Review by Choice Review
Journalist Piore presents an engaging account of recent research in various fields of bioengineering. The book explores a diverse range of innovations--designing advanced prosthetic limbs, regenerating tissues and organs, manipulating genes, enhancing intuition and learning, improving memory, and replacing or modifying sight and other senses. These are highly technical areas often combining computational sciences with genetics, neurophysiology, and other fast-paced biological specialties, but Piore does a fine job of making the research accessible to general readers. He acknowledges that reengineering the human body may lead to enhancement and therapy. Although briefly discussing some of the serious ethical issues that critics have raised about enhancement, these potential problems are not the major focus of the book. Rather, Piore is primarily interested in presenting the personal stories of patients suffering from debilitating illnesses and the researchers who have pioneered exotic approaches to treat them. This is a good literary strategy for putting a human face on often complex research at the forefront of biomedical science. The result is a lively summary of bioengineering that will likely appeal to a broad audience of general readers. Summing Up: Recommended. Lower- and upper-division undergraduates; general readers. --Joel B. Hagen, Radford University
Copyright American Library Association, used with permission.
Review by New York Times Review
CONVENTIONAL WISDOM HAS it that science is always outrunning our ethics, that new technologies overwhelm our ability to reason ethically and regulate breakthroughs. Should we permit - or require - whole genome sequencing of every infant? Should we promote radical life extension? In 1975, Paul Berg, a Stanford biochemistry professor, convened what came to be known as the Asilomar Conference to establish safeguards and prohibitions on the conduct of what then was cutting-edge biomedical research - recombinant DNA technology. Many people were worried that it could create bacteria with foreign DNA that might escape the laboratory, causing cancer in people or disrupting the Earth's ecosystem. Today, Asilomar stands for one of the seminal moments in history when scientists and physicians showed what one scientist called "social responsibility in the face of strong intellectual temptation" to continue experiments. In the view of many, the conference succeeded only because Berg and other organizers focused on safety. In subsequent years, it has become clear that safety is the only shared value that might pause the pursuit of biomedical research. Yet, as the three books under review illustrate, today's big ethical issues in biomedicine are not about safety but often more profound questions of parental control over their children's future; personal identity; and the importance of mortality to being human. And yet these books - and much of American culture - have a hard time engaging with these fundamental questions. In "The Gene Machine," the journalist Bonnie Rochman explores a range of genetic tests from carrier screening to whole genome sequencing. "I am an information junkie," she writes, and because of this predilection, she has a hard time explaining what might be called Huntington's paradox: Before the gene for Huntington's disease was found, about three-quarters of at-risk people wanted to know their genetic status. But after a test became available, only 25 percent wanted to know. In the abstract, more information always seems desirable. In reality, not so much. Why? Maybe because being able to imagine hopeful paths seems to be hardwired. For most people, genetic tests that predict the future, especially when there is no intervention, provide oppressive, not liberating, information. Rochman explains all manner of genetic tests, but don't expect much enlightenment on the ethics. Many arguments are delineated by juxtaposing quotations from experts without any critical assessment of their merits. Are children really entitled to an "open future," and what does it actually entail from parents in terms of genetics? Instead of a deep analysis, Rochman flippantly writes: "In actuality, no one's future is truly wide open; everyone is made up of genes, and genes contain the imprint of generations past." True, but surely there is much more to say about degrees of openness and how genetics might or might not fit into those different conceptions. The "openness" of futures for children born into closed Hasidic, Amish or strict Muslim communities is different from children born into typical Upper West Side households. And that qualitative difference makes a big ethical difference. Rochman never goes there. WHILE ROCHMAN ACKNOWLEDGES the ethical issues at the heart of genetic screening, Adam Piore dismisses all such concerns. In "The Body Builders," he explores the creation of artificial limbs, memoryenhancing drugs and deep brain stimulation to help people who have medical problems. The stories are engaging, and some are even engrossing, but Piore seems a bit too admiring of his scientists and indifferent to any concerns. He is so enamored with the power of deep brain stimulation that when the F.D.A. required a randomized, placebo-controlled study of its use in depression - which revealed no benefit - he simply dismisses the problem by quoting a researcher as saying: "We ended up having a fairly high placebo effect. . . . But it definitely worked in some people." And then Piore confidently predicts advanced technology will solve the problem. By his own admission, Piore is mesmerized by new technologies and unfazed by any larger concerns such as the ethics of enhancement and whether these technologies might be available only to the welloff. On the last page of the book, he simply says without any argument: "I am skeptical that technology will ever fundamentally transform us. . . . The most important story is the one about enhancing not our abilities, but our humanity." This is not the end of an argument. It is just an assertion that seems to border on willful avoidance of any deep thinking about the influences of technology on people and society. "To Be a Machine" is Mark O'Connell's gonzo-journalistic exploration of the Silicon Valley techno-utopians' pursuit of escaping the body and ultimately mortality. Titans of technology - Peter Thiel, Larry Page, Sergey Brin and others - are obsessed by the desire for immortality, and their fixation leads them to pursue a host of science projects: uploading the brain's contents into computers, cryopreservation, radical life extension. We meet a multitude of colorful characters: Aubrey de Grey, with his twofoot beard, who runs the nonprofit SENS Research Foundation (SENS stands for Strategies for Engineered Negligible Senescence) dedicated