04 December 2009

Transhumanism: A Retrospective

As biotechnological research furthers its exploration and measurement of the human body’s capabilities, the concept of Transhumanism becomes a more realistic prospect. Going beyond science’s commitment to saving lives and treating debilitating disease, Transhuamnism encourages the use of emerging technologies and research to annihilate these human “burdens” and propel the body and mind into an idealized state of mastery. There are efforts being made in a variety of fields to combat the limitations of the human condition. Through physical, genetic, cosmetic, and cognitive enhancement, we may one day reach goal of total body and mind manipulation, dissolving any expectation for the “average man.” While the science is young and realistic expectations for the Transhuman movement remain unclear, research continues to advance. The only way to acclimate society to these novel ideas is to reevaluate the essence of the human condition and what it means to a contemporary world inundated with fast paced, digital technologies. Profound philosophical and moral quandaries, inextricably woven into the Transhuman theory, must eventually inform the political agenda regarding healthcare and reform.

Current scientific developments present new possibilities for the future of physical enhancement allowing for the direct control of weight, height, and even muscle growth. Gone are the days of long arduous lifestyle changes; these treatments promise swift results and little demand from the individual undergoing them. Researchers have discovered gene delivery strategies that improve muscle mass and function for both cosmetic reasons and patients with degenerative muscle disorders. Potentially impactful research includes genetic alterations that enable mice to convert fat into carbon dioxide and remain lean while eating the equivalent of a fast-food diet as well as more established technologies such as growth hormones that allow us today to alter an individual’s height with increasing safety and consistency.
Despite their benefits, these treatments place a heavy bioethical and financial burden on our society related to the potential of these technologies to redefine the medical and social norms of our society, effectively leading to the medicalization of the body, re-setting medical standards for physical characteristics such as height and weight. Considering this power, it becomes even more important to question who is eligible for these treatments under proper medical definitions. Our healthcare system today defines disease as the presence of abnormality, but characteristics such as height are increasingly manipulated to satisfy social standards as well as pharmaceutical and medical profits, increasing the financial burden on our healthcare infrastructure.
There are also a host of bioethical problems surrounding such technologies. As Lennard Davis points out when patient “are treated they are not treated as individuals but as instantiations of norms. A good deal of the energy of being alive becomes devoted to this imperative to conform physically." (Bending over Backwards: Disability, Dismodernism and Other Difficult Positions. New York: New York University Press, 2002, pp. 115-116). The solution rests in coming up with sustainable definitions of disability that build healthy foundations for tomorrow's medical and cultural norms, promote social acceptance of a wide range of characteristics, serve as distinct biological entities and are not representative of the interests of physicians, researchers, and policy makers in the biomedical enterprise.

Not unlike physical enhancement, recent advances in technology include the development of drugs and medical devices that focus on “lifestyle” improvement and “wellness.” This expansion, which umbrellas beauty and cosmetic enhancement, has, to some extent, stigmatized the dermatology/plastic surgery profession as superficial and crude. While shows such as Dr 90210 and Extreme Makeover portray the desire for double Ds and Jolie lips as berated clich├ęs, they also show the extent to which we are offering up our identity and physical appearances to science. The body is now deemed perfectible: sooner or later we may well be able to look like whoever or whatever we wish, diluting any original sense of self. For instance, who do face transplant patients see when they look in the mirror? Themselves, the donor, or a sort of aesthetic pastiche of both? Furthermore, as competition within the industry increases, prices will decrease (For example Dysport vs Botox), and the public preference for the makeup aisle may shift to more permanent, reliable treatments at the Doctor’s office.

Thornier bioethical issues arise with regards to the science of designer babies concerning morality, autonomy, the financial barriers to the use of this science that foster inequality and its use for perfection of physical characteristics rather than the treatment of congenital defects. These lines are blurred, and embryonic manipulation must be strictly regulated. Stringent legislature may prevent the use of this technology for purposes not beneficial to society at large, but may impede scientific progress.
Lastly, cognitive enhancement, also termed neuro-enhancement, is a branch of Transhumanism that focuses on improving the functions of the brain. Like the field of neuroscience, cognitive enhancement is a burgeoning field, but it lags behind other more established enhancement sciences. Examples include the creation and deletion of memory in mice; an electrode capable of targeting individual neurons, taking us one step closer to mechanical brain implants. Although the cutting edge of cognitive enhancement seems somewhat irrelevant to the current healthcare debates, the preexisting widely used cognitive enchantment technologies are just precursors to the revolutionary future of cognitive enhancement.
The current trend in cognitive enhancement is the use of nootropics, or “smart drugs”, to increase the brain’s functions such as memory, motivation, intelligence, and concentration. These are mostly the off label or recreational use of prescriptions intended for other purposes. These drugs are currently in a legal grey area; the majorities of the users are either prescribed by a lenient doctor or procure the drugs from a second hand market. The FDA states that all drugs must target a specific disease, but grants the doctors the right to prescribe off label. This slightly inhibits research into cognitive enhancement, but developments in enhancement continue to be an (arguably) positive externality of research into neurological impairments like Alzheimer’s, Post Traumatic Stress disorder, and severe depression. Treatments for these diseases often have enhancing effects to healthy user, but companies are still kept in check not to develop drugs solely for this purpose. Eventually the amount of biotechnology in cognitive enhancement will be too vast to tuck into grey areas and loopholes, and the FDA will have to address the safety and production of treatments whose sole purpose is enhancement. Along with this, another debate rages around the potential consequences of these enhancements. Some fear an unfair advantage to the users, and others fear the advantage is so beneficial workplaces will force workers to use them to increase productivity. With the spread of nootropics and the increased understandings of the mechanics of the mind, cognitive enhancement is no longer a topic the government can ignore and legislation must be passed to monitor their safety and potential.

