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| Interview with Russian geneticist Prokhorchuk: If a woman wants an abortion, she shouldgo to a psychologist: |
| 2024-09-26 |
| Direct Translation via Google Translate. Edited. by Marina Akhmedova Editor in Chief of regnum.ru Egor Borisovich Prokhorchuk is a Russian geneticist, Doctor of Biological Sciences, and Dean of the Medical and Biological Faculty of the N. I. Pirogov Russian National Research Medical University. Prokhorchuk is also a member of the Synodal Commission on Bioethics of the Russian Orthodox Church. In a conversation with the editor-in-chief of the Regnum news agency, Marina Akhmedova, Yegor Borisovich spoke about the interaction of science and religion, the possibility of eternal life, and the difficult ethical questions that new technologies pose to humanity. - Egor Borisovich, what qualities should a person retain in himself so that he can live interestingly until old age? - Be like children, then life will be interesting. The main thing is curiosity, spontaneity, sincerity and a pure heart. - How can you do that? I see people entering middle age losing interest in life because they've seen it all. - They take themselves very seriously. You have to be like children. Look for something new, new people and even new adventures in one place. - Where can I find these adventures? — The Lord will not abandon you, he will give you adventures. You need to listen to your intuition and treat people with care, as you would yourself. If your brain, arms and legs work, you can be interested in life until old age. And then your life will be very interesting until old age. — Have you ever tried to stimulate your interest in life without it being connected to shocks? — Everything is relative. I am 53 years old, I still feel an interest in life. In addition to what I do, I am interested in how the world works. I am interested in building houses, I am interested in people — not as objects, but as subjects. Every single person is interesting to me. At this age, I even unexpectedly make friends. These are the gifts life gives me. — A question for you as a geneticist. I read a text in your Telegram channel where you wrote that at this stage, life extension does not seem possible. — Compared to how people lived 300 years ago, our active life is certainly extended. But personally, I am simply not interested in consciously extending it. - Why? You wouldn't want to live a very long time? — As God wills. I don’t want it to be like in the book “Professor Dowell’s Head,” where the head lives separately from the person. And I don’t want it to be like in the TV series “Black Mirror,” where you can order a complete biological copy of a person who still has memories if they were shared on the Internet. You can live long and meaninglessly, or you can live short and brightly. It doesn't depend on us. Here is my grandfather, born in 1914. He died in 2012, when he was 98 years old. And he told me every time: "If only I could live another year." That is, you don't want to die equally, whether you're 40, 60, or 100. But it still seems to me that we must do everything that is destined for us, and a certain period of time is given for this. The end will be the same for everyone, no matter how long you live. Thank God, humanity today cannot decide questions of life and death. Because this would create new social inequality. Eternal life will be granted later. But not according to our reason, but by the grace of God. — I finished reading a volume of Chekhov’s letters. I remember how he once wrote to his publisher: “I finished one thing, and the thought immediately starts to turn over in me like a heavy core: ‘You must write! You must write!’ But to whom must I write? Why must I write?” And then I thought that he had written little for me. Chekhov died at 44. But if he had lived at least another ten years, he would have managed to write much more. — I also read some of Chekhov’s letters: “I’m sitting, drinking, talking a lot, the weather is beautiful, I don’t feel like working.” So everything is relative. Other people wrote what Chekhov did not write. At least, that's how science works. Don't think that if Einstein hadn't existed, his laws wouldn't have been discovered. In science, there is always a certain vector of development. You can't do anything perpendicular. There are always prerequisites and previous works. Yes, there are people who seem geniuses to us. But if they weren't there, discoveries would have been made anyway, just a little later. Science is a completely collaborative endeavor. There is this giant pool of data that gets converted into hypotheses and probabilities, and all of this determines the massive movement of science. You can't get out of it perpendicularly. Yes, in painting there was Giotto, who introduced perspective. But the entire development of Western European painting assumed that it would be introduced sooner or later. In Eastern painting (icon painting) there is a certain tradition that is observed. That is, before Giotto, painters approached perspective, and he made a leap. In science, it is the same. — And now in science, can something be discovered perpendicularly? — Imagine that you are now in the times of Yaroslav the Wise with a working mobile phone. For the people of that time, this would have been a perpendicular direction, but for us, it is no longer. We understand how semiconductors work. We remember how telephone communication developed. But it took a thousand years to go this way. So life will still be more interesting than what I came up with. I have one hypothesis, I start looking at it, and it turns out that everything is not so, but even more interesting. — What is the meaning of your life now? — The meaning of life is a kind of banality. Life itself is a complex tangle of emotional and psychophysical interactions. Creativity, knowledge, communication with people, observation of nature — this is already a value. If we are not talking about its religious understanding. — Are you a religious person? — Every person is on a certain path to God. Remember what happened to the apostle Peter? "Before the first rooster crows, you will deny Me three times." But Peter was clearly a believer. As a member of the Synodal Commission on Bioethics, I can talk about this one way or another. But I am sure that the moment will come when every person will have to say whether he is a believer or an unbeliever. If he is an unbeliever, go for a walk. If he is a believer, throw him up against the wall. — Have you ever had situations in your life when you had to check what choice you would make? — Every day. When you are driving and someone cuts you off, what choice should you make regarding the driver: pray for him, just watch him go, or curse him? A person makes this decision every second. Like on a ship: you turn the steering wheel half a degree, it seems to you that nothing happened, and a day later it is already sailing in the other direction. — How do you react when you are cut off? - Of course, I try to react in a Christian way. But sometimes my humility is lacking. — The average person has an opinion that science and faith are incompatible. But the great sociologist Pitirim Sorokin said: when faith and science interact, then the time of harmony will come. Doesn't your scientific activity contradict your faith? — These are completely different concepts. Imagine again that you find yourself in the Middle Ages with a working mobile phone. How will people of that time perceive you? — Will they kill you right away? - No, you won't. You will be a god for them, descended from heaven, because you do amazing things. You can talk to a person who is a thousand kilometers away from you. And if you descend to them in a helicopter... They will not be able to comprehend this phenomenon, which goes beyond their world. Science doesn't operate with that kind of distance. In my field, I can imagine what will happen in a year by going to conferences and reading papers and watching trends. But I can't imagine what will happen in ten years, much less in a hundred. Look through the collections of scientific journals from the early 19th century - it's just ridiculous and sinful what they dreamed about. Almost none of it came true. — I had a conversation about bioethics, in particular about IVF, with the Chairman of the Synodal Department for Church-Society and Mass Media Relations of the Moscow Patriarchate Vladimir Legoida. The Church does not welcome this procedure because it is believed that God does not participate when an egg is fertilized by a sperm. I had my own opinion on this matter. What do you think? — My role in the Synodal Commission on Bioethics is very modest. I must share my scientific knowledge with people who can see something with their spiritual vision, and they could then, based on their spiritual experience, which I do not possess, give recommendations. The scientific method of cognition has long been a part of our lives. Without the invention of electricity, we would not have even recorded our interview. Denying scientific facts would be madness for the church, because the church works with people. People live in a world that is structured according to certain laws, and denying these laws would be strange. I gave birth to three children without IVF. We can talk about this procedure separately, but in general I answered your question about science and religion: my opinion as a scientist and my opinion as a child of the Russian Orthodox Church may differ. Life for a scientist and life for God are as different concepts as "red" and "salty". Science cannot be approached from the point of view of faith. Science is about your experiment being able to be repeated in Moscow, Antarctica and Africa, regardless of the psycho-emotional state of the researcher. Let's say an academic comes to me and says: "Believe me, my hypothesis is correct." I won't believe it. Where is your evidence? But in religion, it's the opposite. I will unconditionally trust the spiritual experience of the elder fathers. Because here I have no authority. — And what the elders, wise with spiritual experience, say, cannot contradict scientific facts? - It can. If you want specifics, let's look at it using IVF as an example. In this discussion, we were talking about what moment to consider the origin of life. The egg itself is not a future person. It needs a sperm, which is also meaningless on its own. The sperm penetrates the egg and a complex combination is formed: before your egg was created, it mixed with chromosomes from your mom and dad. This is necessary for variability, for evolution. A population is strong not because it has outstanding representatives, but because it can change and adapt to new conditions, which can change at any moment - it was cold, it became warm. For example, it's February 2022. Conditions change. And the qualities that were needed before February are not very useful in the world after 2022. And if your population has those who live in both warmth and cold, you will have those who survive. And if everyone dies, then the population dies. It will deteriorate as a species. Thank God, there were people left in the country who were able to live after February 2022 - and they actually saved the situation. Otherwise, the whole country would have perished. So, these two altered genomes met. And the genetic material in this cell is the same as in the first approximation. That is, this DNA will be the same throughout your entire life. — Does this mean that DNA defines a person? Is DNA a person or not? — I believe that a person is much more than DNA. There are twins. There are fraternal twins, there are identical twins. Fraternal twins are when two eggs are fertilized by two different spermatozoa, they are a brother and a sister. Identical twins are when an egg is fertilized by a