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    • The Brave New World of Human Enhancement


    As the three powerful technological forces?information technology, biotechnology, and nanotechnology?of the Digital Era converge, our lives and businesses are being reshaped in ways that challenge our abilities as humans to even imagine the possibilities.

    One of the most intriguing outcomes of this convergence is the rise of new tools for enhancing human bodies and minds in order to make healthy people stronger, smarter, and even healthier.

    Although many opportunities for enhancement exist, the three most commonly cited are:

    1. The use of synthetic blood to improve strength, speed, and stamina.

    2. The implanting of chips in the human brain to enable people to process information faster, improve concentration, and store memories indefinitely.

    3. Gene editing in babies to remove genetic defects that are linked to disabilities and diseases.

    Let’s take a closer look at each of these technologies:

    - According to the BBC, in 2015, the United Kingdom’s National Health Service (NHS), announced that it will launch a clinical trial of synthetic blood for transfusions by 2017.1 The Universities of Bristol, Cambridge and Oxford will administer the trial, in which up to twenty healthy volunteers will receive less than two teaspoons of blood created in a lab from stem cells, and the results will be compared to those from donated blood. This will mark the first time humans will receive manufactured blood. The goal is to compensate for declining donations of human blood, and to help people with diseases such as sickle cell anemia.

    - According to a report in the journal Nature, earlier this year, scientists from Ohio State University’s Center for Neuromodulation implanted a microelectrode array in the motor cortex of the brain of a quadriplegic man.2 The array includes a chip that is smaller and thinner than a dime, which is linked to ninety- six wire-shaped electrodes in the outer layers of the brain. The computer chip relays his own brain signals into an electronic sleeve around the man’s arm, allowing him to pick up a glass of water, swipe a credit card, or play the video game Guitar Hero. This is a dramatic advance over previous neuroprosthetics that enabled patients to move a robotic arm, because it bypasses his cervical spinal cord injury and actually allows him to use his own arm and move his own fingers. As PBS NewsHour reported, “It’s the first time a brain-machine interface has restored muscle control to a paralyzed human being.”3 The study’s authors conclude, “These results have significant implications in advancing neuroprosthetic technology for people worldwide living with the effects of paralysis.”

    - Also this year, according to the South China Morning Post, Chinese researchers from Guangzhou Medical University revealed that they used genetic editing techniques to try to create HIV-resistant human embryos.4 As they announced in the Journal of Assisted Reproduction and Genetics, the scientists used CRISPR-Cas technology to attempt to mutate a gene known to resist HIV infection in 213 embryos.5 They succeeded in four cases. All of the embryos were fertilized eggs that had been donated after doctors determined they were unsuitable for implantation as part of in-vitro fertility therapy; all of the embryos were destroyed three days after the experiment.

    Each of these technologies is now being developed as a treatment for existing conditions, rather than as an enhancement for otherwise healthy adults and embryos. But many other therapies that were designed to restore deficiencies in unhealthy people have been used by healthy people to gain a competitive advantage. Consider Tour de France champion Lance Armstrong’s use of testosterone, Erythropoietin, and human growth hormone to improve his performance, as chronicled in Time magazine.6

    Another example is the misuse of nootropics or “smart drugs” by managers, entrepreneurs, lawyers, bankers, college students, and professors. As we discussed in the August 2016 issue of Trends, the most commonly used smart drugs are Modafinil, which is approved by the FDA as a treatment for excessive sleepiness caused by narcolepsy, obstructive sleep apnea, or shift work sleep disorder; as well as Adderall and Ritalin, both of which are prescribed as treatments for attention-deficit hyperactivity disorder.7 Research studies and published reports reveal that these drugs are frequently used by people who do not have sleep disorder or ADHD to sharpen their concentration, work longer hours, and make better decisions.

    Similarly, synthetic blood designed to compensate for shortages of human blood could be enhanced to carry more oxygen, bestowing the recipient with superior speed or strength. Or it could make people healthier by resisting infections and diseases better than normal blood.

