Body politics

Our Posthuman Future: Consequences of the Biotechnology Revolution, Francis Fukuyama, Profile, 2002

Redesigning Humans: Our Inevitable Genetic Future, Gregory Stock, Profile, 2002

Both Francis Fukuyama, political scientist, and Gregory Stock, medical scientist, agree that a revolution is unfolding in the biological sciences and that its transformative effect on modern society is likely to accelerate in the next few years. They both anticipate a future of designer drugs, designer babies and a life expectancy growing by decades.

They differ in that, while Fukuyama regards this prospect as a threat to our very nature as human beings and as a menace to society, Stock welcomes the opportunity to improve on human nature for the benefit of individuals and society.

The defect in this discussion lies in its premise: there has been no revolution in biology in recent years and there is little sign of one in the near future.

As the American geneticist Richard Lewontin observes, ‘scientists are infatuated with the idea of revolutions’ (1). He argues that there have only been two genuine revolutions in the history of biology, the first launched in the seventeenth century by Harvey and Descartes who introduced a mechanistic approach, the second the theory of evolution advanced by Darwin 200 years later.

It seems that since revolution went out of fashion as a social and historical process, it has become commonplace to talk of revolution in the world of science (where, as a result, it has become a somewhat devalued currency). It is, as old Marxists used to say, no coincidence that Fukuyama, the man who announced ‘the end of history’ in 1989 has now rediscovered the dynamic factor in society in the sphere of biology.

There are three areas of biology in which revolutionary developments are supposed to be taking place: in neuroscience and psychopharmacology, in genetics and in the study of ageing. Let’s take these in turn.

• Drugs: myths and realities

Fukuyama presents drugs such as Ritalin and Prozac as examples of the dramatic therapeutic consequences of revolutionary advances in the understanding of neurotransmitters and other aspects of brain functioning. He believes that these drugs are moulding boys and young women (their main consumers) into a new ‘androgynous, median personality’ which is both ‘self-satisfied and socially compliant’ (2).

But there is no relationship between recent developments in neuroscience and the use of these drugs. Though Ritalin has been increasingly prescribed for the treatment of attention deficit hyperactivity disorder in children over the past decade, especially in the USA, it was developed in the 1940s and first licensed for the treatment of hyperactivity in 1954.

Prozac was launched in 1987, but it is merely the latest in a 40-year history of developments in antidepressants; it has a lower incidence of side-effects than earlier drugs, though it may also be less effective. Prozac has been skilfully marketed as a ‘selective serotonin reuptake inhibitor’ (SSRI), though the explanation of the effects of psychoactive drugs in terms of their effects on neurotransmitters has tended to follow their more or less serendipitous discovery and pragmatic introduction into practice (3).

Neither Ritalin nor Prozac can be said to have a transformative effect on personality. Ritalin seems to reduce the excitability and improve the concentration of naughty boys for just about long enough to make them sit through a couple of lessons. Like other antidepressants, Prozac seems to benefit about 70 percent of people who take it (though perhaps half of these would also benefit from a placebo).

The effect of these drugs is on mood, rather than personality: the main action of SSRIs has been described as ’emotion-buffering’ (4). The celebrated claim that Prozac can make some people feel ‘better than well’ (reported in Peter Kramer’s 1993 bestseller Listening to Prozac, evidently Fukuyama’s main source) was first reported in 1958 in a study of the early ‘tricyclic’ antidepressant imipramine (5).

Though Fukuyama is right that the large-scale use of drugs like Ritalin and Prozac reflects an insidious process of medicalisation of social problems, he is wrong to lay the blame for this on developments in neuroscience and psychopharmacology.

Both Fukuyama and Stock believe that advances in genetics will allow the development of psychotherapeutic drugs tailored to individual idiosyncrasies. While this seems a promising field of research, therapeutics still lags far behind basic science. According to the British psychiatrist and historian of antidepressants David Healy, ‘as of the turn of the millennium, the direct impact of neuroscience on therapeutics remains aspirational rather than of clinical utility’ (6).

• Dolly dreams

From the discovery of the ‘double helix’ structure of DNA by Watson and Crick in 1953 to the birth of Dolly the sheep, the world’s first cloned mammal, in 1997, developments in genetics have made a major public impact. The successful completion of the Human Genome Project in 2000 has led to renewed speculation on the prospects for genetic engineering and genetic screening.

Both Fukuyama and Stock offer detailed accounts of the prospects of both somatic gene therapy (the targeting of defective genes in the cells of individuals with conditions such as cystic fibrosis) and germline gene therapy (altering genes in fertilised eggs, introducing changes that will be passed on to future generations).

But before speculating about the future it is worth reviewing the achievements of the genetic revolution so far. This revolution got underway in the early 1970s with the development of the technologies of recombinant DNA, cloning and gene isolation.

In 1971, Macfarlane Burnet, Nobel laureate and pioneer of immunology, issued a gloomy prognosis on the new biological sciences of molecular and cellular biology (7). In his view, observational and social studies had much greater potential for leading to treatments for human disease than the laboratory-based sciences.

