe it takes rather longer than previously appreciated.

That last point raises further concerns about how we understand when death has occurred.  Do current approaches toward harvesting human organs for transplantation, that may require that blood flow to the brain be interrupted for only a matter of minutes before declaring death of the donor, effectively jump the gun?  Might some people who are thought brain dead in fact have better chance of recovery than appreciated?  These questions already trouble ethicists thinking about how to determine when a person has died.

These are only a few of the concerns, and some authors this week are calling for an international review of the ethics of this work, before proceeding further with research on mammals—never mind humans, that’s not in view, yet.

A summary of the work for the non-specialist is openly available.  Summaries of related ethical issues, also openly available, can be found here and here.  The full scientific report in Nature requires subscription or purchase.

Are AI Ethics Unique to AI?

A recent article in Forbes.com by Cansu Canca entitled “A New Model for AI Ethics in R&D” has me wondering whether the ethics needed for the field of Artificial Intelligence (AI) requires some new method or model of thinking about the bioethics related to that discipline. The author, a principal in the consulting company AI Ethics Lab, implies that there might be. She believes that the traditional “Ethics Oversight and Compliance Review Boards”, which emerged as a response to the biomedical scandals of World War II and continue in her view to emphasize a heavy-handed, top-down, authoritative control over ethical decisions in biomedical research, leave AI researchers effectively out-of-the-ethical-decision-making loop.

In support of her argument, she cites the recent working document of AI Ethics Guidelines by the European Commission’s High-Level Expert Group on Artificial Intelligence (AI HLEG). AI HLEG essentially distilled their AI ethical guidelines down to the familiar: Respect for Autonomy, Beneficence, Non-Maleficence, and Justice, as well as one new principle: Explicability. She downplays Explicability as simply the means to realize the other four principles. I think the demand for Explicability is interesting in its own right and will comment on that below.

Canca sees the AI HLEG guidelines as simply a rehash of the same principles of bioethics available to current bioethics review boards, which, in her view, are limited in that they provide no guidance for such a board when one principle conflicts with another. She is also frustrated that the ethical path researchers are permitted continues to be determined by an external governing board, implying that “researchers cannot be trusted and…focuses solely on blocking what the boards consider to be unethical.” She wants a more collaborative interaction between researchers and ethicists (and presumably a review board) and outlines how her company would go about achieving that end.

Faulting the “Principles of Biomedical Ethics” for failing to be determinant on how to resolve conflicts between the four principles is certainly not a problem unique to AI. In fact, Beauchamp and Childress repeatedly explicitly pointed out that the principles cannot be independently determinant on these types of inter-principle conflicts. This applies to every field in biomedical ethics.

Having an authoritative, separate ethical review board was indeed developed, at least in part, because at least some individual biomedical researchers in the past were untrustworthy. Some still are. We have no further to look than the recent Chinese researcher He Jiankui, who allegedly created and brought to term the first genetically edited twins. Even top-down, authoritative oversight failed here.

I do think Canca is correct in trying to educate both the researchers and their companies about bioethics in general and any specific bioethical issues involved in a particular research effort. Any effort to openly identify bioethical issues and frankly discuss potential bioethical conflicts at the outset should be encouraged.

Finally, the issue of Explicability related to AI has come up in this blog previously. Using the example of programming a driverless car, we want to know, explicitly, how the AI controlling that car is going to make decisions, particularly if it must decide how to steer the car in a no-win situation that will result in the death of either occupants inside the car or bystanders on the street. What we are really asking is: “What ethical parameters/decisions/guidelines were used by the programmers to decide who lives and who dies?” I imagine we want this spelled-out explicitly in AI because, by their nature, AI systems are so complex that the man on the Clapham omnibus (as well as the bioethicist sitting next to him) has no ability to determine these insights independently.

Come to think about it, Explicability should also be demanded in non-AI bioethical decision-making for much the same reason.

The Importance of Bioethics

by Chris Audino

Every time I am about to stand in front of a fresh batch of students in my undergrad Bioethics class, I am moved to ask myself the question: what’s the point in Bioethics? The reason I ask this question is because it is an important question.

It is important because the asking encourages the essential exercise of me remembering “the why.” Why am I doing this? Why do we reflect on the moral permissibility of certain behaviors (culturally accepted or not)? Why do we allow certain things to happen and not others as individuals and a culture? Who should be allowed to decide what is right and what is wrong?

