Bertalan Meskó, MD, PhD
Director of The Medical Futurist Institute (Keynote Speaker, Researcher, Author & Futurist)Okay, hands up who can tell who’s the most famous biologically enhanced superhuman in the world? True, it’s a quite close call between Captain America and The Incredible Hulk (sorry Spidey, you’re not even close). But are human-invented superhumans just a thing of a Stan Lee comic, or is it an actual scientific idea from a real laboratory?
As a matter of fact, enhancing human capabilities has been on the minds of people for ages, but it has come a long way from ancient training methods to exoskeletons. Enhancing our abilities, be it permanently or temporarily is a tempting but risky matter. Will it be possible in the not-too-far future to gear up superhuman powers so we don't lag behind the others? Let’s dive in and see how (and if) we can be our better selves.
A brief history of human enhancement
First, we need to ask what ‘enhancement’ exactly is. Throughout history, the enhancement of humans by various tools from physical addendums (remember Icaros?) to drugs (from ferocious Viking “berserkers” to the Nazi army or East German swimmers – or many of the cyclists still today), or even love (just google ‘Sacred Band of Thebes’) have been on the minds of leaders, military chiefs or inventors alike. Or philosophers, as a matter of fact.
The urge to live forever has not passed with our predecessors, let's take a look at Bryan Johnson's Blueprint project with its straightforward goal: don't die. Granted, most of us don't have 30 doctors and millions of dollars to spend on enhancing ourselves in all possible ways. On top of that, I feel a slight contrast between his efforts and the initiative to sell extra virgin olive oil as the omnipotent elixir to the less fortunate. But we can't deny he has gone the extra mile in every possible way to make the most of what money and science offer today and I truly appreciate the dedication here.
However, biological enhancement is a much deeper issue.
The dawn of digital health brought an era of technological advancements and within, the recreation of the human body or body parts or -functions came within reach. It started as a restoration of a certain human function, like eyesight or hearing, or the replacement of a missing limb. Technologies like CRISPR gene editing, nanotechnology and even the revolution of wearables and sensors brought new possibilities in human enhancement, and although longevity is still far away for many, living longer and possibly healthier is a de facto case for the human race. (That is, if we survive the climate catastrophe we created.)
The science of it also has a philosophical backing called transhumanism; a movement that “advocates the enhancement of the human condition by developing and making widely available sophisticated technologies that can greatly enhance longevity and cognition.” The concept states that humankind will evolve into a new intelligent species. That is yet to be seen, however: current affairs indicate no such evolution. But transhumanists live and strive among us. And sometimes episodes of the series Black Mirror have more links to reality than we wish. To know more, read our in-depth interview with one of the world’s most influential transhumanists, Zoltan Istvan!
There is a variety of fields where a superhuman feature could potentially be created. And that will not be the result of a single discipline but of the convergence of multiple scientific fields. Currently, these have a restorative focus rather than a developmental one, although each can evolve towards that in the future. In this article, we split the possible directions into 3 main categories:
- Removable cyborg extensions – the tools enhancing the individual can easily be put away at the end of use
- Cyborg-humans – technologies causing lasting, but not irreversible transformation like prosthetic limbs, digital tattoos and bionic implants
- Technologies changing humans forever – genetic editing (such as CRISPR) is the one that raises the most ethical and moral questions.
This time we categorize the possibilities for enhancements horizontally and have a look at 5 fields where human enhancements would be possible.
1. Brainpower
A microchip in the brain that will enhance our cognitive functions by a zillion – how we all could use such a thing during exams! The concept was first raised back in 1968 by architect Nicholas Negroponte at MIT, and it has come a long way since. Hacking the human brain is more difficult than we could imagine and cannot be solved with a single microchip implant.
But Elon Musk’s other company, Neuralink aims to do just that. The idea is to have a chip implanted in one’s brain; that neural implant will let you control a computer or mobile device anywhere you go. A lot of water has passed under the bridge since Musk presented the pigs with the implants and in 2023 the company is recruiting human candidates with quadriplegia for a six-year clinical trial.
But seeing what Elon Musk did to that poor pig, it did not at all look like the future. We at The Medical Futurist often say that before the digital health transformation, a cultural shift is inevitable. But having a neural implant somehow gives me the creeps – even if it could give me superpowers.
2. Brain-computer interface
With less media hype, Synchron, a company that has developed a minimally invasive brain-computer interface is further along the way. Their implant actually has been working in at least two patients for quite a long time and has now enrolled six patients with severe quadriparesis. The current trial runs in three clinical trial sites in the US. The Synchron implant does not require open brain surgery as it is implanted in the blood vessel on the surface of the motor cortex of the brain via the jugular vein, through a minimally-invasive endovascular procedure.
Once implanted, it is designed to detect and wirelessly transmit motor intent out of the brain, intended to restore the capability for severely paralysed patients to control personal devices with hands-free point-and-click.
