 I give everyone a chance to read from my personal experience, so I can only talk to it from a personal experience position, which is obviously, you know, from the UK. A lot of your discussions relate to disabilities, relates to related issues. When we work in the NHS and provide a clinical service, we get away from any of that because health is provided free at source to anyone that's needed. Irregardless completely of whether you can afford it, or what your ethnic background is, or whether you're disabled. And maybe that's something that might solve some of your problems. We don't have that. Yes. Maybe followed on then with terms of reproductive technologies because you consider a wider understanding of reproduction, which is almost a society's development and how it works. That which I understand. Reproduction, as I see it, which is in a clinic with people who want to get pregnant is actually very private and very basic and the desire to reproduce is there fundamentally for everybody irrespective of where we come from. And we do interbreed as well. We're not separate races from that point of view. We're not separate separate beings. So it's from my perspective, it's maybe stretching. It's a little bit farther to sit far too far to think of reproduction as society issues. But maybe you'd like to. Yeah, let me let me pause on that word private. And have us think about the relationship between the public and the private and how the private itself is a social achievement that not everyone has the luxury to enjoy. That is, many women's reproductive experiences are in public hospitals in which they're highly surveilled and which their choices are not their own. In which the things that we would think are the most intimate private decisions are open for others to decide for them. I have a colleague, Professor Kiara Bridges, who's written two phenomenal books. One was an ethnography of a public hospital in New York. And the second is really theorizing this idea of privacy and its relationship to race. Beginning first with thinking about how private property, which is what I was alluding to in terms of the relationship between real estate, segregated neighborhoods and thinking about the property of your own body, that question, who gets to decide, right? Our history of racial coercion and hierarchy actually informs the way in which people can experience their own bodies as their own. When you go into a public hospital in any major city in the United States as a woman of color, as a poor woman, especially as a young black or Latino girl who is pregnant, you do not have the luxury of privacy, right? In terms of not only your decision making, but in terms of what and how you can berth. And so I think that even in the context of public institutions, whether being public health, public hospitals, there's a lot that goes on even under the cover of public that is coercive, that reproduces social hierarchies. And so only creating an actual robust public health system, right? Where everyone has access to basic health care. It's a starting point. It's important. But it's not a panacea. It's not going to solve everything because within the context of public goods in this country, people are experiencing deeply repressive forms of medicine. And to get a real sense of it, I would encourage you to look up Chiara Bridges' texts on these issues to see both in terms of the ethnographic dimensions, the nitty gritty, the conversations, the way that women are treated on a day-to-day basis when they move in and out of these hospitals. And even the fact that the coercive dimensions go with them into their homes, right? And also to read her work at the theoretical level where she's really conceptualizing the relationship between privacy, the public and race to get a handle, I think, on both of these dimensions in the context of the United States. One of the things that really struck me in the way you were talking about was this concept that a lot of people that suffer from genetic disease, they don't want to be quote unquote cured, right? And I think that's something that's interesting about genetic disease that separates it from having a flu or something like that, right? You know, our genes are very central to our being, but there are patients who do want to be cured. So that's always been a tension that's been on my mind, you know, as a scientist. You know, there is this pressure to try to develop a technological fix, but then of course there's a pressure for people that don't want that fix to take that fix. So I'm really curious your thoughts on that tension. Yeah, I mean, I think that's one of the central fault lines, but I think one of the ways that I think about it is really for us to begin to appreciate the social complexity of the people and the worlds in which medicine and technology are relating, right? I think too often my experience has been that the social dimensions get flattened in these conversations and a particular kind of poster child that is very enthusiastic and as a kind of cheerleader for the science becomes the face of the public and comes to represent everyone. To me that's the kind of flattening of social reality, and so in my work and the talk what I'm trying to do is just to show us a little bit of the contours. It's kind of like a map that shows the rivers and the valleys and the mountains because the flattening is I think a disservice to public discourse where we have professional advocates who their experiences are worthy. They need to be heard, but