Customer Reviews

Intervention: Confronting the Real Risks of Genetic Engineering and Life on a Biotech Planet

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Denise Caruso successsfully brings her considerable writing and science policy skills to bear on a fundamentally important issue. Society is confronted by increasingly complex and difficult decisions as science progresses and the scientific community itself is seldom well equipped or credible to serve as the advocate. Caruso provides a critical bridge between the advances of science and the needs and values of society.

Caruso is trying to operate in the difficult space between unquestioning supporters of biotech and reflexive opponents of the technology. Her careful examination of the regulatory process becomes an indictment of it, but also points a way towards reform. The book is particularly good on questioning both the "benefit" and the "risk" sides of the risk/benefit equation, and in pointing out the repeated tendency of regulators to look only at what they know they can see, rather than asking deeping and wider questions.

I gather that the original publisher backed away from the book because it was not sensational enough. That in itself is an indictment not only of publishing but of our civil discourse, because this is an important book that deserves a wide audience. Scientists should read it to get a broader perspective; non-scientists should read it because we are all being affected by decisions on the use of biotechnology.

This a great book - well thought out, written and informative. The title may sound intimidating, but the content is very accessible.

I like having a fairly complete and accurate picture to understand an issue that is important to me. Food safety and disease avoidance are important to me.

Denise Caruso's Intervention gave me a clear, rationally and historically grounded understanding of the issues surrounding our latest capabilities to alter our environment, AND how the government should move forward to better protect Americans. I enjoy having a framework, with facts, to better understand biotech and my world.

This book is a great and important read for everyone interested in maintaining a livable biosphere for humans.

In Intervention, Denise Caruso, a columnist for the New York Times, has written an important and timely book. The set of people who need to read it include but are not limited to policymakers and voters in the US, in the affluent world, and in the developing world.

Intervention is mainly about transgenic organisms. One of the numerous unsolved problems people need to tackle this century is devising a workable regulatory framework for transgenic plants and animals, aka genetically modified organisms, aka organisms into which engineers have dropped pieces of DNA. In the US, the existing regulatory regime is a patchwork. The biggest part of the patchwork comes from at the dawn of recombinant DNA work at the Asilomar conference in 1975. Asilomar led directly to the "NIH guidelines". These guesstimated different levels of potential risk for different kinds of recombinant DNA experiments, mandated lab practices and levels of containment to conduct research at each level, and set up bodies for review and approval of experiments local to each university. Asilomar also brought about the establishment of an overarching national body, the Recombinant Advisory Committee (aka RAC) to rule on the appropriate level of containment for contested experiments, and established mechanisms by which levels of containment could be ratcheted up or down in response to information coming from new experiments, which in practice has led to sunset of most of the most burdensome regulations as the feared risks did not materialize. The regulatory framework affected experiments in universities funded by the US government, but was extended to commercial work via local communities. Individual cities caused, via their control of zoning, biotech firms to follow the NIH rules. Most of this "Asilomar framework" governs recombinant DNA research in lab organisms such as E. coli, yeast, and mice. In the US, use of recombinant DNA in people, for example in gene therapy, is regulated by the FDA, and release of an organism into the environment, for example a herbicide-resistant potato or an oil-eating bacterium, is regulated by the EPA.

Recombinant work is also regulated in other advanced countries, but in no country is there a system of local and national oversight as strong as that in the US. And the US framework, 32 years old, is fraying at the seams. It is showing its age by showing gaps. Many of the issues are due to the Moore's-law-like growth in the scope and power of the technologies, the democratization of the technical ability to hack DNA, the adoption of recombinant DNA methods by new classes of hackers , and the use of recombinant DNA to engineer different classes of organisms.

The Asilomar framework was designed to regulate research in universities and, extended by zoning regulations, in companies. The Asilomar framework was not designed for a world in which the number of people with basic training in recombinant DNA methods has increased from hundreds to tens or hundreds of thousands worldwide. For example, in most US localities, the only framework that governs recombinant DNA work by private citizens is that sometimes provided by local zoning regulations; and this at a time when affluent parents can and do outfit labs for their high school aged children.

