Part 10 (2/2)

As for the third generation of Bucks, Carrie's daughter, Vivian, was examined at the age of a few weeks by a nurse who testified: ”There is a look about it that is not quite normal.” The baby girl was taken from her family and given to the family of Carrie's rapist. After making the honor roll in school, Vivian died of measles in the second grade. Incidentally, Carrie's sister, Doris, was also sterilized at the same inst.i.tution (more than 4,000 sterilizations were performed there), though doctors lied to her about the operation when it was performed and told her it was for appendicitis. Like Carrie, Doris did not learn until much later in her life why she was unable to have children.

The ”model legislation” put forward by Laughlin, which was the basis for the Virginia statute upheld by the Supreme Court, was soon thereafter used by the Third Reich as the basis for their sterilization of more than 350,000 people-just as the psychology-based marketing text written by Edward Bernays was used by Goebbels in designing the propaganda program surrounding the launch and prosecution of Hitler's genocide. The n.a.z.is presented Laughlin with an honorary degree in 1936 from the University of Heidelberg for his work in the ”science of racial cleansing.”

Shamefully, eugenics was supported by, among others, President Woodrow Wilson, Alexander Graham Bell, Margaret Sanger, who founded the movement in favor of birth control-an idea that was, at the time, more controversial than eugenics-and by Theodore Roosevelt after he left the White House. In 1913, Roosevelt wrote in a letter, It is really extraordinary that our people refuse to apply to human beings such elementary knowledge as every successful farmer is obliged to apply to his own stock breeding. Any group of farmers who permitted their best stock not to breed, and let all the increase come from the worst stock, would be treated as fit inmates for an asylum. Yet we fail to understand that such conduct is rational compared to the conduct of a nation which permits unlimited breeding from the worst stocks, physically and morally, while it encourages or connives at the cold selfishness or the twisted sentimentality as a result of which the men and women who ought to marry, and if married have large families, remain celibates or have no children or only one or two.

Sanger, for her part, disagreed with the methods of eugenics advocates, but nevertheless wrote that they were working toward a goal she supported: ”To a.s.sist the race toward the elimination of the unfit.” One of Sanger's own goals in promoting contraception, she wrote in 1919, was, ”More children from the fit, less from the unfit-that is the chief issue of birth control.”

The United States is not the only democratic nation with a troubling history of forced sterilization. Between 1935 and 1976, Sweden forcibly sterilized more than 60,000 people, including ”mixed-race individuals, single mothers with many children, deviants, gypsies and other 'vagabonds.' ” For forty years, from 1972 to 2012, Sweden required sterilization before a transgendered person could officially change his or her gender identification on government identification doc.u.ments. However, the Stockholm Administrative Court of Appeal found the law unconst.i.tutional in December 2012. Sixteen other European countries continue to have similar laws on the books, including France and Italy. Only a few countries are considering revisions to the laws, despite the lack of any scientific or medical basis for them.

In Uzbekistan, forced sterilizations apparently began in 2004 and became official state policy in 2009. Gynecologists are given a quota of the number of women per week they are required to sterilize. ”We go from house to house convincing women to have the operation,” said a rural surgeon. ”It's easy to talk a poor woman into it. It's also easy to trick them.”

In China, the issue of forced abortions has resurfaced with the allegations by escaped activist Chen Guangcheng, but the outgoing premier Wen Jiabao has publicly called for a ban not only on forced abortion, but also of ”fetus gender identification.” Nevertheless, many women who have abortions in China are also sterilized against their will. In India, although forcible sterilization is illegal, doctors and government officials are paid a bonus for each person who is sterilized. These incentives apparently lead to widespread abuses, particularly in rural areas where many women are sterilized under false pretenses.

The global nature of the revolution in biotechnology and the life sciences-like the new global commercial realities that have emerged with Earth Inc.-means that any single nation's moral, ethical, and legal judgments may not have much impact on the practical decisions of other nations. Some general rules about what is acceptable, what is worthy of extra caution, and what should be prohibited have been tentatively observed, but there is no existing means for arriving at universal moral judgments about these new unfolding capabilities.

CHINA AND THE LIFE SCIENCES.

As noted earlier, China appears determined to become the world's superpower in the application of genetic and life science a.n.a.lysis. The Beijing Genomics Inst.i.tute (BGI), which is leading China's commitment to genomic a.n.a.lysis, has already completed the full genomes of fifty animal and plant species, including silk worms, pandas, honeybees, rice, soybeans, and others-along with more than 1,000 species of bacteria. But China's princ.i.p.al focus seems to be on what is arguably the most important, and certainly the most intriguing, part of the human body that can be modified by the new breakthroughs in life sciences and related fields: the human brain and the enhancement and more productive use of human intelligence.