too often they monopolize public space and they become the poster child. The illnesses, the experiences of parents whose children have a debilitating illness where they, for example, are going to die within the first six months or a year of life or have a lifetime of crippling illness where our sympathies are drawn, but they become the stand-in for everyone, right? And I think what we want to do is bring into the same fold the social complexity. The way that I think about it is that we don't ask a scientist from one field to represent and speak to all of the complexity that's happening in the life sciences, right? You know what you know, you're lame, and we appreciate at the epistemic level the idea of biological complexity that we're not going to have one expert that's going to stand in for all of the dimensions of biological life, but we often do that with social reality, right? We think that one sociologist can speak to all of the complexity, right? And I can't, right? And then same way, one set of patient advocates or one advocacy organization should not present themselves as the voice of the public, as a stand-in for everything and everyone. What we have to do is hone technologies of deliberation in which we can come together in venues like this and give voice to the variety, the heterogeneity that's among us. We're not one group or one stance is monopolizing the conversation and sort of directing the direction either against or for science, which is a false binary that I hope we will begin to dismantle. I want to comment on your question. Often the answer to that question is that we want to give people a choice, and we have to deconstruct choice. What are the factors that influence anybody's decision about such incredibly painful personal complicated issues as using prenatal testing or undergoing abortion or all the issues that we're going to be raising today, and I'm going to be talking more about that this afternoon. We make decisions under the duress of enormous social pressure. However, we're positioned socioeconomically, for example. We'll come back to that. Ruha, you raised such a broad picture. I appreciate the wide view. I often think actually I'm on a panel and I think we should have had more economists here to give us that factor in these discussions. So I just want to hear you talk about economic disparities and how they operate as a subtext to these genetic technologies. Huge question, and I do wish there was an economist here, a critical economist who could speak to some of this. I think my starting point is to yes acknowledge economic disparities, which I see as falling into the questions of access to even basic healthcare, much less high end reproductive access. I remember when I was a grad student at Berkeley on student health insurance, my two year old was running and split his chin open on the sidewalk and sitting there and thinking, can I take him to the ER? Nope, I can't. It wasn't going to be covered and luckily he's one of those over healers, so like Harry Potter just like sizzled up and got a little healed very quickly. But thinking about questions of how people are just juggling the everyday in response to these high end technologies, one of the people I interviewed for people science put it like this. She said, before we figure out how to get to the moon, can we make sure everyone on my block can get to work? That kind of juxtaposition of who gets to set priorities. The initiative that I studied for people science was a stem cell initiative that my dissertation advisor at the time, Professor Thompson, encouraged me to think about with these lenses in mind. And it struck me that at the same time that Californians went to vote for Prop 71, which did invest $3 billion into building an entire infrastructure around stem cell research, a new state agency, a new constitutional amendment that would end up being I think $6 billion with all of the interest over 10 years, the very same ballot had Prop 72 on it, which was attempting to expand employee based healthcare to most Californians and at that election we, those who voted, voted up the future of regenerative medicine and voted down the expansion of basic healthcare. Which to me speaks to this idea of our imagination. What do we think is worth investing in? What is a priority? What can't we live without? And it says to me that you must already be pretty secure with your basic healthcare needs if you can project into the future, future stem cell cures but not so worried about being able to take your son to the ER when they crack their chin open. It says something about where you are currently that you can project into the future and not worry about the now. And so in some ways this is about access but not simply access to what's coming but access to what's already here. There's so much that we're talking about if there was political will around it, if there was a sense of social solidarity. Right? There are things that we could do yesterday that we haven't done that could heighten people's experience of life yesterday, right? That we don't have to experiment, we don't have to tinker with, but that we choose not to do. And this is something I think we have to grapple with. Thank you for that. I want to raise one of the questions that one of our high schoolers actually submitted that kind of feeds into this. And this high schooler said what can we do as high schoolers to impact reproductive technologies in order to focus on bridging, highlighting and educating people on class