spermatozoa, divides once, and from these two cells two people come from. That is, they have the same DNA, but they are completely different people. - So, this is the soul? — You reason like a journalist, and I reason like a scientist. External factors greatly influence the genome. For example, one embryo was closer to the mother's heart, so the heartbeat was transmitted to one embryo more than to another. The same genome can function differently, depending on external conditions. There are things that are in DNA. DNA determines the properties of a person as a physical object, but it does not determine his personality. Personality is determined by upbringing and life experiences. — You have just listed the facts as a scientist. And what would you, as a believer, add to the definition “A person is something more than DNA”? — I have consciousness and an internal mystical experience that says something. But these are very intimate things. I am not a preacher, I do not talk about these things. But I know that a person has a soul. Just like animals. It is just that a person has an immortal soul, and animals have a mortal soul. Animals do not need to be saved after death. Probably, for God they represent an auxiliary function in relation to people, rather than an intrinsic value. — Is the auxiliary function that we eat them? Or that we love them? — That we enjoy the beauty and complexity of the world. When you project something from a multidimensional object onto a plane, you see something, but it is very difficult for you to imagine the prototype. But these projections are so beautiful. Perhaps the prototype is even better. — Returning to our mobile phones: I thought that we are so firmly entrenched in them that we no longer see these projections and cannot create prototypes. - Well, you're not a Luddite (Luddites were people who destroyed machine tools in the early 17th century. - Ed.). You enjoy the benefits of civilization. And then they'll produce something else. The conscious history of mankind is five thousand years old. Mankind has had many temptations to use useful objects for harm. Television can be used for education, or for stupefaction. An atomic bomb can be used to kill people, or it can be used to obtain heat and warm homes. “And I’m still trying to connect you in my mind—I don’t want to separate you into a scientist and a believer.” - No need. Let's go back to IVF. Now, most people who make decisions in the church about the possibility or impossibility of assisted reproductive technologies proceed from the fact that human life begins at the moment of the fusion of sperm and egg. And the IVF procedure is associated with the fact that you fertilize not one egg, but dozens. Some of them develop, some don't. If you have five, it's hard to choose just one. And before, five were always implanted, so that at least one would take root. And if four took root, then the remaining three children were aborted, because it's hard for a woman to carry five children at once. They were simply killed by abortion. Now the technology has advanced. You can estimate the embryos' chances of development. If they have equal chances, by law you can leave a maximum of two. But three remain. What should be done with them? - This is a big ethical question. - Yes. Formally, they are frozen, but we understand what their fate will be - they will be thrown into the trash. From a biological point of view, these are not people. On the 14th-15th day after implantation in the uterus, this is already considered a more or less composed person, and before that, it is not considered as such. That is, what is frozen is not a person. And here, in addition to the theological and technical aspect, there is also a legal aspect - and it is the key one. Let's say there was a rich man. He died. He left behind children who inherited his fortune. Everything was divided, everything was fine. And then a notary comes and says: "You know, he has a dozen more frozen little people lying there. We need to share with them." And then there's another question. If these are people, they may have genetic abnormalities. Then you're legally obliged to treat them. You have to edit their genome. And that's not safe. So this is not a question for scientists, but for those who consider embryos to be people. Perinatal surgery is very developed in Moscow, when the child undergoes the most complex heart operations in the womb. He is not yet a born person, but he is already receiving help. — It seems to me that in this case it is already clear that the child will live. But when we are talking about a two-day embryo that is in a test tube, it is not a fact that it will survive. — An abortion up to 12 weeks can be done without indications. We understand that abortion is murder. Although we do not see this murder at all. This is dangerous logic. — Do you advocate a ban on abortions? There is talk that abortions should be excluded from the compulsory medical insurance. — I believe that we should not force a woman to have an abortion and should not create conditions that abortion is a norm of life. If a woman comes and asks for an abortion, she should be taken to a psychologist so that he can explain that the child should be saved. How do we treat a woman in general: as a mother or as an employee? This is a state issue. Of course, women are involved in the economic life of the country. If all women went home to look after their children, our interview would not have taken place. Our economy would have collapsed. Even if a woman gives birth, she still goes to work afterwards. A friend of mine died at the front. He was a priest. Unarmed. A Hymars came and killed him. He left behind six children. His wife did not work. Her job was to look after the children. But, I repeat, diversity is important in the population. A woman with one child brings a lot of benefit to the workforce. Yes, we want our families to have at least three children. Two