Surgeon responsibility in the era of “outrageous science”

Abstract

Numerous times in the history of mankind there has been a prolific outpouring of scientific discovery, recently and most notably during the Renaissance and the Industrial Revolution. Currently, with the Information Age, another revolution in science is occurring. However, the nature of current discoveries is so far beyond the innovations of the past that the term ‘‘outrageous science’’ aptly applies. The term outrageous means ‘‘exceeding established or reasonable limits; improbable; extraordinary’’ [12]. Why should this be of concern to surgeons? First and most importantly, there are numerous technologies outside the immediate interest or view of surgeons that will either require surgeons to implement or have an impact on the way surgery is performed, possibly even replacing current methods. However, this is a rather egocentric approach to the problem. The changes taking place go directly to the heart of medicine, which is the care and nurturing of our fellow man. Medical technologies are accelerating exponentially, such that the moral and ethical issues provoked will require decades to resolve (Fig. 1). These issues focus on the most fundamental questions, for example: What does it mean to be human? How long should a person live? The following discourse samples some of the incredible discoveries emerging from the laboratory, speculates on their development trajectory, and posits the fundamental moral and ethical issues that pose the major challenges for the coming decades. Other technologies with equally profound effects, such as teleportation, cold fusion for energy, and direct communication from the mind, do not have a scientific basis at this time, and are therefore beyond current speculation, although a sudden scientific breakthrough could instantly project them into the middle of controversy. As an example of such a disruptive change, exactly such an event occurred with human cloning. Seemingly from out of nowhere, the cloning of Dolly the sheep was announced. Shortly thereafter, the French scientist Brigett Boisselier proclaimed the first human clone. There was an immediate public outcry and a political knee-jerk reaction. All nations of the world, except three, agreed not to do research in human cloning. However, three nations currently have state-sponsored human cloning (including embryonic stem cells): China, Korea, and Switzerland. The moral and ethical consequences are profound and currently are being discussed worldwide. What happens if the clone has a severe abnormality? Will it be discarded? Should clones have all the same rights as natural born humans? Will we make clones without brains in order to have ‘‘spare parts’’? Why does China need to create clones? Do they not already have enough children born every day? Human cloning is happening in the present, but what might the future hold? We touch on a number of technologies currently emerging from the laboratories and speculate on the possible inevitable consequence of their full development, as well as the profound moral and ethical issues associated with these technologies.