Criticized by the Soviet philosopher A. Petropavlovsky for his seeming willingness, even enthusiasm, to participate in such a race, Neyfakh shrugged aside the horrors that might be unleashed by hasty application of the new biology, replying merely that the advance of science is, and ought to be, unstoppable. If Neyfakh's political logic leaves something to, be desired, his appeal to cold war passions as a justification for genetic tinkering is terrifying.
In short, it is safe to say that, unless specific counter-measures are taken, if something can be done, someone, somewhere will do it. The nature of what can and will be done exceeds anything that man is as yet psychologically or morally prepared to live with.
THE TRANSIENT ORGAN
We steadfastly refuse to face such facts. We avoid them by stubbornly refusing to recognize the speed of change. It makes us feel better to defer the future. Even those closest to the cutting edge of scientific research can scarcely believe the reality. Even they routinely underestimate the speed at which the future is breaking on our shores. Thus Dr. Richard J. Cleveland, speaking before a conference of organ transplant specialists, announced in January, 1967, that the first human heart transplant operation will occur "within five years." Yet before the same year was out Dr. Christiaan Barnard had operated on a fifty-five-year-old grocer named Louis Washkansky, and a staccato sequence of heart transplant operations exploded like a string of firecrackers into the world's awareness. In the meantime, success rates are rising steadily in kidney transplants. Successful liver, pancreas and ovary transplants are also reported.
Such accelerating medical advances must compel profound changes in our ways of thinking, as well as our way of caring for the sick. Startling new legal, ethical and philosophical issues arise. What, for instance, is death? Does death occur when the heart stops beating, as we have traditionally believed? Or does it occur when the brain stops functioning? Hospitals are becoming more and more familiar with cases of patients kept alive through advanced medical techniques, but doomed to exist as unconscious vegetables. What are the ethics of condemning such a person to death to obtain a healthy organ needed for transplant to save the life of a person with a better prognosis?
Lacking guidelines or precedents, we flounder over the moral and legal questions. Ghoulish rumors race through the medical community. The New York Times and Komsomolskaya Pravda both speculate about the possibility of "future murder rings supplying healthy organs for black-market surgeons whose patients are unwilling to wait until natural sources have supplied the heart or liver or pancreas they need." In Washington, the National Academy of Sciences, backed by a grant from the Russell Sage Foundation, begins a study of social policy issues springing from advances in the life sciences. At Stanford, a symposium, also funded by Russell Sage, examines methods for setting up transplant organ banks, the economics of an organ market, and evidences of class or racial discrimination in organ availability.
The possibility of cannibalizing bodies or corpses for usable transplant organs, grisly as it is, will serve to accelerate further the pace of change by lending urgency to research in the field of artificial organs – plastic or electronic substitutes for the heart or liver or spleen. (Eventually, even these may be made unnecessary when we learn how to regenerate damaged organs or severed limbs, growing new ones as the lizard now grows a tail.)
The drive to develop spare parts for failing human bodies will be stepped up as demand intensifies. The development of an economical artificial heart, Professor Lederberg says, "is only a few transient failures away." Professor R. M. Kenedi of the bio-engineering group at the University of Strathclyde in Glasgow believes that "by 1984, artificial replacements for tissues and organs may well have become commonplace." For some organs, this date is, in fact, conservative. Already more than 13,000 cardiac patients in the United States – including a Supreme Court justice – are alive because they carry, stitched into their chest cavity, a tiny "pacemaker" – a device that sends pulses of electricity to activate the heart. (At a major Midwest hospital not long ago a patient appeared at the emergency room in the middle of the night. He was hiccupping violently, sixty times a minute. The patient, it turned out, was an early pacemaker wearer. A fast-thinking resident realized what had happened: a pacemaker wire, instead of stimulating the heart, had broken loose and become lodged in the diaphragm. Its jolts of electricity were causing the hiccupping. Acting swiftly, the resident inserted a needle into the patient's chest near the pacemaker, ran a wire out from the needle and grounded it to the hospital plumbing. The hiccupping stopped, giving doctors a chance to operate and reposition the faulty wire. A foretaste of tomorrow's medicine?)
Another 10,000 pioneers are already equipped with artificial heart valves made of dacron mesh. Implantable hearing aids, artificial kidneys, arteries, hip joints, lungs, eye sockets and other parts are all in various stages of early development. We shall, before many decades are past, implant tiny, aspirin-sized sensors in the body to monitor blood pressure, pulse, respiration and other functions, and tiny transmitters to emit a signal when something goes wrong. Such signals will feed into giant diagnostic computer centers upon which the medicine of the future will be based. Some of us will also carry a tiny platinum plate and a dime-sized "stimulator" attached to the spine. By turning a midget "radio" on and off we will be able to activate the stimulator and kill pain. Initial work on these pain-control mechanisms is already under way at the Case Institute of Technology. Push-button pain killers are already being used by certain cardiac patients.
