Triumph – but at what cost?

Guess who the most hated man in Egypt is right now?

Clue: It is one of their politicians.

It’s not even Donald Trump.

In fact, it’s got nothing to do with politics.

The man that is fanning the flames at the moment is footballer Sergio Ramos.

Ramos plays for the Spanish team Real Madrid as a centre-back. That is to say, he is one of two players in front of the goalkeeper, to stop opposing players from getting their strikes in.

Ramos has made a reputation for himself over the years as a hardman, using physical play to intimidate or put off opposing strikers from coming into his zone. This means that instead of shooting directly from the front of the goal, where the width gives a larger target, opposing players have to go from the side, where the angle is narrower. Ramos’ reputation as a hardman has meant he has been sent off many times in his career.

And as he has aged, and his physical skills have declined, Ramos has resorted more to guile and trickery, to get players sent off or carded, to influence the game. He writhes around at the slightest contact as if he has been hit by a train, and he is always playing mind games with the opposition.

So why is Ramos the most hated man in Egypt right now? Last night’s Champions League football final saw Real Madrid take on Liverpool. And in the game Ramos practically arm-barred talismanic Mo Salah into the ground, slamming his shoulder into it and dislocating it.

You can see that Ramos deliberately traps the arm before using his left leg to deliberately induce a fall.

The old wily fox realised that the only way to have an edge was to take out the opposing team’s most influential player.

Salah is out for the World Cup. Which is why many Egyptians will be fuming at was what not a deliberate attempt to play the ball at all. With Salah out, Egypt doubts.

The sad message is what it sends to kids and fans. Real Madrid is one of the most popular teams in the world, and Ramos is one of the more well-known players in it.

But subscribing and following a team means justifying such acts and condoning them. It breeds a “win at all costs” mentality that includes negative competition.

Drive is a good thing to have. The Baroque music composer J S Bach once walked two hundred miles to watch a concert by Dietrich Buxtehude. And Bartholomeo Cristofori went through many revisions before he produced the working version of the piano. But when the drive to win is tempered by ill practice, it sets up the wrong mindset, which, exacerbated over time, compounds a disconnect between perception and reality, which is where mental deterioration begins.

The problem is also because supporting bad practice demands we re-frame evidence. Is Sergio Ramos a dirty player? If you are an Egyptian, or a neutral, you might say “Yes”. If you are a Real Madrid fan, you would say “No”, despite his reputation over the years (look how the Real Madrid and Barcelona matches always end up with Madrid trying to roughhouse Leo Messi). But in saying “No”, you are forced to accept and even justify an incorrect act.

Remember how in the World Wars people claimed innocence for acts of atrocities because they said they were only following orders? The whole evidence of evil actions was reframed by the act of purporting to follow the company line – in this case the national line.

And in not admitting to wrong actions, but trying to justify them in order to avoid the humbling admissions, we only create distortions of truth.

The pursuit of success to obtain triumphs at all costs leaves much to be desired. It demands we be ruthless. And the fact that we could even consider ruthless to have some positive tinge to it goes to show how distorted our senses are.

Mental health time bomb.

Painkillers may have effect on your baby’s fertility

Nope, you read right.

Scientists have studied data and suggested that the use of painkillers by women during a pregnancy may have effect on their offspring when it comes to future generations’ intent to conceive.

Scientists studied foetal human tissue and the effects that these had under treatment of paracetamol and ibuprofen. Both are common generic medicines used to manage pain, and hence a common feature of them is the management of pain receptors – the dulling of pain to the point that receptors are less responsive so that the body adapts and is less affected. The scientists found that in both cases, when the foetal human tissue was exposed to pain relief drugs, the number of germ cells, which are the ones that develop into sperm and eggs, were reduced after a week.

Hence, the use of painkillers by women during their pregnancy could lead to these effects being transferred to their off spring.

In other words, their children could have difficulty conceiving.

The problem with this research, as with many other similar kinds, is that it was done not on humans but on tissue-compatible cases. Tests were done on mice and tissues grown in laboratory, and while they have similar bearing to humans, we cannot say for definite if this is what would happen. Unfortunately, it is unethical to prescribe high doses of pain-relief to women only to observe the effects on their offspring a generation later. That cannot happen.

Current pregnancy guidelines do state that it is safe to take paracetamol, but only at the lowest dose and for the shortest space of time.

