Amid fears that the innocent are being discriminated against, the public are being consulted as to whether or not the UK DNA database, the world’s largest DNA database, is expanding too much. The Nuffield Council on Bioethics who are organising the consultation will also consider views on the socio-economic and ethnic make-up of the database.

In a message to the medical profession, Lord Falconer warned doctors and nurses that new laws will cause them to face going on trial for assault should they refuse to allow patients who have made ‘living wills’ to die. This would effectively require them to end lives rather than save them.

An Italian researcher has put forward the view that IVF clinics could unwittingly be creating transgenic humans. Speaking to the British Andrology Society, Dr Corrado Spadafora spoke of the link between sperm, cancer, an unusual enzyme and the risk of making transgenic people.

Writing in the London Daily Mail, Lord Robert Winston, the UK’s most prominent IVF researcher, has vigorously supported social sex selection. He believes parents have a right to choose their baby’s sex.

Sanjiv Bhattacharya writes about the highs and lows of one single dad as he traverses the challenging road known as surrogacy.

Even allowing for the hype with which the more enthusiastic advocates, and more astringent critics, of nanotechnology have pressed their respective cases, there does not seem to be any "perhaps" about it: The technological revolution that will result from the driving down of discovery, invention, and engineering to the nanoscale is set not only to reframe every sector of industry, and to raise profound questions for our notions of privacy and defence, but potentially (and disturbingly) to threaten the human project itself. As so often, there is a thin line separating promise and threat.

Is Nanotechnology a Technology?

1. The essential question that needs to be noted is of course that "nanotechnology" is not a "technology" like others. The reference of the term is to scale, and it is already used to embrace everything from particulate matter to dramatic innovations such as carbon nanotubes and nanoshells -- to the prospect of "molecular nanotechnology," the code-word for Eric Drexler's futuristic vision of molecular "assemblers" (celebrated in different ways in Neil Stephenson's fine 1995 novel The Diamond Age and Michael Crichton's more recent thriller Prey, and resembling nothing less than the achievement of a new alchemy). While molecular nanotechnology has not so far been considered for funding by the US National Nanotechnology Initiative, a change in policy is one of the more interesting (and bizarre?) recommendations of the National Research Council's Congressionally-mandated triennial review (just published).

The focus on scale is one reason why discussions of nanotechnology have been bedevilled by the lack of a generally-accepted definition of the term (must the scale apply to one dimension, or more? What is the relevancy of nanoscale particulate matter? One phrase widely used by the National Science Foundation in grant offerings focuses on "active nanostructures and nanosystems"). It is to be hoped that the several standards agencies will soon resolve this among other definitional questions.

In fact, the term "nanotechnology" has begun to function less as the name of a particular technology than as that of a brand. While it may simply die out at some future point (when so much is done on the nanoscale that the term becomes redundant), the several elements of risk already present in particular applications of the technology have this added: that they are linked together by powerful branding. The recent German "Magic Nano" scare (a bathroom cleaner sent people to hospital, though it would seem it was no more nano than it was magic) offered a welcome reminder of the problems that this brand development may cause (especially in the post-GMO market-place well-known to Europeans, though surprisingly little-known even to well-informed US observers).

Public Science under Scrutiny

2. At the same time, we may note changing patterns and needs at the interface of public funding, research, and industry that are focused by developments in nanotechnology. They are not of course specific to nano, though the high levels of directed nano spending that have in some measure resulted from the hyped claims of enthusiasts have themselves drawn the attention of policymakers to issues of product development and, relatedly, claims of specific beneficial applications (such as the US National Cancer Institute's claim, extraordinary by any account, that by 2015 cancer will be at worst a chronic condition). Policymakers are aware that the last great public science project - the mapping of the human genome - has not led to the kind of clinical applications that had been forecast. It is inevitable that as budgets come under increasing pressure - especially for demographic and healthcare reasons - research expenditures will tend to be tied more closely to outcomes.

Those in the academy will find this unpalatable, but it may be that the massive post-War expansion of public science (associated in the US especially with the work of Vannevar Bush), while in no danger of ending, may be expected to shift more of its resources to focused outcomes. The comparatively recent ability of university researchers to profit from their IP, while it has proved to have merit, may finally prove to have helped destabilize the public science model. In democracies in which increasing expenditures and hopes are being directed at publicly-funded science, the post-War model of government as VC of last resort (dramatically illustrated by current nanotechnology initiatives, especially in the US, European and Japan) may take on new forms, one of which may prove to be a creeping dirigisme.