race and disability divides? What would you say to the young people in this room? I think that also applies to the college students here as well. I have lots of thoughts about that, but I could open it up and just see, does anyone else have some thinking around that before I continue? What did you say a few things? Sure, so I mean I think ground zero for a lot of this is pedagogy, is what happens in classrooms and schools and the way that we discipline students to think and become expert. One thing, and not being able to see the connections between fields, between questions. And one of the programs that I was really impressed with when I was a postdoc at UCLA at the Institute for Society and Genetics was a pilot program in a local school in Watts at Los Angeles in which they were introducing a curriculum around genetics, but that completely integrated the social dimensions, the ethical, the political dimensions and it also started from students own experience of genetics. So it didn't create the false binary of these are the intellectual questions and these are the personal. It brought those into conversation. It didn't rely on the false binary between this are the social things over here and the scientific things over here. It was built around the connections and I think we do our students a disservice. We do our society a disservice because we're not equipping our students to really understand that the social, the political, the ethical are not ancillary. They're not the tag on. They're not the thing that you do the science first and then you add a week of ethical questioning at the end of the semester when everyone's just ready to go home. I've been at so many meetings around whatever gene editing, stem cell research where the ethics are the very last panel at the end of the day when everyone has their carry-ons and about to go. Or the very last panel when there's like you can smell the dinner simmering in the background and no one's really. Or really good one where there was an ethics panel at the end. Someone must have complained so they added an ethics panel at lunchtime when everyone was like opening their chips bags and things and I said the ethics are very hard to hear. And so thinking about pedagogy, so if you're a student and you notice that these false binaries, science over here, society over here, personal over here, scholarly over here, that they're informing the structure of the curriculum or the structure of the class. Ask about it. Say why is this class or this workshop or this curriculum designed like this? And this is what I mean that the questioning of design applies to every social arena. There are always things happening behind the scenes that then we take for granted. We think this is just the way things are. This is just the way things have to be. As students you have to question how things have been designed, right? So one of the people that I interviewed for People Science put it this way with respect to stem cell research. They said and they were talking about different advocacy groups in California after the passage of that Prop 71. They said we don't just want to be on the table of stem cell research. We want to be at the table of research. That is, we don't want to just be the test subjects where you call us in to get a diverse clinical sample, right? Which is where the whole diversity rhetoric steps in. We want to be part of the decision making, the designing, the envisioning of how this thing is going to take shape. And students, again, you empower yourselves to do that questioning. To ask why is this the way it is? Why can't it be differently, right? Because how you're trained now it becomes encoded into you and then when you go off into your professional lives, you know you're going to know what you know. You're going to know what you've been trained. And if you haven't been trained to raise these questions it's going to feel like a foreign language, right? You're going to feel like oh I need the social sciences to do it. No, we need people who are getting trained in engineering the life sciences to also be proficient, right? Be conversant in these kind of things and not sort of tagged on at the end. Right. Do you're reading, participating class, get a good liberal arts education? Yeah, that. And get many perspectives. That's what I meant. Alison, it sounded like you wanted to jump in there. Well, it's perhaps bringing it down to basics just a little bit more because the question came from a high school student and it was about reproductive technologies. And to my mind that means getting pregnant, okay? Which I guess most of you don't want to do just yet. And for most of you it's not going to be a problem. For most of you you're going to conceive very readily. The biggest thing that is affecting your ability to have children in the future is leaving it too late, ladies, okay? There is a change in society now which is encouraging women to be educated, to think, to do the things they want to do in life, to have their family later once they've enjoyed life a little bit. The reality is that your half of life needs to have a healthier baby when you're 35 if you are at 25. So leaving it too late is perhaps going to take away your reproductive choices. I hope none of you will ever need to have the assistance of the reproductive technologies that are provided now. I hope none of you will never need to have stem cells or genetic diagnosis because most of you won't. But I do say that in terms of reproductive technologies