essay – medicine in the future?
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Two great techno-revolutions will impact the future of health care: digital and genetic. The digital changes what we do -The genetic has the power to change who we are. Both together will transform every aspect of health services. Questions for a third millennium: How will people live and die? Will they die? The future of health care will not more of the same but basic human needs will be: physical, emotional, social and spiritual.
Future of biotechnology, genetics, health care, pharmaceutical industry
Dr Patrick Dixon lecture to biotech venture capital investors about future medicine and health care, gene therapy, biotechnology, and the pharmaceutical industry. Dr Dixon is a physician and trends analyst.
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Digital Technology and Health Care Industry
• Huge rise in techno-medicine costs – eg diagnosis / imaging
• Better technology = greater resource conflicts
• B2B: contracting and supplies
o Huge centralisation of purchasing
o Instant price comparisons
o Total transparency on costs and results of care
o Quality control + process management
• Remote medical care
o Online clinical monitoring / specialist advice / video-links
o Robot- assisted microsurgery
o Online pharmacies – risk and benefits
o Patients get wiser – physicians overloaded with data
• Technology = even shorter hospital stays
o Complex diagnostics / intensive care /acute medicine
o Emergencies / micro-surgery growth
o Home nursing = save money
• Mobile technology = community care revolution
o Just-in-time medical data
o Real-time home monitoring
o Efficient visit rescheduling
• Robots will make more accurate decisions than most physicians
o risk of being sued if robot opinion ignored (!)
o Total rethink about physician training
o Surgeons become skilled technicians
o Nurses / paramedics extend roles
• Injectable chips and computers = enhanced bodies
o Restore hearing / blind begin to see / paralysed begin to move
o Remote control by thought alone
o It may work but do we feel comfortable about all this?
• Can digital technology harm health?
o Truth about mobile phones / repetitive strain injury
So much for the digital revolution in health care services – what about genetics in medicine?
How scientists will slow down or stop ageing in humans – Video
Comment by Dr Patrick Dixon on science of ageing, health care, life expectancy, medical advances, pensions, retirement, lifestyles and government policy.
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The Genetic Revolution
• Most illness is influenced by genes
• Amazing progress in understanding and treating illness
• What can we expect in next decade?
• Universal code of life – what does this mean?
o Mix and match – Scorpion into cabbage, mouse into cotton, spider into goat and human insulin gene into bacteria…
o 1 million transgenic animals (two species combined) made in UK alone in last two years
• Predicting disease risk and response to medication – new specialty
• Gene targeting of cancer cells – predict, prevent, destroy, repair
• New vaccines – malaria / HIV / and more
• Genes into cells – how to do it
o Adult / child cells – die with the patient – no moral issue
o Sperm / Eggs – changes passed on forever – huge ethical questions
• Human cloning and stem cells for replacement tissues
o New treatments for brain / muscle disorders
o Diabetes “cure”
o How long till healthy baby clones are born?
o Do we want designer babies?
o Is science running ahead of our values and principles?
• Gene issues
o Tests for insurance / health cover / jobs
o Destruction of foetuses with disease genes
o Destruction of foetuses with possibly low intelligence or strength
o Humanising animals for medical research
o Creating a child to cure another
• How many human genes does a laboratory monkey have to have to win human rights?
• We now have the power to fundamentally alter the nature of human beings
Get ready for the biggest shift in values for over 50 years as people ask profound questions about the meaning of life, and our purpose on earth. These are in part a response to some of the more disturbing challenges presented by genetics, and other problems faced in our changing world today. These value shifts will have a deep and transforming effect on the way that all health care is conducted, in a very positive way, as we reconnect with what is important to us, recognising that we are more than complex machines, with a new emphasis on quality of life and the unique value of every person.
Conclusion: Digital and genetic technologies will totally transform every aspect of future health care ranging from treatments to team management. The process of change will accelerate, creating many new ethical challenges as well as delivering many medical miracles.
People with digital bodies by 2020
Media log of TV / Radio / Press coverage in last few weeks
Chips and genes will combine to produce bionic people by 2030, with the first digitally enhanced human beings by 2020.
We are already able to link computer chips to human cells such as nerves to help those who are paralysed. The next step will be to implant biochips which control blood sugar levels, helping diabetics. Beyond that, biochips will be implanted directly onto the surface of the brain, to restore sight, hearing, movement or enhance memory and intelligence. Early work has already been completed in animals, fusing living nerve tissue with the surface of a chip, allowing nerve impluses to activate a computer pathway, and a computer to activate brain cells directly.
Computers and genetics are the two great technologies for the first decades of the next century. Computers change how we live, but genes can change what we are. Both these technologies will be used to create designer people, with enhanced characteristics. At the same time there will be a backlash against making “unnatural” children and adults.
