Tomorrow is good.

Screen Shot 2016-09-04 at 07.51.59In a weekly column, alternately written by Lucien Engelen, Maarten Steinbuch, Carlo van de Weijer and Daan Kersten, E52 tries to find out what the future will look like. All four contributors are – in addition to their ‘normal’ groundbreaking work – linked to theSingularityU The Netherlands, the organization that focuses on spreading knowledge about technologies that can provide solutions to the problems of our time. This Sunday, it’s Lucien Engelen‘s turn.

By Lucien Engelen
SU Lucien EngelenA lot of ships are lost and sunk in the Bermuda Triangle. If we don’t take good care, a lot of wonderful applications in healthcare technology also get lost in the triangle between technology, ethics and philosophy. To avoid that, we have to give attention to the ethical and philosophical aspects.

It is 2026. A medical specialist today receives two patients at his office. A man of 79 years who has a great chance to become 100 on the basis of his DNA profile, provided he now gets a €300,000 anti-cancer treatment. And a young man of 21 who would like to have the same treatment, but who has a life expectancy of 33 years based on his DNA profile. The insurer provides the doctor only budget for one of the two patients. Whom will he choose?

The doctor of the future is not only a physician, but more than now he should also be an ethicist and philosopher. We will be seeing more and more of these issues because thanks to the evolving technology the possibilities will expand in the near future. The questions that are going to come at us are of an ethical and philosophical level as well, and both in intensity and in number they will be so incredibly abundant that we will never be able to answer them all.

For those who’re thinking “yeah, yeah, I guess so”, and “we’ve been hearing this for years already”, I can assure you that there are plenty of examples that prove the importance. I shall mention two.

  • Researchers at Berkeley have developed wireless sensors that may be implanted in the brains. This ‘Neural dust‘ can be implanted in various parts of the brains for different purposes. Think of fighting epilepsy or controlling prosthetics or exoskeletons. But implanted in other parts of the brains, they can also affect behaviour. Of course this is great news for people with mental illnesses who are dependent on their life-long medication. But when do you have a medical condition and when are you just more susceptible to positive or negative moods? Or: what kind of behaviour do we – as a society – tolerate (or not) and as a consequence, which people do we want to be treated with this neural dust? Will patients still have a choice of their own?
  • And what to think of CRISPR Cas 9, a kind word processor for DNA with which you can restore errors in the DNA by just using a cut and paste functionality. A development with enormous potential, of course, but also with a shadow side. The inventors of this technology have, for now, put a brake on the further development because they recognise that their finding is wonderful to cure diseases, but it also enables the production of ‘designer babies’. They feel that it is time to first conduct a major public debate on the question: how far do we want to go in this development? Scientists in China show, however, don’t feel a similar urge, and are already experimenting with embryos.

Completely new scenarios are coming at us. And all of this will happen more quickly than many people think. We humans tend to think linear, but these developments are exponential. At this point in time we are still at the stage where we experiment, when things can go wrong. That does not matter, you simply have to make mistakes in order to move forward. It’s like kids who learn to walk: first they are very unstable and fall with every step. But once they realise how they can maintain their balance, it all goes very fast.

In short, we must find a (new) balance between technology, ethics and philosophy. It will always be a balancing act between these three forces. And that’s good, because only if the balance sometimes moves a little more towards the technology corner, you arrive at new, innovative ideas. The creators of these ideas should then get healthy opposition from the ethical and philosophical side. It is very good to now and then put a brake on technological innovation in order to conduct a moral discussion. With this kind of development i always have a bamboo clump in mind: gradually the shoot bends in one direction, without breaking.

But that only works if all of us now and then take some time to think about it and discuss. This is not an issue that can wait until tomorrow.

(in collaboration with Mirjam Hulsebos)

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