Toward this end, in 2011 the BGI established China's National Gene Bank in Shenzhen, where it has been seeking to identify which genes are involved in determining intelligence. It is conducting a complete genomic a.n.a.lysis of 2,000 Chinese schoolchildren (1,000 prodigies from the nation's best schools, and 1,000 children considered of average intelligence) and matching the results with their achievements in school.

In the U.S., such a study would be extremely controversial, partly because of residual revulsion at the eugenics scandal, and partly because of a generalized wariness about linking intelligence to family heritage in any society that values egalitarian principles. In addition, many biologists, including Francis Collins, who succeeded James Watson as the leader of the Human Genome Project, have said that it is currently scientifically impossible in any case to link genetic information about a child to intelligence. However, some researchers disagree and believe that eventually genes a.s.sociated with intelligence may well be identified.

Meanwhile, the speed with which advances are being made in mapping the neuronal connections of the human brain continue to move forward significantly faster than the progress measured by Moore's Law in the manufacturing of integrated circuits. Already, the connectome of a species of nematode, which has only 302 neurons, has been completed. Nevertheless, with an estimated 100 billion neurons in an adult human brain and at least 100 trillion synaptic connections, the challenge of fully mapping the human connectome is a daunting one. And even then, the work of understanding the human brain's functioning will have barely begun.

In that regard, it is worth remembering that after the completion of the first full sequencing of the human genome, scientists immediately realized that the map of genes was only their introduction to the even larger task of mapping all of the proteins that are expressed by the genes-which themselves adopt multiple geometric forms and are subject to significant biochemical modifications after they are translated by the genes.

In the same way, once the connectome is completed, brain scientists will have to turn to the role of proteins in the brain. As David Eagleman, a neuroscientist at the Baylor College of Medicine in Houston, puts it, ”Neuroscience is obsessed with neurons because our best technology allows us to measure them. But each individual neuron is in fact as complicated as a city, with millions of proteins inside of it, trafficking and interacting in extraordinarily complex biochemical cascades.”

Still, even at this early stage in the new Neuroscience Revolution, scientists have learned how to selectively activate specific brain systems. Exploiting advances in the new field of optogenetics, scientists first identify opsins-light-sensitive proteins from green algae (or bacteria)-and place into cells their corresponding genes, which then become optical switches for neurons. By also inserting genes that correspond to other proteins that glow in green light, the scientists were then able to switch the neuron on and off with blue light, and then observe its effects on other neurons with a green light. The science of optogenetics has quickly advanced to the point where researchers are able to use the switches to manipulate the behavior and feelings of mice by controlling the flow of ions (charged particles) to neurons, effectively turning them on and off at will. One of the promising applications may be the control of symptoms a.s.sociated with Parkinson's disease.

Other scientists have inserted multiple genes from jellyfish and coral that produce different fluorescent colors-red, blue, yellow, and gradations in between-into many neurons in a process that then allows the identification of different categories of neurons by having each category light up in a different color. This so-called ”brainbow” allows a much more detailed visual map of neuronal connections. And once again, the Global Mind has facilitated the emergence of a powerful network effect in brain research. When a new element of the brain's intricate circuitry is deciphered, the knowledge is widely dispersed to other research teams whose work in decoding other parts of the connectome is thereby accelerated.

WATCHING THE BRAIN THINK.

Simultaneously, a completely different new approach to studying the brain-functional magnetic resonance imaging (fMRI)-has led to exciting new discoveries. This technique, which is based on the more familiar MRI scans of body parts, tracks blood flow in the brain to neurons when they are fired. When neurons are active, they take in blood containing the oxygen and glucose needed for energy. Since there is a slight magnetization difference between oxygenated blood and oxygen-depleted blood, the scanning machine can identify which areas of the brain are active at any given moment.

By correlating the images made by the machine with the subjective descriptions of thoughts or feelings reported by the individual whose brain is being scanned, scientists have been able to make breakthrough discoveries about where specific functions are located in the brain. This technique is now so far advanced that experienced teams can actually identify specific thoughts by seeing the ”brain prints” a.s.sociated with those thoughts. The word ”hammer,” for example, has a distinctive brain print that is extremely similar in almost everyone, regardless of nationality or culture.