Such developments will lead to vast new bio-engineering industries, chains of medicalelectronic repair stations, new technical professions and a reorganization of the entire health system. They will change life expectancy, shatter insurance company life tables, and bring about important shifts in the uman outlook. Surgery will be less frightening to the average individual; implantation routine. The human body will come to be seen as modular. Through application of the modular principle – preservation of the whole through systematic replacement of transient components – we may add two or three decades to the average life span of the population. Unless, however, we develop far more advanced understanding of the brain than we now have, this could lead to one of the greatest ironies in history. Sir George Pickering, Regius professor of medicine at Oxford, has warned that unless we watch out, "those with senile brains will form an ever increasing fraction of the inhabitants of the earth. I find this," he added rather unnecessarily, "a terrifying prospect." Just such terrifying prospects will drive us toward more accelerated research into the brain – which, in turn, will generate still further radical changes in the society.
Today we struggle to make heart valves or artificial plumbing that imitate the original they are designed to replace. We strive for functional equivalence. Once we have mastered the basic problems, however, we shall not merely install plastic aortas in people because their original aorta is about to fail. We shall install specially-designed parts that are better than the original, and then we shall move on to install parts that provide the user with capabilities that were absent in the first place. Just as genetic engineering holds out the promise of producing "super-people," so, too, does organ technology suggest the possibility of track stars with extra-capacity lungs or hearts; sculptors with a neural device that intensifies sensitivity to texture; lovers with sex-intensifying neural machinery. In short, we shall no longer implant merely to save a life, but to enhance it – to make possible the achievement of moods, states, conditions or ecstasies that are presently beyond us.
Under these circumstances, what happens to our age-old definitions of "human-ness?" How will it feel to be part protoplasm and part transistor? Exactly what possibilities will it open? What limitations will it place on work, play, sex, intellectual or aesthetic responses? What happens to the mind when the body is changed? Questions like these cannot be long deferred, for advanced fusions of man and machine – called "Cyborgs" – are closer than most people suspect.
THE CYB
ORGS AMONG US
Today the man with a pacemaker or a plastic aorta is still recognizably a man. The inanimate part of his body is still relatively unimportant in terms of his personality and consciousness. But as the proportion of machine components rises, what happens to his awareness of self, his inner experience? If we assume that the brain is the seat of consciousness and intelligence, and that no other part of the body affects personality or self very much, then it is possible to conceive of a disembodied brain – a brain without arms, legs, spinal cord or other equipment – as a self, a personality, an embodiment of awareness. It may then become possible to combine the human brain with a whole set of artificial sensors, receptors and effectors, and to call that tangle of wires and plastic a human being.
All this may seem to resemble medieval speculation about the number of angels who can pirouette on a pinhead, yet the first small steps toward some form of man-machine symbiosis are already being taken. Moreover, they are being taken not by a lone mad scientist, but by thousands of highly trained engineers, mathematicians, biologists, surgeons, chemists, neurologists and communications specialists.
Dr. W. G. Walter's mechanical "tortoises" are machines that behave as though they had been psychologically conditioned. These tortoises were early specimens of a growing breed of robots ranging from the "Perceptron" which could learn (and even generalize) to the more recent "Wanderer," a robot capable of exploring an area, building up in its memory an "image" of the terrain, and able even to indulge in certain operations comparable, at least in some respects, to "contemplative speculation" and "fantasy." Experiments by Ross Ashby, H. D. Block, Frank Rosenblatt and others demonstrate that machines can learn from their mistakes, improve their performance, and, in certain limited kinds of learning, outstrip human
students. Says Block, professor of Applied Mathematics at Cornell University: "I don't think there's a task you can name that a machine can't do – in principle. If you can define a task and a human can do it, then a machine can, at least in theory, also do it. The converse, however, is not true." Intelligence and creativity, it would appear, are not a human monopoly.
Despite setbacks and difficulties, the roboteers are moving forward. Recently they enjoyed a collective laugh at the expense of one of the leading critics of the robot-builders, a former RAND Corporation computer specialist named Hubert L. Dreyfus. Arguing that computers would never be able to match human intelligence, Dreyfus wrote a lengthy paper heaping vitriolic scorn on those who disagreed with him. Among other things, he declared, "No chess program can play even amateur chess." In context, he appeared to be saying that none ever would. Less than two years later, a graduate student at MIT, Richard Greenblatt, wrote a chess-playing computer program, challenged Dreyfus to a match, and had the immense satisfaction of watching the computer annihilate Dreyfus to the cheers of the "artificial intelligence" researchers.
In a quite different field of robotology there is progress, too. Technicians at Disneyland have created extremely life-like computer-controlled humanoids capable of moving their arms and legs, grimacing, smiling, glowering, simulating fear, joy and a wide range of other emotions. Built of clear plastic that, according to one reporter, "does everything but bleed," the robots chase girls, play music, fire pistols, and so closely resemble human forms that visitors routinely shriek with fear, flinch and otherwise react as though they were dealing with real human beings. The purposes to which these robots are put may seem trivial, but the technology on which they are based is highly sophisticated. It depends heavily on knowledge acquired from the space program – and this knowledge is accumulating rapidly.
