“What’s the problem?” Tony’s roommate asked.
0dating—Cynthia? It turns out she’s a lot older than I thought she was.”
“So. How much older?” asked his roommate.
“Hey, she remembers the assassination of President Kennedy, which happened when she was 10. That makes Cynthia 77 years old. She’s 55 years older than I am! Can you believe that?”
Tony’s roommate was aghast. He’d seen Cynthia. He figured she was around 30, not much more. Tony was pleased about going out with an “older” woman. But neither Tony nor his roommate had guessed just how much older she really was.
“I don’t believe it! I mean, how could she be so old?” stammered Tony’s roommate.
“Well, I found out she’s had skin grafts and plastic surgery on her face; that’s why there are no wrinkles. And of course her hair is dyed, so there’s no gray at all. But it’s the rest of her that’s … I don’t know how to say it … that’s all been replaced. It’s weird. It’s like Cynthia’s body is artificial, the way it is with a cyborg.
“To begin with, she’s got silicone breast implants. OK, not so unusual. But inside she’s artificial, too: all plastic valves in her heart, a liver transplant, hip replacements, and a lot of artificial bones. She’s been on estrogen replacement for years and on other antiaging hormones, too. That’s why she looks so young.
“Cynthia never talked much about things that happened before the turn of the century, and now I see why. I never suspected that she was born in the early 1950s. She admitted it to me last night. I came home and suddenly realized I’ve been dating a cyborg!”
Science fiction stories have had titles such as “I Married a Martian,” and a Star Trek film, First Contact, featured a female “Borg” (for cyborg) as a leading character. Star Trek fans remember that the alien species known as the Borg are creatures that are part human and part machine. Like Tony, Captain Picard found himself in a relationship with a Borg and faced perplexing questions. Is the experience of Tony or Captain Picard a glimpse of things to come?
Cyborgs are not outside the realm of possibility (Clark, 2004). In fact, the era of modern bioethics may be said to have started in 1967, when Christiaan Barnard performed the first successful heart transplant on Louis Washkansky. Tissue transplants have long since become a standard part of modern medicine. Some tissues, such as cartilage and the cornea of an eye, are transplanted easily. With proper safeguards, blood can be safely transfused. Modern medicine has also shown success in transplanting skin, bone, kidneys, and, more recently, lungs, livers, and hearts. The development of monoclonal antibodies, which help suppress rejection of transplanted tissues, has opened up a vast field of surgery to replace organs diseased or worn out with age.
At the same time, biomedical scientists are developing artificial tissues and organs that have been successfully inserted into the human body. Bioengineering has already made possible a variety of “replacement parts”:
Skin: Skin tissue has been successfully grown in the laboratory, and biotechnology companies are now producing it in quantity for use with burn victims.
Cartilage: One of the most common effects of aging is the wear and tear on cartilage. Surgeons can now use cartilage grown in the lab to treat joint injuries.
Bone: Hip replacements have long been a staple of geriatric medicine—even Elizabeth Taylor had one. Today, biotechnology companies are selling bone substitutes manufactured from artificial substances. Companies are working on grafts that would enable the body to replace living tissue with artificial bone.
More exciting innovations are on the horizon with the expanding field of regenerative biology and medicine (Stocum, 2012):
Breast tissue regeneration: Breast implants made of silicone have long been in use, but the results have been controversial. Tissue engineers are working on new techniques to stimulate women’s bodies to grow new breast tissue. Already, plastic surgery has become enormously popular. Tissue engineering and “body sculpting” are likely to become even more important in years to come.
Artificial vision: In Star Trek: The Next Generation, the character Geordi (played by LeVar Burton) is able to see by using a “VISOR”—an artificial vision device worn over the eyes. Today, older adults are the age group most likely to be afflicted with impaired vision or total blindness. But in the future, electronic devices may replace lost visual capacity.
Heart valves: Cardiovascular disease is the biggest cause of death among older Americans. Researchers have long been at work on a totally implantable artificial heart. Today, heart valves from pigs have been transplanted into humans. Researchers have discovered how to grow valves from blood vessel cells in the laboratory, and these lab-grown valves work well in lambs. In the future, thousands of people could benefit from artificially grown heart valves.
Bladder: Urinary incontinence is one of the most troubling afflictions for older adults, and it is a factor in nursing home placement. But scientists are working on producing molded lab-grown cartilage that could function as a valve to keep urine flowing in the proper direction.
Pancreas: Late-life diabetes is one of the most serious diseases of old age, entailing complications such as blindness, amputation, and heart failure. Diabetes results from basic organ failure. The pancreas doesn’t produce enough insulin to metabolize sugar properly. Bioengineers are now working on implants made of pig islet cells, which could produce insulin without injections for people who develop diabetes.
Brain: No one expects medical science to produce anything like Donovan’s Brain, a tissue-culture brain that was the centerpiece of a 1950s science fiction movie. But drugs to stimulate nerve growth are under investigation today, and techniques may soon be available to implant cells or introduce growth factors that would reverse damage to the central nervous system.
So far, cyborgs, like those in Star Trek, are just science fiction. But bioengineering work on transplants and artificial organs is not fictional. Moreover, other scenarios are possible. For instance, Bruce Sterling’s novel Holy Fire (1996) has as its heroine a wealthy 94-year-old woman who gets total cellular rejuvenation based on new genetic material added to chromosomes in her body. The result is an organism constructed from “designer genes,” which is different from Cynthia and her replacement parts. Stay tuned as the 21st century progresses and biomedical technology reshapes our vision of what human aging is all about.
Questions for Writing, Reflection, and Debate
1 What are the arguments for and against the view that aging in and of itself is actually a disease? Pick one side of this issue and then try listing the points that can rebut the opposing point of view.
2 What do James F. Fries and Lawrence Crapo mean by natural death? What is the relationship between natural death and the natural life span? Should we consider the natural life span to be identical to the maximum life span?
3 Swedish data have turned up the surprising fact that death rates for the oldest-old (85+) have actually been going down. Some scientific studies suggest an ever-increasing life expectancy is quite possible. These findings sound like good news. Do we have any reasons to
