Provigil (modafinill) as the first "smart" drug.
Provigil (modafinill) as the first "smart" drug.
By scott

Newsfeed display by CaRP The new incredibles: Enhanced humans
They're here and walking among us: people with technologically enhanced senses, superhuman bodies and artificially sharpened minds. The first humans to reach a happy, healthy 150th birthday may already have been born. And that's just the start of it. Are you ready for your upgrade, asks Graham Lawton

IT IS 2050, and Peter Schwartz is deciding what to do with the rest of his life. He has already had two successful careers and he wants another one before he dies, which he expects to happen in around 50 years. By then he'll be about 150, which isn't bad for a baby boomer, but he expects his son, now 60, to live a lot longer than that.

The world that Schwartz lives in is radically different from the one he grew up in. The industrial and information age has passed into history, overtaken by a revolution in bioscience that began around the turn of the century. Schwartz is surrounded by astonishingly healthy, happy, rich and long-lived people. Many possess biological enhancements that exceed the abilities they were born with: sharper senses, for example, or better memories and greater intelligence.

Meanwhile the ageing process has been radically slowed down; there are centenarians who pass for 50, and 60-year-olds who look 30. Some people are already living beyond 120, and longevity records keep being broken. Disease is largely a thing of the past. Designer babies are commonplace, and some babies are even being born with engineered genetic traits that they will pass onto their own children.

Schwartz isn't in the business of making idle predictions. In the real world of 2006 he is a business strategist and "scenario planner" who advises companies how to prepare for the future. While his vision sounds like a techno-utopian fantasy, as far-fetched as 1950s predictions that by now we would live in cities on the moon or swallow pills instead of food, the prospect of human enhancement is being taken increasingly seriously. The World Economic Forum discussed it at its most recent meeting in January. The US National Science Foundation and the UK's Office of Science and Technology are investigating the issues it raises. Even President Bush has been briefed about it in exhaustive detail.

Humans, of course, have always strived to tame or even transcend nature through technology, but our efforts up to now look puny and ineffectual compared with what is about to happen. "We're at an inflection point in history," says Joel Garreau, a writer with The Washington Post whose recent book, Radical Evolution, has made him something of a guru in human enhancement circles. "For hundreds of thousands of years our technologies have been aimed outward, at modifying our environment. Now we've got a suite of technologies that are aimed inward, at modifying our minds, metabolisms, personalities and children."
The coming revolution

Garreau is not the first to point this out. Back in 2002, a working group set up by the US National Science Foundation (NSF) predicted an imminent scientific and technological revolution that would enable "tremendous improvements" in human abilities. A year later the President's Council on Bioethics, set up by George W. Bush to advise him on issues such as stem cells and cloning, compiled a list of real-world technologies that could, now or in the very near future, be used to enhance normal human functioning. It identified five broad areas, ranging from genetic engineering to replacement body parts (see "We have the technology").

None of these technologies were explicitly designed to allow healthy people to transcend their limits. They were created to cure disease and disability, but what the council recognised was that all of them have potential to be used "beyond therapy" - "to alter the normal workings of the human body and psyche, to augment or improve their native capacities and performances". The council was also among the first to recognise a significant fact about such technologies: if it has enhancement potential, healthy people will start using it to give them an edge.

According to some reports, around 10 per cent of US university students regularly take Ritalin or other prescription stimulants as "smart drugs" to boost their attention and concentration. The wakefulness promoter modafinil (Provigil) is increasingly being used in a similar way (New Scientist, 18 February, p 34). "The drugs are quite primitive but people are paying $80 a pop because they're convinced that they will make all the difference," says Garreau.

Viagra, meanwhile, has become a recreational drug; cosmetic surgery, which is based on techniques originally developed to treat injuries or disfigurements, has never been more popular or socially acceptable; and performance-enhancing substances are rife in professional sport. Even reproductive technologies are being co-opted in ways that blur the boundary between therapy and enhancement: IVF parents requesting sex selection of embryos, for example, to engineer the ideal family.

"All these advances follow the same pattern," says Garreau. "They're initially aimed at people who are sick. Then they move out to the needy well. Then they move out to anyone who's looking for an advantage."