There appears to be no reason, in principle, why we cannot go forward from these present primitive and trivial robots to build humanoid machines capable of extremely varied behavior, capable even of "human" error and seemingly random choice – in short, to make them behaviorally indistinguishable from humans except by means of highly sophisticated or elaborate tests. At that point we shall face the novel sensation of trying to determine whether the smiling, assured humanoid behind the airline reservation counter is a pretty girl or a carefully wired robot. (This raises a number of half-amusing, half-serious problems about the relationships between men and machines, including emotional and even sexual relationships. Professor Block at Cornell speculates that manmachine sexual relationships may not be too far distant. Pointing out that men often develop emotional attachments to the machines they use, he suggests that we shall have to give attention to the "ethical" questions arising from our treatment of "these mechanical objects of our affection and passion." A serious inquiry into these issues is to be found in an article by Roland Puccetti in the British Journal of the Philosophy of Science, 18 (1967) 39-51.)
The likelihood, of course, is that she will be both.
The thrust toward some form of man-machine symbiosis is furthered by our increasing ingenuity in communicating with machines. A great deal of much-publicized work is being done to facilitate the interaction of men and computers. But quite apart from this, Russian and American scientists have both been experimenting with the placement or implantation of detectors that pick up signals from the nerve ends at the stub of an amputated limb. These signals are then amplified and used to activate an artificial limb, thereby making a machine directly and sensitively responsive to the nervous system of a human being. The human need not "think out" his desires; even involuntary impulses are transmittable. The responsive behavior of the machine is as automatic as the behavior of ones' own hand, eye or leg.
In Flight to Arras, Antoine de Saint-Exupery, novelist, poet and pioneer aviator, described buckling himself into the seat of a fighter plane during World War II. "All this complication of oxygen tubes, heating equipment; these speaking tubes that form the 'intercom' running between the members of the crew. This mask through which I breathe. I am attached to the plane by a rubber tube as indispensable as an umbilical cord. Organs have been added to my being, and they seem to intervene between me and my heart ..." We have come far since those distant days. Space biology is marching irresistibly toward the day when the astronaut will not merely be buckled into his capsule, but become a part of it in the full symbiotic sense of the phrase.
One aim is to make the craft itself a wholly self-sufficient universe, in which algae is grown for food, water is recovered from body waste, air is recycled to purge it of the ammonia entering the atmosphere from urine, etc. In this totally enclosed fully regenerative world, the human being becomes an integral part of an on-going micro-ecological process whirling through the vastnesses of space. Thus Theodore Cordon, author of The Future and himself a leading space engineer, writes: "Perhaps it would be simpler to provide life support in the form of machines that plug into the astronaut. He could be fed intravenously using a liquid food compactly stored in a remote pressurized tank. Perhaps direct processing of body liquid wastes, and conversion to water, could be accomplished by a new type of artificial kidney built in as part of the spaceship. Perhaps sleep could be induced electronically ... to lower his metabolism ..." Und so weiter. One after another, the body functions of the human become interwoven with, dependent on, and part of, the machine functions of the capsule.
The ultimate extension of such work, however, is not necessarily to be found in the outer reaches of space; it may well become a common part of everyday life here on the mother planet. This is the direct link-up of the human brain – stripped of its supporting physical structures – with the computer. Indeed, it may be that the biological component of the supercomputers of the future may be massed human brains. The possibility of enhancing human (and machine) intelligence by linking them together organically opens enormous and exciting probabilities, so exciting that Dr. R. M. Page, director of the Naval Research Laboratory in Washington, has publicly discussed the feasibility of a system in which human thoughts are fed automatically into the storage unit of a computer to form the basis for machine decisionmaking. Participants in a RAND Corporation study conducted severa
l years ago were asked when this development might occur. Answers ranged from as soon as 1990 to "never." But the median date given was 2020 – well within the lifetime of today's teen-agers.
In the meantime, research from countless sources contributes toward the eventual symbiosis. In one of the most fascinating, frightening and intellectually provocative experiments ever recorded, Professor Robert White, director of neurosurgery at the Metropolitan General Hospital in Cleveland, has given evidence that the brain can be isolated from its body and kept alive after the "death" of the rest of the organism. The experiment, described in a brilliant article by Oriana Fallaci, saw a team of neurosurgeons cut the brain out of a rhesus monkey, discard the body, then hook the brain's carotid arteries up to another monkey, whose blood then continued to bathe the disembodied organ, keeping it alive.
Said one of the members of the medical team, Dr. Leo Massopust, a neurophysiologist: "The brain activity is largely better than when the brain had a body ... No doubt about it. I even suspect that without his senses, he can think more quickly. What kind of thinking, I don't know. I guess he is primarily a memory, a repository for information stored when be had his flesh; he cannot develop further because he no longer has the nourishment of experience. Yet this, too, is a new experience."
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