Nanotech Scenario Series
Results of Our Ongoing Research
These pages, marked with
GREEN headings, are published for
comment and criticism. These
are not our final findings; some of these opinions will probably change.
LOG OF UPDATES
CRN Research: Overview of Current Findings
Medical Benefits of Molecular Manufacturing
Overview: Molecular manufacturing (MM) will
impact the practice of medicine in many ways. Medicine is highly complex, so
it will take some time for the full benefits to be achieved, but many
benefits will occur almost immediately. The tools of medicine will become
cheaper and more powerful. Research and diagnosis will be far more
efficient, allowing rapid response to new diseases, including engineered
diseases. Small, cheap, numerous sensors, computers, and other implantable
devices may allow continuous health monitoring and semi-automated treatment.
Several new kinds of treatment will become possible. As the practice of
medicine becomes cheaper and less uncertain, it can become available to more
Surgical and diagnostic tools will be elegant and cheap.
||Medicine, especially medical
research, demands cutting-edge, high-tech tools. These are naturally
expensive to manufacture, especially if they must be kept sterile. With a
manufacturing system, the cost of production is unrelated to the complexity
of the product. Design and testing will still be costly, but once designed,
tools can be manufactured in quantity. The incredibly small component size
will allow new kinds of tools: for example, a complete surgical robot can be
built smaller than a hypodermic needle, and a chemical sensor can be small
enough to fit inside a living cell. Because the human body is so complex,
accurate knowledge of its state requires gathering large amounts of data.
The small size and low cost of nano-built sensors will allow hundreds or
thousands of them to be used for routine diagnosis, whereas today only a few
data points can be gathered. Integrated sampling and analysis tools will
allow real-time monitoring; there will be no need for a separate "lab" to
run the tests.
diagnosis will become more efficient.
|Medical research has
traditionally been a process of trial and error. Make a change, then wait a
few hours or days to see its effect on the overall state of health. This
required an extremely conservative approach, as medical techniques had to
evolve one step at a time. With real-time monitoring of the body's systems,
it will be possible to detect undesired effects far earlier, allowing a more
aggressive and experimental approach to treatment. Researchers will be able
to gather far more data and process it with computers millions of times more
powerful. The result will be a detailed model of the body's systems and
processes, and the ability to predict the effects of any disease or
treatment. Diagnosis will also be far easier and more informative. It will
be possible to build thousands of diagnostic tests, including invasive tests
and imaging tests, into a single, cheap, hand-held device. A variety of
single-molecule detection technologies will be available even with early
MM. Trustworthy diagnosis will make medicine far more efficient, and also
reduce the risk of malpractice (and thus liability insurance).
devices can be implanted permanently.
||Today, only a few medical
devices are implanted permanently. Surgery is always undesirable, and not
much functionality can be packed into a device small enough to wear inside
the body. Nano-built devices will be far more efficient and compact. As MM
technologies gain the ability to synthesize chemicals other than diamond,
implantable devices will be able to continuously sense and adjust the body's
chemical balance, in the bloodstream or in specific tissues. Even before
then, implanted sensors will be valuable in acquiring a continuous record of
the person's state of health. This will allow more sensitive adjustment of
the body's state, and earlier detection of problems.
problems will be prevented.
||Many medical problems are
preventable. Some are acquired from the environment, including poisoning,
some cancers, and almost all infectious disease. Widespread monitoring of
health and the environment will allow detection of the source of such
problems before they can injure people. Improved infrastructure such as
water filtration will also help to reduce environmentally-acquired disease.
Other diseases are related to lifestyle. Current lifestyle advice is
difficult to follow and is not always accurate. Better research will greatly
improve our understanding of cause and effect, allowing us to live more
healthy lifestyles with far less effort. Finally, some problems accumulate
over time, and early detection and treatment can correct the problem before
it turns into a full-blown disease.
will be stopped quickly.
||New diseases continue to be a
threat to the human race. Naturally occurring diseases could be far worse
than SARS, and an engineered disease could conceivably wipe out most of the
human race. It will be increasingly important to have a technology base that
can detect new diseases even before symptoms appear, and create a cure in a
matter of days. MM will enable just such a rapid response. With complete genomes
and proteomes for humans and for all known pathogens, plus cheap, highly
parallel DNA and protein analysis and sufficient computer resources, it will
be possible to spot any new pathogen almost immediately. (There is already a
project under way to sequence the DNA of every organism in the Sargasso
Sea.) Curing a new infectious disease will require some method of detecting
and stopping the pathogen. Robert Freitas has described over a dozen
nanotechnological ways to
disable or destroy pathogens.
treatment may be semi-automated.
||The practice of medicine today
involves a lot of uncertainty. Doctors must guess what condition a patient
has, and further guess how best to treat it without upsetting the rest of
the body's systems. By contrast, when pathogens and chemical imbalances can
be directly detected, many conditions will be treatable with no uncertainty,
allowing the use of computer-selected treatment in common cases. This may
further reduce the cost of medical care, although doctors, regulatory
agencies, or the patients themselves may resist the practice initially.
improve and lifespans increase.
||Health improvement and life
extension do not depend directly on molecular manufacturing, but it will certainly make them accessible
to more people. Any treatment that can be automated can be applied to any
number of people at low cost. Efficient research will speed the development
of cures for complex problems such as cancer and aging. New therapeutic
techniques will allow the treatment of more types of diseases.
facilitate genetic therapy.
||Genetic therapy holds great
promise for treating several serious health problems. However, the current
state of the art can also cause problems, including cancer. Eventually, we
may hope that MM will be able to directly edit the DNA of living cells in
the body. But even without that level of sophistication, massively parallel
scanning may enable the sorting of cells modified outside the body. The
ability to inject only non-cancerous cells would make some kinds of genetic
therapy much safer. Microsurgical techniques could allow the implantation of
modified cells directly into the target tissues.
|Some organs will
||Many organs in the body perform
fairly simple functions. Already, sophisticated machinery can replace lung
function for hours, heart function for months, and kidney function for
years. Since MM can build machines smaller than cells, many other organs
will be candidates for replacement or augmentation, including skin, muscles,
various digestive organs, and some sensory functions.
|Systems can be
||The body is made of a large
number of interacting systems. The blood circulates chemicals all through
the body, making each system interdependent with the others. Small,
implanted devices will allow the systems to be decoupled and controlled
independently to some degree. For example, it may be desirable for the brain
to receive more, or less, adrenaline than the muscles. This capability of "heterostasis"
may be useful in cases of trauma and disease, or for long-term health
DEVIL'S ADVOCATE —
Submit your criticism, please!
If everyone were healthy and lived a long time, we'd
overpopulate the earth.
Once infant mortality is minimized, birth rate contributes
far more to population than lifespan, because children grow up to have
children of their own. But as people get healthier, richer, and better
educated, they have fewer kids. The birth rate is already below the
replacement level in several rich countries. MM will also allow us to develop
far more sustainable lifestyles. Overpopulation is a centuries-old problem.
Traditionally, it's been solved by infanticide, plague, and vicious war. With
MM, we'll have many decades to figure out better solutions.
Life extension is immoral and we should resist it.
Smallpox vaccination and anesthesia were also said to be
immoral. Today it's obvious that that's crazy. No one wants to be sick, and
life extension is a natural result of health extension. Anyone who visits the
doctor is working to improve their health, and often trying to increase their
lifespan as well.
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of Molecular Manufacturing
Overview of Current Findings