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. 2000 Jan 15;320(7228):194. doi: 10.1136/bmj.320.7228.194

Future medicine

Kamran Abbasi
PMCID: PMC1128769  PMID: 10634762

Horizon: Life and Death in the 21st Century, BBC2, 4, 5, 6 January

  An elderly Texan oilman has offered a fortune to anyone who can prevent him dying. He doesn't think he will have to wait longer than 10 years to have ageing reversed and immortality bestowed on him. In fact, he knows exactly what he's going to do for eternity: “I'll do a lot of travelling, find me a very nice girlfriend, and enjoy life. After that, I'll get back to work, find some oil, and read the newspaper.” What he'd really like to do is go and live on Mars. Not as crazy an idea as it sounds when you realise that the Earth's supply of oil is likely to run out in the next millennium.

But his offer is cunning. How long would a scientist have to wait before getting paid? Still, countless scientists throughout the world are striving for the same goal. Immortality is next to godliness, a product with a universal market. The inventor will achieve unimaginable fame and fortune, far more than our Texan dreamer could deliver even if he drilled every drop of oil on this planet.

Surprisingly, he is full of hope; he has faith in science. After all, huge scientific advances are predicted for the early years of this century. That's the problem. They are predicted and hoped for, but a world away from becoming reality.

Neatly, our Texan encapsulates the weaknesses in the glut of predictions that accompanied the arrival of the new century. Television, newspapers, magazines, and journals all carried their visions for the future. And health was a major component. But what most broadcasts and publications failed to convey was the huge obstacles we face before designer babies, immortality, and disease free existence are truly possible.

Though why should they? There can be no better time to have a wildly optimistic outlook than at the birth of a new millennium. None the less, a greater measure of caution would have been more sensible.

BBC Horizon's three part series on life and death in the 21st century attempted to juggle with this presentation dilemma. “In the future we are going to be entirely transformed,” predicted Professor Greg Stoke of UCLA School of Medicine, in the programme on designer babies. “Humans are now becoming objects of conscious design.” Already scientists in the United States will let you select the sex of your child. How long before you can choose hair colour, height, and longevity?

Just to stop us getting too excited, we were cautioned by stories of eugenics and mutant pigs. Our ability to make artificial chromosomes, and the need for them to be tested initially in monkeys, lead Professor Lee Silver, a geneticist from Princeton University, to wonder: “If we're trying to increase the intelligence with these artificial chromosomes, we actually might end up with a chimpanzee that has human or greater than human intelligence.”

That's a thought that would warm the hearts of futurologists brought up on Planet of the Apes movies. But it served to emphasise that though existing in the 21st century might feel like we are living science fiction, many of the predictions made in the past haven't come close to being realised. The most glaring of these was the prospect that we would be regular visitors to the moon and our neighbouring planets. So perhaps the lesson is that the early stages of scientific discovery should not be overplayed.

We are indeed on the verge of a momentous unravelling of the human genome, but its application and usefulness are far from proved. Indeed, the Human Genome Project was the basis for most of these predictions of the future. It is a mostly American initiative, and if the Horizon series is anything to go by, the United States holds a monopoly on the future—nearly all the scientists and futurologists featured in the series were from there.

If the future belongs to Uncle Sam, it also belongs to the rich. Horizon's programmes on designer babies and immortality strongly indicated this, the rich being concerned with such issues while the poor worry about survival itself. The third of the programmes spoke of the great plagues and infections that we could expect in this century, more of old enemies like tuberculosis, and newer ones like AIDS and multiple resistant Staphylococcus aureus (MRSA). This programme was an attempt to balance the optimism of the other two, but it served up visions of poor people and homosexuals with gruesome infectious diseases, images that most British viewers could happily distance themselves from.

Despite the overplayed sensationalism, the series, like most other contributions on the future was compelling. However sceptical, we are all intrigued about how the human race might develop, and the speed of change, like the latter half of the last century, is likely to be phenomenal.

Our Texan oilman featured strongly in the programme on immortality. After each innovation had been explained the producers would cut back to him and he would say how he would act on it, a vision of hope. But that's what producers and writers preyed on over the New Year period: our curiosity, our hope, and our selfishness.

They forgot to mention that this prophesising made for formulaic television programmes and newspaper features that could be prepared well in advance, allowing themselves a holiday break. Nor was it surprising that the content was depressingly familiar. At least prophets of the past gave us variety. Now even the future is so bland that we all agree on what it will be.

Figure.

Figure

BBC2

Hoping for immortality


Articles from BMJ : British Medical Journal are provided here courtesy of BMJ Publishing Group

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