A parallel concern is presented by the problem of hyped claims and expectations: as Nobelist Sir Paul Nurse noted of the NCI 2015 claim in a recent issue of the New Yorker, when this promise fails (as, he suggested, it surely will) public confidence in public science will be undermined. This, like other highly specific future claims being made (in the US, by some leaders of the National Science Foundation) could threaten the entire public-science model (there is even a book - a long book - with the title Nano-Hype). If it is the case, as some of us believe, that issues of science and technology policy will become increasingly prominent in the politics of the next generation, much will depend on our capacity to reshape the post-War model in ways that are not deleterious to the interests of long-term research.

A Nano-Divide?

3. One of the greatest uncertainties about the impact of nano may be simply put: Will the nano revolution enhance globalisation and flatten the planet further, or will the so-called "nano-divide" result in a further accretion of competitive advantage to existing industrial powers and a heightening of present global inequities of income and opportunity? I was recently taking part in an international workshop on the societal implications of the technology; someone made the point - often made on these occasions - that we may soon have nanoscale technology solutions for the problem of clean water, with the prospect of an end to one of the grimmest of all global inequities. The more naïve nano-implication discussions tend to take this form. My response was that (a) the provision of clean water is a policy issue for the developed nations: with political will it could be resolved in large measure now; and (b) what if the researcher who comes up with the magic bullet decides to exercise his or her IP rights and squats on the patent for 20 years? Technology contributes to solutions; it does not generally provide them. Whether this technology levels the globe or leads to further orogenesis is entirely unclear; as things stand, immigrant researchers notwithstanding, it is likely to develop in the existing social and economic context and strengthen rather than subvert the status quo. Which is not to suggest that we should work for subversion, but to draw attention to the need to develop approaches that transcend, and not rely on "technology" to solve our problems of political will and social responsibility.

Grey Goo, Transhumanists, and other Threats

4. No nano discussion is complete without reference to the so-called "grey goo" scenario (in which molecular-scale machines run out of control and end up turning the planet into, well, goo). This scenario was popularised by Sun Microsystems co-founder Bill Joy in his (in)famous and remarkable essay in the April, 2000 issue of Wired, "Why the Future doesn't need us." Alongside the "grey goo" scenario he posited another, which many of us found more convincing and certainly more troubling: that artificial intelligence will either create superior beings who will become our masters, or that we will "enhance" our intelligence using a machine model in which our essential humanity is left behind. The emergence of "transhumanists" (sci-fi enthusiasts, some with serious intellectual credentials) who believe our prime task is to transform ourselves into a post-human form of existence, has had the effect of adding further risk to the nano "brand" (since they claim it as their own).

Catherine Verfaillie and colleagues at the University of Minnesota, US, described the "multipotent" adult progenitor cells (MAPCs) in 2002. Isolated from mammalian bone marrow, they belonged to a class called mesenchymal stem cells, which normally form muscle and bone. However, MAPCs seemed much more versatile, able to form any of the body’s tissues (see Is this the one?).

Other teams have since struggled to repeat the results (see Stem cells' miracle postponed). But now Verfaillie has teamed up with Irving Weissman of Stanford University in California, US, to transplant MAPCs into mice that had been irradiated, wiping out their haematopoetic stem cells (HSCs) – another class of marrow cells that give rise to blood. “From the beginning I was very, very sceptical that MAPCs could contribute to blood formation,” says Weissman.

Melinda Tankard Reist

Spinifex (2006)
ISBN 1-876756-59-4
RRP: £12.95

An Australian writer and researcher with a special interest in bioethics and women’s health, Melinda Tankard Reist is clearly an advocate rather than merely a writer of such issues. In this her second book, published by the leading feminist publishing house Spinifex, the author writes of the increasing desire for physical perfection and the consequent pressure such desire is placing on women to terminate ‘imperfect’ foetuses diagnosed by prenatal technology.

