Debating Hats On…..

Well, where do I start describing yesterday at the Science Festival? It was one of the most enlightening, thought provoking, challenging days of my life! You’d be forgiven for thinking that’s an exaggeration but reserve judgement until the end of this article then let me know.

First off was a discussion on ‘Saviour Siblings’ featuring Dr Ian Frayling who took us through the science behind the concept – how IVF can be used to produce a child who is a suitable donor for their ill sibling. Next up was Dr Simon Fishel who was part of the team that oversaw the first successful treatment involving a saviour sibling last year.

Finally Professor Lord Robert Winston opened the discussion with some precautionary words, reminding us that while this technology is wonderful in that it can save lives, there is still much we don’t know. For example, the way manipulating embryos in this way could have as yet unseen effects on children further down the line. He also pointed out that the method used to ensure that the new child is free of disease and a perfect tissue match for their sibling is flawed. PCR (a method of amplifying DNA to check for mutations) on a single cell, as used here, is not perfect and can often lead to misdiagnosis. Not to mention the psychological risk to a child who has been created as “spare parts”.

So I decided it was time for some light relief and headed for the Winton Crucible tent for a discussion on vegetative state. Unsurprisingly I didn’t find much relief in there. What I did find was the editor of New Scientist Roger Highfield talking to Dr Adrian Owen about his pioneering research on the levels of consciousness among patients in PVS (persistent vegetative state). Dr Owen started by defining PVS as “wakefulness without awareness”, by which he means that patients seem awake and will look around the room from time to time but are unable to respond to commands such as “raise your right arm”.

However, in 2006 he published a paper that showed that when a patient in PVS was asked to imagine playing tennis or moving through the rooms of her house, the brain patterns seen on their MRI were almost identical to those seen in healthy people. Since then he has used this technique to converse with patients who have been able to correctly answer questions such as “what is your father’s name?” when two options were provided. In fact he says that around 20% of patients tested display this ability to respond to commands with their thought patterns rather than their physical body.

It’s a fascinating experiment, beautifully explained by Dr Owen and which raises some obvious questions. Could this technology be used in legal battles over whether to withhold nutrition? No, said Dr Owen, it can only be used to prove consciousness, not to disprove it. After all patients could be deaf and unable to respond or simply refuse to respond to commands in which case we may wrongly presume them to be unaware.

Will we be able to use this technology to communicate with these patients? Dr Owen was cautious in the response here; in theory we could but at present the technology is too cumbersome to use for sustained conversations. He suggested that EEG could be used in the future and also mentioned that they are trying to develop other technologies that are as reliable as MRI but which are more portable. One of the major questions that relatives of these patients will want to ask is, “Do you know who I am?” and Dr. Owen was careful again; he said they have done some face recognition experiments but it is hard to differentiate between automatic recognition and awareness of WHO the person is. However, he does say he is quite sure that some of these patients are as aware as anyone in the room. It’s an extremely positive session which can’t fail to leave you feeling optimistic for the future, albeit with a healthy dose of caution.

‘Exploring the Autistic Mind’ was next on the agenda and it was destined to be just as thought-provoking as the other sessions today. Speakers included Gilbert Hardistry-Miller, a non-verbal autistic man who showed a video he created with his artist collaborator Ben Connors about PigPen, a performance art club night they co-ordinate in London, Professor Simon Baron-Cohen, director of the Autism Research Centre, who explained some of the science behind autism and Jon Adams, an artist with Asperger’s Syndrome who took us through some of his art and how it reflects his autism.

It was an extremely enlightening session, from the science presented by Professor Baron-Cohen and the strategies he’s developing to assist autistic people with relating to other people, to the art of PigPen and Jon Adams and the ways they relate to their autism. It was clearly a topic that both interested and personally affected many in the audience and this was reflected in the questions that followed the presentations. For me the most important question came right at the end when an audience member asked if the panel view autism as a disability and the answer was a resounding no. Seeing the world through the eyes of autism is just a different way of looking at things and it is not for us to say whether that is right or wrong.

My final session of the day was a talk by Dr Alice Roberts who asked the question ‘Are We Still Evolving?’ For me the answer was obvious: of course we are, there’s no escaping evolution. But Dr Roberts presented a range of evidence that seemed to suggest that evolution may not be acting on the human race as much as it did in the past. However despite evidence to the contrary the overall conclusion was that, yes we ARE still evolving even though it may be that we are evolving at a slower rate than before.

So there you have it: the ethics and biology of saviour siblings, the consciousness levels of patients in a vegetative state, the world of autism and a new view on evolution. Now tell me that doesn’t sound like a challenging day!