Technology

Humans Are Building Better Versions of Themselves

From insulin to prosthetics, technology makes this the best moment yet to be living with a disability.

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When my wife was diagnosed with Type 1 diabetes in the late 1990s, at the age of 9, the technology available for giving her body insulin, which her pancreas is supposed to make but can't, was relatively primitive: Mollie measured her blood sugar with a device the size of a TV remote. It took a full minute to process the blood sample she provided, which could be obtained only by pricking her finger once for every reading. Administering the insulin required a syringe, a vial, and the assistance of an adult. The hardest part of jabbing herself throughout the day, she says now, was learning to ignore the child's natural instinct to avoid pain.

It was also frighteningly easy back then to take too much insulin. When she was in middle school, my father-in-law found Mollie unconscious from hypoglycemia, a condition that can cause brain death and cardiac arrest. Her first year after college, she ended up in the E.R. again, this time because she hadn't taken enough insulin.

It could've been worse: Until the mid–20th century, Type 1 diabetics seldom survived adolescence.

Today, managing diabetes is a radically different experience. Mollie now uses a microscopic wire inserted under her skin to get real-time glucose updates on her phone (and mine) every five minutes. The sensor she wears is waterproof and roughly the size of a bottle cap, which means she can leave it attached to her arm for days at a time.

More miraculous still is the insulin pump that has replaced her pre-loaded insulin pins, which themselves replaced her hypodermic needles and vials just a few years ago. The pump communicates with her glucose monitor, shutting off if her blood sugar drops too low and alerting her if it appears she needs to increase her insulin rate. The pump is roughly the size of a deck of cards and connects to a port on her abdomen via a small tube. Sometimes that tube catches on things, but it's a massive improvement over jabbing herself with a needle dozens of times a day. A new tubeless pump is already on the market.

As with most people who have a disability, my wife wishes she didn't. But she also says there's no better time to be diabetic than right now.

Other realms of assistive technology have seen similar advances. Massachusetts Institute of Technology biophysicist Hugh Herr, himself a double amputee, designed bionic legs that made it possible for Adrianne Haslet-Davis, who lost her left leg below the knee at the Boston Marathon bombings, to resume ballroom dancing. Herr's latest breakthrough is the Ewing Amputation, a surgical procedure he co-developed that preserves the nerve and muscle connections necessary for the brain to control a robotic prosthesis as if it were a flesh-and-blood limb. Cochlear implants are restoring hearing to an ever-larger subset of deaf people. And a system developed at Duke using both a virtual reality headset and a robotic exoskeleton is helping paraplegics walk again.

Some diabetics now have access to a smart pump that can completely manage their insulin levels based on glucose readings, both cutting the insulin off and administering more when the user appears to need it. Mollie and I are excited about that technology and eager for the price to fall as more governments approve its use.

Many of these technologies are nascent and experimental. They won't be available tomorrow, and they likely won't be truly affordable for years. But the advances aren't just happening at the bleeding edge. Ryan Hines, who was born with arthrogryposis and has very limited use of his arms, used a computer-aided design program to make a specially balanced spoon and fulcrum that allows him to feed himself without his hands or—most importantly—assistance from a caretaker. While a more advanced device is available starting at $8,000, Hines' 3D-printed Bear Paw sells for just $150.

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  1. This sounds a lot like transhumanism. The technology is here, so it is pointless to debate ‘whether’ people should do this; they will. Consider China’s work using CRISPR to genetically alter zygotes. The conversation that needs to be had is how we, as a species, want to approach this. It is a conversation we desperately need to have. Our species is going to change in ways we cannot hope to predict.

    Instead, we are treated to endless MSM sound-bite pablum.

    I am not sure a laisse-faire approach will work WRT transhumanism. The downside consequence of an error is too great to adopt a ‘hands-off’ orientation.

    1. “The downside consequence of an error is too great to adopt a ‘hands-off’ orientation.”

      You make that statement like it’s self evident. I’m not so sure it is, though I assume I know where you are going. I’m sure that government invervention is not going to be done well, and that it would be more likely interferring with the positives, while not really preventing the negatives.

      1. ael….It IS self-evident = the downside consequence of an error is too great. When have we ever had such power, to alter the human genome (or any genome), to alter what it is to be human? Answer: Never. This is totally uncharted territory. It is frightening what can be done already.

        My point is quite simple. These technologies are going to transform our species. And it will happen much, much faster than you think. The time to have this conversation is now. And pretty much everyone should have a seat at the table – not just government. The stakes are existential.

