Our Posthuman Future Consequences of T
by Francis Fukuyama
Keeping Up With the Clonses
A review by Cass R. Sunstein
The word "unnatural" is never a compliment. You would not describe
your best friend as having "a lovely, unnatural smile." No company
would advertise its product as being "one hundred percent unnatural."
But John Stuart Mill, writing in 1874, urged that it is a big mistake
to think that things are better if they are natural. "If the
artificial is not better than the natural," Mill asked, "to what end
are all the arts of life? To dig, to plough, to build, to wear
clothes, are direct infringements on the injunction to follow
nature." According to Mill, "Nearly all the things which men are
hanged or imprisoned for doing to one another, are nature's every day
performances." And Mill went further. He urged that "the duty of man
is the same in respect to his own nature as in respect to the nature
of all other things, namely not to follow but to amend it." For Mill,
"conformity to nature has no connection whatever with right and wrong."
Mill was not writing about modern science, which is the major domain
in which people are now arguing about efforts to "amend" nature.
Mood-altering drugs are prescribed to tens of millions of Americans
to combat depression and anxiety -- both of which are thought to have,
in many cases, a genetic origin. As a result of in vitro
fertilization, babies can be made not the natural way, but by placing
sperm and egg in a plastic dish. Louise Brown, the first human being
conceived outside the womb, was born twenty-three years ago; and more
than two hundred thousand people have now been conceived in this way.
Before very long, some scientists say, human beings will be able to
create "designer babies," with physical and psychological
characteristics meeting the specifications of parents.
Does this seem like science fiction? Recently a Chicago woman gave
birth to a child who had been "pre-screened" for early-onset
Alzheimer's disease, which ran in the family. Doctors examined a
number of embryos before finding that one of them -- the eventual
child -- was free of the early-onset Alzheimer's gene. The child is now
doing well. If genetic screening already allows people to choose
among embryos, might cloning be feasible, too? Consider the birth of
little CC, the recently cloned cat from Texas, a genetically
identical copy of Rainbow, a two-year-old female. (CC does not look
much like Rainbow, because the womb environment led to different
markings on her coat.) Some people think that it is morally monstrous
to clone pets, in part because doing so is "unnatural." The
overwhelming majority of Americans think that it is morally monstrous
to clone people, in part for the same reason. Maybe Mill overstated
his argument.
Francis Fukuyama is best known for an essay that he wrote in 1989, to
mark the fall of communism, called "The End of History." He argued
that liberal democracy had forever triumphed over its adversaries,
which, in his view, had exhausted themselves. There were many
problems with his argument, and in the aftermath of September 11
Fukuyama's claim seems less than plausible; but at least it was a
bold essay with a striking thesis. Fukuyama's new book is not bold
and it lacks a striking thesis. Fortunately, though, it has a rich
and important subject.
One of Fukuyama's goals is to steer a middle position between those
who are phobic about biotechnologies and those who think that
regulation is both impossible and unwise. In Fukuyama's view,
regulation is both possible and wise, above all so that we hold on to
"human nature." But Fukuyama offers inadequate guidance to those who
are uncertain about what exactly should concern us. His book is
earnest, worried, informative, and responsible, but in key spots it
is platitudinous and frustratingly vague. It is also, I think,
fundamentally misdirected: Fukuyama goes wrong by relying on abstract
claims about human nature, instead of exploring in concrete detail
the likely consequences of new technologies for actual human lives.
But I am getting ahead of the story.
Fukuyama begins with a competent, wide-ranging, but scattered survey of scientific developments. Even without modifying genes, doctors are
now able to influence behavior through neuropharmacology, which is
used to control various psychological ailments. Fukuyama emphasizes
the "vast increase in scientific knowledge about the biochemical
nature of the brain and its mental processes," a development that in
his view has left Freud in the dust. "Freudianism might be compared
to the theory developed by a group of primitive tribesmen who found a
working automobile and tried to explain its internal functioning
without being able to open the hood." Owing to modern neuroscience,
we are now able "to peer, however tentatively, at the engine."
Fukuyama focuses in particular on selective serotonin reuptake
inhibitors (SSRIs), such as Prozac, Paxil, and Zoloft, which appear
to constitute what he calls a "happiness pill." Low levels of
serotonin in the brain are associated with depression and aggression,
and by increasing serotonin levels, SSRIs seem to deliver huge
benefits, even miracles. Twenty-eight million Americans -- ten percent
of the population! -- are now using SSRIs.