don't leave having your children too late unless that is your choice. Because I see too many people in the clinic who simply have left it too late and they can't have their children at that stage. So that's going offline a little bit from what we were saying but it is actually what society is doing. So let me push back a little bit on that because I think one of the problems and one of the reasons women do leave it too late is because if they try to have children in their 20s they're going to ruin their careers for their future. Because at least in our country we do not allow for maternity leave universally and we certainly don't have access to good childcare affordable for everyone. And so they're making a choice in their 20s. Do I want to have a career or am I going to take off into the baby track, the mommy track and not be able to come back. And that means if they do come back their income for the rest of their lives is going to be lower and so forth. So there are choices that need to be made along the way. I work in contraceptive research and so my goal is that everybody should be able to choose when they want to have children and how many children they want to have. There is a huge disparity in access and for a long time people made judgments about what did women want. And there was a large study in St. Louis in which they gave young girls particularly from low income communities the choice first they explained to them that a long acting method such as an IUD or an implant would be 99% or more effective. And the typical failure rate for a pill is 9% which is pretty high and those people don't realize that there's maybe a 20 to 50 fold difference in the effectiveness of those two methods. The cost is a lot up front for one of those devices but they last a long time. They didn't have access but they came that by saying you can have whatever you want and we'll give it to you today and they thought maybe 15 or 20% of those young women would choose the long acting methods. In fact it was about 75% and a year later most of them were happy and still using that method. So that was a huge learning curve but you would have thought maybe we would take that lesson and by the way it brought teen pregnancy down in the area from 35 to 6 a huge factor. And it has not been generally applied although at least with the passage of the ACA making methods and having no cost associated with getting the method has been a big factor in increasing the accessibility. But that's a huge, I don't know how you work all that into the health disparities but that is to me a big factor that wealthy young girls manage to find contraception if they need it and want it and low income women do not have that same access. Thank you. So we have some more questions from the audience that we'd love to get to and one of them is, you know, so we've talked a lot about the inequities that are kind of built into the system, built into the design and all that. Are there positive models of reproductive engineering or justice oriented approaches to the way that science gets done and Diana you kind of touched on that a little bit with the adjusting to account for what people actually want in the realm of contraception. So I'd like to throw that open, but you can address that as well, but to the scientists in this room, do you have also some kind of experiences on social justice approaches? I think that knowledge is power and we do not educate our young people about their options and it would be helpful if we could if that were part of the curriculum before they get to college. That would be something that as they get into puberty, it's time to know what the consequences are of their reproductive functions. It shouldn't be a secret that they learn about someday. Education as a form of, as one aspect of social justice. If children are educated to know what their bodies do, what their options are and if they have options, that will create a path to social justice because they have information. They don't have the information and they're victims of whatever environment they happen to be brought up in. Very briefly, one of the things that I studied as an undergrad and that thesis that I projected was what I think of as a positive model designing a different way to relate to to approach reproduction. That was studying the black midwives that have worked historically in this country with often the people who are being underserved or harmed in the more conventional institutions. In Atlanta, Georgia, for example, there is a black midwives network that actually goes across the south that comes all the way to California. One of the differences in this model of approaching reproduction is that these are people who are embedded in the communities that they serve. If you talk about what young women know, they're not first learning about particular things when they go to a visit with a doctor. These are conversations and ongoing relationships that inform what they then know about their body, about childbearing, etc. Part of it is to think about the relationship that experts have to the communities that they purportedly serve and the greater the distance, the likelihood that all kinds of things fall through the cracks. For those who are interested in different kinds of models, this is just one of how we can approach reproduction. I would say look at specifically the black midwives network throughout this country. That in many states has been outlawed or in different ways been pushed to the margins for a variety