For those seeking that advantage, more opportunities are just around the corner - a lot more. Around 40 cognition-enhancing drugs are in development right now, designed to improve wakefulness, attention, memory, decision making and planning (see "Smarter minds"). Gerontologists are starting to believe we could directly intervene in the process of senescence to significantly increase the average human lifespan.

There have also been rapid advances in brain-machine interfaces, such as retinal implants, communication devices for paralysed and locked-in patients, and even memory prostheses, hinting at the possibility of neural implants that enhance normal functioning. Progress in genetic engineering and gene therapy suggests that we will soon be able to rewrite our own genetic code, and that of future generations, removing broken genes, correcting errors and even inserting new ones (See "Designer children"). To Garreau the conclusion is inescapable. "We're not talking about changing humans in some distant science-fiction future. This is happening on our watch."

"We're not talking about some distant sci-fi future. This is happening now"

According to the NSF, the technologies that make human enhancement possible are collectively known as nano-bio-info-cogno - nanoscience, biotech, IT and cognitive science. And if what they are already capable of is hard to believe, what is predicted for the next 20 or 30 years is positively mind-blowing.

When futurologists start gazing into their crystal balls the results are notoriously unreliable, but there are some things we can say with reasonable certainty. One is that if you want to predict where technology will be 20 years from now, you can't use the progress of the previous 20 as your guide. That's because most technologies are advancing not linearly, but exponentially. In other words, what they are capable of keeps on doubling every few months or years. Exponential growth initially looks like linear growth, but soon enough it starts producing spectacular gains in ever shorter periods of time. Once you factor exponential growth into the equation, the progress of the previous 20 years are, at best, a guide to the next eight.

Unprecedented growth

The most celebrated example of exponential growth in technology is Moore's law, which states that by almost any measure you choose - the number of transistors on a silicon chip, say, or the amount of memory you can buy for a dollar - the performance of computing doubles approximately every 18 months (see Graph). The computer industry has obeyed Moore's law for the past 40 years and shows no signs of losing its way. That means within living memory, computing power has increased more than 100 million-fold. You probably have more processing power in your microwave oven than was available to the entire world in 1950. That's a rate of technological growth unprecedented in human history.

Exponential growth in computing power drives similar growth in other technologies. For example, the cost of sequencing a single letter of DNA, a task requiring immense amounts of processing power, has halved every 23 months since 1990. It took 15 years to sequence the genome of HIV; SARS was done in 31 days. The resolution of brain scanners is doubling every 18 months. The number of nanotechnology patents filed in the US has doubled every two years or so since 1990. And so on. According to the NSF, nano-bio-info-cogno all have the capacity to grow exponentially for decades to come.

"No one should confidently bet against any form of scientific progress"

Mutually reinforcing growth is only half the story. The NSF says there is another important trend to take into account. This is "convergence" - the idea that as these separate technological strands develop, the boundaries between them will blur and they will eventually merge into a single, unified science "based on the unity of nature", as the NSF put it.
Life transformed

Some futurologists, notably Ray Kurzweil of Kurzweil Technologies in Wellesley, Massachusetts, argue that exponential growth and technological convergence will lead to a "singularity", a time when change becomes so rapid and pervasive that human life is irreversibly transformed (New Scientist, 24 September 2005, p 32). Even if that doesn't happen - and in Schwarz's 2050 scenario it hasn't - exponential growth still holds out the prospect of extraordinary technological progress in as little as 20 or 30 years: brain implants that allow direct mind-to-mind communication; memory chips that let you upload new knowledge directly into your brain; genetic upgrades that can be reversibly slotted into all the cells in your body; custom-made replacement body parts; and so on.

From a human perspective, that means having almost limitless power over our own biology - the power to end disease, abolish pain and suffering, endow ourselves with superhuman levels of beauty, athleticism and brains, and radically slow down or maybe even halt ageing (see "Towards immortality"). "I believe our descendants will look on our lives with pity, in the same way we look on the lives of our Pleistocene ancestors," says bioethicist James Hughes of Trinity College in Hartford, Connecticut.

For many people that future cannot come soon enough, and no wonder: human enhancement promises to fulfil some of our deepest-held desires. Suppose you were offered an extra 50 years of life, endowed with what Schwartz calls "superhealth", physical and mental capabilities that exceed the ones you were born with, not to mention the prospect of an even better life for your children. Would you turn it down?
Liberation or slavery?