        1. I’m not suggesting a discussion shouldn’t be had, just expressing doubt in the level of fear required, and questioning what the likely solution what might be. Other than incompetent government intervention, what protections would you suggest?
          I know you mentioned CRISPR, but while that is in the same realm as what the article was discussing, it’s not what was discussed.

          1. ael….you ask a good question about suggested protections. At a minimum, we need full disclosure: Who is doing what, to whom, to achieve what modification, to what end? That is not happening right now, and it needs to change.

            You should really understand the far-reaching consequences of what CRISPR is able to do. The time to have the conversation is now, before we go screwing around with CRISPR and change our species – whether we consent to it or not. One can use a virus as a vector to change genes – how do you stop that? It is a very serious matter.

            We have never, ever had ‘species altering’ capability like this before. Not even close. So yeah, there is a very heightened level of anxiety.

        2. People say this about pretty much every new technology, did you catch the podcast interview Nick had with the Pessimists Archive creator recently? Also I’m not sure what you mean by “have a conversation,” it’s not as though nobody is discussing these technologies.

          1. Rhay….The conversations are sporadic, episodic, usually at the governmental level, and besides…who really has a seat at that table? Answer: Not enough .

            Transhumanism is here. The genie is out of the bottle. There is no stopping it. So that choice was made. But what we can do now is to understand what the implications are, and make informed choices as a species on how we will use this technology. Right now, that is not happening, and it must.

            There is a huge difference between introducing technology like a new computer, or a better car…..and technology that will completely transform an entire species.

        3. If someone questions your “self-evident” assertion, then maybe it’s not quite as “self-evident” as you think it is.

          1. ahf….All I can do is to point out the risk. It is up to Readership to do their research and become familiar with the technology. There really isn’t much of the way of opinion here….it will, or will not alter our genome. It will.

            1. Last two words are an opinion. Your self-evident assertion is an opinion.

              Neither is self-evident at all.

            2. All I can do is to point out the risk. It is up to Readership to do their research and become familiar with the technology.

              Shifting the burden of proof fallacy. “In everyday debate, the burden of proof typically lies with the person making the claim.” It is not the readership’s job to prove your claim for you.

    2. re: “The downside consequence of an error is too great …”

      This is known as the Precautionary Principle Fallacy in which the unknown downsides are overweighted while the unknown (and sometimes, the known) upsides are underweighted or even ignored. Further, because the Precautionary Principle is based on unknowable negatives, there is no threshhold of positive knowledge at which it can be overcome. No matter how much we learn, there will always be additional unknowns with their own unknowable consequences. The Precautionary Principle, while a basic human bias, provides no useful guidance for proper risk management or decision-making.

      You are welcome to “have a conversation” but this is not “species altering”. These changes, even if they are adopted, will affect only those who choose to adopt them. The rest of the species will continue along as they always have. Hyperbole is inappropriate.

      1. Rossami…May I suggest you research CRISPR, and fully understand what it does? I don’t wish to be insulting or demeaning, but your comment leads me to think you may not understand the technology.

        Your statement, “You are welcome to “have a conversation” but this is not “species altering”. These changes, even if they are adopted, will affect only those who choose to adopt them. The rest of the species will continue along as they always have.” is just completely wrong. The use of viral vectors will eliminate your choice. Viral vectors won’t ask permission to alter you. You will not have a choice.

        You also fail to consider the ‘Ooops factor’. We literally just saw this happen in China, with genetically modified embryos bred to resist HIV. Guess what….Oooops, did not work too well. If it happens there, I can assure you it is happening elsewhere.

        This is no hyperbole. CRISPR (and follow on technology) are going to change what it is to be human. If anything, I understate the impact. The time is now to have the conversation.

        1. Good morning, Atlas. I am quite familiar with CRISPR. I also have some familiarity with all that it takes to make the process happen. Despite the fear-mongering, these are not viral vectors that can survive in the wild.

          That’s not to say there are no risks. But I continue to maintain that your evaluation of the risks (at least, as you expressed them above) demonstrates the Precautionary Principle Fallacy. That is, you are overweighting the risks of the new while underweighting the costs of the status quo.

          1. What are the costs of the status quo?
            Just curious.

            Anyway, the greatest risk is also the plan: global socialism and the techno eugenic cleaving of Man into two distinct species. The proles and the elite.

            1. re: “What are the costs of the status quo?”

              See the article above. The Precautionary Principle inevitably blocks innovation. (How much depends on how thoroughly the Precautionary Principle is incorporated into policy. The strong application stops all innovation.) In doing so, you lock in the pain, isolation and infirmity of all those with disabilities which could be mitigated or cured. You lock in the burdens not merely to those afflicted individuals but also all the people who have to care for them, people who would (mostly) happily turn to more productive work if their loved ones were cured.

