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Work, health, military: is the augmented human revolution already here?

Biohacking : medical promises or ethical perils ?

with Andrew Steele, PhD in physics from the University of Oxford, Science Writer and Columnist at Polytechnique Insights
On September 6th, 2023 |
6 min reading time
Andrew Steele
Andrew Steele
PhD in physics from the University of Oxford, Science Writer and Columnist at Polytechnique Insights
Key takeaways
  • The idea of rewriting our DNA dates back to the 20th century, when selection techniques were widely accepted for use on human beings.
  • Despite scientific advances, genetics is still a very poorly understood field because of its complexity.
  • Nevertheless, projects using CRISPR or Neuralink technology are emerging with this objective in mind.
  • From eradicating fatal genetic diseases to improving the cognitive performance of our descendants, biohacking continues to develop and inspire dreams, despite the ethical challenges it poses.

What does the future of huma­ni­ty look like ? Will we sur­vive the next few cen­tu­ries with our des­cen­dants loo­king rough­ly as we do now, living out their three score years and ten ? Or will bio­lo­gy and tech­no­lo­gi­cal enhan­ce­ment see us spor­ting stron­ger, fas­ter mecha­ni­cal limbs and gene­tic aug­men­ta­tion giving us eve­ry­thing from enhan­ced cog­ni­tion to lon­ger, heal­thier lives ?

Advances in science, com­pu­ting and bio­tech make this future, and the ethi­cal chal­lenges it might throw up, worth consi­de­ring. But they also mean that those willing to do some extra leg­work (and some­times take signi­fi­cant risks) can try aug­men­ting their own bodies at home. Let’s take a look at some of the pre­dic­tions, pro­mises, per­ils and per­so­na­li­ties of bio­ha­cking, and see how they’ve pan­ned out.

Building better babies

With an almost end­less sup­ply of head­lines sug­ges­ting that scien­tists have found the ‘gene for’ this and that, ran­ging from com­plex diseases to cha­rac­ter traits, it’s hard to shake the sense that our des­ti­ny is writ­ten in our DNA. So, could we rewrite that DNA and improve eve­ry­thing from health to intelligence ?

This idea took root in the ear­ly 20th Cen­tu­ry, when using simi­lar bree­ding tech­niques to those that allo­wed us to opti­mise farm ani­mals and crops to do the same to human beings was sho­ckin­gly wide­ly accep­ted. Euge­nic poli­cies were pushed by poli­ti­cians from Wins­ton Chur­chill to William Beve­ridge and stu­died by giants of sta­tis­tics and gene­tics like Fran­cis Gal­ton and even Fran­cis Crick, co-dis­co­ve­rer of the struc­ture of DNA. While the hor­ri­fic crimes of the Nazis tra­shed the field’s repu­ta­tion, euge­nics adap­ted and sur­vi­ved, down­playing overt ties to race and coer­cive birth control, and empha­si­sing indi­vi­dual liber­ty and the impor­tance of the wel­fare state to maxi­mise humans’ poten­tial by means other than pure heredity.

Even as the poli­ti­cal decline of euge­nics conti­nued, howe­ver, modern science has shown us that the whole edi­fice was built on sha­ky foun­da­tions : most traits and diseases we might want to select for or against are incre­di­bly gene­ti­cal­ly com­plex. Sad­ly, for those head­lines pro­mi­sing a ‘gene for’ some­thing, most traits of inter­est are high­ly ‘poly­ge­nic’, with hun­dreds or thou­sands of genes acting in concert with one-ano­ther and the envi­ron­ment to create a predisposition—not even a cer­tain­ty ! —for a given cha­rac­te­ris­tic to manifest.

Scree­ning deve­lo­ping babies for serious gene­tic pro­blems is alrea­dy common—but com­pa­nies are alrea­dy appea­ring that offer more com­pre­hen­sive gene­tic testing.

Even eye colour, which we are taught in school has a very simple pat­tern of inhe­ri­tance, is pre­dic­ted non-deter­mi­nis­ti­cal­ly by about 16 genes ; height is explai­ned by about 10,000 gene­tic variants spread across around 30% of our DNA, plus diet and more in youth ; and intel­li­gence is both har­der to quan­ti­fy and, even if we take IQ as a good proxy, is gene­ti­cal­ly less well-unders­tood still. We may not even be able to selec­ti­ve­ly breed for eye colour with certainty—let alone intelligence.