Fukuyama is especially interested in the apparent fact that SSRIs
increase self-esteem. This, he remarks, "refers to a critical fact of
human psychology, the desire all people have for recognition." He
thinks that this desire "has a biological base ... related to levels
of serotonin in the brain." It is at this point that Fukuyama gets
nervous. "Virtually all human progress has been the by-product of the
fact that people were never satisfied with the recognition they
received; it was through struggle and work alone that people could
achieve it." For people who do not have a clear psychological
illness, SSRIs start to mark a path that looks "uncomfortably like
the soma of Aldous Huxley's Brave New World."
Fukuyama is similarly uncomfortable with Ritalin, which in his view
"has come to play the role of an overt instrument of social control."
Ritalin is prescribed for Attention Deficit Hyperactivity Disorder
(ADHD), a "disease" (the quotation marks are Fukuyama's) associated
with, though not limited to, young boys who have a hard time sitting
still and paying attention. According to one account, as many as
fifteen million Americans may be suffering from one or another form
of ADHD. Fukuyama is skeptical. He thinks that the simpler
explanation is that ADHD is really "just the tail of the bell curve
describing the distribution of perfectly normal behavior." He fears
that people with certain problems "would like to absolve themselves
of personal responsibility for their actions." In his account, both
parents and teachers are avoiding old-fashioned discipline and
training, and resorting far too often to the view that even mildly
wayward children suffer from a pathology.
Fukuyama goes further. Prozac is heavily prescribed "for depressed
women lacking in self-esteem," giving them "more of the alpha-male
feeling that comes with high serotonin levels." Ritalin, by contrast,
is prescribed "largely for young boys who do not want to sit still in
class because nature never designed them to behave that way." The
result of the two drugs is to move boys and girls "toward that
androgenous median personality, self-satisfied and socially
compliant, that is the current politically correct outcome in
American society."
Yet Fukuyama is far more concerned with what is to come. He thinks
that more sophisticated, powerful, and targeted efforts will emerge
before long, operating as techniques of social control, marketed by
pharmaceutical companies, and exercised not by the state but "by
parents, teachers, school systems, and others with vested interests
in how people behave." Medicines that modify behavior are one route
by which we might become "post-human." Another route, Fukuyama
contends, involves longevity, which has grown dramatically in the
last century. In 1900, the average life expectancy in the United
States was in the late forties; it is now in the mid-seventies.
Significant further increases may be possible -- and if "a genetic
shortcut to immortality exists, the race is already on within the
biotech industry to find it."
What are the social and political consequences? One result is that
"voting age populations in the developed world will be more heavily
feminized, in part because more women in the growing elderly cohort
will live to advanced ages than men, and in part because of a
long-term sociological shift toward greater female political
participation." Fukuyama also thinks that "biotechnology is likely to
offer us bargains that trade off length of life span for quality of
life." Eventually our relationship "to death will change," and
"accepting death will appear to be a foolish choice, not something to
be faced with dignity or nobility."
However dramatic this seems, Fukuyama insists that genetic
engineering is "the most revolutionary technology of all." This
technology is already being used in agriculture, producing
insect-resistant corn and herbicide-resistant soybeans. "The next
line of advance is obviously to apply this technology to human
beings." Armed with an understanding of the functions of genes,
researchers might well be able to affect intelligence, crime, even
sexual orientation, for all of these have genetic components.
Fukuyama predicts that the initial steps in this general direction
will consist of pre-implantation genetic diagnosis and screening (as
in the case of pre-screening for early-onset Alzheimer's). In his
view, parents will routinely be able to screen embryos for a wide
variety of disorders -- and to implant in the mother's womb those with
the preferred set of genes. He also thinks that human cloning will
precede genetic engineering. The ultimate prize will be the "designer
baby," meaning a baby with pre-selected characteristics such as
"intelligence, height, hair color, aggression, or self-esteem."
Fukuyama believes that genetic engineering "puts eugenics squarely
back on the table."
What is wrong with all this? Fukuyama's answer is based on the idea
of human nature, which he defines as "the sum of the behavior and
characteristics that are typical of the human species, arising from
genetic rather than environmental factors." This definition raises
many questions. What does "typical" mean, and how can we figure out a
"sum" of genetically determined behavior and characteristics?
