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From Cyborg Fiction to Medical Reality
I'm coming to the conclusion about the human subconscious...that, no matter how you look at it, machines really are our subconscious. I mean, people from outer space didn't come down to earth and make machines for us...we made them ourselves. So machines can only be products of our being, and as such, windows into our souls....
--Douglas Coupland, Microserfs 1
Although Douglas Coupland, in the quotation above, is talking about highly complex machines such as computers, his words echo true even for the far simpler tools and machines that human beings have used since early times. These devices are more than imaginative solutions to problems; they reflect their creators' desires for a better life. The stone axe was a more efficient way to cut down trees and kill animals than hands and teeth. Obsidian blades made the butchering of animals easier than ripping flesh by hand. While aiding early humans to adapt to and use their environment, these tools simultaneously reflected who human beings were: They used sharp blades to hunt food, to whittle wood into art, and to maim or kill other people. The ways in which humans use their tools show the spectrum of human behavior, from creating art to waging war.
Over the centuries, human beings have constructed tools to replace or augment natural physiologic functions: ear horns aided the hard of hearing, eyeglasses enhanced failing eyesight, and dentures enabled a person to eat solid foods. These external devices restored abilities lost to injury or disease. In the past few decades, technological developments have transformed such simple external tools into complex machines that are smaller, more efficient, and implantable. These devices become part of the body, extending aptitudes without encumbering the person with extraneous parts: Cochlear implants permit a limited form of hearing, artificial lenses and implanted telescopes [End Page 39] restore sight, and dental implants permanently replace lost teeth. Technology has now gone beyond the dreams of earlier ages (see Figure 1): there are cardiac pacemakers, implantable defibrillators and insulin pumps, as well as artificial hearts, bones, blood vessels, and skin.
These complex, integrated devices require an intermediary to make the minute and tedious connections between the human body and the machine parts. Since medical practitioners are already experts in anatomy and physiology, they are the obvious choice to serve in this capacity. Thus, physicians function as gatekeepers in determining which human-machine connections to permit and to develop. Should a certain machine be implanted? Should a particular technology be developed? Facilitators of the human-machine interaction face new choices, new responsibilities, and new patients. Some of these technologies are so recent that there are no real-world guides as to how to use them responsibly or as to what social implications they may hold. One place to look for such guidance is science fiction.
Science-fiction authors have written for decades about the intersection between human and machine. The writers of these tales draw their visions from the traditions, values, and trends that exist at the time they pen the story. Even though these authors write about the future, they actually comment upon the present. Such stories suggest possible good and bad outcomes of worlds in which cyborgs thrive. In the case of cyborg fiction, these stories motivate the reader to consider the social and ethical implications of new technologies. These narratives also provide mirrors in which the practitioner can view the praxis of medicine.
What Is the Cyborg?
Manfred E. Clynes and Nathan S. Kline originally coined the term cyborg--an abbreviation of cybernetic organism--in a 1960 article on the future of humans in space. Cybernetics examines human physiology and neurology, looking at mechanical and electrical replacements for these systems. An organism is a living being composed of various structured systems and parts that operate interdependently. Thus, a cyborg is composed of human, mechanical, and electrical systems organized to function as a living person. 2
Clynes and Kline used cyborg to mean an artificially...