This, like Ernest Rutherford’s notorious judgement in the 1930s that the discoveries of nuclear physics would never unleash nuclear power, is often cited as evidence that the greatest of scientists can be unreliable guides to future possibilities. Yet, despite all the hype, the disappointing results of the first 30 years of the genetic revolution tend to vindicate Burnet’s outlook.

Looking back on the products of biotechnology in the field of therapeutics in 1996, the prestigious medical journal The Lancet commented that there was ‘very little to show for much investment’. The two best-known products of these techniques – human insulin and interferon – have failed to fulfil expectations, the former causing a wave of hypoglycaemic episodes when it was introduced and the latter proving of marginal therapeutic value in a wide range of conditions.

A vaccine against hepatitis B and the production of erythropoietin (EPO), which has been widely used in the treatment of anaemia in chronic renal failure (not to mention in enhancing performance in the Tour de France), have been more successful. In his critical survey of the ‘new genetics’ James LeFanu notes the contrast between a ‘relentless catalogue of failed aspirations’ and a ‘pervasive belief in its limitless possibilities’ (8).

While Fukuyama and Stock speculate about genetic screening leading to the enhancement of human personality, the development of genetic screening to prevent the births of children with some 4000 recognised ‘single gene’ disorders (such as cystic fibrosis, muscular dystrophy, Huntington’s disease, thalassaemia) has been painfully slow. Though the gene for cystic fibrosis was identified in 1984, babies continue to be born with this condition in Britain at the rate of around 300 a year.

As Juliet Tizzard, director of the Progress Educational Trust, argues, the real scandal in the field of pre-implantation genetic diagnosis is not the quest for babies with blue eyes, high IQs and perfect pitch, but the limited availability of the existing technology for the prevention of major genetic disorders (9).

The quest for genes linked to a predisposition towards cancer (such as the BRCA1 and BRCA2 genes found in families with a strong history of breast cancer) has yet to yield clinical benefit. While controversy rages around the prospects for germline engineering, the protagonists seem not to have noticed that, despite numerous trials and experiments with ingenious techniques of somatic gene therapy, the outcomes have been overwhelmingly disappointing. Though there have been recent successes, it is fair to say that no technique has yet become established in clinical practice. In relation to reports of dramatic breakthroughs, Richard Lewontin counsels that ‘the prudent reader should await the second report’.

But what about Dolly? The success of the Roslin Institute in Scotland in cloning a sheep from an adult cell has understandably raised fears (and enthusiasms) that it will soon be possible to clone or genetically modify human beings. Yet Ian Wilmut, the head of the Roslin team, is sceptical. In a review of the Fukuyama and Stock books in the Times Higher Educational Supplement he points out that, quite apart from the ethical problems, there are enormous technical difficulties involved (10).

To produce a genetically engineered baby it is necessary to derive cells from embryos, make precise genetic changes in these cells and produce offspring by nuclear changes from such cells. Several of these steps have been achieved in laboratory mice, but at low efficiencies; in rats, rabbits and other species no step can be done as a routine despite considerable research effort. In Wilmut’s view, the biotechnology discussed by Fukuyama and Stock is ‘at best several decades away and may not be practicable for a very long time’.

• The spectre of grey power

According to Stock, ‘present prospects for retarding or even reversing key aspects of human ageing are reasonably good’, and he proceeds to speculate on the social consequences of a doubling in life expectancy. Fukuyama also anticipates an increasing lifespan, though this leads him into gloomy reflections on the likely social conflicts emerging both at home and abroad under a conservative ruling gerontocracy. But is the prospect of a happy 150 really imminent?

Because life expectancy in the West has nearly doubled over the past century, there is a tendency to extend the graph into the next century. But it is well known that the major contribution to increased longevity has been the decline in infant and child mortality from infectious diseases. The increase in lifespan resulting from the prevention or treatment of the diseases of the elderly (heart attacks, strokes and cancer) has been minimal. Indeed, according to Lewontin, in ‘the past 50 years only about four months have been added to the lifespan of a person who is already 60 years old’.

No doubt there is much interesting research going on into the processes of ageing, but there is equally little doubt that therapeutic intervention to delay these processes remains a distant prospect. Widely publicised treatments for Alzheimer’s and Parkinson’s have so far proved of limited value in practice. It is ironic that Stock’s model for today’s ‘war on ageing’ is US president Richard Nixon’s ‘war on cancer’ launched in 1971, a war that was about as successful as his ‘war on drugs’.

A brief survey of the current state of the revolution in different areas of biology reveals a remarkable gulf between the speculations of commentators like Fukuyama and Stock and the realities of contemporary medical practice.

It is true that there have been exciting developments in research in various aspects of genetics and there are many areas with great promise for the prevention and treatment of disease. It is possible that major breakthroughs will take place in the years ahead, opening up the possibility of improving the human species as well as reducing the burden of disease; it is also possible that such breakthroughs may be much further into the future than current commentators suspect. On the evidence of the past 30 years of the biological revolution, the latter scenario seems far more likely.

• Biology and society

How is it that developments in biotechnology (developments of little immediate and questionable long-term significance) have become the focus of public controversy? It appears that, at a time when any concept of social progress has become attenuated (which was the core of Fukuyama’s ‘end of history’ thesis), both hopes and fears for the future have been displaced from the sphere of politics to the world of biology.

