Precision treatment, ethical puzzle
In a basement laboratory at ETH Zurich, the air was as cold as a scalpel. Luca stood before a one-way glass window, gazing at a brain scanner in the next room. Inside, a volunteer was undergoing a cognitive test, a screen displaying a real-time map of activity in their prefrontal cortex.
"Look here," neuroscientist Professor Werner pointed to a red area on the screen. "When the subjects were faced with the stressful task, activity in this area was 32% higher than in normal subjects. According to our database, this indicates a high susceptibility to anxiety disorders."
Luca silently recorded the data. This was part of the "Genome of the Mind" project, a collaboration between the Foundation and leading research institutions. The project aims to uncover the biological basis of psychological traits through gene sequencing and neuroimaging. Over the past three years, the project has yielded impressive results: identifying genetic markers associated with stress tolerance, mapping the neural pathways underlying depressive tendencies, and even exploring the physiological basis of empathy.
When the light of science shines into the dark box of the mind, we see both hope and shadow.
The project data sparked a heated debate within the foundation. Cheng Han's technical team was excited about the potential for precision prevention: "Imagine, we could provide help before problems occur!" Meanwhile, Nila and Kadir were concerned: "Will this lead to new forms of discrimination? What about those labeled 'high-risk'?"
The controversy culminated when the project team received its first legal inquiry letter from a US insurance company inquiring about the possibility of obtaining a "genetic resilience score" for use in insurance pricing.
"Absolutely not!" Luca said firmly during the emergency meeting. "This goes against all our ethical principles."
But even more complex ethical dilemmas arose. At a pilot school in Berlin, a girl assessed as "high risk for anxiety" was overprotected by her teacher, which only exacerbated her psychological burden. Meanwhile, at a Silicon Valley tech company, a job applicant was rejected due to "genetic markers of low empathy."
The best of intentions, if unexamined, can pave the way to the abyss.
The turning point came from an unexpected discovery. The research team tracked a pair of identical twins who had almost identical "psychological risk gene markers," but developed very different life trajectories: the elder sister became a successful crisis intervention expert, while the younger sister suffered from long-term anxiety.
"Genes give us different starting points," the researcher in charge of the case said at the conference, "but what determines the finish line is always those things that science cannot quantify - love, choice, persistence, and unpredictable twists in life."
The case shook the team's certainty, and Luca proposed suspending all individual risk assessments and convening a global ethics summit instead.
On the day of the summit, the Geneva venue was packed. Neuroscientists, ethicists, lawyers, religious leaders, and ordinary people from all walks of life gathered together. Most eye-catching were the volunteers who voluntarily shared their "psychological genomes."
One of the young women, Sophie, took the podium and said, "I know I carry the 'depression susceptibility gene,' but this doesn't define me. On the contrary, this knowledge has made me more aware of how to take care of my mental health. Knowledge itself is not a crime; what is sinful is how we use it."
When data returns to stories, science regains its humanity.
During the heated discussions, a new framework gradually took shape: the “Responsible Psychological Risk Assessment Framework”:
Informed consent: All assessments must be based on fully informed and voluntary participation
Confidentiality of results: Personal psychological genetic information enjoys the highest level of privacy protection
Dynamic understanding: Any assessment should emphasize plasticity and room for development
Support-oriented: Evaluation results must be tied to corresponding support resources
Meanwhile, Nila’s discoveries in the Arctic Circle provide a cultural dimension to this framework. “We never predict what kind of hunter a child will be,” a Sámi elder told her. “We give them tools, teach them to watch the weather, and then let them find their way.”
Based on these insights, the foundation completely changed the direction of its program, destroying all personally identifiable psychogenomic data and shifting its research focus from predicting risk to understanding resilience.
The most innovative solution comes from Cheng Han's team. They developed a "growth mindset training" specifically designed to help those who understand their "psychological risks." The core message of the program is: "Your brain is not the verdict of your fate, but a garden that requires special care."
True empowerment is not about labeling people, but about helping them remove labels.
Six months into the project, Luca received a letter from Sophie, who had once worried about her "depression-prone gene" but now volunteered at the foundation, helping others with similar situations.
“Knowing my vulnerability has made me stronger,” she wrote, “because I’ve learned to buckle up before the storm hits.”
At the quarterly ethics review meeting, Luca presented reassuring data: 87% of those assessed under the new framework said it helped them better understand themselves, 92% took positive mental health actions, and there wasn’t a single complaint of discrimination.
“We almost made a historic mistake,” Luca concluded, “reducing the complexity of life to data points. Fortunately, we managed to regain the balance between science and humanity in time.”
Professor Werner has now become the most active advocate of ethics. He wrote in the journal Nature:
“Science tells us what is, but it can never tell us what should be. The mysteries of the mind exist not only in neurons, but also in the choices made by each person.”
Late at night, Luca was alone in the office. He opened the initial experimental data and marked each file with a new classification: "Understanding tool, not judgment tool."
Outside the window, Lake Geneva shimmered in the moonlight, a shimmer of silver. Luca thought of the photo Sophie had recently sent him—she was standing at the finish line of a marathon, smiling brightly. On the back of the photo was a line of text:
“Thank you for not defining me, but for giving me the courage to define myself.”
In this data-driven age, perhaps the most valuable wisdom is recognizing the boundaries of science. Measurable things are important, but never forget that the most important things in life are often unquantifiable.
Protecting this knowledge may be one of the most important missions of the Foundation in this new century.
“Science can measure the tendencies of the mind, but it can never define its endpoint.”
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