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Designer
Lives; Digitally Enhanced
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Vinod
Scaria
Two
technologies are sure to dominate the early decades of the new
millennium biotechnology and digital technology. These
technologies though at first sight seem to be completely unrelated, are
going to merge into one another, and profoundly influence every aspect
of human existence, including medicine.
When the boundaries of fact and fiction merge into one another, and
possibilities grow far beyond the wildest dreams any philosopher worth
his salt would not attempt to predict the future. Are we just going to
remain the same as human beings, or are we going to initiate an
independent evolution into a new species? perhaps time will have
its answer. It was man who created the language of technology, and now
technology dictates our language. We have no option, but to speak it or
else we just fail to exist. Here we would review the major developments
and their possible impact on our future lives.
Human genome
Project:
This ambitious plan to create our `blue print' would signal radical
changes in the concepts of life and living. The immediate impact would
of course, be in the diagnosis and therapy of genetic diseases, which
were hitherto considered untreatable. With almost all human ailments,
with the probable exception of trauma having one or another genetic
attribute involved in the progress or prognosis, one could just imagine
how far reaching the changes would be. Medicine would never continue to
be as it is today, but would be specifically tailored to suit the
patient.
Gene diagnostic arrays that could have a 'snapshot' of our genetic
makeup in no time would emerge as widely used diagnostic tools. This
would enable us to predict with precision what exactly the outcome of a
disease would be by taking into consideration both the agent and host
factors down to the molecular levels.
Stem cell
research:
Stem cells are 'blank' cells that could differentiate into any of the
specialised cell types. Scientists are just beginning to learn how to
cajole these immature cells into being organs in the lab. This would
mean one could now have 'spare parts' tailored to suit his
immunophenotype virtually an autograft. It would also mean one
wouldn't have to wait a long time for a suitable donor.
The benefits of stem cells just do not end there it offers
potential cure to hitherto untreatable diseases like Alzheimer's disease
and Diabetes mellitus, which has already been proved feasible in animal
models.
Smart molecules:
Chemotherapeutics has been facing a dilemma with microbes playing games
with antibiotics. With a deeper understanding of the subcellular
signalling mechanisms, new genre drugs would emerge that would sense the
problem and act accordingly. Viruses and their use in therapy would
emerge as a new science in light of the emergence of antibiotic
resistant microbes, and the need for ultraspecific vectors for gene
therapy. This would mean man could initiate an attack from within the
enemy bunkers.
Reproduction:
Human reproduction was till recently considered as something beyond
human understanding. Louise Brown, the first test tube baby turned 23
this year; and more than a million children has followed him to date
Artificial reproductive techniques, with the inherent advantage that
gametes could be manipulated both for diagnostic and therapeutic
measures, before implantation makes it a lot more attractive. There have
been reports that even apparently normal individuals are opting for
artificial reproductive techniques due to this advantage. This also
would mean more and more fetuses, which fail short of parental
expectations would be targeted and destroyed the ethical
implications of which, are yet to be formulated.
Male pregnancy is just another reality, with clinical trials going on.
If proved feasible for general application, it would probably free woman
from her last constraint. But I don't want to guess how many hubbies
would agree to become 'pregnant'. The ethical implications and its
impact on family and social structure should be well reviewed before it
emerges as another clinical option.
Human cloning, would emerge as yet another standard infertility clinical
option in about a decade, despite widespread public unease and
apprehension. With motivated couples and dedicated researchers, probably
nobody can stop researches in this field.
Transgenics:
The universality of our genetic code would enable us to have infinite
number of genetic 'swaps' from other organisms. This would perhaps be
used enhance our livesincrease memory, confer specific disease
resistance; delay ageing etc.
Evolution:
Evolution hitherto occurred at the mercy of nature. Man now is all set
to engineer his evolution and the evolution of his fellow organisms.
Time would say if it would be like what H.G. Wells had predicted in his
book 'Time'. But this could mean the people living in the underdeveloped
countries would be left out, probably serving as 'museum exhibits' or
even worse as slaves. This is a question worth considering.
Digital
Technology:
Computers have already changed, in a big way the face of medicine
and are all set to change it in a bigger way in the future. With
microprocessors shrinking in size and their computational capacities
shooting up; and with the emergence of nanotechnology as one of the most
'hot' sciences in medicine, microrobots would be a reality that
could altogether do away with invasive diagnostic and therapeutic
measures.
With knowledge exploiding out of the boundaries of our skull, manmachine
interfaces has already emerged as the need of the hour. With more
understanding of neural networks and biocomputing, this won't just
remain has another piece of fiction.
A Doctor in the
new age:
Current medical training is based on the notion that every doctor can
carry in his head on the day of qualifying, enough information that
would enable him to practice safely for many years. But that scenario is
fast changing. With information at our fingertips, and that too almost
instant, doctors need to get updated every now and then and with
medicine growing beyond bounds and borders, it is virtually impossible
for anyone to cope up with the pace of developments. With virtual
doctors; and software capable of eliciting beautiful histories, doctors
are all set to be redundant creatures in the future. A surgeon, as a
highly skilled personnel would perhaps survive for a limited period,
that too, relying heavily on microtechnology.
The only probable way out for doctors is to shift from 'practice' of
technology to 'creation' of technology i.e., research. Anyway we can be
sure that anyone who is not willing to speak the language of technology
will simply cease to exist in the new age.
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