PROGRAM GUESTS

STEVEN ROSENBERG, M.D., Ph.D.
Dr. Steven Rosenberg is Chief of Surgery at the National Cancer Institute in Bethesda, Maryland. He is an innovative leader in the battle against cancer. Dr. Rosenberg earned his medical degree at Johns Hopkins University and his doctorate in biophysics from Harvard. During his residency training in surgery, he became interested in the mysteries of the human immune system. In 1970 Dr. Rosenberg joined the National Cancer Institute and went on to pioneer the development of the first effective immunotherapies for patients with advanced cancer. He helped initiate the development of gene therapy and became the first surgeon to successfully insert foreign genes into humans. This brilliant and controversial surgeon-researcher is the recipient of numerous international honors including the recent designation as America's"Scientist of the Year."

JOAN A. STEITZ, Ph.D.
Dr. Joan A. Steitz is a professor of molecular biophysics and biochemistry at Yale University School of Medicine in New Haven, Connecticut. Dr. Steitz is a graduate of Antioch College and earned her doctorate at Harvard. She became an assistant professor at Yale in 1970 and began investigating how a number of small particles, found in all cells, contribute to basic life processes-research which is important not only for basic molecular biology, but also for improving the diagnosis and treatment of rheumatic diseases. This respected investigator and teacher is the recipient of many honors including the Dickson Prize for Science, the Warren Triennial prize, and the National Medal of Science (the highest honor America bestows upon its scientific pioneers).

BACKGROUND

The genetic revolution has put into the hands of human beings powers which a few years ago could only be imagined. Genetic engineering has had a major influence on science and business and has begun to alter medicine and agriculture. Genetic engineering techniques have made possible large-scale production of certain medically-useful substances, such as insulin and interferons.

The issue of the right to privacy comes to bear when discussing genetic engineering as it applies to the use of techniques such as genetic fingerprinting and gene therapy. Privacy becomes an issue, also, in considering the role of government in requesting and requiring testing.

GENETIC REVOLUTION IN MEDICINE

by Steven A. Rosenberg, M.D., Ph.D.

This is an extraordinary era in the biological and medical sciences. Our knowledge of the genetic basis of life and disease is increasing at a rapid pace. Almost daily, human genes are being identified, cloned and sequenced and their roles in basic life processes delineated. The application of knowledge from this genetic revolution can be used to improve the quality of human life and combat disease.

Genetic manipulations ranging from the development of more productive crops to the curing of disease will touch all of us in the years to come: The application of modern genetic research has the potential to completely change the practice of medicine in the next century. From the time of Hippocrates to the present, physicians have utilized external forces such as scalpels, drugs or radiation beams to directly attack disease processes such as cancer and infectious diseases. The success of these approaches has been dramatic. Smallpox, once the cause of millions of deaths each year, has now been eradicated and the last case of smallpox on this planet occurred in 1977. Four decades ago polio was the fear of every parent and child. This disease has now been virtually eradicated and not a single new case was reported in the Western hemisphere last year. However, some diseases have been refractory to these treatments and in the United States last year 515,000 Americans died of cancer and even more of heart disease.

To control these problems new treatment approaches that affect the body's own natural defense mechanisms against disease are being developed. In May 1989, we first introduced foreign genes into humans and a new door was opened to an important application of modern genetic research.

Genetic manipulation in humans is an entirely new approach to treating disease and has been referred to as gene therapy. In gene therapy foreign genes are introduced into humans, either to bring new functions to the human body or to correct inborn defects. In 1992, physicians are no longer limited to the properties of human cells and human physiology that nature has naturally provided to the sick patient. Using modern tools of gene manipulation, we can now introduce properties into human cells that have never existed before in the course of evolution. The opportunities that this presents to prevent or treat disease by changing the basic genetic makeup of humans has extraordinary implications and is now being widely pursued by scientists and medical researchers around the world.

But with this immense power to manipulate the gene pool of plants, animals and humans comes enormous responsibilities as well. As with any new technology, it can be used to benefit or it can be abused and it is the responsibility of all of us to see that this new technology is applied wisely. Genetic characterization of humans and the possible ability to predict future human characteristics raises significant ethical problems as does the ability to introduce genes into germ cells that can affect future generations.

With increased understanding of modern genetics has come a humbling view of the role of humans in the earth's ecosystem. The entire human DNA differs from that of the pigmy chimpanzee by only 1.6 percent. Humans represent only one of the two million species on this planet. As we begin this genetic revolution we face the challenge of using this extraordinary tool to protect not only human life but also the fragile ecosystem that is plant earth.

STUDENT ASSIGNMENTS

1. Before the program define any of the following terms you don't know:

DNA
RNA
Genetic Fingerprinting
Eugenics
Biotechnology
Chromosomes

After the program.

2. The technology of gene-transfer spans many possibilities. Discuss:

What are the beneficial uses to treat or prevent disease?
How might gene therapy technology be abused? For example, is it reasonable to insert genes to make people stronger, to change hair color, etc.?

3. What are the techniques that are used to actually insert foreign genes into humans? (For example, the use of viruses, mechanical techniques, electric shock, etc.)

4. In what ways has gene transfer already been useful? (For example, in treating cancer, agriculture, etc.)

5. The right to privacy is a controversial constitutional issue because the founding fathers of the Constitution did not expressly delineate this right. What is "privacy" and how has the definition evolved from 1787 to today's world? Read the following sections of the U.S. Constitution in terms of right to privacy:

4th amendment (security of person, home, papers, and effects)
5th amendment (selfincrimination)
9th amendment (rights not mentioned, but assumed)
14th amendment (due process clause)

6. Investigate the rights to privacy guaranteed under your state's constitution.