Fukuyama recognizes that human characteristics, such as height, are
variable within the species and over time, but he stresses that
nature determines "the overall degree of possible variance."
Environmental factors "can change median heights," but they "cannot
push human heights above or below certain limits." And what is true
for height is true for intelligence as well. Fukuyama adds that there
are "species-typical ways in which we perceive, learn, and develop
intellectually." Language is central, as are certain values of
parental love and reciprocity.
In his discussion of these matters, Fukuyama explores a number of
philosophical issues, particularly the "naturalistic fallacy," that
is, the idea that empirically based claims about human nature cannot
furnish any guidance on what we should be doing. Hume, for example,
is widely thought to have shown that one cannot get an "ought" from
an "is." But Fukuyama thinks that the naturalistic fallacy is itself
fallacious. In his opinion, you can get an ought from an is. To
establish this point, he offers nothing less than a brief tour of the
"Western tradition," beginning with Socrates and moving briskly
through Rousseau, Kant, and Rawls. Fukuyama urges that "virtually all
philosophers" who offer theories of rights "end up reasserting
various assumptions about human nature into their theories." Thus
those who contend that reproductive choices should be treated as
special rights must think that such choices are "somehow more
important than other kinds of rights, based on their importance for a
median or average human individual."
To support the claim that human nature exists, and that it matters
for purposes of policy, Fukuyama also offers some remarks about the
idea of animal rights. He suggests that some such rights should
indeed be recognized, simply because nonhuman animals "can feel pain
and suffer." But the idea of animal rights grows out of "an empirical
observation of what is typical for their species" and hence a
"substantive judgment about their natures," which, for an opponent of
the naturalistic fallacy such as Fukuyama, is an appropriate basis
for establishing rights.
Fukuyama moves rapidly from human nature to human dignity, which
derives from "some essential human quality underneath that is worthy
of a certain minimal level of respect." He sees this idea as deeply
egalitarian, because it "entitles every member of the species to a
higher moral status than the rest of the natural world." With respect
to biotechnology, he is concerned that social elites will be able to
bypass the genetic lottery and ensure preferred characteristics for
their children. Notwithstanding its random quality, or indeed because
of its random quality, such a lottery has a kind of egalitarianism,
"since everyone, regardless of social class, race, or ethnicity, has
to play in it." But "when the lottery is replaced by choice, we open
up a new avenue along which human beings can compete, one that
threatens to increase the disparity between the top and bottom of the
social hierarchy." Fukuyama fears that the belief in human dignity
might be at risk if we are no longer bound to our (or his) notion of
human nature.
What does Fukuyama propose to do? His argument is not for any
particular law, but for institutions that will ensure a democratic
check on biotechnology. "In the face of the challenge from a
technology like this, where good and bad are intimately connected, it
seems to me that there can be only one possible response: countries
must regulate the development and use of technology politically,
setting up institutions that will discriminate between those
technological advances that promote human flourishing, and those that
pose a threat to human dignity and well-being." Fukuyama hopes for
both domestic regulation and international regulation. He wants to
rely not on existing agencies, but on "a new agency to oversee the
approval of new medicines, procedures, and technologies for human
health." This agency should have authority "over all research and
development, and not just research that is federally funded." In
arguing for such regulation, he spends much of his time urging that
we move beyond the polarized debate between libertarians who oppose
any regulation at all and morally motivated critics of biotechnology
as such.
Fukuyama is alert to an obvious question: who will oversee any new
regulatory institutions? He responds that institutions should be
controlled by "the democratically constituted political community,"
bringing its own judgments to bear on the key questions. Fukuyama
also believes that "it is simply not the case that the speed and
scope of technological development cannot be controlled." In many
morally vexing matters, such as those involving human body parts and
nuclear weapons, domestic and international regulation has been quite
effective. While no regulatory system is entirely successful,
controls are possible if enough people are committed to them.