Other extraordinary possibilities facing tomorrow’s adults will be the ability to transplant human heads onto new bodies – already achieved in quadraplegic monkeys and one US scientist ready to start in humans, cloning for spare parts, humanised animals as organ factories, “magic bullets” for cancers, entire drug factories contained in the cell of a single microbe, viruses built to correct gene defects in people, new genetically modified foods such as bananas containing vaccines and other medical ingredients, continous bio-monitoring of human body functions such as blood glucose by implanted electrical devices that need no batteries and last a lifetime.
Robots will be used to treat the sick
Media log of TV / Radio / Press coverage in last few weeks
Doctors will be forced to consult computers for advice before making any important decisions about treatment, with the risk of being sued for mismanagement if they don’t. These diagnostic robots will draw on global research to offer expert opinion, which few doctors will dare to ignore. Medical training will shift from what people know, to getting accurate data on which robots can make decisions, and providing “high-touch” emotional support.
Skilled surgeons will always be at a premium, together with hands-on carers who will be increasingly community based, with highly specialised qualifications. Remote surgery will be a regular part of every specialist centre’s routine, whether tele-conferencing advice to surgical teams, or actually controlling surgical equipment remotely.
The line between doctors and nurses will continue to blur as nurses are authorised to make more decisions. As a result nurse training will get longer and top-grade nurses will be more expensive. At the other end of the scale, we will see the return of nursing auxillaries: low cost care assistants with vital front-line roles.
Smart drugs for designer people
Media log of TV / Radio / Press coverage in last few weeks
A new generation of smart drugs will change society by 2015, improving sex lives, intelligence and slowing down the ageing process.
The anti-impotence pill Viagra is the archetypal smart drug, and is a fore-runner of hundreds of others. Within 14 weeks, two million men in America alone had taken Viagra, the vast majority using it purely for recreational reasons. Drug companies woke up to a vast new market for performance-enhancers, as people strive for the ultimate in physical perfection and personal enjoyment. There will be a shift in emphasis by researchers from treating disease or preventing it, to enhancing normal life.
Every aspect of human life will be targetted with smart drugs: all designed to improve lives of people who are perfectly healthy.
A new branch of “designer” medicine will develop, which is neither treating nor preventing disease, but merely satisfying an insatiable appetite for human pleasure and achievement. It will be highly controversial and its practitioners will be shunned by the rest of the medical profession.
For example, students will be able to add the equivalent of 20 points to their IQ in exams by using memory enhancing, and other stimulatory drugs developed for Alzheimers, while drugs will also be available to let people eat as much as they like without ever growing fat. Others will slow down the process of ageing beyond anything we dream possible today.
Smart drugs will raise huge moral dilemmas because they will be widely used in wealthy nations at a time when millions are still living in terrible poverty in most of the rest of the world. And of course, addiction to a variety of substances will continue to be a major problem, in the medical profession as well as the rest of the population.
Human-monkey creatures will be born early in the third millennium
Media log of TV / Radio / Press coverage in last few weeks
Gene technology will give today’s children the ability to redesign the human race and all other life on earth, with some bizarre and disturbing results including the creation of creatures that are half monkey, half human.
We need a sense of history to understand the future. When we look back over the last two decades at the acceleration of genetics, we begin to understand the vast powers that gene technology will give us beyond 2000.
Using today’s technology we already have the power to create humonkeys, creatures which are half monkey, half human. Will such an animal have human rights? Could it be prosecuted for murder? Would it have a soul? These are profound philosophical, ethical and spiritual issues we will have to face early in the next millennium.
We can clone hundreds of identical animals — and humans in future. We can produce designer animals to order, many containing human genes. We have added scorpion poison genes to cabbages to kill caterpillars and other insecticide genes to potatoes to kill Colorado Beetle. We have added human genes to cows, pigs, sheep, fish, rats, rabbits, and bacteria. Using today’s technology we will soon be able to produce human breast milk from cows.
Every step will be justified with promises of health benefits or increased food production.
We need this technology, but we also need to regulate its awesome power. Gene accidents or biological warfare could unleash killer viruses a thousand times more deadly than HIV, while genetically modified fish, if released into the sea, could profoundly affect life in the oceans.
The lesson of history is that whatever can be done, will be done, sometime, somewhere, by someone. However regulation makes abuse less likely. We urgently need a biotech summit and which every aspect of gene technology is discussed with the aim of reaching agreement across as many nations as possible about, for example, the birth of human clones.
Gene researchers have consistently understated the progress of their work, to avoid alarm and prevent interference but as recent events have showed, yesterday’s science fiction is today’s reality when it comes to biotechnology
As with any medicine or diet change, you should discuss it with your doctor. Fruits, both fresh and dried, have a natural sugar in them that will raise blood sugar levels, so be careful about eating too much. Not sure about the nuts. Moderation is always the key. I’ve been diabetic for 18 years and just recently changed insulin types. I love it because it gives me more freedom in when and what I eat.
So in short for small little things it will become more distant.