of reasons. But just thinking about how to recoup some of those traditions and those approaches as we move forward. It's not either or. It's not high tech or kind of low tech midwifery. It's thinking about how we can integrate it so that everyone can have the experience that they need to have. Can I respond? Sure. I had a second to think about the question about planning, young women planning their motherhood around their careers. How about putting pressure on employers to be much more flexible with part-time work, with childcare in the workplace, with working at home? Yes. I think that point bridges the idea that what happens in the privacy of your individual choices is informed by these larger structures. Yes, it's your choice, but it's your choice within parameters that you haven't set. What if we broaden those parameters so that we redefine what a choice is and say in fact you're not making a choice out of a whole universe of possibles, you're making it within a narrow set of parameters that have been set. And what if we actually attacked some of these problems from thinking about broadening the context in which you're deciding employment, social network, social support systems. So that, for example, I had my two sons in my twenties in part because I had a small but strong social support system that allowed me to navigate grad school and my first jobs so that it wasn't just me in the nuclear family. I think of nuclear family, nuclear, like tick-tock. It doesn't work just to support those kinds of decisions where you're trying to have kids and juggle everything. Right, and I think just tweaking that language and saying that it's a decision takes away some of that connotation when people say choice, it implies some desire and I don't like that word because it often times is not a desire, it's a decision. Alison, you need something else? I would like to go. It was following the question that I wasn't quite picking out on about what are the good points and are the good experiences of reproductive technology. There are lots and lots and lots and lots of them and I would not be working in a clinical practice providing reproductive technology on a day to day basis unless 99% of what I did was what patients wanted and they went away happy. The problem is I think it is at the press, the media, they like the difficult stories better than the good stories. So we hear the bad things, they like science fiction stories, so we hear science fiction is what if this is going to happen, this is bad and we're not hearing those good stories. But I mean there are dozens of clinics out there providing treatments, not some of the new things we're still talking about now that are being developed, the mitochondr stuff, the stem cell stuff, that's still very new but technologies that 10, 20 years ago were new but are now absolutely standard and we don't worry about them. We thought heart transplants, kidney transplants were going to be horrendous things that were going to change people's personality now they're everyday. So there are lots of good news stories out there, it's just they don't always make the headlines. I just wanted to pick up on a couple of points that have been circling around but many of you are probably aware that some of the Silicon Valley technology companies have instituted a benefit they cover egg freezing for women. And that's an example I think on the one hand it's a wonderful thing to do, it recognises that you're likely not going to have your family life and your reproductive time be right in relation to where you are in your work until it's quite late. But it also is this thing that you talked about, the technological fix for the social problem that instead of doing what Marsha was asking for and actually reframing the workplace somewhat to allow people to have their children earlier it assumes or accepts the status quo. And I also wanted to just kind of bring that back to this idea of going wide that Ruha has been talking about and not really necessarily seeing it as confrontational with the science but actually seeing the two as really coming together on this. So there's an old feminist slogan that every technology is a reproductive technology and I'm somebody I'm trained in the sciences originally and I'm a real technophile. So I love the sciences, I love technology and so I always in my classes I teach every technology is also a destructive and a productive technology. And being able to pan back when you need to to think about what lives are being made to live, what futures, presents and pasts are dying in living in the way that we're currently living and who works and how do they work and what kinds of work is recognised and remunerated. And I'm working in the US partly at the moment and there the healthcare is dependent on the labour function as well. But one of the situations we have with reproductive technologies and the genetic screening technologies and mitochondrial work and things that's happening at the moment is we're extremely concerned rightfully about becoming selecting societies. Of course we're already selecting societies in all the ways that Ruha was talking about but we're concerned about doing it in this very, very purposive way. But what we're dealing with is what you were saying which is individual people often watch the child die or they're living with children with large amounts of suffering or they themselves have. And often they don't want to select to design a race, they just want a baby who won't die or won't really