Researchers have been investigating the possibilities of brain-computer interfaces or BCIs for quite a while now. At first, these were thought to be tools on one hand to provide constant monitoring of the brain’s electrical activity; this could support a wide range of applications from monitoring epilepsy or ADHD to pain management and sleep assessment. On the other hand, the concept was thought to be a solution for paralysed people to move and control things around them with only thoughts… Taking it onto the next level, such an implant could also be used as an external hard drive for the mind.
Enhancing cognitive performance would be able to change the lives of millions suffering from memory loss, and neurological or psychological disorders. Restorative processes like stroke rehabilitation would also gain from the technology. Or, as a matter of fact, these can help reduce the cognitive effects of ageing. No wonder there are many studies that focus on the possibilities such technology can provide for seniors.
3. Muscle strength and robotic exoskeletons
There is a huge cultural acceptance issue with technological solutions for restoration vs. tech for boosting performance. According to a study on the matter, the public almost unanimously agrees with technological enhancement if it’s used for restorative purposes: 95% support physical restorative applications, and 88% support cognitive restorative applications. But when it comes to the enhancement of human capabilities for the reason of boosting performance – well, that’s a big no-no, according to the study. Only 35% of respondents agree with the concept.
Robotic exoskeletons are also becoming more and more common. Paralyzed people or those who lost a limb have now the chance to move again with such technological advancements. Certain industries like construction also make use of the extra power robotics can give. The next step will be the AI-powered prosthesis; or ones that can supplement healthy individuals with additional limbs. Not to mention a future where we share bodies and senses with machines.
But what are advanced technologies worth if only the wealthiest can afford them? That has been the case with many exoskeletons therefore it's so great to see more and more covered by health insurance.
In 2023 October ReWalk Robotics, Inc. announced that the Centers for Medicare & Medicaid Services (CMS) finalized a rule benefitting its exoskeleton technology. "Earlier this year, CMS released a proposal aiming to establish new regulatory definition of “brace.” Adding the definition of brace would expedite coverage and payment for newer technology and powered devices, according to CMS. This potentially enables faster access to the newer technologies, like those made by ReWalk and Myomo as well."
The new CMS proposal includes personal exoskeletons in the Medicare benefit category for braces meaning that benefits would extend to exoskeletons which allow paralyzed patients to stand and walk. This follows a similar announcement from Germany from 2022.
4. Enhancing the senses
What if technology could aid humans to have better hearing than bats? What if we could filter out the smell of urban decay and only experience pleasant odours? Or what if implants could let us see microscopic objects? Or special features, such as the heat map of an abandoned terrain? These questions led us to list how technology could help augment human senses in our previous article. One exciting example of this was the AI-supported hearing aid presented at the 2021 CES. This device features an onboard deep neural network that gives people with hearing loss a better experience. And there are many more examples of that.
Supercharging human senses with technology for the blind or the deaf are entirely feasible enhancements. When a person loses a sense, the area of the brain that was responsible for handling that sensory information does not go unused. The brain rewires itself and uses that area to process other senses. This is neuroplasticity, the ability of the brain to change with experience. Researchers “just” need to find out how to use this natural superpower.
Temporary or long-term sensory enhancements are also not limited to the ones with certain disabilities: the technology goes beyond that. In the Handbook of Neuroethics, the authors explain that the enhancement tools “could be implemented in mainly two ways: either via the application of digital technology or by genetic engineering of the human body.” Augmented reality just takes this realm a step further.
Augmented reality is not only revolutionary but can also give us real superpowers. It is one of the most promising digital health technologies, from operations to providing information and education. Heightened capabilities of our vision by AR, VR, digital contact lenses or even retina chips have been bugging the minds of researchers for the past decade. And although many of the concepts have failed (remember Google’s glass or glucose-level measuring contact lenses?), these flops don’t necessarily mean the concepts are wrong.
5. Genetic engineering – a brave new world?
A lot of research is underway in gene therapies. CRISPR editing was a huge step in this direction. While its original vision, to serve as a tool offering gene therapies for patients is noble and just, there is a significant, primarily moral and ethical resistance against the method. For example, researchers in Oxford’s Nuffield Laboratory of Ophthalmology help restore eyesight to patients with genetic vision defects with gene therapy, which seems acceptable as a method; while genetic engineering on an embryo-level is more of a moral issue than a scientific one.
While CRISPR therapies are still considered experimental, and none have been approved, and some even have been unsuccessful, we've also seen some success stories and several creepier announcements.
Editing DNA can become a powerful tool in the diagnosis and the treatment of diseases. The European Union is trying to add the ethical component on the first level of its scientific programme in the genetic engineering leg of its human enhancement project. Sienna, and other such organisations and projects also raise and include ethical issues in their projects. However, with such technologies becoming more available, cases like the creation of first designer babies in China appear. After this scandal, the WHO launched a global registry to track research on human genome editing.
Transhumanists predict that with the convergence of new technologies in science, we could create healthier, smarter and stronger humans. They think it’s our duty to evolve into something beyond ourselves. But as much as I love science, my idea of a happier life does not begin with being faster and stronger. It begins with the core values of humankind: empathy, tolerance and kindness. And if we can cure something or someone with the help of science, we should do that. But my brave new world shall not take place in Gattaca.
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