              One economist recently estimated that the economic cost of having a disabled person in the household is between 35% and 55% of average income. The author argued that this calculation worked both for adults with disabilities and for adult care-givers of children with disabilities.

              A different calculation from a 2011 study by the WEF (Bloom, et al) puts the burden at approximately $50 trillion per year globally. That 2011 study was based on 2010 data so that works out to about 75% of total GDP.

              Alternatively, you could look at direct disability payments such as through SSDI, other government programs and private insurance. (Though I would argue those measures significantly undercount the total costs.)

              Now, obviously not all diseases and disabilities can or will be cured so you have to apply some multiplier to the numbers above to estimate the incremental opportunities that will be lost by shutting down innovation. But even if you assume a modest percentage of improvement, the numbers are big and on-going. All of that is sacrificed when the Precautionary Principle is enforced.

  2. Just remember, Obamacare specifically targets medical devices for special taxes.

    Yup, Obama and the Democrats in the Party of slavery wanted the devices you mentioned to be specially taxed to keep that unconstitutional law going.

  3. Of course, the choice still remains.
    Those convenient, easy to use, easy to read (big dosage numbers) insulin pens are a patented injection device, and on Medicare are $300 a month in the donut hole. The inconvenient vial and syringe, with tiny dosage marks, is $5 a month. I have no idea what the interactive monitors with pumps cost, and no idea what they are under Medicare.
    The point is that, for now, the choice is mine. I am not so sure I will have the choice under the socialists.

    1. You will have ‘choices’ , you just won’t like them.

    2. Under socialism, your choices will be free, effective, and unavailable.

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  5. And technology could advance further and faster if government were less intrusive.

    Case in point – New Mobility (it’s an industry trade magazine) had an article years ago about FDA testing requirements for wheelchairs. According to them, it runs about $500K to get a cushion approved for wheelchair use. Bear in mind that wheelchair cushions are not just a block of foam, but this testing drives up cost (a lot) and keeps new products off market.

    1. There’s a fascinating no-brainer example with the FAA, I think it is. Maybe the NTSB. All light airplanes have to have Emergency Location Transponders, which (a) always start in a terrible crash, (b) never go off otherwise, (c) have long battery life, (d), report faint signals to satellites from impossible locations (steep canyons, heavy forest).

      ELTs suck. They go off for no reason while sitting in powered-off airplanes,they don’t go off in crashes. They are so prone to false positives that standard procedure is to wait 48 hours before acting on them.

      So someone invented a much simpler smart alternative called “trail of crumbs” reporters. Basically, a small device which you start when your fire up your plane, and it radios in your location every 5 minutes. It only sends an alarm if the 5 minute reports stop unexpectedly and you don’t answer to say you are ok.

      Doesn’t have to be tough to withstand crashes, in fact you don’t want it to. Doesn’t need batteries of any sort. No false alarms. Reports your entire track since take-off.

      FAA will not authorize them in place of ELTs. I’m not sure they are authorized to even be present in planes at all, but people use them anyway; unfortunately, they still have to have the useless ELTs.

      1. Interesting story. A couple follow-up questions:

        1. Do you have a link to a specific example of the alternative technology or to a paper that discusses it in more detail?

        2. Assuming everything you imply is true, does the FAA have the authority to approve them in place of ELTs? Or does the wording of Congress’ statutes effectively mandate that particular technology? In other words, are you lobbying the right arm of the government for the change you want?

        1. 1. Nope. Wouldn’t even know what to google for. ELT alternative? Don’t care.

          2. You assume the government has good intentions, and the FAA wants to do the right thing. It was pretty obvious from all the obstacles that the FAA didn’t give a shit about actually doing decent. Regardless of where the excuse lies, it is what government does best — stall, obfuscate, get in the way, and collect as much tax as possible to do do.

  6. actually we are preventing darwinism from doing its job to improve the natural human stock by saving those who should have passed for the betterment of society. thats all sarcasim with a hint of truth but i can’t complain since i am alive because of medical progress.

    1. Sarcasm for you, but plenty of people on the left agree.

      1. Even from a libertarian point of view, you have to point out that there are issues around reproduction. Unfortunately, a Type 1 diabetic is substantially more likely to have Type 1 diabetic offspring. If Riggs and his wife have children, that’s a substantial additional risk. Let’s say it’s a 5% chance of $1000000 lifetime medical costs, or an expected loss of $50000.

        Who is going to assume that risk? Socialized medicine just distributes it across the population, but that’s not a sustainable model for healthcare. What’s the solution?

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