One of the most startling examples of this new potential was reported in 2010 by neuroscientist Dr. Adrian Owen, when he was at the University of Cambridge in England. Owen performed fMRI scans on a young woman who was in a vegetative state with no discernible sign of consciousness and asked her questions while she was being scanned. He began by asking her to imagine playing tennis, and then asking her to imagine walking through her house. Scientists have established that people who think about playing tennis demonstrate activity in a particular part of the motor cortex portion of the brain, the supplementary motor area. Similarly, when people think about walking through their own home, there is a recognizable pattern of activity in the center of the brain in an area called the parahippocampal gyrus.

After observing that the woman responded to each of these questions by manifesting exactly the brain activity one would expect from someone who is conscious, the doctor then used these two questions as a way of empowering the young woman to ”answer” either ”yes” by thinking about playing tennis, or ”no” by imagining a stroll through her house. He then patiently asked her a series of questions about her life, the answers to which were not known by anyone partic.i.p.ating in the medical team. She answered correctly to virtually all the questions, leading Owen to conclude that she was in fact conscious. After continuing his experiments with many other patients, Owen speculated that as many as 20 percent of those believed to be in vegetative states may well be conscious with no way of connecting to others. Owen and his team are now using noninvasive electroencephalography (EEG) to continue this work.

Scientists at Dartmouth College are also using an EEG headset to interpret thoughts and connect them to an iPhone, allowing the user to select pictures that are then displayed on the iPhone's screen. Because the sensors of the EEG are attached to the outside of the head, it has more difficulty interpreting the electrical signals inside the skull, but they are making impressive progress.

A LOW-COST HEADSET developed some years ago by an Australian game company, Emotiv, translates brain signals and uses them to empower users to control objects on a computer screen. Neuroscientists believe that these lower-cost devices are measuring ”muscle rhythms rather than real neural activity.” Nevertheless, scientists and engineers at IBM's Emerging Technologies lab in the United Kingdom have adapted the headset to allow thought control of other electronic devices, including model cars, televisions, and switches. In Switzerland, scientists at the Ecole Polytechnique Federale de Lausanne (EPFL) have used a similar approach to build wheelchairs and robots controlled by thoughts. Four other companies, including Toyota, have announced they are developing a bicycle whose gears can be s.h.i.+fted by the rider's thoughts.

Gerwin Schalk and Anthony Ritaccio, at the Albany Medical Center, are working under a multimillion-dollar grant from the U.S. military to design and develop devices that enable soldiers to communicate telepathically. Although this seems like something out of a science fiction story, the Pentagon believes that these so-called telepathy helmets are sufficiently feasible that it is devoting more than $6 million to the project. The target date for completion of the prototype device is 2017.

”TRANSHUMANISM” AND THE ”SINGULARITY”

If such a technology is perfected, it is difficult to imagine where more sophisticated later versions of it would lead. Some theorists have long predicted that the development of a practical way to translate human thoughts into digital patterns that can be deciphered by computers will inevitably lead to a broader convergence between machines and people that goes beyond cyborgs to open the door on a new era characterized by what they call ”transhumanism.”

According to Nick Bostrom, the leading historian of transhumanism, the term was apparently coined by Aldous Huxley's brother, Julian, a distinguished biologist, environmentalist, and humanitarian, who wrote in 1927, ”The human species can, if it wishes, transcend itself-not just sporadically, an individual here in one way, an individual there in another way-but in its entirety, as humanity. We need a name for this new belief. Perhaps transhumanism will serve: man remaining man, but transcending himself, by realizing new possibilities of and for his human nature.”

The idea that we as human beings are not an evolutionary end point, but are destined to evolve further-with our own active partic.i.p.ation in directing the process-is an idea whose roots are found in the intellectual ferment following the publication of Darwin's On the Origin of Species, a ferment that continued into the twentieth century. This speculation led a few decades later to the discussion of a new proposed endpoint in human evolution-the ”Singularity.”

First used by Teilhard de Chardin, the term ”Singularity” describes a future threshold beyond which artificial intelligence will exceed that of human beings. Vernor Vinge, a California mathematician and computer scientist, captured the idea succinctly in a paper published twenty years ago, ent.i.tled ”The Coming Technological Singularity,” in which he wrote, ”Within thirty years, we will have the technological means to create superhuman intelligence. Shortly after, the human era will be ended.”

In the current era, the idea of the Singularity has been popularized and enthusiastically promoted by Dr. Ray Kurzweil, a polymath, author, inventor, and futurist (and cofounder with Peter Diamandis of the Singularity University at the NASA Research Park in Moffett Field, California). Kurzweil envisions, among other things, the rapid development of technologies that will facilitate the smooth and complete translation of human thoughts into a form that can be comprehended by and contained in advanced computers. a.s.suming that these breakthroughs ever do take place, he believes that in the next few decades it will be possible to engineer the convergence of human intelligence-and even consciousness-with artificial intelligence. He recently wrote, ”There will be no distinction, post-Singularity, between human and machine or between physical and virtual reality.”

