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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 people.
Surgical and diagnostic tools will be elegant and cheap.
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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 molecular 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.
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Research and diagnosis will become more efficient.
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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).
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Small medical devices can be implanted permanently.
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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.
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More medical problems will be prevented.
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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.
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New diseases will be stopped quickly.
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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.
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Diagnosis and treatment may be semi-automated.
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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.
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Health will improve and lifespans increase.
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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.
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MM will facilitate genetic therapy.
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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.
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Some organs will be replaceable.
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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.
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Systems can be individually improved.
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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 maintenance.
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Further reading...
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DEVIL'S ADVOCATE —
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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