    Neuroprosthetics could be used to improve brain functions in people who have not suffered from brain injuries or diseases. Brain-machine interfaces could evolve?as information technology makes devices more powerful and nanotechnology makes them smaller?to the point that people will have chips implanted in their brains that will provide instant access to terabytes of data. Or nanoscale computers embedded in gray matter will enable the brain to process information faster, learn a foreign language instantly, understand advanced physics, or think creatively.

    Genetic editing of human embryos opens up the potential for “designer babies” that will develop bigger brains, stronger muscles, and other traits chosen by parents, such as a specific eye or hair color. According to Associate Professor Robert Sparrow of the Monash University Centre for Human Bioethics in Melbourne, the experiment at Guangzhou Medical University’s “most plausible use, and most likely use, is the technology of human enhancement.” As he asserts, “If you were serious about not wanting to go down this path where wealthy people are having children who have been genetically modified to have capacities that aren’t available to the children of poor parents, then the time to try and stop it is now. Once someone shows they can do it safely and effectively and then we try to say ‘no, we shouldn’t do it,’ that strikes me as too late.”8

    Based on this fascinating trend, we offer the following forecasts:

    First, the emergence of technologies that offer the potential for human enhancement will prove useful to society when used to treat people with disabilities or to prevent diseases.

    The most promising new tool in this regard is the CRISPR-Cas gene editing technology. Compared to existing techniques for gene editing, “It’s about 1,000 times cheaper,” according to Harvard Medical School geneticist George Church. It’s also faster and more accurate. And it now has the support of the U.S. government. According to New Scientist magazine, in June 2016, the National Institutes of Health’s Recombinant DNA Advisory Committee announced that it had approved the first human trials using CRISPR to study whether it can be used to bolster the immune systems of cancer patients.9 Jennifer Doudna, a researcher at the University of California at Berkeley who co-invented CRISPR, believes that the tool will ultimately lead to effective treatments and cures to cancer, Alzheimer’s, Parkinson’s, and other diseases.

    Second, several obstacles stand in the way of commercialization of these technologies as paths to human enhancement.

    One hurdle is technological. Although progress is being made, it isn’t certain that the vision of enhanced bodies and brains will ever become a reality. Science still has a long way to go before it will fully understand how the brain works, why people age, or what constitutes consciousness. In the case of genetic editing, according to a Time magazine essay by Craig Venter, who oversaw the sequencing of the human genome, “We have little or no knowledge of how (with a few exceptions) changing the genetic code will affect development and the subtlety associated with the tremendous array of human traits.”10 As he points out, “Genes and proteins rarely have a single function in the genome and we know of many cases in experimental animals where changing a ‘known function’ of a gene results in developmental surprises.” Another obstacle is religious. Many religions oppose the enhancement of bodies and minds because it is considered an attempt by scientists to “meddle with nature” and assume the role of God in designing and redesigning human life. Yet another barrier is ethical. According to this way of thinking, if only the wealthiest people can afford stronger bodies and sharper minds, the gap between the privileged and the disadvantaged members of society will widen. All of these issues will need to be sorted out before technologies for human enhancement will reach the market.

    Third, most Americans will oppose the use of scientific enhancements to human brains and bodies until they are convinced the benefits will outweigh the risks.

    A recent survey by Pew Research Center highlights this widespread resistance.11 According to the survey, about two-thirds of U.S. adults say they would be “very” or “somewhat” worried about the use of gene editing, brain chips, and synthetic blood in healthy people. When asked if they would want chips implanted in their own brains, 66 percent said no, while only 32 percent said yes. When it comes to synthetic blood, 66 percent would not want it, while only 35 percent would want it. The issue of whether they would want to use genetic editing to prevent diseases in their children drew a more mixed response, with 50 percent opposed and 48 percent in favor. Two reasons for their concern are that nearly three-quarters of Americans expect that the technologies will become available before they have been fully tested or understood; and most believe they will widen the gap between rich and poor people. For example, 73 percent predict inequality will increase if brain chips become available because only the wealthy will be able to afford them, and 63 percent say that people who receive synthetic blood will feel superior to those who have not received it. These findings suggest that the easiest ways to persuade the American public to begin to accept enhancements are to market them as a way to prevent diseases in their children, and to make the technologies equally accessible to people of all incomes through a government subsidy or via health insurance coverage that would pay for itself in the form of lower healthcare costs over the patient’s lifetime.

