Oscar Pitorius – the “blade runner”
Oscar Pistorius – also known as ‘Blade Runner’ – is a double leg amputee who is using specially developed artificial legs to compete in races. A world record holder in the 100, 200 and 400 meters Paralympic events, Pistorius was denied by the International Association of Athletics Federations (IAAF) his application to participate in the 2008 Summer Olympics. The IAAF argued that his prosthetic racing legs give him a clear competitive advantage. On May 16, the IAAF’s decision was overturned by the Court of Arbitration for Sport, allowing Pistorius to participate in the Olympics if he could make the minimum qualifying time.
This episode drives home the monumental issues our society will be facing in the not too distant future thanks to our increasing technological ability to enhance the human body.
Terms like ‘health’, ‘disease’, ‘therapy’ and ‘medicine’ will have to be radically redefined. Just take one example: once nanotechnology-enabled biosensing techniques are able to identify individual cancer cells inside the body, when do we say that a person is suffering from cancer? Already with one cell (everyone is carrying abnormal cells)? With 100 cells? A million? When does a person’s status change from ‘healthy’ to ‘sick’? What implications does that have for, say, the cost of their health insurance?
A plethora of problems arises in the area of human enhancements as exemplified by the Pistorius case.
While Pistorius made a virtue out of necessity (his need for artificial legs), the modern history of sport shows that there are always athletes who will do anything to run faster, jump higher or hit that ball further. Performance enhancement, legal or illegal, already is no longer limited to doping. For instance, laser surgical procedures to improve eyesight are common among top athletes. These are not just corrections of bad eyesight to reach the standard 20/20 vision but they go beyond. The golfer Tiger Woods reportedly used LASIK to improve his vision to 20/15, meaning he can see at 20 meters, what the average person can only see at 15.
Dr. Gregor Wolbring, a biochemist, bioethicist and science and technology studies researcher at the University of Calgary, who is very involved with disability and ability studies, has recently published a discussion of the Pistorius case (“Oscar Pistorius and the future nature of Olympic, Paralympic and other sports”). Wolbring argues that the Pistorius case is just a harbinger of the many ethical, moral, economic, regulatory and medical dilemmas and conflicts that our societies will have to face in the coming years.
He points out that the ever increasing appearance of internal and external enhancements of the human body – driven by lucrative and big business sport disciplines on one hand and the medical technology to deal with injuries on the other – enables a culture of increasing demand for, and acceptance of, improvements to and modifications of the human body (structure, function, abilities) beyond its species-typical boundaries.
“Furthering the establishment of new social concepts such as transhumanism and the transhumanisation of ableism, demand a broad public debate as to what people see as important – it is not just a technical debate” Wolbring tells Nanowerk.
He explains that the transhumanist model of health sees enhancement beyond species-typical body structures and functioning as therapeutic interventions. “In the transhumanist model of health, ‘health’ no longer has the endpoint of biological systems functioning within species-typical, normative frameworks” he says. “In this model, all Homo sapiens – no matter how conventionally ‘medically healthy’ – are defined as limited, defective, and in need of constant improvement made possible by new technologies; a little bit like the constant software upgrades we do on our computers. ‘Health’ in this model means having obtained maximum (at any given time) enhancement (improvement) of one’s abilities, functions, and body structure.”
He notes that disabled people are seen to play a key role in mainstreaming and in increasing the acceptance of beyond species-typical functioning, of ‘therapeutic enhancements’. “Transhumanists see the potential of using disabled people as a trailblazer for the acceptance of transhumanist ideas and products.”
In his paper, Wolbring lays out the three types of interventions that will be used to enhance the human body: external temporarily (these are basically tools, for instance for medical use such as wheelchairs or for sporting use such as hi-tech shoes, rackets, etc), internal temporarily (interventions which lead to internal metabolic and/or body structure changes that influence the capability of the body; these changes reverse when the interventions are stopped), and internal permanent.
It is this latter ones – permanent internal interventions – that will be the bridge to the transhumanist world. The eye surgery that gives the eyes beyond species-typical eyesight is just one example. Nanotechnology will have a big impact on bionics, a field that effectively bridges the interface between electronics and biology (read more: “Nanobionics – where the boundaries between electronics and biology become fuzzy”).
