Enhancement, longevity, and on-demand spare parts: But can Joe Six-Pack compete with Sid Cyborg?

When the celebrated Tin Woodsman of The Wizard of Oz suffered a series of body-part losses owing to clumsiness with an ax, he replaced each severed section with metal until he was pure tin. But he remained recognizably human.

Ronald Bailey’s Liberation Biology: The Scientific and Moral Case for the Biotech Revolution and Ray Kurzweil’s The Singularity Is Near describe a journey toward a new Oz, in which advances in areas from medicine to materials science will transcend biological constraints, extending lives and enhancing appearance, ability, and resilience.

Some say these technologies will transform us into something no longer human. Nobody objects to therapies that leave us essentially unchanged. But Francis Fukuyama, author of Our Posthuman Future: Consequences of the Biotechnology Revolution, worries about treatments that render recipients “better than well.”

These, he suggests, could distort our human essence, perhaps irreversibly.

“There’s no tablet up in the sky that says all forms of enhancement are terrible, and there’s no political principle that says my views should be the ones that prevail in American society,” Fukuyama told me in a recent interview. “A lot of things fall along a continuum. But you still want to draw that red line somewhere.”

He admits that drawing lines isn’t easy. We’ve been spawning enhancement technologies since fire was domesticated. Now we’re internalizing them: eyeglasses, contact lenses, laser keratotomy; next, polymeric accommodative lens implants; eventually, retinal imaging. Is enhancement angst simply an old whine in a new test tube? Or might quantitative change lead to qualitative change?

Kurzweil reminds us that the atoms in our bodies are constantly replaced: “Even our neurons ? change all their constituent molecules within a month.” Bailey trumpets performance-modifying drugs, regenerative tissue implants, anti-aging potions, gene therapy, germ-line alterations, and nanotechnology. Are these foreseen technologies for real? Will our triumph over biological limitations change us beyond recognition? It’s worth a closer look. Performance-enhancing drugs are here. People who don’t need them medically use them to boost moods, cram for exams, or hit more home runs. Modafinil, approved for narcolepsy, perks up pretty much everybody, apparently with few side effects. Once there was coffee - but the pills works better. If modafinil keeps truck drivers alert at midnight, and next-generation drugs improve confidence, focus, and muscularity without side effects, where’s the harm? Of course, in competitive endeavors such as sports and college admission tests, rules - and enforcement - are needed to maintain a level playing field.

Investigators have recently identified proteins that propel adult cells backward in development, restoring embryonic stem cell-like proliferation and plasticity. That’s a big step toward generating any tissue a patient needs, with zero risk of immune rejection, and without embryos or egg donors. Some normally cautious experts say this “regenerative medicine” could mature with in a decade. Backup body parts are already a reality: Wake Forest University’s Anthony Atala has started growing artificial bladders in young patients from their own cells. Atala is working on other organs, too.

These kinds of advances will eliminate the ethical obstacles to regenerative medicine. Embryos, as well as oocytes (which are technically capable of generating an entire new individual when their nuclei are replaced with donors’ nuclei), are at the center of a ferocious debate about when life begins. Absent their use, regenerative medicine is simply another promising therapy.

The era of swallowing scrambled bull testicles is behind us. Anti-aging research now attracts first-rate scientists. Biotech executives have told me that their compounds may actually slow the aging process, but they would never pursue FDA approval on that basis. (Demon strating life extension would take a 30-year trial.) Instead, they are develop ing products for particular “diseases of aging” like stroke and Alzheimer’s.

Despite Fukuyama’s fears of a dystopi an “nursing home society,” it is doubtful that anti-aging medicine will trap us in everlengthening stages of senes cence and decrepitude. The idea is that chronic diseases and the weakness afflict ing older people are by-products of intra- and intercellular signaling phenomena that, fully understood, could be halted. Rejuvenated elders can work longer. Impatient upstarts, impeded in their career advancement by seniors who never quit, can open their own businesses, as they do now. In 1900, when life expectancy in America for men was 48 years, did 70 look boring?

Stem-cell technology will help get genes into relevant tissues. Putting them into the germ line requires in vitro fertilization, but IVF already accounts for 4% of births in Israel, 2% to 3% in Europe, and 1% in the US (where the expense is largely out-of-pocket). Aging populations and later marriages portend big increases in IVF births, especially among well-heeled professional couples. Genetic selection is now practiced in IVF clinics for parents concerned about transmitting genetic diseases to their children.

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