 Thank you so much, Harris, for tying all of the different threads together in this talk. That's a huge job that you did. Thank you so much for that. And so I thought I would throw open, again, the conversation to our panel speakers up here for any thoughts or responses. Go ahead. You go. I was going to start with one question for you, because it's to do with the gender. One of the problems we find when we talk to people in the clinic who are of different gender orientations is the language that we use, and the fact that they're often particularly sensitive about the language, although it's never meant to be anything difficult, and what advice you might have about how we approach that and how we change the way the discourse that we use to try and address the issue. Yeah. I mean, there's a lot of very generic advice that's good for, you know, all walks of life that I think is good, which is asking people their pronoun preference and their name preference, not everybody's given name is the name they go by, and that sometimes has something to do with their gender identity. And then the, I guess, it can be irritating, regardless of one's gender identity or sexuality to see, you know, Google's 57 categories choose one every time you want to know what kind of a patient you have. So it, you know, judiciously applying it. But I think very much in the face-to-face context, the, you know, asking people what they, how they identify what name they'd like to go and what their pronoun uses is a really, really good place to start. Fertility patients in general really hate the ways that women's bodies are always failing. And that's all the words to do with failure, sterility and all those kinds of things, which I know that many fertility physicians have talked about themselves and the language use has changed a lot over the years, but that can be something that's just really, can really make you feel down. I've also seen a lot of, a lot of anxiety with male patients around these things to do with masculinity that I talked about, including, you know, real concerns about what it does mean for how people think about them more broadly and how they should think about themselves, which I think don't get enough attention. I mean, they shouldn't be getting any attention, but the issues should be being taken seriously, I think. Okay. I'm sure you do. Thank you so much for that amazing talk. So the thing that struck me most was the way that you wove the biblical narrative in and out of the conversation. And the thing that it reminded me is that there are stories embedded in science, whether they're explicit or implicit. So we heard, you know, a few times reference to science fiction as a kind of over-the-top set of stories that can distort public understandings and public engagement. But I think what your talk sort of brought to the surface was that there are the explicit stories that are, you know, know that they are stories and are presented, but there are all kinds of other stories embedded in how we talk about science. And for me, one of the things that's interesting for us to think about is what if we sort of made those stories more explicit, right? And so it also troubles the binary between what's fiction and what's facts. So I teach a class that I actually miss teaching. My students are maybe they're happy, but I'm meeting with them on Saturday, so I'm that kind of mean professor. They're not. We're going to reschedule. So the class is called Black to the Future, Science, Fiction, and Society. And what we're trying to do is think about the facts that are embedded in science fiction. What kinds of things do they tell us about social reality? But what are the narratives that are embedded in science that we can also bring to the fore? And I think what your presentation helped me sort of think about is that, you know, there are not only the bad stories that we might point to as distorting what people think about science, but let's pay attention to all of the storytelling that happens, even when a presentation or when a headline or, you know, some kind of scientific fact is being presented. There's a story in there that we're being enrolled in. And let's bring those out also and not sort of think of them as separate from science. No, I love that. One of the things that I always, it's striking to me in listening to scientists speak is how frequently people revert to metaphors to kind of articulate certain ideas and those metaphors are really embedded in pre-existing ideas about what a computer means and so what hard-wiring means and all of these things. And so I love that point. Anyone else? I'd like, are both Diana and Allison offered timelines in their talk this morning. And I'm interested in hearing you reflect on this idea that the technologies are moving quickly or not quickly, that the public is shifting in its tolerance over time or resisting. I'm sure there's too many factors to consider, but I'd love to just hear you talk about how the progress is tolerated or enabled. Yeah. So I think that there are some very well-known patterns that happen. There's one common thing people say that I do take some exception to, and that's the idea that ethics is constantly paying catch up to science and technology. I feel as if Plato might have a thing or two to say about that and as if the ethical issues and so on have been around for a long time and continue to develop and continue to be deployed and that it's much more of a back and forth. The technology is new and the application or the response in that context is often new and the specific policy for the new technology is often new. But I think it's misleading to cast the science as the new and then this kind of following role. I think there's enormous social innovation, for example, enormous social innovation to even thinking about making a family, however problematic it might be with 3, 4, 5 biological partners involved in what it is to produce a child. And I think that social imagination is moving back and forth with the technical in mutually very inventive ways that have long histories and are new and inventive. There's a common process that things go through where people are really concerned about them for a while and so they have this window of opportunity for something akin to public discourse and then really often they go through what I call the inuring function where people become, I also refer to it as the end of the beginning. And that early phase is over, we've decided how we're going to handle the things that are most troubling to the society in question about them and it becomes routine, it becomes science as practice and we have a relatively good level of trust in the way that it's happening and things do come up and trouble that and disturb it but there is this sort of window of opportunity at the beginning when people are often quite open to having discussion and I'm