It is best prescribed under the supervision of a doctor, but it is difficult to prevent pregnant women to walk into a supermarket and get some for themselves!

The study was carried out by researchers from the University of Edinburgh and Copenhagen University Hospital. It was funded by the UK Medical Research Council, the Wellcome Trust, and a British Society of Paediatric Endocrinology and Diabetes Research Award. It was published in the peer-reviewed journal Environmental Health Perspectives.

The researchers did say their results suggested that painkillers have an effect on the level of germ cells, which may alter how DNA is formed and so could potentially affect future generations. But these results came from tests that were not performed in humans, and many other factors that contribute to fertility were also not accounted for.

And while these kinds of studies may never be fully conclusive, it is always better to be aware, than sorry!

The real health concern behind energy drinks

Could your regular normal drink give away your age? Possibly. It is conceivable that your pick-me-up in the morning is a general indicator of age. Those who prefer nothing more than a coffee are more likely to be working adults in their mid thirties or older. Those within the younger age brackets prefer to get a caffeine fix from energy drinks, the most popular among them being Red Bull, whose popularity has arguably been enhanced by its ability to be mixed with other drinks. Why is there this disparity in preference? It has been suggested that the older generation are more health conscious of the levels of sugar within the energy drinks and their effect, and hence avoid consuming them, while younger professionals who perhaps lead a more active lifestyle, including going to the gym, are more inclined to think they will somehow burn off the sugar over the course of the day, and they need the sugar to power them through the day, in addition to the caffeine.

Research suggests this kind of thinking pervades the younger generation, even right down to the teenage age group. In a bid to seem more mature, many are adopting the habits of those they see around them. The image of a twenty-something with energy drink in hand along with a sling bag, possibly a cigarette in the other, on the way to work, whatever work may be – perhaps a singer-songwriter? Or something with a socially glamorous title – is seemingly etched on the minds of youngsters as a life of having made it. This, coupled with the media images of celebrities on night outs with energy drinks in hand, to enable them to party the night through, have certainly promoted the rise of the energy drink among teenagers. It is arguable that energy drinks are the stepping stones from which the younger generation obtain their high before they progress to the consumption of alcohol. Research has demonstrated that it is usually within three years of starting energy drinks that a young adult progresses to consuming alcohol in the search of newer buzzes.

There are the obvious problems of over consumption of alcohol and it is of increasing concern that the copious amounts of energy drinks among young people prime them to reach for higher volumes of alcohol once they make the transition. Simply put, if a young person has habitually consumed three or four cans of Red Bull every day, and then progresses to try alcohol – usually the drink with the highest alcohol percentage, usually vodka for the same reason of the perception of being socially prestigious – then a starting point appears to be three or four shots of the alcoholic drink.

And one of the drinks that helps bridge the divide between energy drinks and alcohol?

Red Bull mixed with vodka.

Ever seen the videos of young adults knocking down shots of vodka or whisky like a fun game?

It seems that imprinted in the social subconscious is the idea that part of maturity and social status is the ability to knock down many shots of high strength alcohol. These has implications for the health of the future generation.

But it is not just the alcohol time bomb that is worrying. Over consumption of energy drinks causes tooth decay and a high level of caffeine and side effects within the body now.

A study of over 200 Canadian teenagers found that consumption of energy drinks caused incidences of sleeplessness and increased heart rate. They also reported other symptoms such as nausea and headaches.

But while the tabloids, in their usual way, exaggerated the links in the way that tabloids do, claiming that energy drinks can cause heart attacks and trigger underlying stress-related conditions, only one in five hundred suffered seizures, but even these cannot be traced directly to the energy drinks.

Energy drinks not only have implications on health, through the impact of sugar and caffeine, but they are subtly dangerous because they blur the lines between non-alcoholic drinks and alcoholic ones, and make the latter more trendy and accessible. In a way, they are similar to vaping. Both are supposedly healthier imitations of what they are supposed to replace. Apparently vaping has no significant effect on the compared to smoking; energy drinks are non-alcoholic ways of obtaining a high or rush.

The problem, however, is that once users have had their fill of these – the so-called healthier options – these options actually compel the individuals to move on to the less healthier option. And when they embark on the more health impacting lifestyle choices – either alcohol or smoking – the patterns of dependency have already long been established.

So the dangers of energy drinks are not so much they cause sleeplessness and increased heart rates.