Kurzweil is seldom reluctant to advance provocative ideas simply because many other technologists view them as outlandish. Another close friend, Mitch Kapor, also a legend in the world of computing, has challenged Kurzweil to a $20,000 bet (to be paid to a foundation chosen by the winner) involving what is perhaps the most interesting long-running debate over the future capabilities of computers, the Turing Test. Named after the legendary pioneer of computer science Alan Turing, who first proposed it in 1950, the Turing Test has long served as a proxy for determining when computers will achieve human-level intelligence. If after conversing in writing with two interlocutors, a human being and a computer, a person cannot determine which is which, then the computer pa.s.ses the test. Kurzweil has a.s.serted that a computer will pa.s.s the Turing Test by the end of 2029. Kapor, who believes that human intelligence will forever be organically distinctive from machine-based intelligence, disagrees. The potential Singularity, however, poses a different challenge.

More recently, the silicon version of the Singularity has been met by a compet.i.tive challenge from some biologists who believe that genetic engineering of brains may well produce an ”Organic Singularity” before the computer-based ”Technological Singularity” is ever achieved. Personally, I don't look forward to either one, although my uneasiness may simply be an ill.u.s.tration of the difficult thinking that all of us have in store as these multiple revolutions speed ahead at an ever accelerating pace.

THE CREATION OF NEW BODY PARTS.

Even though the merger between people and machines may remain in the realm of science fiction for the foreseeable future, the introduction of mechanical parts as replacements for components of the human body is moving forward quickly. Prosthetics are now being used to replace not only hips, knees, legs, and arms, but also eyes and other body parts that have not previously been replaceable with artificial subst.i.tutes. Cochlear implants, as noted, are used to restore hearing. Several research teams have been developing mechanical exoskeletons to enable paraplegics to walk and to confer additional strength on soldiers and others who need to carry heavy loads. Most bespoke in-ear hearing aids are already made with 3D printers. The speed with which 3D printing is advancing makes it inevitable that many other prosthetics will soon be printed.

In 2012, doctors and technologists in the Netherlands used a 3D printer (described in Chapter 1) to fabricate a lower jaw out of t.i.tanium powder for an elderly woman who was not a candidate for traditional reconstructive surgery. The jaw was designed in a computer with articulated joints that match a real jaw, grooves to accommodate the regrowth of veins and nerves, and precisely designed depressions for her muscles to be attached to it. And of course, it was sized to perfectly fit the woman's face.

Then, the 3D digital blueprint was fed into the 3D printer, which laid down t.i.tanium powder, one ultrathin layer at a time (thirty-three layers for each millimeter), and fused them together with a laser beam each time, in a process that took just a few hours. According to the woman's doctor, Dr. Jules Poukens of Ha.s.selt University, she was able to use the printed jaw normally after awakening from her surgery, and one day later was able to swallow food.

The 3D printing of human organs is not yet feasible, but the emerging possibility has already generated tremendous excitement in the field of transplantation because of the current shortage of organs. However, well before the 3D printing of organs becomes feasible, scientists hope to develop the ability to generate replacement organs in the laboratory for transplantation into humans. Early versions of so-called exosomatic kidneys (and livers) are now being grown by regenerative medicine scientists at Wake Forest University. This emerging potential for people to grow their own replacement organs promises to transform the field of transplantation.

Doctors at the Karolinska Inst.i.tute in Stockholm have already created and successfully transplanted a replacement windpipe by inducing the patient's own cells to regrow in a laboratory on a special plastic ”scaffolding” that precisely copied the size and shape of the windpipe it replaced. A medical team in Pittsburgh has used a similar technique to grow a quadriceps muscle for a soldier who lost his original thigh muscle to an explosion in Afghanistan, by implanting into his leg a scaffold made from a pig's urinary bladder (stripped of living cells), which stimulated his stem cells to rebuild the muscle tissue as they sensed the matrix of the scaffolding being broken down by the body's immune system. Scientists at MIT are developing silicon nanowires a thousand times smaller than a human hair that can be embedded in these scaffolds and used to monitor how the regrown organs are performing.

As one of the authors of the National Organ Transplant Act in 1984, I learned in congressional hearings about the problems of finding enough organ donors to meet the growing need for transplantation. And having sponsored the ban on buying and selling organs, I remain unconvinced by the argument that this legal prohibition (which the U.S. shares with all other countries besides Iran) should be removed. The potential for abuse is already obvious in the disturbing black market trade in organs and tissues from people in poor countries for transplantation into people living in wealthy countries.