really pleased to say that a lot of my scientific colleagues love that period too because it does normalize things, it does decide what the regulatory arenas will be, it does give a sort of robustness and it does put some of the de-risking onto other bodies, onto other people, it gets some of the thinking around well what are we going to do and say about embryos and things and just give me the rules, because we've all got to get on with our work and we want to get on with our work in a really robust way. So I think that there is a definite pattern and it's much harder, I mean it's already much harder to open up any question about stem cell research because we do IPS and use pluripotent stem cells now, by and large we're not using human embryos specifically for that, it's not entirely true but and because we've decided how we're going to deal with, we've made a particular kind of committee specifically for dealing with getting this thing that we're not going to say if it is a subject of research or not, that's the embryo, but we're going to use this concept of acceptably derived to bring those materials into the lab through the right ethical overview, that settles that question, it means that if you like laundered or it's okay by the time it gets to the lab, we've done due diligence, we've done that work, they made it a separate committee in many places because unlike other subjects of research, animals and humans, which have their own histories and their own trajectories and nobody questions whether they're subjects of research, it was precisely the subject hood of embryos that was at stake, but you know I think so that kind of thing happens and then science can go on with a kind of materialization if you like of a lot of debate, concern and commitment of expertise from many people to make it happen, to make practice happen. I think if I can sort of pick up on that timeline because I would probably agree with you that in social sciences, as new things develop in the science and the clinical field, my experience is that ethicists, anthropologists, everyone else do come on board very quickly and get involved with the debate and the discussion, but I think society is much slower than that and I think there are a lot of people out there, politicians, rules and regulations, the vast majority of people who actually don't really perhaps understand the science are not scared by the headlines of the sci-fi, it takes a lot longer for them to change, the church doesn't change quickly because that's delivered by a doctrine that's ancient, so actually taking society along is more than taking academic social sciences along with the science as well. Sort of riffing off that, I like what you said about we continually change our views as we you know as we enter new situations and I think that certainly that's part of the act of science, new data comes in and you might change how you think about that new data and I think one question that I would sort of have for everyone is how do we reconcile that with this very American notion in which people who are flip-floppers and wishy-washy are devalued, right, it's bad to change your mind, you get new data you shouldn't change your mind, right and it's very strange, right, we value somehow, you know I think on this panel we've talked a lot about how you enter a new situation, things could be different, we have to look at things from different view points and of course science is all about new data, how do we incorporate that into this very American way of viewing the world and opinions? I think it's really hard, I think science is really hard as a scientist, I'm always frustrated by what I don't know and recognizing that there's so much that I don't know, some things I might have a suspicion about or I might know well or think something is going, you know, is a certain way and then some new piece of data will come along that will entirely change how we think about something so as an example there is an an ion channel in humans that is a really good target for male contraception but that ion channel, that ion channel is turned on by progesterone but not in mice so all the studies done in mice that ion channel is important but it doesn't work the same way, so much of reproductive biology is done in another species but it may not be applicable to humans and that makes it really difficult to have strong opinions and try to fight with people who are fighting back at you and say well you know why aren't you getting doing more progress, why aren't you doing it sooner, why don't we have this product now and all it's really a very frustrating science that science is frustrating but it's wonderful I mean it's also incredibly exciting I wonder if it's a combination of maybe people need to think more deeply about what they mean by science right so scientific process as opposed to the information or ideas that people are that science has brought us and so kind of that people I think want to believe that well science is something we should trust and it gives us these things that have improved our lives or whatever and we should trust science right like climate science and things like that but if they don't understand how science works which is all about asking questions and trying to get better data a revision of something that people thought was like this is the truth doesn't mean that science is all just kind of hogwash it means that the scientific process is working because we're trying to understand things better and it seems like that's the tricky thing to say believe this science like we've done tests right we should trust us but it should maybe be shifted to you should trust the the process and there's certain you know levels of confidence for certain different types of results I'm positive about this until I learn something new yeah I mean I think so much of what we've been talking about and certainly Jacob's question speaks directly to pedagogy and through K through 12 education and so if we think about what does it mean to be a student so much of the performance of being a student is not about that iteration it's not about creative thinking it's not about changing your mind it's about knowing what's going to come on the test so it's not about you know the the creative process of thinking and inquiry and curiosity and so if the point is and I see the students over there like um yeah no test that's my my take home tell your teachers I said that but certainly if everything that they're doing and I have a ninth and 11th graders so everything that they're doing is about a performance on the test the test is not asking you to think iteratively or creatively right it's there's a one answer you get the wrong answer your test score goes down you get a lower SAT score you have a less likely chance to go in XYZ and so I think we have to think about and so the the greater point here so that's a