The book roughly divides into three main sections. Firstly, the author offers a comprehensive and substantial 70-page introduction discussing the main premise of the book, namely that the widespread practice of prenatal screening and abortion are a continuation of eugenics and that despite claims that such screening is supposed to give women more power it often takes the power of choice away from them. Twenty narratives then follow of women who have continued their pregnancies despite immense pressure from medical staff, family members and social expectations. These accounts make for stimulating, shocking and sympathetic reading and yet they do not all follow a repetitious story line. Some of the stories documented concern women who, despite being told to abort their babies because of the possibility of abnormalities, resisted the pressure to ‘conform’ and gave birth to perfectly healthy babies. Conversely, other accounts are told of women who have given birth to babies with various sorts of complications, despite being warned of the risks. There is something refreshing in having these stories, as they not only communicate how character can be shaped and developed from bringing such a child into the world but also of the enrichment they bring to the lives of others. As Teresa Streckfuss writes, “It’s about love. It’s about our babies”. A sentiment also conveyed in the story of Julia Anderson, concerning her son Andrew, “Andrew’s life saw us often wondering what we had done to deserve so much difficulty. His passing sees us wondering what we did to deserve so rich a blessing as his short six-month life was ultimately meant to be”. Furthermore, stories are also shared of those women who have disabilities themselves and who in the face of much opposition and disapproval have given birth to their babies anyway. In conclusion, the author expresses her hope that the book will inspire and stir other women in similar circumstances to take courage in the midst of immense pressure to conform and resist giving birth to babies that fit in the rigidly constructed categories of what is acceptable in today’s society.

Despite the fact that the length of the introduction may put off some readers, it nevertheless helps to establish the context for the stories that follow. Paucity of sources is no issue here as the author writes in a lucid manner, drawing in relevant research and information concisely and intelligently. Despite initial thoughts that one might have of the passing of Nazis history heralding a new epoch of value and respect for all humanity, Tankard Reist convincingly writes of the incessant undercurrents that have continued to ‘bubble away’ over time that are now once again fuelling the quest for a perfect society, or at the very least a society populated by perfect people. Emerging medical technologies are helping to propel society all the more to what is commonly termed as the ‘brave new world’. Pregnancy as it was known only a decade ago has been completely transformed as a result of many scientific advances such as prenatal screening and the growing understanding the medical profession possesses concerning genetic bases. Whilst the author rightly acknowledges the usefulness of such tests, it is how these test results are being used to coerce women into making decisions that the medical profession deem to be correct that is questioned by the author. Should a possible medical problem or defect be detected by the tests, there is only one of two options that the women can take; either proceed with the pregnancy or abort. If there is even the slightest chance the baby will be “less than perfect”, it is advised that life is simply disposed of in favour of trying again and getting it right next time.

Into this context, the author asserts three main tenets of belief. Firstly, that through the branding of prenatal screening as a simple ‘routine procedure’, a women’s autonomy is undermined and they are deemed irresponsible when the medical profession and society at large determine they have not exercised the ‘right’ choice. Secondly, due to the ‘benevolent tyranny of expertise’ women are obligated to put all their faith in the absolute expertise of medical staff and test results. This is a worrying state of affairs to be faced with, states Tankard Reist, as some of these predictions of possible abnormalities are not certain and do in fact turn out to be incorrect. Conversely, those who do succumb to following the advice never know whether or not the doctor’s advice was right or wrong. Thirdly, through such manipulation, what masquerades as “purely health, reassurance and beneficial reasons” in favour of screening, is in fact an eugenic philosophy, weeding out the imperfect in pursuit of the perfect. Two forces seem to drive such a philosophy, namely a reductionistic view of humanity coupled with economic factors. A reductionistic view determines the value of a human being to what they can do as opposed to who they are, whilst economic decisions are made based upon costs and benefits. Simply put, it is cheaper to kill a baby with an abnormality than invest money into the necessary care and provision such a baby requires in order to live.

Whilst the title of this book may not attract a large male readership, this young male reviewer would certainly call for it to be read widely by both male and female audiences alike as the issues it contains pertain to all of society. It is simply not a matter for women to deal with exclusively. Whilst the book does not champion the cause of the medical profession, this very fact may cause the book to be the provocation that is required in order to see further balanced and informed debate and discussion take place concerning these issues.