It is actually that they propel individuals towards alcohol dependency. The main research question that should be asked, is, “Have you been tempted to try alcoholic drinks mixed with energy drinks such as Red Bull?”

Ibuprofen and the fertile imagination

There is an astounding variety of painkillers available for purchase both in supermarkets, chemists, and corner shops. Just take a look at the shelf of your nearest Tesco or Sainsbury. You have various types of paracetamol, both made by pharmaceutical companies as well as in house versions of the supermarkets.

What is the difference between them and why are there so many varieties?

When pharmaceutical companies take on the decision to manufacture a new drug, they are given a twenty-year patent which covers the research into the product, testing and manufacturing, and sales. The period of twenty years, a monopoly as such, is to reward them for the time invested into the research. In the course of the research into the product, pharmaceutical companies must publish various forms of medical evidence and put it into public domain, so that if there is any medical evidence that points to the contrary, these can be debated both by the medical community and the pharmaceutical world.

The problem, if we can call it that, is that business is a very competitive world, and if research is put out in the open without any form of intellectual protection, any manufacturer can pounce on the research undertaken by someone else who has taken the effort and trouble to do it, and produce their product off the back of it. They would have saved the time and cost investment.

Imagine if a writer has taken the time to research a topic, organise his thoughts succinctly, and find a publisher. And when his book is published, someone else photocopies it, binds the copied pages and subsequently peddles it as their own.

Within the period of twenty years, a pharmaceutical company has to research, market and sell enough of the product to recoup the investment costs and profit. It is after the twenty period has expired that the other sharks enter the fray. This is where you get the supermarket brands of the product, which are cheaper because they don’t need to pay for research.

What is the difference between brand names and generics? They essentially do the same thing. But if the original company has done a good job in making the product synonymous with its own brand, then you might think they are better. If you take Neurofen for headaches, then you might think it better than Tesco ibuprofen, even though they both contain the same active ingredient.

But pharmaceutical companies have to reinvent themselves, to make varieties of the same product, otherwise they will lose their market share and eventually die out. If you realise that Neurofen is matched in ability by the cheaper Tesco ibuprofen, you would buy the latter, unless you are persuaded that Neurofen for Flus and Colds, or Neurofen Muscle Pain has something clinically formulated for that specific purpose.

So the shelves of supermarkets are stacked with different priced products with the same active ingredient, as well as different varieties of the same product.

Painkillers are a common medicine because there will always be a demand for pain management.

The availability of pain relief medicine means it is easy for the average individual to obtain them. There is the possibility of overdose, and while this may be a rarity, there is a higher likelihood that the greater availability may mean individuals are taking more doses than they should.

What are the long term health impacts of taking ibuprofen for prolonged periods?

One problem is that the body adapts and so the long-term resistance is affected. In certain groups such as the elderly, aspirin also increased the risks of stomach bleeding.

A clinical trial seemed to suggest it may impact on testosterone production and hence affect fertility.

Test subjects were administered 2 x 600mg doses of ibuprofen daily for six weeks, much higher than the average dose. The sample size was only a small group of 30, and half received ibuprofen, while the others received a placebo. It would have been better if the subject group had been greater, so that there could be more confidence in the test results, but because a test of such nature is to examine human resistance to what is essentially toxicity, it would have been unethical to involve a large group of participants. The research findings found that there was no impact on testosterone already in the body, but the pain relieving nature of ibuprofen, as a relaxant of sorts, had impact on the production of testosterone and appeared to slow down production.

How did these reports end up in the media? The tabloids had a field day, and you would undoubtedly have found one with the usual wisecracks about balls and other man-related genitalia, along the lines of “Ibuprofen shrinks your balls” or “Ibuprofen smalls your balls”.

Maybe instead of Ibuprofen for colds or fast relief, we need Ibuprofen for Dummies.

One cigarette a day can cost a lot

According to the newspaper headlines of late, teenagers should be kept away from cigarette exposure because of this worrying statistic.

A survey of over 216,000 adults found that over 60% of them had been offered and tried a cigarette at some point, and of these, nearly 70% went on to become regular smokers. The conclusion drawn was that there are strong links between trying a cigarette ones to be sociable and going on to develop it as a habit.

