Fighting their way back from decades of war, many countries are re-constructing foundations for better futures. Somewhere in the fields, memorial of the not so distant past reminds buried, deeply buried in the ground. When the gateman shuts the gate of the cemetery, a part of the nation remains unseen. The other part is lived.
In war-torn and post-war countries such as Cambodia, Iran, and Afghanistan, 80 to 85 percent of amputees are land mine survivors. These mines are responsible for 26,000 amputations per year and have produced 300,000 amputees worldwide. In the US, however, the most common cause of amputation is vascular disease.
Flip it, on the hinges of imagination. Imagine a customizable exoskeleton that replicates the exact function of the amputated limb, one that will allow the user to regain much of her freedom and functionality due to their complexity and specialized labour. What about a limb that is made by the application of biological methods and systems?
At the age of 14, Daniel Omar had both of his arms blown off. He lived in a 70, 000 person refuge camp in Yida, South Sudan and considered his life unworthy of living. Early in 2012, Mick Ebeling, the founder of Not-Impossible Labs, a research firm that aims to tackle daunting healthcare challenges using low cost and open source methods, was reading The Times Magazine when he stumbled on Daniel’s story. The latter quickly assembled a team that sought to build an artificial limb- with what they called PROJECT DANIEL. He traveled to Sudan and together with Dr. Tom Catena, an American surgeon then living and working in Sudan’s Nuba Mountains, set-up a lab at a local hospital where consumer-grade 3D printers were used to produce prosthetic limbs. In November, 2013, Daniel received the first limb that cost 100USD and could be printed in six hours. Even though the artificial limb could not do everything, it gave users some degree of independence. Since then, other people have been beneficiaries of this technology.
Human beings have always sought ways of improving their conditions. Whether it is sexual enhancing drugs or cosmetic surgery, human ingenuity has been at the forefront. Such has been the subject of human enhancement techniques and methods, an endeavor that encompasses a range of approaches that may be used to improve aspects of human function. This may either be for the purpose of restoring impairments or to raise function to a level considered as beyond normal for humans. At the workplace, it will change people’s work ability to perform tasks and influence motivation, and boost learning in schools.
In pharmaceuticals, most probably, the commonest enhancement available is Viagra. Originally meant to treat heart conditions and then erectile dysfunction, people without sexual problems use it to improve sexual performance and stamina. In a sense, vaccines are immune enhancing drugs, then we have all those that are taken to make the user look slimmer, younger and the rest are enhancers too.
Emerging approaches will allow cognitive enhancing drugs that will be used in treating neuropsychiatric disorders and could also improve mental faculties such as memory and facilitate cognitive maintenance which will be very much helpful for a continually aging workforce.
Non-pharmacological cognitive enhancement will include non-invasive brain stimulation and monitoring its activity may offer new insights in the restoration of brain function in some disorders. Cognitive training will become important and technology undoubtedly will have roles to play. In language learning for example, it will be adaptive, responsive and patient.
Genetic techniques have allowed a new type of in-vitro fertilization procedure that allows doctors to transfer mitochondrial DNA from one woman into the eggs of the other. This is intended for women who have what’s known as ‘’mitochondrial disease’’. It went on clinical trial in 2014. Similarly, cytoplasmic transfer allows cytoplasm from a donor egg to be injected into an egg with a compromised mitochondrion. Pre-implantation genetic diagnosis (PGD) makes genetic profiling of embryos prior to implantation and embryo selection possible.
In medicine, implants such as pacemaker and magnetic implants and also organ replacement help to restore biological functions of human organs. From kidneys to hands, 3D bioprinters are churning out bones and rudimentary organs. These organs could also be genetically modified to improve its functions.
A four year old girl, Ashanthi De Silva had congenital disease called adenosine deaminase (ADA) deficiency which affects immunity and the ability to fight infections. In 1990, Dr. W. French Anderson from the National Heart, Lung and Blood Institute performed surgery for her by taking white blood cells from her, inserted the correct genes for making ADA and then, re-injected into her (one was unsuccessful, Jesse Gelsinger). She was cured and for the larger scientific community, it brought into fruition what scientists have conceptualized since the ‘60s. Despite this early feat, gene therapy is still at its infantile stage. Looking into the future, gene therapy will play huge role.
There is also in emerging technologies, a direct communication pathway between the brain and an external device. Brain- computer interface is often directed at assisting humans, augmenting, or repairing human cognitive or sensory- motor functions. Cyberware seeks to implant machine parts in human bodies and acts as an interface between the central nervous system the hardware connected to it. Alongside this, nanomedicine could transform medicine by devising artificial antibodies, artificial white and red blood cells, and antiviral nanorobots. There could also be nanomachines inside the human body that could monitor functions of organs and deliver drugs.
Scientists are working to have mind uploading where the whole brain can be scanned and mapped in details, and then copied onto a computer system. As prosthetic technology advances, some scientists are considering the use of advanced prosthetic enhancements which will replace healthy body parts and systems to improve function. Bioelectronics and biomechatronics could be employed in the creation of cyborgs and biorobots with a biological brain and mechanical limbs.
But much of the conversation has been about the ethics of these approaches. Some argue that the human agency is slowly being eroded with the pursuit of a certain societal perfectionism and transhumanism. There is also the moral argument of playing God. In PGD for example, parents may opt to safely abort fetuses with Down’s syndrome. Critics say this is no different from state sponsored Nazi eugenics programmes. In defense, proponents say that eugenics has always existed even by choosing partners from many. They also say that it cannot be the case that all parents will wish for the same enhancements. This falling into the hands of individuals instead of the state will ensure variety. But who has the right to determine what is good for the fetus. The parent?
Like every technology, human enhancements lie between moderation and extremism. There are obvious advantages and threats. As we traverse this earthly journey, the pendulum can swing either way.