2023 FUTURE OBSERVATORY
2023 FUTURE OBSERVATORY
We are now beginning to understand some, at least, of the mechanisms involved - especially at the level of the cell - and are starting to develop our own answers to the faults which may occur in these. All the research groups rated genetic engineering as a major driver for change.
This not to say that we so far have many answers. The human genome project will, by itself, not provide the solution to all the ills of humanity - as some of its supporters would suggest. Its real benefits will accrue from the foundation of knowledge it provides for later work. So, we should not expect to see the wave of practical, medical advances it promises put into widespread practice until the middle of the 21st century; though this will be when many of those already born will need them!
It is an important project, though, not just for the ultimate research benefits it promises, but as a symbol of the very real advances in human cell-level engineering if represents; when it is remembered that it was only in 1972 that the first gene was cloned. With, or without, the knowledge it provides, we are developing ever more advanced capabilities to repair the human body, at the cellular level. One way of another, we can now, or soon will, send biological or molecular (or even electro-mechanical) devices into cells to diagnose faults, followed by others to repair them. This represents a massive leap forward for medicine in general. It allows the application of at least some of the genuinely scientific method, which has been used so successfully in other fields, to the treatment of many more illnesses. Previously, much of the treatment was, as we have seen, hit and miss.
One outcome of this process is that health in general should improve. Not merely will life-threatening illnesses, or those which severely incapacitate, be deemed suitable for treatment but many of the things which reduce the performance of, or quality of life, of an individual will also considered to be treatable and, as diagnostic tools improve along with treatment methods, affordable. This is not a trivial point. I well remember being involved myself in the early development of the treatment for the - fortunately rather rare - disease cryoglobunaemia. When the temperature dropped, crystals formed in patients' blood; causing much pain and threat to life. We were able to cure this, for a period of time before the treatment had to be repeated, by a very expensive technique called plasma exchange. We were very proud of our achievement, which was a genuine advance in medical practice, until we realised that it would be much cheaper to send the patients to spend the winter, when the problem occurred, in the Caribbean. Needless to say, however, the health authority was not allowed to spend money on what were seen to be holidays for its patients - so it had to continue with the much more expensive hospital treatment we had developed! Such ethical problems, arising from a desire to offer at least some patients the benefit of leading-edge treatments, has been a feature of many recent medical advances. Fortunately, perhaps, the days of treatment at any cost, for the few, are however now numbered; and the many should benefit from the expansion of more cost-effective measures.
One more extreme view of the future would have individuals being cloned. Surprisingly, perhaps, more than two thirds of the research groups believed that this was a possibility - though they were all vague about what exactly they meant by this. Was it to counter genetic diseases, which does look like a welcome possibility, or was it to have a 'tailor-made population', as one group put it? In view of what is already being done with animals, the latter is technically quite feasible, but it is a very contentious - and indeed sometimes abhorrent - issue; especially in view of the still-remembered experiments of the Third Reich . Just under a half saw 'baby farms', perhaps echoing Aldous Huxley's Brave New World, to be a possibility - though not necessarily related to cloning. Finally, more than two thirds believed that new forms of animals will be created, though usually for food! Surprisingly, in view of the actual developments being reported, only one group mentioned their use in producing organs for human transplantation.
The human genome project will take much longer to deliver real benefits than is promised, but the processes it embodies will move medicine into a new era; and will deliver levels of health - in general - previously unrealised. The use of genetic engineering, in as yet unspecified forms, will become widespread in the near future.
The prediction above was written at the end of the last century, when the human genome project was about to be completed. Now, half a decade later, it still remains true - as have most of the other predictions - despite the very rapid advances being made in this field. A number of developments have looked promising, but the complexity of the subject has so far defeated them.
Genetic engineering is a popular topic, and one on which most futurologists express an opinion. On the other hand, their suggestions are quite diverse, and it is not yet clear to what specific uses the techniques will be put; though their use in screening is already an established fact.
90% of individuals expected gene manipulation to be common by 2025. But, perhaps surprisingly, only half of our expert groups - and none of the corporate strategists amongst them - expected this to happen. Joseph Coates[b], for instance, forecasts that by 2025 "All human diseases and disorders will have their linkages, if any, to the human genome identified."
Millett & Kopp, researchers at the Battelle Institute, suggest that the development of ‘genetaceuticals’ will result in "...a boom over the next decade in the pharmaceutical industry, as genetic research closes in on treatments for a host of illnesses from allergies to AIDS." As Oliver Morton[a] points out, "...in laboratories all around the world dozens of genes are cloned every day, thousands a year. The creation of recombinant people, with foreign genes stitched into their cells is widely accepted."
Despite its reservations about the true importance of medical advances to date, The Economist still optimistically - but probably with reasonable justification - predicts that "There will be drugs for hitherto untreatable diseases. There will be easy-to-use medical tests that predict a person's prospective state of health throughout his lifetime so steps can be taken to prevent disease. There will be surgical robots operating with a precision that puts their human counterparts to shame."
Michael Fossel - coming at the problem from the direction of the ageing of normal cells - predicts that "Cancer, in which malignant cells refuse to age, will be among the first to go. Instead of being a source of terror and tragedy, it will become a bad memory..."
Four fifths of individuals expected cures to be found for the major diseases by 2030; though only a quarter of them thought that there would be no infectious disease left to affect our lives.
1 April 2003
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