But perhaps the most public change since Asilomar is the increase in the number of different engineered organisms intended to be used outside of the lab. Here, agriculture has emerged as a flashpoint. Last year most of the dollar value of the US corn, soybean, and cotton crops came from transgenic plants. Although introduction of recombinant crops in Europe is stalled, due in part to old fashioned trade protectionism, worldwide, farmers are planting them everywhere they can, from Brasil, where the Lula regime retroactively legalized herbicide resistant soybean seed in the face of the fact that farmers were enthusiastically smuggling in metric tons of the stuff from Argentina and Paraguay, to China and India, where genetically modified insect-resistant rice seed, probably made by multiple independent firms, has been sold since at least 2005. In agriculture, without outright prohibition, the spread of genetically engineered plants and animals is likely to continue until most species of economic importance have been engineered. But even though farmers may love the stuff, it turns out that people tend to view technologies such the recombinant DNA that enables transgenic plants as affecting their lives. Moreover, many may feel that the changes the technologies are bringing are occurring without their understanding or consent.

In Intervention, Caruso uses this steady increase in the contribution of genetic engineering to the economy as a test case, an example to consider how new technologies might be regulated. The book requires the reader to face the question of what an international regulatory framework for recombinant DNA work and genetic engineering of organisms should look like.

Caruso does not lay out solutions, but she does describes processes for involving larger numbers of stakeholders in decisionmaking, promising tactics to provide additional ways for societies to get a handle on the pace of technical change.

Intervention is not horatory, it is not prescriptive. Caruso raises issues and suggests mechanisms that might help address them, but does not provide a ten point set of solutions. I find this aspect of the book to be a strength, although as a consequence the book leaves the reader with many more questions than answers. Here, I will mention two.

First, at the moment, in the US, a new technology is typically regulated only after has been shown to cause harm, and, by law, the degree of regulation is based on assessed risk, and the assessment of risk is supposed to be based on the best science available. Overall, at least for recombinant DNA, I believe that this conceptual framework for regulation has worked pretty well (To my knowledge there has only been one death directly attributable by recombinant DNA (the child Jesse Gelsinger, who died during an experimental gene therapy trial in the 1990s from a dose of a gene therapy vector that should never have been allowed by the local review committee)). But there are other ideas on which regulation can be based. Should the US exchange this basis for regulation for that used in the EU, grounded in "precautionary principle", derived from German Social Democratic legal theory in the 1930s, even if to do so were to carry a cost of delaying the benefits new technologies might bring?

Second, in part because of the science-based risk assessment mandated in the US, people who feel uneasy about a new technology or who simply dislike it are almost always required to assert that their opposition or unease is due to the fact that the technology presents a risk. Why always talk piously about risk if the real issue that one finds some work of engineering distasteful (Caruso even has a term for this, the "ugh factor")? In a democracy, should widespread dislike, by itself, ever constitute grounds for regulating or even prohibiting a technology? If not, why not?

I hope that the publication Denise Caruso's Intervention marks the start of a broader discussion, one that might help societies gain better control of technical change and its consequences.

If you've become worried about our food after watching Food, Inc. or reading Michael Pollan, or our planet after watching An Inconvenient Truth or the natural disaster du jour on the evening news, then like me you might have thought you had your biohazard bases covered. After accounting for these looming issues I was happy to relegate the risks of genetically modified organisms (GMOs) to the dusty corner where I pile up my back issues of National Geographic and Scientific American.

Then (belatedly) I read Denise Caruso's book, Intervention. I've known Denise for a long time and knew she'd become an expert on social risks but perhaps the titles on her website didn't scream out "This means you!" loudly enough for me to pay close attention until now. I figured that if I stuck with eating wild fish and meat from cows with only two horns I could outlive any problems caused by GMOs in general and specifically transgenics (where scientists start fiddling with multiple species and transferring genetic material between them). Now I'm not so sure.

Like most laymen I assumed the process of genetic modification was simple and orderly, no worse than taking some software code from one web page and pasting it into another (come to think of it, that's not as harmless as it looks either). But her descriptions make it clear that there are literally innumerable side effects, both known and unknown. Some of these are relatively simple to characterize but hard to measure, like the problem that breeding crops with a "RoundUp resistant gene" will inevitably cause some of that gene to wind up pollinating weeds and creating a class of Superweeds. Everyone agrees that more weeds are becoming RoundUp resistant, but there isn't any consensus on how much of that is due to extensive use of the pesticide and how much is due to genetic transfer from crop to weed.