Indeed, existing controls, mostly covering agricultural
biotechnology, do a great deal. The problem is that in light of
recent scientific innovations there are "gaping holes in the existing
regime." But Fukuyama is unclear on the substantive content of any
regulation, devoting only a few pages to the details. With respect to
reproductive cloning, he takes a firm stand, arguing for a ban on
both practical and moral grounds. The practical problem, he writes,
"is that cloning is the opening wedge for a series of new
technologies that will ultimately lead to designer babies." The moral
problem is that "cloning is a highly unnatural form of reproduction
that will establish equally unnatural relationships between parents
and children," with a parent having to "nurture a younger version of
his or her spouse."
Fukuyama is more ambivalent about the appropriate treatment of early
embryos, which are the source of the ongoing controversy over
stem-cell research. Early embryos -- less than a few days old, just
tiny clumps of cells -- might be created and used to produce stem
cells, which are highly adaptable, and which might be used for
therapeutic and research purposes. Very recently, for example, stem
cells were used to cure a mouse whose blood and immune system had
been destroyed. Congress is now debating whether to ban cloning of
human embryos for therapeutic and research purposes; and some people
would like to ban stem-cell research altogether.
But in this matter Fukuyama does not offer a final judgment. In his
view, it is morally relevant that an embryo "has the potential to
become a full human being." It is entitled to less protection than an
infant, but still "it has a higher moral status than other kinds of
cells or tissue that scientists work with." For this reason, Fukuyama
doubts whether scientists "should be free to create, clone, and
destroy human embryos at will." He urges that "if we are to do things
like harvest stem cells from embryos, we should put a lot of limits
and constraints around this activity to ensure that it does not
become a precedent for other uses of the unborn that would push the
envelope further."
More generally, Fukuyama, with his emphasis on human nature, contends
that it is important "to distinguish between therapy and
enhancement," authorizing the former while restricting the latter.
"The original purpose of medicine is, after all, to heal the sick,
not to turn healthy people into gods." He knows that the distinction
between therapy and enhancement is unclear and deeply contested, but
he thinks that this is the sort of distinction that regulatory
agencies can administer. His closing plea is not for any particular
set of controls but for a new set of institutions, representing a
higher form of freedom than the freedom recommended by those who
argue for unfettered freedom of choice. "True freedom means the
freedom of political communities to protect the values they hold most
dear, and it is that freedom that we need to exercise with regard to
the biotechnology revolution today."
Many of Fukuyama's positions are reasonable. He is right to insist
that these scientific advances raise serious ethical issues. Prozac
and Ritalin certainly do seem to be overused. It is sensible to
restrict scientific experimentation with fetuses; even those who
support the right to choose abortion should want to regulate the
research uses of unborn children who have reached a certain stage of
development. Fukuyama is also correct to criticize those who think
that legal restrictions cannot possibly work. At the very least, such
restrictions will reduce the level and the likelihood of the
prohibited conduct. It is certainly reasonable for Fukuyama to want
some democratic control of the emerging situation; no sensible person
is opposed to that. But on the hard questions -- those on which people
are now disagreeing -- Fukuyama says much too little, and what he says
offers too little help. More important, his emphasis on the idea of
"human nature" seems to me confusing and wrongheaded. This is not
because human nature does not exist, or because it is irrelevant to
politics, but because it offers us too little guidance for thinking
about biotechnology, and because it does not support the distinction,
crucial to Fukuyama, between "therapy" and "enhancement."
Let us turn to specific issues. Begin with stem-cell research. As I
have said, Fukuyama concludes that the potential of a human embryo
entitles it to a lower moral status than that of a human child, but a
higher moral status than that of other cells. There is nothing wrong
with middle positions, but what exactly is his argument here? Some
people insist that embryos, even at a very early stage, have the same
moral status as children. Other people believe that an early human
embryo -- smaller than the period at the end of this sentence -- is
entitled to no greater moral status than any other group of cells.
Fukuyama offers his plausible centrist view, but he provides no
argument against the views that he rejects.
Consider the following position. Stem-cell research promises to
produce significant social benefits, including better treatment of
many medical conditions, such as diabetes, Parkinson's disease, heart
disease, paralysis, cancer, burns, and other conditions related to
specific cell abnormalities. If scientists will be using and cloning
embryos only at a very early stage when they are just a handful of
cells (say, before they are four days old), there is no good reason
for a ban. It is silly to think that "potential" is enough for moral
concern. Sperm cells have "potential," and (not to put too fine a
point on it) most people are not especially solicitous about them.