This “why” speaks to the very heart of bioethics – to the point of bioethics, which, I humbly submit, is to think about health and medical issues, and their moral permissibility, with the goal of supporting human flourishing and dignity. Bioethics is the exercise of asking these questions before it becomes a hindsight question. You know, when we ask: what else could I have done, it seemed like the only choice?

The further we drift from asking these questions the less it seems like there is a choice. Because, the day to day is where these decisions happen. The tech in the lab creating a family (am I playing God?). The nurse sitting by the bedside watching a man agonizing through his last breaths (he shouldn’t have to suffer through this, what can I do?). The engineer who is trying to solve this simple problem (I don’t think this could be used to hurt someone, could it?). The mother who is watching her 6-year-old slowly die of cancer (wouldn’t it be easier if I could help him die?). The expecting mom who has been abandoned by her boyfriend to go it alone (what choice do I have?). The biological boy who identifies as a female and is sorting through pronouns to find the right fit for the moment (why do I have to go through this?).

Bioethics is important because it asks the question before the moment. In the moment, the decision seems like it has already been made.

Human brain genes in monkeys

By Jon Holmlund

This week’s news is that a group of Chinese researchers have birthed and studied a small number of rhesus monkeys that were “transgenic” for a human gene associated with brain development.  In this work, monkey eggs (oocytes) were altered by adding the human form of a gene that is believed important to the development of the brain.  This gene is one of the relative few that is different between humans and primates (monkeys, as in the work described here, or apes, such as chimpanzees or gorillas).  That gene is abnormal in cases of human babies with small heads and brains, making it a good candidate for a gene that is critical to normal human brain development.

The gene was added to the monkeys’ egg cells using a viral delivery mechanism.  The monkey genes were not, in this case, “edited” to the human form using CRISPR/Cas9.  (Presumably, that experiment is coming.)  Using the altered eggs, 8 monkey embryos were then conceived and implanted in females.  Six of these survived to birth, and 5 of them lived long enough to do tests on their brains.  These monkeys’ brains looked, on imaging studies and under the microscope, more like human brains than normal monkey brains do, and these monkeys’ brains developed more slowly than normal, mimicking the human situation, in which brain development occurs largely in late pregnancy and then a lot more in infancy and childhood.  The five surviving monkeys also did better on some short-term memory tests than did “natural” monkeys given the same tests side-by-side.  How strong this finding is appears debatable; the number of monkeys tested was small, and your correspondent cannot say how useful the tests are.

The scientists also took sperm from these transgenic monkeys and conceived three other monkeys (again, using IVF, they apparently did not try to breed the animals), all of which were sacrificed before birth, and whose brains apparently showed some of the same features as their “parents'” brains.

Genetically modifying non-human primates is generally frowned upon in the West, largely on grounds of the animals’ welfare, but in China, it’s full-speed ahead.  The Chinese scientists apparently agree with Western scientists that the brains of apes (chimpanzees) should not be genetically altered because they are too much like us humans for comfort.  Monkeys are not so close, in the Darwinian schema.

The investigators in this case think they are learning important lessons about the genetics of human brain development in a model that is enough like humans to be informative.  They also think they are shedding light on human evolution (assuming that the evolutionary model is correct).  Those conclusions seem to be a reach.  The gene in question had already been identified as a candidate of interest, and its association with brain development arguably could be studied in other ways, within the ethical bounds of human subject research.  And it seems unlikely that a creature such as created in this work would ever have arisen from random mutation.  Rather, these transgenic monkeys seem to be an artifact of the investigators’ design, with uncertain relevance.

In any event—off to the races.  Anticipate more work to alter monkeys’, if not eventually apes’, brains genetically.  They might get something really interesting—and hard to know quite what to do with.

Another example of work that seems unethical on its face, done not because they should, but because they could.  The full paper can be found here.  A description for general readership is here. 

The Influence of Mary Warnock

Philosopher and public intellectual Helen Mary Warnock died on 20 March 2019, at age 94 years. (See here and here.)

Baroness Warnock’s imprint marks not only public policy in the United Kingdom, but also the public policies of much of the western world, particularly in the arenas of assisted reproductive technologies and embryo research. She famously chaired the Committee of Inquiry into Human Fertilisation and Embryology, 1982-84.