This hasn’t stop­ped com­pa­nies from offe­ring ser­vices that may allow parents to choose a future child based on gene­tic pre­dic­tions of brain­po­wer. Scree­ning deve­lo­ping babies for serious gene­tic pro­blems is alrea­dy common—but com­pa­nies are alrea­dy appea­ring that offer more com­pre­hen­sive gene­tic tes­ting. Known as ‘pre-implan­ta­tion gene­tic diag­noses, or PGD, couples under­going IVF can have a sample of just a few cells taken from a set of embryos deve­lo­ping in a test-tube, and get their DNA tes­ted for risk of diseases like can­cer and diabetes—and also intelligence.

US com­pa­ny Geno­mic Pre­dic­tion offers a num­ber of ser­vices under their ‘Life­View’ brand, up to and inclu­ding a deluxe ver­sion cal­led PGT‑P : T stands for ‘tes­ting’, and the ‘P’ for ‘poly­ge­nic’. Poly­ge­nic risk scores are cal­cu­la­ted using a sta­tis­ti­cal tech­nique that searches for asso­cia­tions bet­ween changes in hun­dreds of places across our DNA and risk of spe­ci­fic condi­tions. While this is fas­ci­na­ting science at a popu­la­tion level to unders­tand how diseases deve­lop, it has seve­ral short­co­mings for pre­dic­ting the future health of unborn chil­dren. The main one is that these asso­cia­tions are pure­ly statistical—the genes used to pre­dict risk are often not cau­sal­ly rela­ted to the condi­tion of inter­est, mea­ning that even if the risk of, say, can­cer is les­ser, you may be unin­ten­tio­nal­ly selec­ting an embryo with a higher risk of some­thing else that isn’t mea­su­red by the test.

The other pro­blem is that pros­pec­tive parents will almost always end up for­ced into some kind of trade-off : even if you take the scores at face value, per­haps the embryo pre­dic­ted to be most intel­li­gent will also have the highest can­cer risk. Not only is this an impos­sible dilem­ma for mums and dads, but it illus­trates the other pro­blem with gene­tic scree­ning as social poli­cy : even if the tests pro­vi­ded cer­tain­ty (which they don’t), we’d end up for­ced into deci­ding whe­ther one disease or trait is worth more than ano­ther, for future gene­ra­tions who may not share our views—especially if we opt to lower their risk of a disease that’s cured in future at the expense of one that isn’t !

Biohacking

If we’re not com­for­table choo­sing the DNA we start our lives with, per­haps we’d be hap­pier with alte­ring our gene­tic lot as consen­ting adults ? CRISPR and other gene-edi­ting tech­no­lo­gies are making this pro­cess dra­ma­ti­cal­ly easier—both for scien­tists and doc­tors, who are using first-gene­ra­tion the­ra­pies to cure dead­ly gene­tic diseases, and for garage ‘bio­ha­ckers’ loo­king to modi­fy their own bio­lo­gy at home.

One example is bio­ha­cker Josiah Zay­ner, who runs a com­pa­ny pro­vi­ding DNA-edi­ting kits—and once injec­ted him­self on came­ra with a sup­po­sed­ly muscle-boos­ting gene edit using CRISPR tech­no­lo­gy. That this is even a plau­sible concern shows us how far the tech­no­lo­gy has come, but DIY DNA alte­ra­tion comes with serious risks. For a start, it may sim­ply not have done any­thing : get­ting DNA edi­ting machi­ne­ry into enough cells to make a signi­fi­cant dif­fe­rence to the bio­lo­gy of an adult human is a work in pro­gress, and most gene edi­ting right now hap­pens out­side the human body, by extrac­ting some cells and modi­fying them in control­led condi­tions in the lab. The big­gest risk if it does work might be can­cer from ‘off-tar­get’ gene­tic edits. This kind of extreme bio­ha­cking is very ris­ky, and any bene­fits are very hard to quantify—and, for what it’s worth, Zay­ner says that he regrets set­ting such an auda­cious example.

The second type of bio­ha­cking involves mel­ding human bio­lo­gy with tech­no­lo­gi­cal implants. Elon Musk co-foun­ded Neu­ra­link, a com­pa­ny making brain–computer inter­faces, with the long-term goal of enabling a ‘mer­ger of bio­lo­gi­cal intel­li­gence and machine intel­li­gence’. He hopes that this will be the solu­tion to ali­gning arti­fi­cial intel­li­gence with human inter­ests, by giving humans a direct inter­face to ensure that AI advances aug­ment rather than oppose our desires.