Pending the development of artificial and regenerated replacement organs, Internet-based tools, including social media, are helping to address the challenge of finding more organ donors and matching them with those who need transplants. In 2012, The New York Times's Kevin Sack reported on a moving example of how sixty different people became part of ”the longest chain of kidney transplants ever constructed.” Recently, Facebook announced the addition of ”organ donor” as one of the items to be updated on the profiles of its users.

Another 3D printing company, Bespoke Innovations of San Francisco, is using the process to print more advanced artificial limbs. Other firms are using it to make numerous medical implants. There is also a well-focused effort to develop the capacity to print vaccines and pharmaceuticals from basic chemicals on demand. Professor Lee Cronin of the University of Glasgow, who leads one of the teams focused on the 3D printing of pharmaceuticals, said recently that the process they are working on would place the molecules of common elements and compounds used to formulate pharmaceuticals into the equivalent of the cartridges that feed different color inks into a conventional 2D printer. With a manageably small group of such cartridges, Cronin said, ”You can make any organic molecule.”

One of the advantages, of course, is that this process would make it possible to transmit the 3D digital formula for pharmaceuticals and vaccines to widely dispersed 3D printers around the world for the manufacturing of the pharmaceuticals on site with negligible incremental costs for the tailoring of pharmaceuticals to each individual patient.

The pharmaceutical industry relied historically on large centralized manufacturing plants because its business model was based on the idea of a ma.s.s market, within which large numbers of people were provided essentially the same product. However, the digitization of human beings and molecular-based materials is producing such an extraordinarily high volume of differentiating data about both people and things that it will soon no longer make sense to lump people together and ignore medically significant information about their differences.

Our new prowess in manipulating the microscopic fabric of our world is also giving us the ability to engineer nanoscale machines for insertion into the human body-with some active devices the size of living cells that can coexist with human tissue. One team of nanotechnologists at MIT announced in 2012 that they have successfully built ”nanofactories” that are theoretically capable of producing proteins while inside the human body when they are activated by s.h.i.+ning a laser light on them from outside the body.

Specialized prosthetics for the brain are also being developed. Alongside pacemakers for hearts, comparable devices can now be inserted into brains to compensate for damage and disorders. Doctors are already beginning to implant computer chips and digital devices on the surface of the brain and, in some cases, deeper within the brain. By cutting a hole in the skull and placing a chip that is wired to a computer directly on the surface of the brain, doctors have empowered paralyzed patients with the ability to activate and direct the movement of robots with their thoughts. In one widely seen demonstration, a paralyzed patient was able to direct a robot arm to pick up a cup of coffee, move it close to her lips, and insert the straw between her lips so she could take a sip.

Experts believe that it is only a matter of time before the increased computational power and the reduction in size of the computer chips will make it possible to dispense with the wires connecting the chip to a computer. Scientists and engineers at the University of Illinois, the University of Pennsylvania, and New York University are working to develop a new form of interface with the brain that is flexible enough to stretch in order to fit the contours of the brain's surface. According to the head of R&D at GlaxoSmithKline, Moncef Slaoui, ”The sciences that underpin bioelectronics are proceeding at an amazing pace at academic centers around the world but it is all happening in separate places. The challenge is to integrate the work-in brain-computer interfaces, materials science, nanotechnology, micro-power generation-to provide therapeutic benefit.”

Doctors at Tel Aviv University have equipped rats with an artificial cerebellum, which they have attached to the rat's brain stem to interpret information from the rest of the rat's body. By using this information, doctors are able to stimulate motor neurons to move the rat's limbs. Although the work is at an early stage, experts in the field believe that it is only a matter of time before artificial versions of entire brain subsystems are built. Francisco Sepulveda, at the University of Ess.e.x in the U.K., said that the complexity of the challenge is daunting but that scientists see a clear pathway to succeed. ”It will likely take us several decades to get there, but my bet is that specific, well-organized brain parts such as the hippocampus or the visual cortex will have synthetic correlates before the end of the century.”

Well before the development of a synthetic brain subsystem as complex as the hippocampus or visual cortex, other so-called neuroprosthetics are already being used in humans, including prosthetics for bladder control, relief of spinal pain, and the remediation of some forms of blindness and deafness. Other neuroprosthetics expected to be introduced in the near future will, according to scientists, be able to stimulate particular parts of the brain to enhance focus and concentration, that with the flip of a switch will stimulate the neural connections a.s.sociated with ”practice” in order to enhance the ability of a stroke victim to learn how to walk again.

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