Nanomedical and bionic products that could directly improve sensory, motoric and other functions cover all aspects of the human body. A 2002 report by the U.S. National Science Foundation (“Converging Technologies for Improving Human Performance”; pdf download, 5.9 MB) describes several nanotechnology-based areas for the improvement of human health and capabilities in the next 10-20 years. These visions go far beyond the current implant technologies (bionic ears and limbs, neural and retinal implants, artificial muscles, nanotechnology skin for prosthetic arms, etc) under development:
Nano-Bio Processor – A device for programming complex biological pathways on a chip that mimics responses of the human body and aids the development of corresponding treatments. An example would be the precise “decoration” of nanoparticles with a tailored dosage of biomolecules for the production of nanomedicines that target specific early biomarkers indicative of disease. Self-Monitoring of Physiological Well-Being and Dysfunction Using Nano Implant Devices – One outcome of combining nanotechnology with biotechnology will be molecular prosthetics – nano components that can repair or replace defective cellular components such as ion channels or protein signaling receptors. Another result will be intracellular imaging, perhaps enabled by synthetic nano-materials that can act as contrast agents to highlight early disease markers in routine screening. Through self-delivered nano-medical intervention, patients in the future will be able in the comfort of their homes to perform noninvasive treatments autonomously or under remote supervision by physicians. Nano-Medical Research and Intervention Monitoring and Robotics – Nano-enabled unobtrusive tools will be invaluable for medical intervention, for example, nanorobots accomplishing entirely new kinds of surgery or carrying out traditional surgeries far less invasively than does a surgeon’s scalpel. Brain-to-Brain and Brain-to-Machine Interfaces – One goal is to establish direct links between neuronal tissue and machines that would allow direct control of mechanical, electronic, and even virtual objects as if they were extensions of human bodies. Researchers are already closing in on this sci-fi sounding scenario.
“‘Enhancement medicine’ is a new field providing remedy through surgery, pharmaceuticals, implants and other means that increasingly will blur the boundaries between therapeutic interventions and performance/ability enhancement” says Wolbring. “In the transhumanist enhancement model the notions of disease prevention, public health, healthy community, health promotion and the actions they entail, all change substantially.”
Putting permanent, especially nanotechnology-enabled, body enhancements into a broader societal context, the issues of their (legal or illegal) use in sports becomes almost trivial. Wolbring says that the sport regulatory system is not prepared for what is coming. It appears that not only the general legal system but all levels of our society are not prepared either.
Wolbring cautions that for any given enhancement product that will become available, there will not be a bell curve distribution, but rather a distribution jump from the “have nots” to the “haves”, which will lead directly to an ability divide.
“GDP of the economy, income levels and other parameters of a society will determine how many people end up as ‘haves’ or ‘non-haves’” he warns. “The ability divide will be bigger between low- and high-income countries than it will be within any given low-, middle- or high-income country, and the ability divide will develop between the poor and rich within every country. Not everyone can afford to enhance their body. And no society can afford to enhance everyone’s body if everyone so wishes.”
While today’s enhancement procedures – LASIK for athletes or plastic surgery for actors and fashion models – are relatively inconsequential for you and me, what will happen when enhancement technologies will result in vastly enhanced physical or mental abilities? It would give physical laborers an advantage in strength and dexterity over their non-enhanced co-worker; it would give white-collar workers an edge over their non-enhanced neighbor in the next cubicle – improved cognitive abilities or the ability to stay concentrated for long hours on end (without the side effects of amphetamines). The list is long. Just try thinking through the issues of how employers would react; the response of unions; how this would affect people’s income levels; the impact on ‘expected performance’ standards; etc.
There is already a clear divide even today between people in the richest societies who can afford the latest and best medical care and therapeutic procedures. The fact that this divide is much bigger in some societies, like the United States, and less distinct in others, like most European countries, also makes clear that political – and not just economic – factors play a large role in creating or diminishing such inequalities. And then of course there is the majority of the world population that can’t even get access to the most basic medical care. If billions of people don’t even have access to clean drinking water today, how would they be able to afford bionic enhancements tomorrow?
Wolbring sees the potential for a scary scenario as more powerful and sophisticated enhancements become available: “Those deemed able by most people today, but who cannot afford or do not want the technological enhancements, will become the new class of ‘techno-poor impaired people’. Billions of people who today are seen as able will become impaired, not because their bodies have changed, but precisely because they have not changed their bodies in accordance with the transhumanist norm. It will likely lead to a transhumanized version of disablism, where those who do not have or do not want certain enhancements (the intrinsically techno-poor impaired) will be discriminated against, given negative labels and suffer oppressive and abusive behavior and other consequences (the techno-poor disabled).”
Wolbring argues that without dealing with ableism (for a discussion of this concept read his “NBICS, Other Convergences, Ableism and the Culture of Peace”), one cannot deal with transhumanism and the transhumanized version of ableism and its consequences, such as the generation of the new social group of the ‘techno-poor impaired and disabled people’.
In a recent article (“Why NBIC? Why human performance enhancement?”) he proposes the new field of ‘Ability Studies’ – a discipline under which various issues and groups could converge and where these emerging challenges could be studied.
Ability Studies investigates:
(a) the social, cultural, legal, political, ethical and other considerations by which any given ability may be judged, which leads to favoring one ability over another;
(b) the impact and consequence of favoring certain abilities and rejecting others;
(c) the consequences of ableism in its different forms, and its relationship with and impact on other -isms;
(d) the impact of new and emerging technologies on ableism and consequent favoritism towards certain abilities and rejection of others; and
(e) identification of the abilities that would lead to the most beneficial scenario for the maximum number of people in the world.
Sounds like a good start to making sure that a potentially exciting future doesn’t turn into a nightmarish world where a small, rich caste of enhanced superhumans reaps the overwhelming majority of benefits of nanomedicine and bionics.