Of course, "better" is always subjective. If the prospect of a world full of youthful centenarians, drugged up to the eyeballs, bristling with brain implants and possessed of the power to engineer the genetic future of our species makes you feel vaguely uneasy, you're not alone. Human enhancement might promise liberation, but it will bring its own peculiar difficulties, which is why we need to start thinking about it now.

Imagine it's 2026 and your 17-year-old daughter or granddaughter has decided she wants to go to Harvard. She works hard at school but her grades are not quite good enough. Then a technology comes along - a memory-boosting drug, say - that would significantly increase her chances of getting in. She begs you for it. She tells you all her classmates are taking it and if you say no you will be jeopardising her chances not only of getting into Harvard but of getting into higher education at all. What do you do?

Perhaps you decide that if she's going to get into Harvard, she has to do it using the brainpower she was born with. On the other hand, what's the difference between buying the drugs and paying for extra tuition? Maybe you can't afford it anyway, which is a relief as you're not convinced it's safe. If you can afford it, perhaps you worry that if she gets in off the back of a performance-enhancing drug, she won't feel an appropriate sense of achievement. And what happens when the next enhancement technology comes along? Will you have to buy that one too, just so she can keep up? Perhaps the easiest thing to do would be to start a campaign to get cognitive-enhancing drugs banned in schools...

As more and more enhancement technologies become available, these dilemmas will grow increasingly familiar. Is it safe? Should it be regulated? Will it lead to an "enhancement divide" between the haves and have-nots, or even conflict between the "enhanced" and the "naturals"? Would people feel pressured or even coerced into using them simply to keep up?

"They're legitimate concerns," says Hughes, who has argued that the enhancement divide is a real enough worry that some such technologies ought to be made available through the public health system. Then again, says Hughes, they're arguably nothing new. Society already faces such problems in spades. According to bioethicist Arthur Caplan of the University of Pennsylvania in Philadelphia, none of these issues are showstoppers for human enhancement. "They're not good arguments about why we shouldn't try to improve ourselves," he says.

Enhancement does, however, bring one new and potentially explosive question: what will it do to our sense of being human? If your daughter takes the drug and gets in to Harvard, she has arguably missed out on an essential human experience - striving for success and learning to deal with failure. Similarly, if you knew you could live to be 150, would you bother working hard on your career right now? How would you decide when it was time to settle down and have kids? If you could download knowledge onto a memory chip, why bother to learn anything, or value knowledge and experience? If life was free of pain and disease, would you have any idea what happiness is? If everyone was enhanced, would the world be a dull and homogeneous place?

These are tough questions, but they all boil down to the same thing: by enhancing ourselves would we somehow throw away our humanity? For many opponents of these technologies, the answer is an emphatic yes. To them, a world of enhanced humans would be a world that has lost all meaning. The President's Council on Bioethics likened it to Aldous Huxley's Brave New World: its technologically enhanced inhabitants live cheerfully, without disappointment or regret, the council's report points out, but lead "flat, empty lives devoid of love and longing, filled with only trivial pursuits and shallow attachments". Some opponents of enhancement argue that these dangers are so great that the only safe course of action is to put a stop to the whole enterprise. Bioethicist George Annas of Boston University, for example, has proposed a global treaty making human genetic modification a crime against humanity.

"I believe our descendants will look on our lives with pity"

Others turn the human nature question on its head. "To the extent that we are born with impulses for aggression, racism and selfishness or limits on our capacity for wisdom and compassion, we may be morally obliged to modify human nature," says Hughes. Caplan argues that all technologies are attempts to transcend human nature. "That's what agriculture is. That's what plumbing is. That's what clothes are. That's what transportation systems are. Do they make us less human? Or are they one possible contender for what it means to be human?"

Not everyone believes we will have to face these questions imminently. Alfred Nordman, a historian of science at Darmstadt Technical University in Germany, doesn't buy into the inevitability of explosive technological progress leading to a post-human future. "I don't have a sense that I'm living in an era of accelerating technological change," he says. "I think my grandparents saw more technological changes that I will." And even if technology does make radical enhancement technology such as brain implants possible, Nordman doesn't see much demand for it. "We need a reality check," he says.