critique we can all probably probably get on board with I think the greater point is that when we're talking about public engagement in science right to have this conversation to be able to change our mind the seeds of being able to do that start in preschool start in kindergarten this is not something that you round up a bunch of adults and sit down and try to do at this stage I mean it's great that we're doing it but if we're serious about it we have to begin the planning reconceptualizing education to have citizens who can have that conversation in the first place right and so the the larger question also means that for those of us who are in our little corners of you know their little professions for me this is the way that I think about it I need I have my own area of expertise but I have a stake in these larger issues because if I want to have you know the conversations that you know I think are really productive then I have to care about kindergarten education I can't just care about sociology and being a good sociologist right and so to me it's a question of thinking about moving beyond our individual professional identities and having a stake as citizens about how to craft a world and institutions that can make us do our profession with greater effectiveness I don't think we can just be good at what we do anymore we have to have this broader view right great thank you so let's oh a problem that I have with bioethics is that often the process is so much about debate and point counterpoint I'd so much like to have deep listening as central to the process where we listen to each other not with the intent of making the other wrong in our argument but with really deeply listening understanding and appreciating people's back stories people's deep histories people's ancestral histories that impinge and create or inform at least our points of view our standpoints and I okay we'll stop there yeah so I'd like to maybe introduce some some audience questions and we have one question that I think kind of ties back to something that was brought up earlier as regard to science fiction one audience member asked do you think science fiction helps or hinders public perception of reproductive technology because they're powerful stories right and there's lots to yeah do you think it helps or hinders or combination of both overall I would probably say hinders they're great fun and I will read science fiction books quite happily and I'm sure it sells a lot of business for people if they are read on the basis gosh this is interesting this is fun but it's not real then that's okay but unfortunately it's quite difficult for people who don't understand the level of the science that is at the time to understand that it's not real and some you know some of the best science fiction ones are the ones that are maybe nearly real and they're the ones that are most almost most believable and the ones we like best because we know it's just not you know fantasy land we're never going to get rid of science fiction but it really is important for people to make that distinction from the science that we're actually doing because it is it is very difficult to try and make new developments if there are frankenstein headlines on top they are just not helpful for anybody and the consequence of things potentially being banned because people are scared because they've been scared by bad headlines because they've been scared by science fiction because they're being scared by people for lots of reasons saying this is not good is that new science new clinical treatments won't happen and ultimately that's bad for us all because we have to make progress we've always made progress i think there could there could be a counter i mean i in terms of reproductive science science fiction has for some reason been almost unanimously very negative but science fiction can be this interesting place where people test out new ideas about the world without putting them into practice yet and say what would this look like what would this look like and it's sort of a way to do the thought experiment and a lot of ways science fiction actually ends up it ends up inspiring scientists to do new things the most famous example of this is that the the modern communications satellite array was first invented by Arthur C Clark in a science fiction novel so he imagined it came up with it and then he like he actually literally invented it he holds the patent on on communication satellites so i think that there is an opportunity to not just envision something good about the world and then say great this is my vision statement of what i think is going to improve our lives and do something about that it seems though you know because of a lot of the sort of deeply personal issues we talked about during this science fiction and reproductive technology has not gone that way and it's instead been mostly about the negative side effects that might happen as opposed to say you know new opportunities for people to have children and they couldn't before i routinely run talk to researchers who are inspired by science fiction who's either for going into that field or for the particular things that they work on right so we think about science fiction as a reaction to particular scientific fields but as the inspiration and the impetus i think i find that a lot especially with respect to a star track comes up over and over again in my conversations and certainly it was one of my formative sort of representation but i i also think really agree that it's this realm of what if thinking through alternatives so we started the first question with why is it so hard for people to change their minds but i think science fiction is a realm where people can play around with different scenarios before they fully change their mind they kind of follow the rabbit hole and i like it as that this kind of playground for the imagination for us to think through different scenarios before we actually go in that direction so i think of it as a kind of methodology that we can use to tinker and to experiment for me i would i i really love science fiction and i you know i think perhaps the thing to do is to get people to actually read frankenstein like they did here and find out just how much interesting stuff is in there including the kinds of things you're concerned about and i understand that it's the headlining headlinization we might call it of of these terms that becomes particularly troubling that the real work is not being done but i really love science fiction the thing that i would very precisely the reasons others are talking about but the thing i i always want to insist it be combined with is knowing something of your histories you have to know what's gone wrong in the past there no nothing is innocent nothing is perfect nothing is certain and nothing is innocent that you need to know something about the