is only reproduction, but three is already a step forward. This issue cannot be resolved by prohibitions or permissions. It is a whole complex of scientific, economic and cultural problems. — A question about parents. Is it possible to look at their genotypes and identify a predisposition to having healthy children? - Predisposition is like fortune telling with Tarot cards. Each of us is a carrier of thousands of genetic diseases. But we do not get sick because we have two chromosomes from mom and dad. If there is a mutation in one of the genes, the second chromosome compensates for it. This is a recessive trait of inheritance. But if your husband or partner carries a mutation in the same gene, then there is a high probability that a sick child will be born, because he will receive one and the second copy of the mutant one. A very high probability - 25%. That's why consanguineous marriages are not allowed because we carry the same mutations. You also carry about a dozen of these mutations. But these diseases are very rare. For example, cystic fibrosis. Every 50th person on the planet is a carrier of this disease, and children are born 1 in 10 thousand. Why? If every 50th person is a carrier, then the probability that you will form a couple will be 50 times 50 - one in two and a half thousand marriages. 25% of children are born sick. 25,000 multiplied by 4, we get 10,000. Here is one in 10,000 - the frequency of birth of children with cystic fibrosis. But every 50th person is its carrier. And there are many such diseases. Let's say your risk of asthma is 11% higher than the population average. What does that mean for you other than a disorder? Nothing. No medical recommendations can be given to you based on the results. Exercise, go outside, drink grapefruit juice. But here the situation is completely different. Here the disease will definitely occur when you know before marriage that you are a carrier. This is a very big ethical problem. — I helped a deeply religious family whose first child was born with spinal muscular atrophy. He was a wonderful baby. But in the third month, his mother began to notice that life was fading in him. His arms and legs were weak. — What happened next? — I helped them raise almost 30 million for Spinraza. When the baby was given his first injection, he died. It was an incredible tragedy. The parents love each other, but they are afraid that their next child could repeat his fate. - Can I ask you some questions now? - Let's. — You collected 30 million, but the child died. Let's say you saved him. But do you know that in Kargopol (Arkhangelsk region) there is a very bad situation with children's clinics. There are 10,000 people there, quite a few children. For 28 million you could provide for the life of 1,500 children in this city in the near future. And how would you resolve this ethical problem? — I have no choice in this situation. I am ready to help everyone. The boy was already born, a beautiful baby. He was already, how can you say that I will not help him? What choice do you have? If the situation with polyclinics in Kargopol is so bad, I am ready to give part of my salary to them and to the baby. — When in ancient times a woman had to choose who to save during war or famine, she saved a man, not a child. Because children can be born again. Of course, every family that faces such a situation will want to help their child. And society must train the muscle of compassion to help such children. If everyone is born healthy and happy, then the muscles of compassion will atrophy. But to pay huge amounts of money for an injection for the sake of one child? — This is not a question for parents, but for the manufacturers of the drug. — Do you know why the drug is so expensive? - Yes, I know. I was interested in this. — There are just few such children. And to make a drug, you need very expensive science. Drugs for cancer, which hundreds of millions of people suffer from, are a source of money for pharmaceutical companies and are cheaper. But when you have 10 people in the world who are sick, these investments will not pay off. This is capitalism. Everyone needs profit. That is why Spinraza is so expensive. But let's continue. What does the family you were talking about want now? To have a healthy child? - I don't know what they want. I left them in complete confusion. They were heartbroken and afraid of the future. They didn't know what to do. — Let's say they knew before marriage that they could have a child and die. Not because they are bad, but because of a genetic lottery. Or because God gave them such qualities. And then everything depends on how ready they are to accept and fight it. Judging by my pride, you might think that I am ready to put up with everything. But the statistics are that in Russia, 90% of mothers of children with Down syndrome abandon them. This is reality, not an illusion, as it should be, but reality. By the way, in Denmark, where complex biomedical tests can be done before birth, the abortion rate for children with Down syndrome is the same as the refusal rate in Russia. Although Denmark has an amazing program to help such families: tax breaks, inclusive schools, help with socialization. That is, it is not about money or the environment. It is just that the human psyche is not ready for such difficulties. — Do people abandon such children because they don’t want to face difficulties? Or because they don’t want their child to grow up unhappy? - It doesn't matter. You can explain it any way you want, but you're either abandoning the child or killing it. — I just now, excuse my conceit, imagined that I was accepted to the bioethics council. You say that abortion is murder. But is abandoning a child better than murder? How will a woman who abandons a child feel? — We shouldn’t overestimate the importance of our minds and our words. To abandon a child, afraid of suffering, is a biological property of the human