The body and mind are quickly becoming part of a medicalized industry ready to satiate any insufficiency with a prescription pill or lunchtime laser treatment. Biotechnological advancements present us with a plethora of new and exciting possibilities for altering and improving the way the body looks and performs. However along with these come serious debates over what the scientific exploration of the body means to our progress. The further we depart from an appreciation of nature, and the more we merge with the indestructible machine, the less we depend on mental diligence and self-motivation, hallmarks of the human condition. Laying parallel, and paradoxical, to this drive for Transhuman superiority is nostalgic rejection. Discourses encouraging harmony with the land, balance between the mind and body and chemical detox dismiss the exploitation of industry as destructive and unnecessary. While society will never regress from this point of technological prowess, there must always remain a grounding dialogue with our natural roots. Humans are inescapably creatures of becoming, growth, and change. In order to curtail an apocalyptic perception of Transhumanism, new scientific advancements will hopefully promote new avenues of thought and debate and new industry specialties, not only defining a new relationship between society and the drug industry, but also challenging present notions of the body and the self.

23 November 2009

A Baby, Please. Blonde, Freckles -- Hold the Colic.

Laboratory Techniques That Screen for Diseases in Embryos Are Now Being Offered to Create Designer Children.

So you want to design your baby? A girl you say? Blue eyes? Brown hair? You want her to be intelligent and athletic? Is there anything else you desire?

The first two articles posted on "designer babies" focused mainly on the prospect of genetically altering embryos for disease prevention and the option to choose the sex of one's baby; the thought of genetic alterations for cosmetic enhancements seemed a controversy too distant to dwell on. Yet, a clinic (Fertility Institutes) recently claimed to not only allow couples to create "savior babies" or to eliminate embryos of genetic risk but also to choose gender and physical traits in their babies. It seems the dawn of "designer babies" is upon us.

Cosmetic traits will be a difficult form of preimplantation genetic diagnosis; not only are features such as intelligence and athletic ability also affected by environmental factors but cosmetic traits are centered around a large number of DNA variations and may be harder to pinpoint. Yet, scientists in Iceland and the Netherlands have made major advancements, pinpointing the genetic markers responsible for eye, hair and skin color. Therefore, scientists can now offer the probability that a genetically enhanced embryo will have the specific hair/eye color requested by the parents.

While Fertility Institutes claims to offer cosmetic PGD, the controversial treatment is not on the open market yet. It has been met with much opposition as well as threats to ostracize any clinic who begins this embryonic enhancement. Even the general public does not agree with the implantation of cosmetic enhancement. According to statistics, the majority of people said they would support genetic tests for the elimination of specific diseases but when asked about cosmetic enhancement only 10% supported enhanced athletic ability, 10% supported improved height and 13% supported enhanced intelligence. Even key figures in the PGD world such as Dr. Kearns (found enough data to identify SNP's to relate N. European skin, hair and eye pigmentation) do not support preimplantation cosmetic enhancement. As said by Dr. Kearns, "I'm not going to do designer babies, I won't sell my soul for a dollar."

The future of natural wonder and imperfection hang in the balance.

First "designer baby" Born Free of Breast Cancer Genetic Risk

Embryo Screening and the Ethics of Human Genetic Engineering

Recently, the world's first "designer babies" have been born.

A baby girl born was embryonically screened to be free of the genetic risk for breast cancer. Scientists removed the faulty BRCA1 gene from the embryo to prevent the child from inheriting the genetic risk for breast cancer that is prevalent in her ancestry.

This procedure is known as preimplantation genetic diagnosis (PGD) and has become routine in preventative medicine. The beginnings of preventative medicine only allowed for the screening of diseases such as Huntington's disease and cystic fibrosis leaving the mother with the opportunity to either continue with or terminate the pregnancy. Today though, PGD allows the prescreening of embryos to solely allow those free of genetic diseases to implant.

While a wonderful advancement to most, some opposition still arises with some who say, "it reinforces existing discrimination in a 'neo-eugenic future'". Also, the prevention of the transmission of genetic diseases may be beneficial but where is science headed now? Babies with predetermined cosmetic features, or increased mental ability? Are we moving toward Gattaca?

Damage Control

Perhaps the most psychologically, emotionally, and physically devastating injury to the human body is facial disfigurement. Not only is one shunned by such an image-conscious culture as our own, they are also alienated from their own appearance and identity, shocked by their own mirror reflection. Beauty aside, the face is the main site for human expression and interaction. A mother’s nurturing smile, a lover’s sensual gaze, an enemy’s vengeful scowl, or a comedian’s trickster wink, are all elements of facial complexity that help us to evaluate and develop our own subjectivity and social competence in the world.