to finding a way for people to live to 1,000 and then avoid death altogether; Max More, the proprietor of Alcor, a cryopreservation facility in Phoenix that for $80,000 will detach and store your head in "medical-grade antifreeze" - after you die, of course - "with a view to the later uploading of your brain, or your mind, into some kind of artificial body." The book is a wonderful, breezy romp filled with the beginnings of philosophical reflections on the meaning of the techno-utopians' search for immortality, or as O'Connell puts it, "solving death." He notes that underlying their view is a techno-mechanistic view of humans as simply "meat machines" that process information - information that can be extracted and exported to a computer or silicon-based robot. But while O'Connell suggestively quotes Rilke, St. Augustine, Gnostic texts and Hannah Arendt in critiquing technoutopians, he never goes very deep into understanding the pathology driving them. He feels no attraction to their philosophy and notes that his child playing horsy with his wife could not be "rendered in code.... Their beauty was bodily, in the most profound sense, in the saddest and most wonderful sense." But he fails to translate that feeling into anything approaching a coherent social or ethical critique. This limitation may be most manifest in O'Connell's failure to mention one of the most disturbing aspects of this immortality mania: its utter selfishness. If Thiel and others actually succeeded in achieving superlong lives, then reproduction would end. And with it, the possibility of creating new people with novel characteristics and perspectives. Life would become one long, boring rerun. It would not, as one of O'Connell's characters thoughtlessly says, be because childbirth would become "a thing of the past, . . . with babies being produced by ectogenesis and whatnot." It would be because with all those old Peter Thiels living on and on forever, the Earth would lack the carrying capacity for more people; there would be total resource limits precluding adding one more infant, much less the 130 million currently added each year , Maybe this is why the titans of technology want so badly to escape to Mars. ? EZEKIEL J. EMANUEL is chairman of the department of medical ethics and health policy at the University of Pennsylvania and author of the forthcoming "Prescription for the Future."
Copyright (c) The New York Times Company [March 19, 2017]
Review by Booklist Review
Sensing that biomedical research is on the cusp of a revolution, journalist Piore reports on what researchers are pursuing in the realms of prosthetics, tissue regeneration, and neuroscience. Hugh Herr had a strong motivation for a career in biomechanics: he lost both feet in a hiking accident. Setting a template for each scientist he introduces, Piore accompanies Herr through his MIT labs and recounts in lay terms Herr's explanations of his projects to develop artificial limbs. Other researchers with similar restorative goals are discovering the processes of tissue growth at the genetic and cellular levels and believe that growing an entire organ or hand will be possible. Piore also reports on efforts to restore sight and hearing, including a blind woman who can see with the hearing area of her brain. Piore visits research sites as varied as the Pentagon and a San Diego start-up called Dart NeuroScience, and he touches on the ethical aspects of augmenting human physical and mental abilities. Piore's informative and optimistic account will fascinate popular-science fans and all readers following developments in therapeutics.--Taylor, Gilbert Copyright 2017 Booklist
From Booklist, Copyright (c) American Library Association. Used with permission.
Review by Publisher's Weekly Review
In this accessible work on bioengineering, former Newsweek editor Piore documents where humans stand in our attempt to borrow-and build on-nature's "sublime" healing solutions, which have been "refined by evolution over billions of years." Piore's aim is not to offer a clinical tome on scientific progress, but to reveal the "human spirit" that undergirds the search for ways to heal an array of debilitating physical and mental injuries and impairments. He checks in with researchers exploring a number of new technologies, including electrical deep brain stimulation, bionics derived from reverse-engineering the human body, and altering genetic details through "gene doping." Piore also speaks to scientists tinkering with the human brain, "the world's most sophisticated pattern recognition machine," which plays a role in "amazing feats of associative learning" such as intuition and the ability of blind people to "see" when exposed to "soundscapes." Piore makes a few overstatements, as when he writes that the human body "has been honed over millennia for maximum efficiency," but his central conceit-that scientists may soon be successfully "hacking" the human body-is on point. Piore writes gracefully, and with deep insight, about complex scientific endeavors that could ease human suffering but are fraught with myriad ethical perils. (Mar.) © Copyright PWxyz, LLC. All rights reserved.
(c) Copyright PWxyz, LLC. All rights reserved
Review by Library Journal Review
Journalist Piore (contributing editor, Popular Science, Discover) expands previous articles about human limb -regeneration and "telepathic" soldiers (among other topics) and examines additional uses of technology to improve movement, sensation, and thought. The author dispatches commendably accessible (and much-needed) background information on physiology, human development, and neuroscience. But his primary emphasis are the innovative researchers, clinicians, and adventurous patients who venture together into the search for cures for disease and disability. Some comments may come across as ageist or ableist. -Compared to Malcolm Gay's more focused The Brain Electric: The Dramatic High-Tech Race To Merge Minds and Machines, this title is considerably weaker in coverage of political, social, and economic issues. Ethical questions are better addressed by Michael Bess's Our Grandchildren Redesigned: Life in the Bioengineered Society of the Near Future. Surgical patients and their caretakers may feel Piore downplays the significant risks associated with various medical procedures (particularly invasive brain operations). Nevertheless, this is an upbeat and appealing overview of cutting-edge biomedical research. VERDICT For popular science and consumer health readers. [See Prepub Alert, 8/26/16.]-Nancy R. Curtis, Univ. of Maine Lib., Orono © Copyright 2017. Library Journals LLC, a wholly owned subsidiary of Media Source, Inc. No redistribution permitted.
(c) Copyright Library Journals LLC, a wholly owned subsidiary of Media Source, Inc. No redistribution permitted.