This of course ended up in the newspapers with headlines such as “One cigarette is enough to get you hooked”. The Mail Online, Britain’s go-to newspaper for your important health news (and I’m being ironic here) went a step further, saying one puff from a cigarette was enough to get you hooked for life. Never mind if you had one draw of a cigarette, felt the nicotine reach your lungs, then coughed in revulsion at the bitter aftertaste and swore that you would never again try a cigarette again. The Mail Online bets you would return to the lure of the dark side, seduced by its nicotine offers.

I digress.

While we all know that any event, repeated many times becomes a habit, the statistics in this case are a little dubious.

The study was conducted by Queen Mary University (nothing dubious in itself) but among the various concerns were what you might call the high conversion rate. Nearly 70% of those who tried a cigarette once went on to smoke regularly as a habit.

I’m not sure why the 70% is worrying. In fact, I wonder why it is not 100%! Surely, if you asked a habitual smoker, “Have you smoked a cigarette before?”, the answer would be a resounding “Yes”!

Unless you have caught someone in the act of sneakily smoking his virgin cigarette. But he wouldn’t yet be a habitual smoker.

Let’s establish the facts of the matter again.

216,000 adults were surveyed.

130,000 of them (60% of the adults) had tried a cigarette before.

86,000 (40%) have never smoked before.

Of the 130,000 who had tried a cigarette before, 81,000 (70%) went on to become regular smokers.

49,000 (30%) of those who tried a cigarette before either did not go on to smoke at all or did not smoke regularly.

Another way of looking at the data would be as follows:

216,000 adults surveyed.

135,000 adults do not smoke regularly or at all. Some did try once in the past.

81,000 adults smoke regularly and these people have obviously tried a cigarette before.

Suddenly the data doesn’t look sexy anymore.

The data was an umbrella studywhich means data was pooled rather than created from scratch through surveys. As previously examined, the final outcome is also dependent on the integrity of the original source.

Bias can also creep in because the data has not been directly obtained and inferences have been drawn.

For example, the influence of e-cigarettes and vaping on the results have not been scrutinised, because some of the data may have existed before then.

Before we leave it at this, here is another example of data bias:
216,000 adults were surveyed.

130,000 of them (60% of the adults) had tried a cigarette before.

86,000 (40%) have never smoked before.

We can conclude that 100% of the 86,000 who have never smoked a cigarette in the past have never smoked a cigarette.

You can see the absurdity more when it’s spelt out more in words than in numbers.

If research is costly and expensive, in terms of money and time, then why is it wasted on these?

One reason is that it keeps academics and researchers in their jobs, if they produce findings that are financially low-cost but can stave off the question of what they actually do, and their purpose.

This kind of research is the academic version of the newspaper filler article, one that columnists generate based on the littlest of information, in order to fill the papers with “news”, that actually mask the fact that they are there to sell advertising space. And in this, columnists and researchers are at times colluding for the same purpose. Vultures who tear at the carcass of a small rodent and then serve up the bits as a trussed up main meal.

Unethical? Who cares, it seems. Just mask the flawed process and don’t make it too obvious.

A short history of non-medical prescribing

It had long been recognised that nurses spent a significant amount of time visiting general practitioner (GP) surgeries and/ or waiting to see the doctor in order to get a prescription for their patients. Although this practice produced the desired result of a prescription being written, it was not an efficient use of either the nurses’or the GPs’time. Furthermore, it was an equally inefficient use of their skills, exacerbated by the fact that the nurse had usually themselves assessed and diagnosed the patient and decided on an appropriate treatment plan.

The situation was formally acknowledged in the Cumberlege Report (Department of Health and Social Security 1986), which initiated the call for nurse prescribing and recommended that community nurses should be able to prescribe from a limited list, or formulary. Progress was somewhat measured, but The Crown Report of 1989 (Department of Health (DH) 1989) considered the implications of nurse prescribing and recommended suitably qualified registered nurses (district nurses (DN) or health visitors (HV)) should be authorised to prescribe from a limited list, namely, the nurse prescribers’formulary (NPF). Although a case for nurse prescribing had been established, progress relied on legislative changes to permit nurses to prescribe.

Progress continued to be cautious with the decision made to pilot nurse prescribing in eight demonstration sites in eight NHS regions. In 1999, The Crown Report II (DH 1999) reviewed more widely the prescribing, supply and administration of medicines and, in recognition of the success of the nurse prescribing pilots, recommended that prescribing rights be extended to include other groups of nurses and health professionals. By 2001, DNs and HVs had completed education programmes through which they gained V100 prescribing status, enabling them to prescribe from the NPF. The progress being made in prescribing reflected the reforms highlighted in The NHS Plan (DH 2000), which called for changes in the delivery of healthcare throughout the NHS, with nurses, pharmacists and allied health professionals being among those professionals vital to its success.