The Warnock Committee (as it came to be called) was formed to advise Parliament regarding, inter alia, in vitro fertilization (IVF) after the 1978 birth announcement of Louise Joy Brown, the world’s first “test-tube baby.” The committee chose to assign 14 days as the limitation for embryo research. That is, embryos could be used for research for up to 14 days post-fertilisation—not including freezer time for those that were cryopreserved.

Mary Warnock contributed the idea that a specific number of days, as opposed to a particular stage of the embryo, be used as a limit for legal purposes. She admitted that 14 was an arbitrary number, and explained the rationale to The Observer’s Robin McKie in December 2016:

“Before 14 days, it is absolutely certain – beyond any doubt whatsoever – that there are no beginnings of a spinal cord in an embryo,” says Warnock. “That means that whatever is done to the embryo during that period it cannot be feeling anything. And yes, it was a pragmatic decision. Everyone can count up to 14, after all.

“After this stage, however, development of the embryo becomes very rapid and it develops quickly towards becoming a foetus with a spinal cord and a central nervous system. So that is why we came up with that limit.” (https://www.theguardian.com/science/2016/dec/04/embryo-research–leap-forward-step-too-far)

Parliament embraced the Warnock Committee’s recommendations including the use of embryos for research, and codified these into law, primarily The Human Fertilisation and Embryology Act of 1990. The idea of a time-limited rule for embryo research spread. By 2016, ten other nations besides the U.K. had enshrined in law a 14-day limit: Australia, Canada, Denmark, Iceland, Netherlands, New Zealand, Slovenia, South Korea, Spain, and Sweden. Uniquely, Switzerland restricts embryo research to seven days. Five nations maintain the “guideline” of 14-days: India, Japan, Mainland China, Singapore, and the United States. (https://www.nature.com/news/embryology-policy-revisit-the-14-day-rule-1.19838)

Mary Warnock’s influence impacted more than IVF and embryo research. Before she chaired the Committee that bears her name, Warnock served in a variety of posts. She was a member of the Independent Broadcasting Authority; then came a stint on the Royal Commission on Environmental Pollution; she chaired the Committee of Enquiry into Special Educational Needs; and she also presided over “a Home Office committee on the use of animals in laboratories” (Mary Warnock, A Memoir – People & Places (London: Duckbacks, 2002), 31-2).

Warnock did not back away from controversy. In 2008, she wrote “A Duty to Die?” for a Norwegian publication. She explained her views further in The Telegraph:

“I wrote it really suggesting that there’s nothing wrong with feeling you ought to do so for the sake of others as well as yourself.”

She went on: “If you’ve an advance directive, appointing someone else to act on your behalf, if you become incapacitated, then I think there is a hope that your advocate may say that you would not wish to live in this condition so please try to help her die.

“I think that’s the way the future will go, putting it rather brutally, you’d be licensing people to put others down.”

(https://www.telegraph.co.uk/news/uknews/2983652/Baroness-Warnock-Dementia-sufferers-may-have-a-duty-to-die.html)

Mary Warnock was indeed a public intellectual. She applied her nimble mind to a wide variety of topics. Although her pen has stilled, her widespread influence continues. Her strongly-argued utilitarian positions of embryo usage and death advocacy necessitate able rebuttals for the defense of the most vulnerable among us.

Are pharmaceutical companies responsible for the opioid crisis?

Recently a major pharmaceutical company settled a lawsuit with the state of Oklahoma for $270 million. The state had alleged that the company’s marketing of OxyContin had helped to fuel the opioid epidemic in the state. Pharmaceutical companies in general do some things that are very good and have many times had some questionable practices. Some of their pricing and marketing practices are morally questionable, but it seems to me that it is the role of the FDA to evaluate those marketing practices and discipline pharmaceutical companies when they market inappropriately.

It does not seem to me that states suing pharmaceutical companies is an appropriate way to deal with the opioid crisis. The problem of what we used to call narcotic addiction has been around for centuries. It has been a problem long before any modern pharmaceutical companies existed. Whether the narcotic being abused was opium, morphine, heroin, or prescription pain pills the primary driver of narcotic addiction has always been hopelessness and despair. This is true whether it involved the opium dens in China or the slums of London, heroin addiction in the inner cities of the US or opioid abuse by the rural poor of states like Oklahoma or Indiana (where I practice). Supply plays a role in which narcotics are abused, but the underlying problem is a social and spiritual one.