Even though I hadn't thought through all the issues with transgenics related to the food supply, I was pretty confident that the issues began and ended there. Turns out even that is a false security. Some of the scariest scenarios Denise points out involve the transfer of diseases or other genetic problems from food crops to food animals and then to people. I won't try and recap the dozens of illustrations Denise uses in Intervention (you need to read it yourself), but they range from scary stuff that has already happened mostly in small scale, to studies showing a lot worse could happen, to plausible scenarios which get really ugly.

All that said, Denise is the first to applaud the benefits of genetic fiddling, particularly in medicine. The point of the book isn't (just) to scare us, but to make society as a whole sit up, take notice, and have educated conversations between all the stake holders about the potential risks and rewards to all of us of these technologies and products. Like with factory farming, offshore oil drilling and many other technology areas we have plunged ahead based on the financial interests of a few and the short term good to many without really honest discussions of the potential downsides.

A major portion of the book is devoted to showing how the system is stacked against the greater good as special interest economics and a revolving door regulatory environment conspire to make it easy to put blinders on and get approval for crops and animals which are guaranteed to have unintended consequences often of unforeseen magnitude. To those who've read Pollan on the corn industry this will sound very familiar. Denise is hardly a luddite, having spent her career in high-tech and been the digital commerce writer for the New York Times for years. So she isn't arguing we should go back to growing penicillin on bread but she does make a convincing case we need a better system for getting issues out in the open.

As a process for working through these types of risks and rewards systemically, Denise leads us through an entirely rational workshop model that frankly would be equally valid for working through immigration, health care or mid-east peace. But like those issues the challenge will be having a truly open and rational discussion where there is more light than heat. I'd certainly encourage you to read Intervention for yourself, although perhaps not right before bedtime.--David Cardinal

This easy-to-read, cogent analysis of the bio-tech - including genetic engineering - industry serves a critical purpose in the world right now. Denise Caruso brings a diligent journalist ethic to a subject that should have most of us putting pressure on our leaders (business, scientific and political) to insist on more rigor in our decision making process in the better interests of humanity and the environment. While she grounds this in the bio-tech industry, Caruso's warnings and proposed solution (of an analytic deliberative process) are equally relevant to many other highly uncertain, risk-fraught, unfettered science domains. I highly recommend this book.

Intervention in one of those books that wakes you up. Not only did I learn a tremendous amount about the potential risks of genetic engineering, I also gained a new understanding about the process of risk assessment itself. The book is a model of critical thinking, as Caruso questions in a fairminded, non-sensationalistic way fundamental assumptions surrounding the biotech industry and the way genetically engineered products are developed and marketed. As I read Intervention, I kept having "ahas" on two levels. The first involved a growing awareness of how we are increasingly all participants in what amounts to an ongoing series of lab experiments as genetically engineered products are introduced around the globe without fully comprehending what the consequences might be. The second concerned a new understanding of the field of risk assessment and the increasing need for collaborative, cross-disciplinary approaches to problem solving and decision making. This is a rich, engaging, thought provoking work that deserves widespread attention and discussion. I recommend it most highly.

Just because we can genetically engineer things doesn't mean that there aren't any consequences. In this passionately argued treatise, Caruso provides a welcome antidote to the boosters of biotech. She's not anti-genetic engineering per se, but wants us to truly debate the consequences. Caruso calls upon readers not to merely accept the words of government and industry to "trust us, everything will be fine." Recommended.

I bought "Intervention" a couple of months ago and found it extremely enlightening, sobering, and supportive of very very careful and broadly inclusive development in transgenics. Hand delivered my copy to the top scientist at work and have e-mailed friends and associates to get "Intervention" and read. This is a highly important pro-science science book that asks right-questions and explains much that needs explaining and proposes a far safer course for continuing development of manipulated creations. More than five stars!

An important and interesting book. Important because of the timing as millions of acres of new food crops could conceivably alter the genetic legacy of the biosphere. In considering conceivably irrevocable processes its best to think early and big about unknowns. Interesting because its style combines fascination for ideas with skepticism and sometimes-unmet expectations of intellectual rigor and integrity among the "players". Out beyond the rhetoric of "right" versus "wrong", there is cool deep truth to be seeking, honest work to do, and good clean scientific and intellectual fun to be had. This book's clear eyes live there to inspire and apply far beyond the specific topic.