From Stock’s radical perspective, aspirations for a better world are invested in the potential of biotechnology to improve the human species. While his enthusiasm for scientific experimentation and his hostility to attempts to restrain such research are welcome, his expectation that any such advance can tackle the social problems facing humanity is naive.

Furthermore, his futuristic fantasies about cyborgs and fyborgs and genetic engineering have the effect of provoking popular anxieties about biotechnological advances that are disproportionate to the realistic prospects of these technologies. In turn, these anxieties tend to encourage restrictions on biotechnological advance of the sort favoured by Fukuyama (and the Bush government to which he is an advisor on these matters). Medical scientists would be best advised to leave the fantasies to the novelists and film-makers who have discovered that gloomy times provide a ready market for science fiction.

Fukuyama, by contrast, is conservative and pessimistic. His book reveals a preoccupation with a series of problems of contemporary society – family and community breakdown, the decline of parental authority, the tensions resulting from declining (and ageing) indigenous populations, a rising number of immigrants in the West, and the growing gulf between rich and poor, nationally and globally. All these problems have been around for some time (European birth rates, for example, have been declining for more than a century), and were a central theme in Fukuyama’s last book (11).

In Our Posthuman Future, Fukuyama seems to project his anxieties about social fragmentation into the sphere of biology, and speculates at length on the potential of advances in biotechnology to make existing social problems even worse. The result is a remarkable disjuncture between problems facing humanity today and developments which may (or may not) make them worse decades into the future. The last sections of his book are taken up with a discussion of measures to regulate biotechnology to stave off the dangers that he fears it may bring. It scarcely needs stating that, whatever the effect of such regulatory mechanisms on science and technology, they will do nothing to alleviate existing social problems.

In different ways, both these books exemplify what Lewontin terms ‘the fetish of DNA’, the notion that the DNA in our genes, fixed at the moment of conception, determines our destiny as human beings. ‘How much of human life will be explicable in terms of genetics?’, asks journalist Bryan Appleyard. ‘In the current climate the usual answer is: almost every aspect of human nature has a large and frequently decisive genetic component.’ (12).

Statements such as the claim that humans share 98 percent of their genes with chimpanzees have become a familiar device for both dismissing claims for the exceptional qualities of humanity and for demonstrating our subordination to our DNA. Another way of looking at this statement is that, given the enormous gulf between human civilisation and the society of chimps, our almost identical DNA cannot be so important.

For Lewontin, our DNA has made possible our complex bodies and brains, making possible ‘human nature, a social nature whose limitations and possible shapes we do not know except insofar as we know what human consciousness has already made possible’ (13). In the making of human consciousness, our genes ‘have been replaced by an entirely new level of causation, that of social interaction with its own laws and its own nature that can be understood and explored only through that unique form of experience, social action’.

The real problem underlying this debate is the stasis of contemporary society and its theoretical reflection in the ‘end of history’ thesis (14).

Dr Michael Fitzpatrick is the author of MMR and Autism, Routledge, 2004 (buy this book from Amazon (UK) or Amazon (USA)); and The Tyranny of Health: Doctors and the Regulation of Lifestyle, Routledge, 2000 (buy this book from Amazon UK or Amazon USA). He is also a contributor to Alternative Medicine: Should We Swallow It? Hodder Murray, 2002 (buy this book from Amazon (UK) or Amazon (USA)).

Buy Our Posthuman Future from Amazon (USA) or Amazon (UK)

Buy Redesigning Humans from Amazon (UK) or Amazon (USA)

Read on:

History has not yet begun, by Frank Furedi

‘I have not jumped off the modernity boat’, an interview with Francis Fukuyama by Helene Guldberg

(1) It Ain’t Necessarily So: The Dream of the Human Genome and Other Illusions, Richard Lewontin, Granta, 2000, p43

(2) Our Posthuman Future: Consequences of the Biotechnology Revolution, Francis Fukuyama, Profile, 2002, p52

(3) The Anti-Depressant Era, David Healy, Harvard, 1997

(4) Psychiatry and the Human Condition, Bruce Charlton, Radcliffe, 2000, p94

(5) See The Creation of Psychopharmacology, David Healy, Harvard, 2002, p366

(6) The Creation of Psychopharmacology, David Healy, Harvard, 2002, p49

(7) Genes, Dreams and Realities, Macfarlane Burnet

(8) The Rise and Fall of Modern Medicine, James LeFanu, Little Brown, 1999, p306

(9) Designer Babies: Where Should We Draw The Line?, Institute of Ideas/Hodder and Stoughton, 2002. Buy this book from Amazon (UK)

(10) ‘Big plans for our blueprint’, Times Higher Educational Supplement, 24 May 2002

(11) Trust: The Social Virtues and the Creation of Prosperity, Francis Fukuyama, 1995

(12) Brave New Worlds: Genetics and the Human Experience, Bryan Appleyard, 1999, p16

(13) The Doctrine of DNA: Biology as Ideology, Richard Lewontin, 1992, p123

(14) See History has not yet begun, by Frank Furedi