Nordman, however, is in a minority. According to Schwarz, it is almost inevitable - "overdetermined", in the jargon of his profession - that the next 20 to 30 years will see the rapid progress that makes his 2050 scenario possible. "The problems are really difficult," he says. "Really controlling genetic systems, really understanding the brain. They won't be solved by 2010 or 2015. I think it will be slower than some people hope, but it's inevitable that we will make great scientific progress."

If you accept that, the big question facing us now is whether we want to go down the road towards an enhanced future. The President's Council on Bioethics is clear that this is not a debate that can be delayed. "Decisions we are making today - for instance, what to do about sex selection or genetic selection of embryos, or whether to prescribe behaviour-modifying drugs to preschoolers, or how vigorously to try to reverse the processes of senescence - will set the path 'beyond therapy' for coming generations," its report says.

Chances are, of course, that human enhancement will lead neither to utopia nor to the end of humanity. More likely each new technology will be debated, tested and, if useful and not directly harmful, eventually assimilated into everyday life. Already there are people among us who possess what once seemed like superpowers: vision more acute than anything anyone was born with thanks to laser surgery, superhuman powers of concentration or the ability to go for days without sleep thanks to psychoactive drugs, and the ability to perform astonishing feats of strength, speed and endurance thanks to steroids.

Even technologies that seem morally questionable at first soon become socially acceptable. In 1969, a poll found that a majority of Americans believed that IVF "violated God's will"; by 1978 a majority said they would use it. In the 1960s many US states outlawed the contraceptive pill for fear that it would be too socially disruptive; few would do the same now. Most experts agree that human enhancement is coming, and that there is no off button for what we have already started. But the outcome is not predetermined. It's time to start choosing your future.

From issue 2551 of New Scientist magazine, 13 May 2006, page 32
Towards immortality

Woody Allen once said: "I don't want to achieve immortality through my work. I want to achieve it through not dying." It won't happen for him, nor for anyone else alive today, but many researchers believe that we are at the start of a revolution that could deliver if not immortality, then something resembling it.

A century ago, life expectancy in the developed world was around 55 years. Today it is nudging 80. "We have made tremendous advances - by accident," says Sarah Harper, director of the Oxford Institute of Ageing at the University of Oxford. "We weren't actually planning to extend lives."

That is all changing. Harper says there is now a widespread belief that we can "effect radical change, extending both maximum lifespan and normal healthy lifespan". It will be slow and painstaking, but some gerontologists are willing to bet that there are people alive today who will still be alive in 2150.

One of those is Aubrey de Grey, a theoretical gerontologist at the University of Cambridge. He will tell anyone who is prepared to listen that in 20 to 30 years it will be possible to deliver radical increases in longevity, largely by repairing cellular and molecular damage. "I think the first person to live to 1000 might be 60 already," he says.

Among gerontologists, De Grey is almost universally regarded as a maverick and a nuisance, but even some of his fiercest critics agree that it now appears possible to deliberately intervene to increase longevity. Among them is Jay Olshansky of the University of Illinois in Chicago, who with three colleagues recently called on the US government to invest $3 billion a year into anti-ageing research (The Scientist, vol 20, p 28). "The time has arrived to slow ageing in humans," says Olshansky. His target: seven years.


Why seven? Olshansky says that the risk of death and age-related diseases rises exponentially throughout your lifetime, starting at puberty and with a doubling time of seven years. So if you could delay ageing by seven years, you would halve everyone's risk of dying at any given age. And when the end does come, he says, you suffer a relatively short period of ill health and die quickly, avoiding the nightmare scenario of a "nursing-home world" full of decrepit old people.

Underpinning Olshansky's plan is animal research showing that mice on severely calorie-restricted diets live around 40 per cent longer than normal. They remain vigorous, healthy and alert deep into old age, and then die quickly. According to Olshansky's colleague Richard Miller of the University of Michigan in Ann Arbor, we now know of 10 mutations in mice that accomplish the same effect as caloric restriction, suggesting the possibility of anti-ageing drugs that recreate these effects.

