IF a brain implant were safe and available and allowed you to operate your iPad or car using only thought, would you want one? What about an embedded device that gently bathed your brain in electrons and boosted memory and attention? Would you order one for your children?
In a future presidential election, would you vote for a candidate who had neural implants that helped optimize his or her alertness and functionality during a crisis, or in a candidates? debate? Would you vote for a commander in chief who wasn?t equipped with such a device?
If these seem like tinfoil-on-the-head questions, consider the case of Cathy Hutchinson. Paralyzed by a stroke, she recently drank a canister of coffee by using a prosthetic arm controlled by thought. She was helped by a device called Braingate, a tiny bed of electrons surgically implanted on her motor cortex and connected by a wire to a computer.
Working with a team of neuroscientists at Brown University, Ms. Hutchinson, then 58, was asked to imagine that she was moving her own arm. As her neurons fired, Braingate interpreted the mental commands and moved the artificial arm and humanlike hand to deliver the first coffee Ms. Hutchinson had raised to her own lips in 15 years.
Braingate has barely worked on just a handful of people, and it is years away from actually being useful. Yet it?s an example of nascent technologies that in the next two to three decades may transform life not only for the impaired, but also for the healthy.
Other medical technologies that might break through the enhancement barrier range from genetic modifications and stem-cell therapies that might make people cognitively more efficient to nano-bots that could one day repair and optimize molecular structures in cells.
Many researchers, including the Brown neuroscientist John Donoghue, leader of the Braingate team, adamantly oppose the use of their technologies for augmenting the nonimpaired. Yet some healthy Americans are already availing themselves of medical technologies. For years millions of college students and professionals have been popping powerful stimulants like Adderall and Provigil to take exams and to pull all-nighters. These drugs can be highly addictive and may not work for everyone. While more research is needed, so far no evidence has emerged that legions of users have been harmed. The same may be true for a modest use of steroids for athletes.
Which leads us to the crucial question: How far would you go to modify yourself using the latest medical technology? ?
Over the last couple of years during talks and lectures, I have asked thousands of people a hypothetical question that goes like this: ?If I could offer you a pill that allowed your child to increase his or her memory by 25 percent, would you give it to them??
The show of hands in this informal poll has been overwhelming, with 80 percent or more voting no.
Then I asked a follow-up question. ?What if this pill was safe and increased your kid?s grades from a B average to an A average?? People tittered nervously, looked around to see how others were voting as nearly half said yes. (Many didn?t vote at all.)
?And what if all of the other kids are taking the pill?? I asked. The tittering stopped and nearly everyone voted yes.
No pill now exists that can boost memory by 25 percent. Yet neuroscientists tell me that pharmaceutical companies are testing compounds in early stage human trials that may enable patients with dementia and other memory-stealing diseases to have better recall. No one knows if these will work to improve healthy people, but it?s possible that one will work in the future.
More intriguing is the notion that a supermemory or attention pill might be used someday by those with critical jobs like pilots, surgeons, police officers ? or the chief executive of the United States. In fact, we may demand that they use them, said the bioethicist Thomas H. Murray. ?It might actually be immoral for a surgeon not to take a drug that was safe and steadied his hand,? said Mr. Murray, the former president of the Hastings Center, a bioethics research group. ?That would be like using a scalpel that wasn?t sterile.?
HERE is a partial checklist of cutting-edge medical-technology therapies now under way or in an experimental phase that might lead to future enhancements.
More than 200,000 deaf people have had their hearing partially restored by a brain implant that receives sound waves and uses a minicomputer to process and deliver them directly into the brain via the cochlear (audio) nerve. New and experimental technologies could lead to devices that allow people with or possibly without hearing loss to hear better, possibly much better.
David Ewing Duncan is a journalist who has contributed to the science section of The New York Times.
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