In any case, scientists are now permitted to experiment on grown
animals; and if we want to prevent unjustified suffering, surely we
should be more concerned about experiments on monkeys, pigs, and dogs
than about research involving very early human embryos. Some people
respond that if we allow such research, then we will encounter some
hard line-drawing problems. They maintain that if we are to keep our
moral convictions intact, then we must draw the line here and now.
But if significant medical advances are likely, why not draw the line
there and then? Fukuyama does not argue for a ban on stem-cell
research; the problem is that his discussion provides no response to
the opponents or the supporters of such research.
With respect to human cloning, Fukuyama's arguments are
embarrassingly thin. In his view, cloning is an "unnatural form" of
reproduction that might lead to "unnatural" relationships between
parents and children. But artificial insemination and in vitro
fertilization are unnatural, too; and I doubt that Fukuyama would
want to ban them. Does Fukuyama object also to cesarean section? To
anesthetizing women during childbirth? Believe it or not, Fukuyama
seems worried that parents might develop inappropriate feelings
toward their spouses' clones. (Maybe we should not abandon Freud
quite yet.) Less ridiculously, he fears that if we allow human
cloning, we will be on the way to "designer babies." But if we are to
recoil at the prospect of "designer babies," why should we draw the
line between in vitro fertilization (now permitted) and cloning,
rather than between cloning and selecting for genetically programmed
traits?
A great deal (though not all) of the opposition to human cloning
seems to be rooted in ignorance, even in hysteria; and yet I do
believe that human cloning should probably be banned, and for a
simple reason. The reason -- which is, astonishingly, not emphasized by
Fukuyama -- is that in its current form the technology creates
significant risks of serious illness and early death for the children
who would result. And it would impose risks on their mothers, too.
Unless the accompanying benefits are extraordinary, no technology
should be permitted if it creates risks of this magnitude. It is also
plausible to fear other concrete harms, such as adverse psychological
effects on people who are genetically identical to one or another
parent; but this is a speculative concern. The sheer risks of illness
and death are enough to stay our hands for now. (But note that this
argument does not support a ban on non-reproductive cloning, that is,
the cloning of very early embryos for medical and scientific uses.)
Fukuyama is in favor of "therapy," but he is against "enhancement."
He wants this distinction to serve as the basis for "draw[ing] red
lines" between "what is legitimate and what is illegitimate" in many
areas, including pre-implantation diagnosis and screening. But surely
this is a very fragile distinction; and if it pivots on the
difference between "normal" health and better-than-normal health, it
is not clear that the distinction has much moral relevance. Suppose
that medical technologies could make ninety-five percent of Americans
as healthy, physically and psychologically, as the most healthy
Americans now are. That would seem to be an extraordinary advance
that would greatly reduce human suffering. Would this be therapy or
enhancement? Would it be wrong to use technologies that would make
all of us as healthy as, say, the top one percent?
Fukuyama offers no argument against practices of this kind, and I am
not at all sure that he would oppose or ban them. But now suppose
that biotechnology could move people well beyond the top one
percent -- that it could make people healthier than anyone is today.
This would undoubtedly qualify as enhancement. But what would be
wrong with it, if we were not causing harm to anyone or
discriminating against anyone? Should we really feel a strong moral
allegiance to the "typical" characteristics of the human genotype?
People with certain theological positions might have an affirmative
answer, but Fukuyama is arguing on secular grounds. Anyway, how can
we be so sure that God, who endowed us with minds, would not like us
to improve our genetic capacities?
Fukuyama refers with approval to the claim, which he attributes to
Leon Kass, that "there is a natural functioning to the whole organism
that has been determined by the requirements of the species'
evolutionary history, one that is not simply an arbitrary social
construction." The claim seems correct. What is missing from
Fukuyama's account, however, is an explanation of why human beings
should not improve, if they can, on this "natural functioning." Why
should the outcome of evolutionary history enjoy such special moral
status?
At times Fukuyama seems concerned about inequality -- not about an
across-the-board increase in human health and abilities, but about a
situation in which some people, and not others, are able to enhance
the capacities of their children. The concern is perfectly
legitimate, but here, too, Fukuyama just skims the surface. In vitro
fertilization is expensive, and poor people are unlikely to be able
to afford it -- and yet it would be odd to ban it for that reason. It
costs a lot of money to screen embryos for early-onset Alzheimer's:
would Fukuyama prohibit such screening on equality grounds? Prozac
and Ritalin are expensive, but if they help people they should not be
forbidden on the ground that wealthy people are far more able to
afford them. Of course much more should be done to improve medical
treatments for people who lack money. But how are poor people helped
by bans on therapy and even enhancement? On the contrary, any bans
are most likely to hurt poor people, if only because scientific
advances are driven in part by the profit motive, and such advances
help most people, not just a few.