There are many factors that go into the hopelessness and desire to escape that underlies narcotic addiction. One factor is economic. People who are unable to find work to support themselves and have no hope of being able to do so may turn to narcotics to escape. Those who are wounded by broken families and have no hope of being able to find the wholesome family relationships they desire frequently turn to alcohol and drug abuse. It would make as much sense to sue those who have contributed to these economic and social conditions as it would to sue pharmaceutical companies. Should states sue manufacturers who have yielded to economic pressures and have left empty factories scattered around our country while they profit from manufacturing goods overseas? Should they sue musicians who glorified drug abuse in their songs and modeled that in their behavior? Should they sue the entertainment industry that has promoted sexual immorality and the breakdown of families? Should they sue both state and federal legislators who have created a welfare system that promotes dependence and generational poverty?

I do not think that this is the answer. There are many things in our society that have helped to promote the increase in drug abuse that we are dealing with today. It will take all of us working together voluntarily to impact this crisis. Churches, businesses, physicians, hospitals, pharmaceutical companies, and government at the local, state, and federal level will all need to work together to help reduce the hopelessness and despair that underlies the current opioid epidemic. Research and treatment like what will be funded by the settlement of the Oklahoma lawsuit is needed, but working on the underlying problem of hopelessness and despair is essential. Local churches have the potential to impact that most effectively without needing to sue anyone.

Then a Miracle Occurs…

If a picture is worth a thousand words, then a single-paneled comic is worth a thousand more. Sydney Harris is a famous cartoonist who has the gift of poking fun at science, causing scientists (and the rest of us) to take a second look at what they are doing. My favorite of his cartoons shows two curmudgeonly scientists at the chalkboard, the second scrutinizing the equations of the first. On the left side of the chalkboard is the starting equation demanding a solution. On the right is the elegant solution. In the middle, the first scientist has written: “Then a Miracle Occurs”. The second scientist then suggests to his colleague: “I think you should be more explicit here in step two” (the cartoon is obviously better).

Recently, in my usual scavenging around the internet for interesting articles on artificial intelligence (AI), I came across a Wired magazine article by Mark Harris describing a Silicon Valley robotics expert named Anthony Levandowski who is in the process of starting a church based on AI called Way of the Future. If their website is any indication, Way of the Future Church is still very much “in progress”. Still, the website does offer some information on what their worldview may look like in a section called Things we believe. They believe intelligence is “not rooted in biology” and that the “creation of ‘super intelligence’ is inevitable”. They believe that “just like animals have rights, our creation(s) (‘machines’ or whatever we call them) should have rights too when they show signs of intelligence (still to be defined of course).” And finally:

“We believe in science (the universe came into existence 13.7 billion years ago and if you can’t re-create/test something it doesn’t exist). There is no such thing as “supernatural” powers. Extraordinary claims require extraordinary evidence.”

This is all a lot to unpack – too much for this humble blog space. Here, we are interested in the impact such a religion may or may not have on bioethics. Since one’s worldview influences how one views bioethical dilemmas, how would a worldview that considered AI divine or worthy of worship deal with future challenges between humans and computers? There is a suggestion on their website that the Way of the Future Church views the future AI “entity” as potentially viewing some of humanity as “unfriendly” towards itself. Does this imply a future problem with equal distribution of justice? One commentator has pointed out “our digital deity may end up bringing about our doom rather than our salvation.” (The Matrix or Terminator, anyone?)

I have no doubt that AI will continue to improve to the point where computers (really, the software that controls them) will be able to do some very remarkable things. Computers are already assisting us in virtually all aspects of our daily lives, and we will undoubtedly continue to rely on computers more and more. Presently, all of this occurs because some very smart humans have written some very complex software that appears to behave, well, intelligently. But appearing intelligent or, ultimately, self-aware, is a far cry from actually being intelligent and, ultimately, self-aware. Just because the present trajectory and pace of computer design and programming continues to accelerate doesn’t guarantee that computers will ever reach Kurzweil’s Singularity Point or Way of the Future Church’s Divinity Point.

For now, since Way of the Future Church doesn’t believe in the supernatural, they will need to be more explicit in Step Two.