suffer. And one of the things that the youth can do is ask for good data. We need to take those decisions off the backs of individual couples and off the backs of the individual petri dish and say let's just take a deep breath. What are we selecting for? What are we selecting for? Who gets to go to school? Who gets to go to university? Which embryos are we deselecting? Which pregnancies are we supporting? Which mothers get to keep their children and raise them in conditions of dignity and economic stability and housing security? We need to be able to collect good data and we have the capacity now we're living in a data rich society. Nearly every student in the liberal arts will have some science and some humanities. Demand the best we need to be able to ask those questions based on the data not on the backs of individuals who are suffering and for whom the privacy is all important or their physicians who are trying to care for them to the best of their capacity. Thank you. So I think we have time for one more question before we have to head out for lunch. Eight minutes. Okay. So we have another question here. If the technology to alter the genetics of humans before they're born becomes available, how do we prevent the privatization of this technology from creating an elitist society in which only those whose parents could afford their genetic advantages succeed? So is the answer to, you know, it's kind of gets, you're critiquing this idea that, you know, is access the solution so that everyone is that going to level the playing field? Or is it a zero sum game? Is it just not, is it not possible to actually be socially just? And if that then, then what? So I don't know if perhaps I don't want to put anyone in the hot seat, but there's some people here who might want to talk about that. But this is something that, I mean, I think about this a lot because it's, this is really tough, right? I mean, there are already huge disparities in medicine to begin with, right? Who gets access to different medicines? But writing that into someone's genome and passing it down to their kids, that's a whole different ball game from like, do you have access to the latest cancer drug, right? But like, you know, do your kids get this disease or not? It's a totally different thing. And I have no good answers to that. I mean, I think as a, you know, I think all sciences are members of the public and members of the community, right? And so we're interested in research and we're interested in trying to provide solutions to problems. You know, patients come to me and I get a lot of emails from people saying, oh, you know, my kid has this disease. Is there some way that we can do something about this? And yes, I want to help, absolutely. But, you know, all I can say right now is that at the moment we can draw this distinction between so-called somatic editing, which affects just you, just one individual. And then there's germline editing, which could be passed down to kids. And I think that at this point in time, given that, you know, there's by no means have we addressed a lot of societal problems, maybe we should stick with things, you know, if you could address a disease with somatic editing, you should stick with somatic editing. I think that sometimes, for good reason, patients poach back on that. And I think that's another really hard problem. You know, if you tell someone, okay, you have this disease, we're going to cure you right now, there are patients that have come back and have said, well, okay, great, I'm cured, but now you're going to have to cure my kid and then the grandchild is also going to need the same cure and it's just going to keep going, why don't we just stop it right here? And that's, I think, a tough problem, right? If you could cure something with somatic editing, but you could also cure it with germline editing, why not do germline editing? I think there are a lot of reasons, there are a lot of pluses and minuses and I think that's maybe one of the good reasons to have this kind of audience and this kind of panel to talk about, not just technologically, can you do it, but like, should you do it? Dr Cornwright, now if I could, you might want to offer a little brief definition of somatic versus germline editing. Yeah, sorry about that, I skipped over that. So somatic editing would mean you edit just the one individual. So, for example, in sickle cell disease, you might take bone marrow out of a person, edit it to take the sickle mutation, put it back to wild type and then put it back into the bone marrow and that's not going to be passed down to traits, but you could do the same thing in a so-called germline way and that trait would then be passed down. So not only would you no longer have sickle cell disease but your kids would not get sickle cell disease as well. This is especially important in cases, it's not as important for sickle cell disease, but there are some diseases, for example Huntingston's disease, so-called repeat expansion neurodegeneration diseases where the kids are always affected more than the parents and then the grand kids are affected even more than them, right? So it gets worse and worse and worse by generation and those have been put forth as good reasons maybe we should be doing germline editing because then you just stop out right there. I think that these are things that you don't necessarily want to say we should for all diseases do X and all diseases do Y. We're talking about personal cures for personal individuals and