Perhaps this misses Fukuyama's real concern. If wealthy people are
able to engage in genetic engineering, they might be able to bypass
the genetic lottery and give their children special characteristics,
with the result of placing less-wealthy people at a new and
potentially massive social disadvantage. In his fascinating book
Remaking Eden, which appeared in 1997, Lee Silver discusses the
possible rise of a new kind of social stratification, with the rich
creating a class of "gene-enriched" people. To be sure, there is a
potential problem here worthy of sustained thought: rich people do
receive the best medical treatments, and perhaps even larger social
disparities will increase over time. But at present this possibility
does not offer a reason for government to impose new regulatory
controls. At most, this anxiety should be taken to suggest that the
relevant technologies should be made available to many rather than to
only a few.
Inequality is not at the heart of Fukuyama's argument. His real claim is on behalf of "human nature." He thinks that if we understand what
human nature is, we will be better equipped to approach the ethical
issues raised by biotechnology. There is a sensible and important
point in the background. To see it, consider Fukuyama's brief but
suggestive treatment of the rights of animals. Dogs, cats, and horses
should indeed have the right to be free from cruelty and neglect; and
they do have that very right under state law. Still, as Fukuyama
urges, no one thinks that dogs, cats, and horses should have the
right to vote or to participate in literacy programs. A claim about
what a dog is entitled to has everything to do with the kind of
creature that a dog is. The same is true for human beings. When we
think about human rights, and about what makes those rights
distinctive, we can make a great deal of progress by emphasizing
distinctly human characteristics.
The problem is that Fukuyama confuses this point with a very
different one that has to do with what he sees as the importance, for
purposes of assessing biotechnology, of "behavior and characteristics
that are typical of the human species, arising from genetic rather
than environmental factors." Suppose that it is "typical" for members
of the human species, on the basis of genetic factors, to fear flying
in airplanes, to respond with violence when insulted, or to die from
cancer or heart disease after a certain age. Surely Fukuyama would
not object to cultural interventions that would counteract genetic
predispositions to fear of flying or to excessive violence. Surely he
would not oppose efforts to alter diet so as to counteract the
genetic predisposition to die from cancer or heart disease. Why,
then, should anyone object to medical technologies that would take
people beyond the domain of the "typical" -- by, for example, screening
out genetic predispositions that lead to preventable illnesses and
death? Or suppose that scientists can make human beings taller,
healthier, faster, stronger, and smarter than is "typical." Why,
exactly, object to that?
I do not think that Fukuyama has a good answer to that question. But
I do think that he has an intuition. The intuition is nicely captured
by his suggestion that Prozac makes girls more like boys and Ritalin
makes boys more like girls, thus pushing members of both sexes
"toward that androgenous median personality, self-satisfied and
socially compliant, that is the current politically correct outcome
in American society." The suggestion seems to me daft -- but let us
suppose for a moment that it is right. Suppose that some girls have a
genetic predisposition toward depression and that some boys have a
genetic predisposition toward excessive aggression, and that Prozac
and Ritalin provide help on both counts. Suppose that the result is
to make girls somewhat more self-satisfied and boys somewhat more
compliant with social norms against aggression. Is this bad?
I think that Fukuyama's abstract interest in "human nature" and in
what is "natural" prevents him from attending enough to what most
matters: the concrete consequences, for actual human lives, of
biotechnological advances. Sadness, anxiety, and aggressiveness
should not be treated or screened out: bad and dark feelings are an
essential part of good human lives. But if neuropharmacology can
counteract crippling depression, which is far more dire than
melancholy, surely it should be applauded. Human cloning should not
be permitted if it would cause, for the children who result, serious
illness and early death, or even serious psychological harm; but if
stem-cell research promises to deliver significant benefits, surely
government should encourage it. Mill was right. If science is able to
make human lives healthier, longer, and better, then it is foolish to
object in nature's name.
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