Howe­ver, des­pite big claims and even FDA appro­val for a cli­ni­cal trial, Neu­ra­link remains vapour­ware. Musk has pro­mi­sed ‘to address brain inju­ries or spi­nal inju­ries and make up for wha­te­ver lost capa­ci­ty some­bo­dy has with a chip’, but so far the company’s highest-pro­file demo in 2021 was a mon­key playing com­pu­ter game ‘Pong’ with its mind.

Other bio­nic implants seem to have gar­ne­red publi­ci­ty not through being huge tech­ni­cal advances, but more because they seem weird and underw­hel­ming. One com­pa­ny, Bio­hax Inter­na­tio­nal, has implan­ted ID ‘bio­chips’ in a few thou­sand customers—but use-cases range from no lon­ger having to ever wor­ry about losing your keys, to paying for gro­ce­ries with a wave of your arm. It seems that most of us would rather leave a spare key with a neigh­bour or use our phone to pay than have a minor sur­gi­cal procedure.

Other bio­ha­ckers are trying to use more conven­tio­nal medi­cal inter­ven­tions to opti­mise them­selves. This ranges from using sup­ple­ments and off-label appro­ved drugs like rapa­my­cin to opti­mise health or cog­ni­tion. There are dozens of com­pa­nies offe­ring eve­ry­thing from sup­ple­ments with dubious evi­dence to online phar­ma­cies that will ship you drugs without a prescription—or any easy way to check that they are what they say they are, cor­rect­ly dosed, and so on.

Whe­ther from infec­tions from an implant gone wrong, or pro­blems from drug or sup­ple­ment side-effects, do-it-your­self medi­cine defi­ni­te­ly comes with a health warning.

A sliding scale

Most ideas for human enhan­ce­ment exist on a sli­ding scale (or per­haps a slip­pe­ry slope, depen­ding on your out­look): as these tech­no­lo­gies approach fea­si­bi­li­ty and wides­pread adop­tion, might they sim­ply cease to be consi­de­red ‘bio­ha­cking’, and become regu­lar medi­cine, or eve­ry­day tech ?

When dis­mis­sing the prac­tice of having an ID chip embed­ded in your hand as dan­ge­rous and eccen­tric, it’s easy to for­get that human–technology inter­faces are alrea­dy in use eve­ry day, like micro­chip-enabled modern pace­ma­kers kee­ping hearts bea­ting, or cochlear implants wiring an exter­nal micro­phone to the brain and giving some deaf people the abi­li­ty to hear. Simi­lar­ly, implan­table glu­cose moni­tors, are beco­ming avai­lable for dia­be­tics as a more com­for­table and conve­nient alter­na­tive than fin­ger-prick tests or exter­nal ‘CGM’ devices.

It’s easy to ima­gine the lines beco­ming blur­rier as tech­no­lo­gy advances.

It’s easy to ima­gine the lines beco­ming blur­rier as tech­no­lo­gy advances. Many of us alrea­dy wear smart­watches that moni­tor our heart rate and count our steps—could implan­table ver­sions sen­si­tive to blood che­mis­try be diag­no­sing diseases or pro­vi­ding diet and exer­cise tips in the next decade or two ? Is this bio­ha­cking, or a conti­nua­tion of modern medi­cal and tech­no­lo­gi­cal innovation ?

Simi­lar­ly, the line bet­ween gene­tic treat­ments and enhan­ce­ments isn’t hard and fast. Most people would agree that it’s OK to use gene the­ra­py to cor­rect a gene that causes a fatal gene­tic disease, even if the disease isn’t fatal in all cases. Is it OK to lower risk of death from heart disease by 50% in someone at gene­ti­cal­ly high risk ? What about 10% in someone with no overt gene­tic risk fac­tors ? What about if it improves their ath­le­tic abi­li­ties a bit at the same time ? Where does the line bet­ween treat­ment and enhan­ce­ment lie, and how com­for­table are we with the lat­ter ? These are impor­tant ques­tions, and deli­nea­tion will become increa­sin­gly com­pli­ca­ted as gene-edi­ting tech­no­lo­gy becomes safer and more powerful—maybe even safe enough that, one day, we’ll all be doing DNA modi­fi­ca­tion at home.

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