histories but you also need to know the potentialities where are the fault lines in your culture and in your societies what are the things that are going to keep bubbling up and be concerns how do people what do they mean by inclusion what's a polity for them what is it to have voice and if you don't know something about the history as well as having the science fiction if you can't say something about what is possible as well as what might be possible and read those together it's it's i feel almost to the point that it's irresponsible great thank you we have a question from a high schooler it's a very happy question um and allison asks are we cheating natural selection in a sense by making reproduction much more achievable so evolutionarily if humans are successfully reproducing a generation or generations of healthy and law-loving offspring water natural resources be depleted much sooner due to reproductive technologies is there a line between the desire to raise a biological family and the sustainability of humankind technology can interfere and reproduce you know with biology and genetic engineering but it cannot replicate basic human necessities how do we not only create life but sustain it i think that's that's a big touch it i think we've got phd student coming up with it i mean the bottom line is that when you're interviewing introducing reproductive technologies we're changing reproductive history of individuals of populations we've been doing that for a long time we've been doing that with the pill we've been doing it with abortion we've been doing it more recently with the change in time that people decide they want to conceive agriculture and food lots of different reasons we've changed it by getting antibiotics to stop viruses so the whole families don't die of smallpox there are lots and lots of different ways and i don't think at the moment that i would see assisted conception as being any other any any any bigger step in terms of changing the patterns in society than all those other things have been and in fact probably significantly less because most of the big population changes in the world have come with social improvements clean water good food um and and those those things not not um not rvf right i have a question about the question um the two examples i've heard um where a genetic a flaw um affords some value our sickle cell in relation to malaria and cystic fibrosis in relation to the plague are there other examples are we looking for that is that an important question in genetic research the value of genetic flaw a very quick answer if there is if there are other things that are there does it mean that might be harmful does it mean we shouldn't be doing looking at it to developing for the sickle cell so you're looking ahead at the next stage does a potential problem at the next stage mean that we shouldn't be treating sickle cell now right i mean sort of the way that i think about those things is that they certainly could exist and there could be a lot of them but typically um those types of traits arose over hundreds of thousands of years of essentially no modern technology and so you know if if a trade is beneficial when people are not living in houses and don't have clothes and things like that you know it it may not be as event as as uh useful not useful it's maybe the wrong word but it may not be as beneficial anymore and you know it may only be detrimental and whatever beneficial effect it had would be covered by technology that we just take for granted and it's completely basic to our lives these days it's one possibility um we have another question from the audience um in my experience most of the work of having and raising babies and gender inequity happens after the baby is born how can robots having babies help with gender inequity you know that one's for me i will ask my students um the uh there's still a measurable promotion and wage gaps to do with taking any time off to have children and there's still a difference in the amount of the the impact on productivity for the person who carries the pregnancy even in a couple who co are committed to co-parenting one of the there's a couple of very striking figures from the world of academia um one is that uh when men take paternity leave uh they write extra papers and when women take maternity leave they take care of the baby another really really striking finding is that the most productive people um among the faculty are men with um are married men the least productive are married women and they're usually married to each other thank you um so we also have another really quick question that i do want to get to and then we're going to come switch gears and have everyone speak to the the topic of the plenary session um but there was a quick question about us versus uk regulation so strengths and weaknesses of both um and uh and this this questioner was asking if you if especially um professor tomson and and and dr murdoch could mention the differences um regarding ivf and egg donation in the us versus uk and what are the strengths and weaknesses just really quickly the the strength of the uk legislation is that there is legislation and one of the difficulties that you have the worst scenarios is when you have an open free for all and if you have a legislation that you don't like you can challenge it and you can go to court and you can you go go back to parlance and try to change it but when you have a free for all that opens lots of doors to exploitation that are perhaps not quite so good so there is regulation in the us and in a sense there's lab there's lab certification and all kinds of safety things and some fda things and drug testing and things like that there's also a really really extraordinarily interesting history of and current database from which demographic trends with reproductive technologies are collected and which becomes its own basis of data driven activism in the field itself it's also there's also quite a high degree of self regulation and patient advocacy regulation but it doesn't amount to a regulatory system and that's why people refer to it as the wild wild west there aren't hard and fast caps on how much you can pay for certain things and so on and it will surprise everyone English myself included when you come here how great the national health service themes thank you so i'd like to take this moment to just kind of switch gears we've had this wonderful discussion and now we're beginning the plenary session portion of our our evenings entertainment and i would like to ask each of the panelists and maybe each person can can speak on this what are the big um what lies ahead in the future what are the big questions the problems the possibilities and what kinds of that you see on the horizon for reproductive technologies and for yourself having participated in this conference what are the things that you