Time

that determines being human? Is it the flesh and blood with which a person is born?

is found? What happens when a person is suspended for decades and awakes in the future, e.g., financially, psychologically, etc.? Will only a few persons be able to afford this treatment?

3.8 Suspended Animation

The research at the University of Alaska, Fairbanks, of hibernation has elucidated some key knowledge: Animals do not hibernate because it is cold; they hibernate because they control their metabolism and literally "turn off" their need for oxygen [13]. The evidence for the mechanism of action is postulated to be signaling molecules that arise in the hypothalamus and attach to the mitochondrial membrane, preventing oxidative phosphorylation. In a complementary fashion, Safar et al., at the University of Pittsburg Center for Resuscitation Research [14], have a reproducible animal model in which they can exsanguinate the animal to a point where there is no blood pressure, respiration, or electro-encephalographic activity (clinical death) and perfuse the animal with a hypothermic perfusate. Two hours later, the shed blood is reinfused, the animal regains consciousness, and 2 weeks later meets all criteria of normal, including cognitive function. These and similar projects provide the scientific basis for significant progress toward suspended animation. Will suspended animation replace anesthesia? If there is success in suspended animation for more than a few hours, days, years, or decades, what are the consequences for society? Should all people with terminal diseases be placed in suspended animation until a cure for their disease

3.9 Summary

The future is bright with disruptive technologies, and the rate at which such technology is being developed is accelerating logarithmically (Fig. 3.3). Technology development explodes with a revolutionary scientific breakthrough, and business is close behind with commercialization plans to profit from the new technology. However, society is much slower to respond, especially in addressing many of the moral and ethical issues raised above. The medical profession is even slower to respond; there needs to be stringent evaluation and validation to ensure the new discovery is safe and applicable to patients. The medical profession is caught between two conflicting priorities: not providing a new diagnostic modality or treatment quickly enough, and not jumping on every bandwagon before the science is proven safe and effective for patients (primum non nocerum). The other aspect of the rapid scientific development is a society that is not prepared to deal quickly with the enormous psychological changes, at both the societal and individual person levels.

The technologies above are discussed in greater depth in many scientific discourses, as well as in the following chapters; however, there has been very little attention to the consequences of the innovation, either intended or unintended. These technologies are revolutionary and will take decades to become commonplace. Likewise, the moral and ethical issues raised by these disruptive changes will take decades to debate and resolve [15]. Now is the time to begin consideration and debate; if we wait, as in the case of human cloning, the science will overtake our ability to respond. And the issues to be addressed are so much more fundamental than they were in the past, when the focus was on an individual or society. Some of the technologies challenge our most basic tenants, such as what it means to be human, should we design our children, can machines become human and have rights, and even, what is evolution? With these new powers from science, the moral and ethical consequences are even more threatening. For the first time in history, there now walks upon this planet a species so powerful that it can create its own evolution to its own choosing: Homo sapiens. What shall humans choose to become?

References

1. Toffler A (1980) The third wave. Bantam, New York, pp 8-12

2. Satava RM (ed.) (2000) Innovative technologies: the Information Age and the BioIntelligence Age. Surg Endosc 14:417-418

3. Kurzweil R (2000) The Age of Spiritual Machines. Penguin Putnam, New York, pp 102-104

4. Hwang WS, Ryu YJ, Park JH et al (2004) Evidence of a plu-ripotent human embryonic stem cell line derived from a cloned blastocyst. Science doi:10.1126 /science.1094515

5. Stock G (2002) Redesigning humans: our inevitable genetic future. Houghton Mifflin, New York

6. Verlinsky Y, Rechitsky S, Sharapova T, Morris R, Taranissi M, Kuliev A (2004) Preimplantation HLA testing. JAMA 29:2079

7. Gorbunov V, Fuchigami N, Stone M, Grace M, Tsukruk VV (2002) Biological thermal detection: micromechanical and microthermal properties of biological infrared receptors. Biomacromolecules 3:106-115

8. Goldsmith TH (1980) Hummingbirds see near ultraviolet light. Science 207:786-788

9. Saito K, Yoshioka H, Cutler RG (1998) A spin trap, N-tert-butyl-a-phenylnitrone extends the life span of mice. Biosci Biotechnol Biochem 62:792-794

10. Serruya MD, Hatsopolous NG, Paninski L, Fellows MR, Donoghue JP (2002) Brain-machine interface: instant neural control of a movement signal. Nature 416:141

11. Lalan S, Pomerantsva I, Vacanti JP (2001) Tissue engineering and its potential impact on surgery. World J Surg 25:1458-1466

12. Selam JL (2001) External and implantable insulin pumps: current place in the treatment of diabetes. Exp Clin Endo-crinol Diabetes 109(Suppl 2): S333-S340

13. Buck CL, Barnes BM (2000) Effects of ambient temperature on metabolic rate, respiratory quotient, and torpor in an arctic hibernator. Am J Physiol 279:R255-R262

14. Safar P, Ebmeyer U, Katz L, Tisherman S (eds) (1996) Future directions for resuscitation research. Crit Care Med 24(Suppl 2):S1-S99

15. Fukyama F (2002) Our post-human future: consequence of the biotechnology revolution. Farrar, Straus and Giroux, New York

Part II

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