The publication of Investment and Reform for NHS Staff –Taking Forward the NHS Plan (DH 2001) stated clearly that working in new ways was essential to the successful delivery of the changes. One of these new ways of working was to give specified health professionals the authority to prescribe, building on the original proposals of The Crown Report (DH 1999). Indeed, The NHS Plan (DH 2000) endorsed this recommendation and envisaged that, by 2004, most nurses should be able to prescribe medicines (either independently or supplementary) or supply medicines under patient group directions (PGDs) (DH 2004). After consultation in 2000, on the potential to extend nurse prescribing, changes were made to the Health and Social Care Act 2001.

The then Health Minister, Lord Philip Hunt, provided detail when he announced that nurse prescribing was to include further groups of nurses. He also detailed that the NPF was to be extended to enable independent nurse prescribers to prescribe all general sales list and pharmacy medicines prescribable by doctors under the NHS. This was together with a list of prescription-only medicines (POMs) for specified medical conditions within the areas of minor illness, minor injury, health promotion and palliative care. In November 2002, proposals were announced by Lord Hunt, concerning ‘supplementary’prescribing (DH 2002).

The proposals were to enable nurses and pharmacists to prescribe for chronic illness management using clinical management plans. The success of these developments prompted further regulation changes, enabling specified allied health professionals to train and qualify as supplementary prescribers (DH 2005). From May 2006, the nurse prescribers’extended formulary was discontinued, and qualified nurse independent prescribers (formerly known as extended formulary nurse prescribers) were able to prescribe any licensed medicine for any medical condition within their competence, including some controlled drugs.

Further legislative changes allowed pharmacists to train as independent prescribers (DH 2006) with optometrists gaining independent prescribing rights in 2007. The momentum of non-medical prescribing continued, with 2009 seeing a scoping project of allied health professional prescribing, recommending the extension of prescribing to other professional groups within the allied health professions and the introduction of independent prescribing for existing allied health professional supplementary prescribing groups, particularly physiotherapists and podiatrists (DH 2009).

In 2013, legislative changes enabled independent prescribing for physiotherapists and podiatrists. As the benefits of non-medical prescribing are demonstrated in the everyday practice of different professional groups, the potential to expand this continues, with consultation currently under way to consider the potential for enabling other disciplines to prescribe.

The bigger issues that come with preventing hearing loss

Is there cause for optimism when it comes to preventing hearing loss? Certainly the latest research into this suggests that if positive effects experienced by mice could be transferred to humans and maintained for the long term, then hereditary hearing loss could be a thing of the past.

It has always been assumed that hearing loss is always down to old age. The commonly held view is that as people grow older, their muscles and body functions deteriorate with time to the point that muscle function is impaired and eventually lost. But hearing loss is not necessarily down to age, although there are cases where constant exposure to loud noise, over time, causes reduced sensitivity to aural stimuli. Over half of hearing loss cases are actually due to inheriting faulty genetic mutations from parents.

How do we hear? The hair cells of the inner ear called the cochlea respond to vibrations and these signals are sent to the brain to interpret. The brain processes these signals in terms of frequency, duration and timbre in order to translate them into signals we know.

For example, if we hear a high frequency sound of short duration that is shrill, our brain interprets these characteristics and then runs through a database of audio sounds, an audio library in the brain, and may come up with the suggestion that it has come from a whistle and may signify a call for attention.

What happens when you have a genetic hearing loss gene? The hairs on the inner ear do not grow back and consequently sound vibration from external stimuli do not get passed on to the brain.

With progressive hearing loss too, the characteristics of sound also get distorted. We may hear sounds differently to how they are produced, thereby misinterpreting their meaning. Sounds of higher and lower frequency may be less audible too.

How does that cause a problem? Imagine an alarm. It is set on a high frequency so that it attracts attention. If your ability to hear high frequencies is gradually dulled then you may not be able to detect the sound of an alarm going off.

As hearing gradually deteriorates, the timbre of a sound changes. Sharper sounds become duller, and in the case of the alarm, you may hear it, but it may sound more muted and the brain may not be able to recognise that it is an alarm being heard.