at least to me, I think you should be talking about the application of these technologies in a very personal way. I think we have time for just one more question actually and this is I think interesting and it's a question that I think that all of us as we go off to lunch can think about what is the relationship between private and public? So how can the private or individual choice about reproduction affect the public and the social, right? So do individuals have an obligation to put off having children or not reproduce for the public good? Like who's responsibility is that we've talked about scientists and we're going to talk about these larger structures but where's the individual and all of this? So for sustainability or something, there was a study recently that came out that said it was an article that said the things that you can actually do to help the environment and number one in terms of the greatest impact was not having kids and the recycling was much more. So I think what this person was asking and there was a problem with that because it didn't acknowledge that individual choices are a drop in the bucket compared to corporations and governments, right? But I think it raises this interesting question. How should we as individuals be thinking about our own obligations to the greater good and then you get into these sticky questions of who decides who makes those decisions? I'll give a round about just my thinking around that. It's not a prescriptive like this is how you should think about it. But just again employing that principle of relationality that it's not a binary. It's not that some things are private and some things are public but it's thinking about how they relate in all kinds of ways and the relationship is not one thing. But let me just use an example that perhaps many of you can relate to as you're in the college setting. Show of hands, how many of you did any kind of SAT prep class or workshop? Yeah? All right so you know when I was applying to school it wasn't really a thing yet where everyone felt pressure or that was going to give you the edge, right? Let me take that SAT prep program. Individual choices, people started taking that, they became offered. And so now if you choose not to do that, for many people it puts you at a disadvantage, right? You don't have that same preparation. It's individual choices but it's creating a social phenomenon, right? In which the choice to opt out actually has repercussions, right? And so we want to think about how our individual choices take shape in a network. We are connected to one another. Our choices matter for one another. And so if you think about when something starts out as a choice but then becomes more and more of an imperative, right? Then we have to question is it really a choice anymore when there are these repercussions if you decide not to do it? It blurs the line between a choice and something that's imposed upon you, right? And so I think we want to take that principle and think about how it relates to all kinds of things that start out purely, seemingly, individual, private. But through the collective choices that are made, the kinds of availabilities that it creates imperatives that when you decide not to and it relates to the question before that it can then leave the realm of pure individual choice and become a public issue. It's a feedback loop and everything. Alison, yes. Yes, just can I address this in nothing reproductive terms because I think that is too complicated because the individual drive to reproduce is just too strong. But think of it in terms of vaccinations. In society, we encourage everybody to vaccinate their children against German measles or measles or whichever you want to do. And society is certainly in the UK, it's a national programme. Probably the same here. Some children are going to feel a bit ill but we actually agree that it is better from the benefit of society that small number of children might become in order for the greater good of the whole society. So there are good examples of where private and public matters do work together very well. I was going to bring that up as one of the problems that's happening right now with vaccinations. A programme that has done away in this country with polio and measles and deaths from whooping cough and so many other things but now with the anti-vaccination programmes that are happening out there these diseases are coming back. So the decision to opt out now not only has consequences for the child but for the herd immunity that the vaccination depends on to be protective of the entire population. Thank you so much. I just want several cliches come to mind. The personal is political, private decisions have public consequences and a bumper sticker I saw which is everyone does better when everyone does better. And I very much appreciate that question because it speaks to the realisation that our thinking collectively benefits everybody. And we're so pressured in our lives now to think about what's going to work best for me and my children and we don't realise the cost of that mindset. Right, these things are not mutually exclusive. Thank you. Thanks to our panellists. And just a reminder if you would like to continue this discussion or another discussion there will be tables in the forum inviting you to do so. Thanks for the enormous numbers of questions that came in. Look for some of those questions to appear on the screen here and also the results of the first poll. Enjoy your lunch. Thank you.