Alvin Toffler - Future Shock

Buried behind this tongue-in-cheek are serious issues, made more profound by the immensity of the possibilities – some of them so grotesque that they appear to leap at us from the canvases of Hieronymus Bosch. Mention was made earlier of the idea of breeding men with gills or implanting gills in them for efficiency in underwater environments. At a meeting of world renowned biologists in London, J. B. S. Haldane began to expatiate about the possibility of creating new, far-out forms of man for space exploration. "The most obvious abnormalities in extra-terrestrial environments," Haldane observed, "are differences in gravitation, temperature, air pressure, air composition, and radiation ... Clearly a gibbon is better preadapted than a man for life in a low gravitational field, such as that of a space ship, an asteroid, or perhaps even the moon. A platyrrhine with a prehensile tail is even more so. Gene grafting may make it possible to incorporate such features into the human stocks."

While the scientists at this meeting devoted much of their attention to the moral consequences and perils of the biological revolution, no one challenged Haldane's suggestion that we shall someday make men with tails if we want them. Indeed, Lederberg merely observed that there might well be non-genetic ways to accomplish the same ends more easily. "We are going to modify man experimentally through physiological and embryological alterations, and by the substitution of machines for his parts," Lederberg declared. "If we want a man without legs, we don't have to breed him, we can chop them off; if we want a man with a tail, we will find a way of grafting it on to him."

At another meeting of scientists and scholars, Dr. Robert Sinsheimer, a Caltech biophysicist, put the challenge squarely:

"How will you choose to intervene in the ancient designs of nature for man? Would you like to control the sex of your offspring? It will be as you wish. Would you like your son to be six feet tall – seven feet? Eight feet? What troubles you? – allergy, obesity, arthritic pain? These will be easily handled. For cancer, diabetes, phenylketonuria there will be genetic therapy. The appropriate DNA will be provided in the appropriate dose. Viral and microbial disease will be easily met. Even the timeless patterns of growth and maturity and aging will be subject to our design. We know of no intrinsic limits to the life span. How long would you like to live?"

Lest his audience mistake him, Sinsheimer asked: "Do these projections sound like LSD fantasies, or the view in a distorted mirror? None transcends the potential of what we now know. They may not be developed in the way one might now anticipate, but they are feasible, they can be brought to reality, and sooner rather than later."

Not only can such wonders be brought to reality, but the odds are they will . Despite profound ethical questions about whether they should, the fact remains that scientific curiosity is, itself, one of the most powerful driving forces in our society. In the words of Dr. Rollin D. Hotchkiss of the Rockefeller Institute: "Many of us feel instinctive revulsion at the hazards of meddling with the finely balanced and far-reaching systems that make an individual what he is. Yet I believe it will surely be done or attempted. The pathway will be built from a combination of altruism, private profit and ignorance." To this list, worse yet, he might have added political conflict and bland unconcern. Thus Dr. A. Neyfakh, chief of the research laboratory of the Institute of Development Biology of the Soviet Academy of Sciences, predicts with a frightening lack of anxiety that the world will soon witness a genetic equivalent of the arms race. He bases his argument on the notion that the capitalist powers are engaged in a "struggle for brains." To make up for the brain drain, one or another of the "reactionary governments" will be "compelled" to employ genetic engineering to increase its output of geniuses and gifted individuals. Since this will occur "regardless of their intention," an international genetics race is inevitable. And this being so, he implies, the Soviet Union ought to be ready to jump the gun.

Criticized by the Soviet philosopher A. Petropavlovsky for his seeming willingness, even enthusiasm, to participate in such a race, Neyfakh shrugged aside the horrors that might be unleashed by hasty application of the new biology, replying merely that the advance of science is, and ought to be, unstoppable. If Neyfakh's political logic leaves something to, be desired, his appeal to cold war passions as a justification for genetic tinkering is terrifying.

In short, it is safe to say that, unless specific counter-measures are taken, if something can be done, someone, somewhere will do it. The nature of what can and will be done exceeds anything that man is as yet psychologically or morally prepared to live with.

We steadfastly refuse to face such facts. We avoid them by stubbornly refusing to recognize the speed of change. It makes us feel better to defer the future. Even those closest to the cutting edge of scientific research can scarcely believe the reality. Even they routinely underestimate the speed at which the future is breaking on our shores. Thus Dr. Richard J. Cleveland, speaking before a conference of organ transplant specialists, announced in January, 1967, that the first human heart transplant operation will occur "within five years." Yet before the same year was out Dr. Christiaan Barnard had operated on a fifty-five-year-old grocer named Louis Washkansky, and a staccato sequence of heart transplant operations exploded like a string of firecrackers into the world's awareness. In the meantime, success rates are rising steadily in kidney transplants. Successful liver, pancreas and ovary transplants are also reported.

Such accelerating medical advances must compel profound changes in our ways of thinking, as well as our way of caring for the sick. Startling new legal, ethical and philosophical issues arise. What, for instance, is death? Does death occur when the heart stops beating, as we have traditionally believed? Or does it occur when the brain stops functioning? Hospitals are becoming more and more familiar with cases of patients kept alive through advanced medical techniques, but doomed to exist as unconscious vegetables. What are the ethics of condemning such a person to death to obtain a healthy organ needed for transplant to save the life of a person with a better prognosis?

Lacking guidelines or precedents, we flounder over the moral and legal questions. Ghoulish rumors race through the medical community. The New York Times and Komsomolskaya Pravda both speculate about the possibility of "future murder rings supplying healthy organs for black-market surgeons whose patients are unwilling to wait until natural sources have supplied the heart or liver or pancreas they need." In Washington, the National Academy of Sciences, backed by a grant from the Russell Sage Foundation, begins a study of social policy issues springing from advances in the life sciences. At Stanford, a symposium, also funded by Russell Sage, examines methods for setting up transplant organ banks, the economics of an organ market, and evidences of class or racial discrimination in organ availability.

The possibility of cannibalizing bodies or corpses for usable transplant organs, grisly as it is, will serve to accelerate further the pace of change by lending urgency to research in the field of artificial organs – plastic or electronic substitutes for the heart or liver or spleen. (Eventually, even these may be made unnecessary when we learn how to regenerate damaged organs or severed limbs, growing new ones as the lizard now grows a tail.)

The drive to develop spare parts for failing human bodies will be stepped up as demand intensifies. The development of an economical artificial heart, Professor Lederberg says, "is only a few transient failures away." Professor R. M. Kenedi of the bio-engineering group at the University of Strathclyde in Glasgow believes that "by 1984, artificial replacements for tissues and organs may well have become commonplace." For some organs, this date is, in fact, conservative. Already more than 13,000 cardiac patients in the United States – including a Supreme Court justice – are alive because they carry, stitched into their chest cavity, a tiny "pacemaker" – a device that sends pulses of electricity to activate the heart. (At a major Midwest hospital not long ago a patient appeared at the emergency room in the middle of the night. He was hiccupping violently, sixty times a minute. The patient, it turned out, was an early pacemaker wearer. A fast-thinking resident realized what had happened: a pacemaker wire, instead of stimulating the heart, had broken loose and become lodged in the diaphragm. Its jolts of electricity were causing the hiccupping. Acting swiftly, the resident inserted a needle into the patient's chest near the pacemaker, ran a wire out from the needle and grounded it to the hospital plumbing. The hiccupping stopped, giving doctors a chance to operate and reposition the faulty wire. A foretaste of tomorrow's medicine?)