Another problem with hearing loss is the loss of perception of volume. You may be crossing the road and a car might sound its horn if you suddenly encroach into its path. But if you cannot hear that the volume is loud, you may perceive it to be from a car far away and may not realise you are in danger.

The loss of the hairs in the inner ear is a cause of deafness in humans, particularly those for whom hearing loss is genetic. Humans suffering from hereditary hearing loss lose the hairs of the inner ear, which result in the difficulties mentioned above. But there is hope. In a research experiment, scientists successfully delayed the loss of the hairs in the inner ear for mice using a technique that edited away the genetic mutation that causes the loss of the hairs in the cochlea.

Mice were bred with the faulty gene that caused hearing loss. But using a technology known as Crispr, the faulty gene was replaced with a healthy normal one. After about eight weeks, the hairs in the inner ears of mice with genetic predisposition to hearing loss flourished, compared to similar mice which had not been treated. The genetic editing technique had removed the faulty gene which caused hearing loss. The treated mice were assessed for responsiveness to stimuli and showed positive gains.

We could be optimistic about the results but it is important to stress the need to be cautious.

Firstly, the research was conducted on mice and not humans. It is important to state that certain experiments that have been successful in animals have not necessarily had similar success when tried on humans.

Secondly, while the benefits in mice were seen in eight weeks, it may take longer in humans, if at all successful.

Thirdly, we should remember that the experiment worked for the mice which had the genetic mutation that would eventually cause deafness. In other words, they had their hearing at birth but were susceptible to losing it. The technique prevented degeneration in hearing in mice but would not help mice that were deaf at birth from gaining hearing they never had.

Every research carries ethical issues and this one was no different. Firstly, one ethical issue is the recurring one of whether animals should ever be used for research. Should mice be bred for the purposes of research? Are all the mice used? Are they accounted for? Is there someone from Health and Safety going around with a clipboard accounting for the mice? And what happens to the mice when the research has ceased? Are they put down, or released into the ecosystem? “Don’t be silly,” I hear you say, “it’s only mice.” That’s the problem. The devaluation of life, despite the fact that it belongs to another, is what eventually leads to a disregard for other life and human life in general. Would research scientists, in the quest for answers, eventually take to conducting research on beggars, those who sleep rough, or criminals? Would they experiment on orphans or unwanted babies?

The second, when it comes to genetics, is whether genetic experimentation furthers good or promotes misuse. The answer, I suppose, is that the knowledge empowers, but one cannot govern its control. The knowledge that genetic mutation can be edited is good news, perhaps, because it means we can genetically alter, perhaps, disabilities or life-threatening diseases from the onset by removing them. But this, on the other hand, may promote the rise of designer babies, where mothers genetically select features such as blue eyes for their unborn child to enhance their features from birth, and this would promote misuse in the medical community.

Would the use of what is probably best termed genetic surgery be more prominent in the future? One can only suppose so. Once procedures have become more widespread it is certain to conclude that more of such surgeons will become available, to cater for the rich and famous. It may be possible to delay the aging process by genetic surgery, perhaps by removing the gene that causes skin to age, instead of using botox and other external surgical procedures.

Would such genetic surgery ever be available on the NHS? For example, if the cancer gene were identified and could be genetically snipped off, would patients request this instead of medical tablets and other external surgical processes? One way of looking at it is that the NHS is so cash-strapped that under QALY rules, where the cost of a procedure is weighed against the number of quality life years it adds, the cost of genetic surgery would only be limited to more serious illnesses, and certainly not for those down the rung. But perhaps for younger individuals suffering from serious illnesses, such as depression, the cost of a surgical procedure may far outweigh a lifetime’s cost of medication of anti-depressant, anti-psychotics or antibiotics. If you could pinpoint a gene that causes a specific pain response, you might alter it to the point you may not need aspirin, too much of which causes bleeds. And if you could genetically locate what causes dementia in another person, would you not be considered unethical if you let the gene remain, thereby denying others the chance to live a quality life in their latter years?

Genetic editing may be a new technique for the moment but if there is sufficient investment into infrastructure and the corpus of genetic surgery information widens, don’t be surprised if we start seeing more of that in the next century. The cost of genetic editing may outweigh the cost of lifelong medication and side effects, and may prove to be not just more sustainable for the environment but more agreeable to the limited NHS budget.

Most of us won’t be around by then, of course. That is unless we’ve managed to remove the sickness and death genes.