Next month will mark one year since the most invasive and extensive face transplant was performed in the United States. In September 2004, Connie Culp was shot in the face by her husband outside a bar in Hopedale, Ohio. The gunshot wound left her with shattered features; the nose, cheeks, roof of the mouth, and one eye were left mutilated and therefore functionless. The transplant surgery, which was performed at the Cleveland Clinic, did little to restore Culp’s original appearance, her face now boxy and caricature-like, the skin thick and bloated. However, no signs of rejecting the skin graft have been reported and there is hope that significant progress can still be made. As nerves continue to regenerate (growing about an inch in one month), Culp’s sense of smell, taste and sight have the potential to be restored. And as circulation improves, additional surgeries may be performed to normalize her appearance and help Culp blend back into society.

With advances in surgery techniques as well as the medications that supplement such procedures, medical intervention is progressing to soon alleviate and hopefully erase all visible signs of severe trauma. Victims of abuse may soon be able to permanently erase the scars of brutal injuries. Surgical procedures along with psychiatric drugs for erasing memory may one day be used in tandem so that soldiers returning from war are able to return to a previous state of optimal functioning, both physically and emotionally. But as we transgress the boundaries of disease and trauma, as we extend life far beyond a biologically natural endpoint, what will become the future dangers to our wellbeing and health?

Deeper Brain Stimulation

Newly designed brain implant looks to stimulate more effectively.

Deep brain stimulation has been the last resort for patients suffering from the neurological disorders of Parkinson’s to chronic pain to dystonia or even major depression. This process, discovered in the late 90’s has been moderately successful at treating the symptoms of these causes utilizing a method similar to the pace maker of the heart. This surgical procedure implants electrodes in different places in the brain (depending on the treatment desired) and sends electrical pulses to disrupt the communications of the neurons. Despite the years of application, the exact explanation of its effectiveness is still relatively unknown. From a laypersons understanding, the procedure essentially puts electrodes in the brain and blasts it with electrical pulses.

Though this explanation is far oversimplified, compared to the new treatments being invented, the current treatment is not that far from the “shotgun blast” analogy. The electrodes currently used are about a millimeter in length which makes it very difficult to target only the desired neurons.

Depression, hallucinations, addictions, hypersexuality, and cognitive dysfunction- these symptoms of what sound like a trip to Las Vegas, are what lead Wolfgang Eberle, of IMEC’s bioelectronics research group, to develop a smaller more accurate electrode to pinpoint specific neurons. Due to the large size of the current electrode, researchers conclude that “collateral damage” of the large pulses leads to these neurological side effects. Wolfgang Eberle presented his new more precise electrode to the Design, Automation & Test in Europe (DATE) conference showing his studies which utilized “multi-physics simulation software COMSOL 3.4 and 3.5.” Using the advanced simulation software, Eberle designed an electrode about 10 micrometers in sized that would be placed in greater numbers than the current electrodes but work in a more precise stimulatory manner. His breakthrough has the potential to change the pulses from “shotgun” to “sniper rifle.”

Though this procedure seemingly has little to do directly with neuro-enhancment , it is a step in the direction of a more feasible and accurate brain-machine interface. The movement from the macro scale to the micro scale precedes the eventual movement into nanotechnology which could open the doors to mechanical brain enhancement only seen in science fiction. From researches at Stanford designing a circuit board hippocampus to Eberle’s tiny electrodes, the brain is becoming a mainframe for unprecedented technological breakthroughs.

22 November 2009

Gene Therapy allows for muscle growth.

From movie stars to athletes to the average highschool teen, the desire to have a muscular body has become ever more important. Outside of popular culture, several neuromuscular disorders result in severe weakness of the quadriceps. Researchers at Nationwide Children's Hospital are developing a gene delivery strategy that produces follistatin. Follistatin is a naturally occurring protein that inhibits myostatin, a growth factor expressed specifically in skeletal muscle. The result of this inhibition is that directly long-term gene expression with muscle enhancing effects.

Brian Kaspar, PhD, principal investigator in the Center for Gene Therapy of The Research Institute at Nationwide Children's Hospital said that "studies indicate that this relatively non-invasive approach could have long-term effects, involve few risks and could potentially be effective in various types of degenerative muscle disorders including multiple forms of muscular dystrophy." Their research has proven successful in non-human primates. The muscles size was shown to increase by 15%, and muscle strength was shown to increase by 78%. The effect lasted for the 15 month study with no negative health effects. The research could also highlight methods of weight control and reduction of obesity.

This drug would be able to tap into an extensive market with an estimated 7 million people who take steroids to boost their muscles (in spite of the health risks), while also providing a solution to a wide range of neuromuscular diseases and weight control. Thus, the research has the potential, like many other gene targeted drugs, to remove a large burden from the current healthcare infrastructure. Shifting emphasis towards preventive solutions, and avoiding high cost surgical and invasive options.