If the mouse results were translated into humans, Miller says, it would mean a healthy lifespan of 112 years. "Learning how to do this in humans would be a good idea," he says. Olshansky insists that stopping or reversing ageing is not the issue. "We're not talking about dramatic extension of life," he says. "The operative word is delay. But if you want to achieve immortality, this is a good place to start."
Designer children

In June 2003, Michelle Whitaker gave birth to a baby boy, James, in a hospital in Sheffield, UK. During the birth doctors took a sample of James's umbilical cord blood and banked it for later use. The intended recipient wasn't James: it was his older brother Charlie, who suffers from a rare form of anaemia and whose only hope of a cure was an injection of tissue-matched stem cells.

James was a "designer baby", conceived by IVF and selected from among many embryos to ensure that he would be a suitable donor for Charlie, using a technology called pre-implantation genetic diagnosis. PGD involves taking a single cell while the embryo is at an early stage - just 4 to 10 cells - and scrutinising its genome. It has been used thousands of times since its first success in 1990, but the Whitakers' case broke new ground.

Until James, PGD had been almost exclusively used to reject embryos carrying undesirable genes for diseases or disabilities including Huntington's, cystic fibrosis, sickle cell anaemia and even a predisposition to cancer. The Whitakers' case showed it can also be used to positively select for desirable traits. And that, some people believe, marks the beginning of a world where parents can start to choose their children's genetic make-up.


Of course, to select desirable traits you have to know which genes you're looking for, and that is a big challenge. Even so, some geneticists think it might soon be possible to specify relatively uncomplicated traits such as height or leanness, and as our understanding of the human genome improves, the possibilities are going to expand.

Screening, however, is not the same as creating genuine designer babies. To do that you would have to genetically engineer the embryo. Some PGD researchers are already working on "embryo gene therapy" to repair defective genes at a very early stage. Once you can do that, it may be possible to alter perfectly healthy genes to boost intelligence, height or other valued traits.

No one believes that will be easy, and many scientists think it is unrealistic to expect anything like it. Traits such as intelligence result from the interaction of hundreds, possibly thousands, of genes, plus myriad environmental factors. Controlling the outcome might prove to be nigh on impossible, as well as hugely expensive. There are technical hurdles too, such as the need to create dozens of embryos to have enough to screen. But as the President's Council on Bioethics put it: "In this enormously fertile and rapidly developing field, the future is unknowable... No one should confidently bet against any form of scientific and technological progress."
Smarter minds

In a lab at the University of Cambridge, Danielle Turner is turning ordinary Joes into masterminds. She gets them to perform a test called the one-touch Tower of London planning task, which measures one aspect of intelligence (see Diagram). The harder the task, the more mistakes her volunteers make, but when she gives them a dose of the drug modafinil they suddenly find it easier. "You see quite a dramatic improvement in their performance, particularly when the problem gets more difficult," she says.

Modafinil was not developed to make people smarter. It is sold as a prescription-only "wakefulness promoter" for people with narcolepsy and other sleep disorders, but it has a remarkable effect on normal cognition: it improves not only planning but also decision-making and verbal and visual memory. This has made it the latest drug of choice among people looking for a mental boost or competitive edge.

Barbara Sahakian, also at Cambridge, describes modafinil as the "first true smart drug". It won't be the last. There are dozens more "cognition enhancers" in the pipeline. Last year an expert panel appointed by the UK government identified 15 molecular pathways in the brain that are under active investigation as targets for cognition enhancement. All are being developed to help people with cognitive impairment such as memory loss due to Alzheimer's, but many will turn out to have a positive effect on normal, healthy brains, and end up being guzzled like coffee.


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Submitted: 05/22/06 (Edited 05/22/06)

Description: Barbara Sahakian, also at Cambridge, describes modafinil as the "first true smart drug". In a lab at the University of Cambridge, Danielle Turner is turning ordinary Joes into masterminds. She gets them to perform a test called the one-touch Tower of London planning task, which measures one aspect of intelligence (see Diagram). The harder the task, the more mistakes her volunteers make, but when she gives them a dose of the drug modafinil they suddenly find it easier. "You see quite a dramatic improvement in their performance, particularly when the problem gets more difficult," she says.

Modafinil was not developed to make people smarter. It is sold as a prescription-only "wakefulness promoter" for people with narcolepsy and other sleep disorders, but it has a remarkable effect on normal cognition: it improves not only planning but also decision-making and verbal and visual memory. This has made it the latest drug of choice among people looking for a mental b

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