psyche. Anyone can get scared here. Even me. There was a big risk that my third child would be born with Down syndrome. I really didn’t want to find myself in such a situation. Now, under one program, all women are tested. Research has shown that if 100 women are given this risk, one child can be born with Down syndrome. That's a lot. Research can lead to a lot of abortions. There are pros and cons to this. But the cons are that you know for sure that it is so. You have no choice, you make a decision. Now I would not want to be in such a situation. Thank God, everything went well. A wonderful girl was born. But I wavered at some point. I started thinking about what I would have done. — And yet, when you have the opportunity to find out in advance about a child’s serious illnesses, is it good or bad? — We talked about SMA and Down syndrome. Down syndrome cannot be predicted in advance. It can only be found out after the fact. But SMA could be predicted. If this family had known in advance that they were carriers of such a disease, would they have agreed to marry? — What about love? - And love is blind. When you get married, you go to that person's house. You look at their family album. You smell them. You subconsciously evaluate their family, their appearance, their ethnic background. Genetics must be one of those factors. You must decide: are you ready for the fact that the child may suffer, and you will suffer from the choice of what to do with him if he dies in your arms. Maybe you feel the strength to fight, you are a supporter. And what options does the couple have? The first is to run away. Let's say the couple knows that they are SMA carriers. Run away. Life will take its toll anyway, you will find another person. - It sounds very pragmatic. — The second option: say that you don’t care. “I don’t believe in all this, as God wills, so it will be.” You get married, have a child, everything is wonderful. But if he is healthy, that’s one situation. If he is sick, you bear it as a cross. If he dies, that’s also your cross. The state has two strategies on this matter. First: it warned you that you could give birth to a sick child. The state says: "Since we warned you, we will not help you." Second: "We warned you, but by giving birth to such a child you performed a feat, so we will help you." Both of these strategies can be considered. The next story is when you use assisted reproductive technologies. You fertilize 4 eggs, 3 of which will not carry the disease. You say, "I'm not implanting this one, I'm throwing it out." The question arises: do we kill it or not? It turns out that you are going against the Church. Although the Church does not forbid anything to anyone. It simply says that this is according to God's law, and this is not. — Before this technology, a woman couldn't choose, she just gave birth. She didn't know that a child with Down syndrome could be born. She didn't commit murder, she wasn't guilty before God. — We live in a world where diagnostics exist. We can detect cancer at an early stage. You can resign yourself to it: well, God gave us cancer, why fight it? But no, we go and do CT, MRI… And this applies not only to cancer, but also to other diseases — heart disease, for example. Healthcare is moving forward. Medicines prolong our lives in a miraculous way. And returning to our question: the fact that a woman learned earlier does not make her more or less guilty. But what to do with this knowledge is a big ethical problem. - That's what I'm talking about. - But let's take cancer again. It was detected, it's a gift from God. What should we do, go against God? Let's not treat it. - I disagree. When a person treats cancer, he does not kill anyone. But when he decides to have an abortion, he kills a child. - Okay. And when a woman finds out that she is a carrier of SMA, her child has already died. What should she do? - It's a monstrous choice. I'm trying to understand: if God gave people these technologies, then that's what he wanted. - In that case, nuclear explosion technologies are also from God. The question is how to use them. Any technology can be used for good or for harm. That's how the world works. — All these biotechnologies put people before a new choice. - Any technology puts a person before a choice. Previously, a hundred peasants fed one landowner. Then the tractor arrived, the peasants became unnecessary. A revolution occurred because people needed to move to the city. They needed a change in the social system and economic formation. And now artificial intelligence is coming. Most creative people will be unnecessary, texts are already being written for them. In agriculture, they came up with GMOs. The point is not that you will grow a scorpion's tail. The point is that you can keep even fewer people on the land. You raise the productivity of agriculture so much that one person on the land will feed a thousand city dwellers. This is a political problem. I recently drove through the Tver region and saw that people are leaving because there is no point in living there. Agriculture in the Tver region is incomparable to agriculture in Kuban. There is no point in raising cows there - milk is more expensive there. And if you want to increase the efficiency of agriculture, the territories will be devastated. The question is how a person with a sincere attitude towards life can accept these technologies. - And how? — The Patriarch says: we have encountered a challenge where we cannot draw on patristic guidance. These questions have never been illuminated, there is nowhere to draw on. These are complex questions. And we ourselves must find answers to them. And for this you need what we talked about at the beginning: you need to have the ability to learn about the world, communicate with people and engage in education. If you study something deeply, you can foresee a lot and use this knowledge to plan the life of the country. |
| Posted by:badanov |