As demand for organ transplants skyrockets, a new artificial heart and other sophisticated prostheses are among the medical-tech advancements raising troubling questions.
PARIS — Meet Rex, the robotic exoskeleton that was presented a few months ago at London’s Science Museum. His heart is made of plastic, his pancreas is an insulin pump, silicon filters act as kidneys, his trachea is made of human tissue, he has an autonomous blood circulation system as well as visual and hearing implants all attached to a structure that can replicate the most important human movements.
Rex is a collection of all the recent scientific progress in artificial organ designing. “These products are not all implantable yet, and this pipe dream still lacks vital organs, like a stomach,” explains Bertolt Meyer, a Swiss psychologist who lent his face to this sort of bionic Frankenstein. “But Rex is proof of how quickly we’ve gone from the wooden leg to such sophisticated prostheses that there is hope that one day they could be as good as or even better than the level of perfection of biological constructions.”
In just a few months, Carmat’s artificial heart, invented by French surgeon Alain Carpentier, will be implanted in four patients, and this will illustrate the imminent future Meyer describes. “This worldwide first will make everything else possible,” says philosopher Roger-Pol Droit, who outlined in his 2012 book Human the physical mutations that will shake up our human condition.
By “everything else,” Droit means the surprising (or worrying?) innovations that are brewing in laboratories: nano pores made out of composite polymers so as to produce insulin in place of a failing pancreas, bionic retinae with tiny electrodes that can replace damaged photoreceptors, and prostheses made from collagen and glycoprotein fibers to build resorbable scaffolding that enable bone recolonization. Then, of course, there are the artificial uteri for “outside womb pregnancies” that would make babies born like soil-less plants.
“Rex shows that we can reproduce up to 60% or 70% of a human being, but we’re still a long way away from reconstructing a whole body,” explains Rich Walker, managing director of the robotics team Shadow that built Rex. “What we’re starting to obtain are prostheses that resemble human parts. But they still lack the ability to transmit sensory information.” In other words, what science delivers, for now, are mere spare part of a body, like a jigsaw puzzle.
Even as things stand, doctors have no doubt whatsoever that these evolutions are positive. In France, the number of organs is nowhere near enough for transplants. Since the end of the 1990s, the number of people donating organs increased by 56.5%, but the number of people on waiting lists also rose significantly. There were a total of 5,023 transplants performed in 2012, according to the French Biomedicine Agency.
Surgery itself is not to blame: surgeons can successfully — and with very low rejection rates — transplant the following six vital organs: kidney (which represent 60% of operations), liver (23%), heart (8%), lungs (6.4%), pancreas (1.4%) and intestines. With an aging population, one in five people over 65 in France have already had at least one body part replaced, be it a new organ, a prosthesis, a dental implant or a valve.
Carmat, a company valued at more than half a billion euros, symbolizes the hopes aroused by new technological substitutes. Philippe Pouletty, its founder, explains how the artificial heart they have invented functions. “It mimes exactly the human heart. It has two ventricles that mobilize the blood like the cardiac muscle would, and sensors that allow it to accelerate or decelerate the beats, depending, for example, on whether the person is going up or down the stairs,” he says.
“From the point of view of anthropology, we are now reaching a breaking point that will represent a fracture from the totality of human experience,” says sociologist and philosopher Marcel Gauchet. “I am convinced that scientific and technical mutations will have deep repercussions on human identity. By increasing life span, the medical world is already blurring the definition of death. We used to have the impression of a clean frontier, but with organ transplants, it appears that we don’t really know when we die,” he explains
Upcoming revolutions will raise this and other issues even more strongly. For instance, artificial uteri will undoubtedly spark debates about the descendancy chain. “Imagine that for the sake of equality, men demand to be allowed to use it,” suggests anthropologist Françoise Héritier. “The male gender will then be able to give birth to children, and women will lose the fundamental certainty they have acquired thanks to maternity.”
The ethical challenges that these technological breakthroughs raise are at least as important as the scientific barriers they overcome. Rex’s artificial organs were created to restore lost functions or to replace failing parts of the body, but what will it be tomorrow? Will we have substitute organs that offer better possibilities than the original ones? Who will be allowed to have them? How will the selection be made? How much will it cost? And what will be our legal and moral relationship with post-humans whose capacities will be superior to our own?
In the end, will the announced revolution of the “enhanced human” be digested as easily as the invention of the steam engine? “On an individual scale, there’s no doubt about that,” argues psychologist Bertolt Meyer, who was born without a left hand. “I have such a sophisticated bionic prothesis that it allows me to make the finest movements. I have developed a very emotional relationship with this limb. Just like my right hand, it’s part of my identity and of the image I have of my own body.”