Corporal Mergers

Devices to repair the body as it breaks down might one day overcome the ravages of age. New engineering tools and government-funded research with this aim are spurring discussions about "cybernetics"--the blending of humans with machines. How should people prepare for a world in which cybernetics might also enhance bodies beyond normal capabilities?

Strategies for curing age-related diseases or extending human life span usually involve drugs or genetic engineering. But biological advances are occurring side by side with other technological achievements: Electronic devices, computer chips, sensors, actuators, and wireless communications have gotten orders of magnitude smaller and more powerful. That progress has led to many new and improved medical devices, from prosthetic arms that can pick up a sandwich without crushing it to cochlear implants that allow deaf people to once again hear a spouse’s nagging.

Expect a leap toward more radical devices that might give healthy people new capabilities, such as enhanced memory, 20/10 vision, and the strength of a forklift. Advances in the fields of nanotechnology, biotechnology, information technology, and cognitive science—collectively called NBIC—will dramatically improve how we age and learn, says Mihail Roco, senior adviser for nanotechnology at the National Science Foundation (NSF): "These four fields are now interrelated, and they will bring profound changes to society, so we want to be ready for this."

A February conference on NBIC technologies sponsored by NSF revealed how new ethical issues arise as scientists manipulate materials at the nanoscale (one-billionth of a meter) and exploit advances in electronics and computer neural networks. Rodolfo Llinas, a neuroscientist at New York University, described how he uses wires only 600 nanometers wide to monitor frog brain activity. He threads these wire electrodes through blood vessels to the brain, where they record from or stimulate neurons through the capillary walls. Although no one yet knows how safe this approach would be in humans, such tools might eliminate the need to drill holes through the skull to implant electrodes for stimulating sluggish neurons in illnesses such as Parkinson's disease. Moreover, nanowires could potentially seed hundreds of electrodes in the brain, which would presumably allow researchers to fine-tune neural activity. Such precision might enhance treatments for other disorders such as chronic pain. But this research, Llinas told the audience, could theoretically lead to devices for modifying people's behavior or eavesdropping on their thoughts and feelings. Wrye Sententia, director of the Center for Cognitive Liberty and Ethics, a nonprofit organization in Davis, California, comments, "Llinas’s presentation showed right where we are heading." Sententia envisions a day when brain privacy will have to be legally protected, she says.

But well before that time, cybernetics will raise issues about enhancements: how to define them, who should get them, and which, if any, should be banned. Answering those questions could create clashes between people with different views on what it means to be human. A new generation of enhancements, some of which will directly alter the brain, might prove as popular as today’s cosmetic surgeries.

This possibility elicits a wide range of reactions. Some Christians, as well as some environmentalists, worry that widespread enhancements would rob us of our humanity, which they see as fixed by God or nature. “God created us and declared us good,” says C. Christopher Hook, a physician and bioethicist at the Mayo Clinic in Rochester, Minnesota. "My wish is that society would respect and accept individuals in their current state and not pursue the re-engineering of humankind." On the other hand, so-called transhumanists say that people should actively seek improvement using new technologies; moreover, each individual has the right to choose his or her enhancements. "We argue that you’re a person because of your existential experience of self," not whether you've got synthetic components, says James Hughes, executive director of the World Transhumanist Association and a teacher in the public policy studies program at Trinity College in Hartford, Connecticut.

Scientists, however, are forging ahead, developing new disease treatments and tapping the growing pot of federal dollars for nanotechnology--nearly $4 billion over the next 5 years. Last fall, NSF promised $34 million over 10 years for a multi-institutional Center for Biomimetic Microelectronic Systems, which aims to develop electronic replacements for lost neural function. Participating researchers are working on a retinal prosthesis to restore vision and a silicon chip to revive memory in stroke victims by filling wiring gaps in the brain’s hippocampus. Both gadgets will connect hundreds to thousands of electrodes to the nervous system, compared with 22 in the most advanced cochlear implants today. "These devices are different because they’re not just going to stimulate the nervous system, they will also sense what the body is doing and then respond appropriately," says James Weiland, a biomedical engineer at the University of Southern California in Los Angeles.

The retinal prosthesis might be the first of the new "smart" implants to be offered to aging baby boomers. Several competing university groups and companies are already testing them in a small number of people. If successful, these gadgets will probably shift from treating diseases to catering to desires. Bringing sight to the blind would be a wonderful medical advance. Yet the retinal prosthesis raises questions about how far cybernetics should go, because it could augment vision beyond normal. "Once you have an artificial imaging system, you could put night vision or infrared vision on it--theoretically, you could hook it up to the Hubble Space Telescope," says Weiland. The U.S. military already funds research on expanding the sensory abilities of soldiers to improve survival on the battlefield. And some employers might prefer to hire security guards equipped with night vision.

No one can predict how the convergence of NBIC technologies will play out, or which new medical devices will be used or abused. But NSF is trying to steer a responsible path. "We don’t want to let this develop by accident," says Roco. "We must look to respect human dignity." Toward that aim, NSF is funding the Citizen’s Technology Forum, a project starting this month to find out what a sample of citizens in Raleigh, North Carolina, and Boston thinks about how nanotechnology and related tools should be used. For the first time, average people have been invited to join a public discussion about emerging technologies. These ordinary folks could help decide how bionic our futures might become.

Karen F. Schmidt is a freelance writer in California who wants to become a cyborg and then run for governor.