    References
    1. BBC, June 25 2015, “NHS to Test Blood Made in a Laboratory,” by James Gallagher. ⓒ 2015 BBC. All rights reserved. http://www.bbc.com/news/health-332703342. Nature, May 12, 2016, Vol. 533, Iss. 7602, “Restoring Cortical Control of Functional Movement in a Human with Quadriplegia,” by Ali R. Rezai, et al. ⓒ 2016 McMillan Publishers Limited, part of Springer Nature. All rights reserved. http://www.nature.com/nature/journal/v533/n7602/full/nature17435.html3. PBS NewsHour, April 13, 2016, “Paralyzed Man Moves Fingers, Plays Guitar Hero with Brain Implant Milestone,” by Nsikan Akan. ⓒ 2016 NewsHour Productions LLC. All rights reserved. http://www.pbs.org/newshour/updates/paralyzed-man-moves-fingers-plays-guitar-hero-with-brain-implant-milestone/4. South China Morning Post, April 12, 2016, “It’s Most . . . Most Likely Use Is the Technology of Human Enhancement,” by Ben Westcott and Zhuang Pinghui. ⓒ 2016 South China Morning Post Publishers Ltd. All rights reserved. http://www.scmp.com/news/china/society/article/1935476/its-most-most-likely-use-technology-human-enhancement-chinese5. Journal of Assisted Reproduction and Genetics, May 2016, Vol. 33, Iss. 5, “Introducing Precise Genetic Modifications into Human 3PN Embryos by CRISPR/Cas-Mediated Genome Editing,” by Yong Fan, et al. ⓒ 2016 Springer International Publishing AG. Part of Springer Nature. All rights reserved. http://link.springer.com/article/10.1007/s10815-016-0710-86. Time, August 24, 2012, “Which Drugs Is Lance Armstrong Accused of Taking?” by Alice Park. ⓒ 2012 Time Inc. All rights reserved. http://healthland.time.com/2012/08/24/which-drugs-is-lance-armstrong-accused-of-taking/7. Trends, August 2016, “‘Smart Drugs’ Are Coming to the Office.” ⓒ 2016 AudioTech Inc. All rights reserved. http://audiotech.com/trends-magazine/smart-drugs-coming-office/8. South China Morning Post, April 12, 2016, “It’s Most . . . Most Likely Use Is the Technology of Human Enhancement,” by Ben Westcott and Zhuang Pinghui. ⓒ 2016 South China Morning Post Publishers Ltd. All rights reserved. http://www.scmp.com/news/china/society/article/1935476/its-most-most-likely-use-technology-human-enhancement-chinese9. New Scientist, June 22, 2016, “First Human CRISPR Trial Given Go-Ahead: Your Questions Answered,” by Michael Le Page. ⓒ 2016 Reed Business Information Ltd. All rights reserved. https://www.newscientist.com/article/2094832-first-human-crispr-trial-given-go-ahead-your-questions-answered/10. Time, February 2, 2016, “We Are Not Ready to Edit Human Embryos Yet,” by J. Craig Venter. ⓒ 2016 Time Inc. All rights reserved. http://time.com/4204210/craig-venter-gene-editing/11. To access the report “U.S. Public Wary of Biomedical Technologies to ‘Enhance’ Human Abilities,” visit the Pew Research Center website at: http://www.pewinternet.org/2016/07/26/u-s-public-wary-of-biomedical-technologies-to-enhance-human-abilities/