Oscar Pistorius Now … Elective Amputation in 10 Years?

Oscar Pistorious’ – nicknamed “Blade Runner” and “The Fastest Man On No Legs” – was the first ever amputee to compete in the World Olympics.

Ever since the announcement that Pistorius would race for South Africa in the 2012 Olympics there has been much public debate over whether or not the “cheetah legs” he is running on give him an unfair advantage. A thorough investigation in 2008 purported to demonstrate that Pistorius’ cheetah legs, while they do give him some leverage over non-amputees, such as lower energy expenditure when running at top speed, when all factors are considered (such as greater inefficiency in starting) he cannot be said to have an advantage overall. Many, however, still take issue with the ruling, for various reasons, and find his inclusion in the competition controversial. The question “Is Oscar Pistorius ‘enhanced’?” persists: a point of dispute that will surely gain wider public discourse if he, or his relay team, is awarded a medal.

That an amputee could be considered “enhanced”, even within a narrow domain, is a relatively novel phenomenon, and represents a notable milestone in amputation technology. Thinking broadly and more long-term, some have pointed out that the milestone Pistorius represents is only the first of many yet to come in terms of amputees out-performing non-amputees, whether in circumstances with well defined parameters and restrictions, such as the Olympics, or in everyday human tasks. It’s only a matter of time, some have suggested, before amputation technology can provide amputees with limbs so similar or superior in function to real ones, that it becomes routine for amputees to out-perform non-amputees in a number of complex and diverse tasks, including those that require precise sensory ability in the limb itself, as well as the integration of synthetic sensory data and nervous system. Prosthetics could also one day provide amputees with extrasensory capabilities, such as: optics, chemical sensitivity, echolocation, infrared etc. Could such a reality, many ask, invert public opinion and preference regarding amputation, making amputated limbs a desirable characteristic? And what if, at such point, people without illness or injury desire to amputate their own limbs?

As far out as it may sound, “elective amputation”, choosing to undergo the surgical removal of a limb, or portion thereof, has received a good deal of discussion in recent years, in particular after two disabled patients decided to undergo amputation to improve the function of an injured extremity. The most recent, in May of last year, a young man known as “Milo”, a patient of Dr. Oskar Aszmann (of Vienna School of Medicine), made news around the world for deciding to trade his biological hand for a prosthetic one. Ten years prior, Milo had injured his shoulder in a motor vehicle accident, leaving his hand with very little sensory or motor ability. Recognizing the relative sophistication of current era prosthetic technology, and how the device could improve his life, Milo went without hesitation into the operating room, and professed it a decision made without regret. Milo was the second patient of Dr. Aszmann to electively amputate, the first (and first ever, it is believed) being ‘Patrick’, a young man who lost the fingers of his left hand in an electrical accident, and underwent prosthetic surgery in 2010 to obtain a bionic one.

In futurist circles, many characterize events of this nature as congruent with general techno-social trends underway: the surpassing of man by machine, and the gradual integration of the biological and non-biological. Futurist bloggers and social media figures confidently herald Milo and Patrick’s decisions as harbingers of times to come; where prosthetic technology becomes so exceedingly superior, functionally and aesthetically, that even those without injury or disability would electively amputate their limbs. Those outside futurism have formed similar abstractions. Medical ethicist Dr. Bennette Foddy of Oxford University, for instance, argues “Now as the technology improves, we will eventually get to the point where the prosthetics function better than people’s original hands, and we may see people with perfectly healthy, functional hands, wishing to have a cybernetic replacement.” Many in the field of bioethics, however, responded to news of Milo and Patrick with concern. Due to the permanent nature, and the chance that a more organic means of improvement may later be found, many believe that amputation should only be offered in dire circumstance. Other patients, however, are on their way to elective amputation, and as the technology improves, we can expect such an operation to become more popular.

Since Milo’s surgery, a good deal more progress has been made in prosthetic technology research. For instance, a robotic finger is now able to differentiate textures better than humans, and identify 115 textures with 95% accuracy. Also, researchers at Sandia National Laboratories have broke engineering ground in the development of a body-machine interface for limbs. Using bio-compatible interface scaffolds, the artificial limb could be attached directly to the body, including the nerves, making it possible for the new limb to have the same sensory-motor characteristics as the real one. In addition, 3D printing technology has advanced to the point where it is now commercially feasible to print customized artificial limbs, further increasing functionality, but more notably, opening up a wealth of aesthetic possibilities.

Research and development relevant to advancing the field of prosthetics is expected to continue progressing at a considerable rate, and some believe that within the next few decades we will see prosthetics that are superior in every way to their biological counterparts. Anders Sandberg, perhaps more optimistic than most, predicts that in approximately ten years time we can expect prosthetics significantly better than the real thing.

But when this point is reached, however soon it may be, can we expect a substantial number to undergo elective amputation for the sake of enhancement? Or, will the majority prefer less permanent/invasive means of limb augmentation, such as the use of an exoskeleton?

Preferences and predictions on the matter are divided. Transhumanists, on the one hand, appear to tend towards preferring elective amputation. A poll of Transhumanist Facebook groups “Singularity Network” and “Human 2.0” posing the question indicated a preference for amputation over exoskeleton devices by a factor of 2 to 1. In addition, elective amputation, and the notion of replacing body parts and systems more generally, is arguably more consistent with Transhumanist philosophy in the longer term (in terms of perpetually increasing complexity, for example), since the exoskeleton route entails unnecessary upper bounds. Outside Transhumanism, however, most find the notion undesirable, and/or “too radical”, and many, even professionals in the technology field, believe the majority preference will be for exoskeletons. Noel Sharkey, PhD in psychology, chartered electrical engineer, and computer scientist, is doubtful that elective amputation will ever catch on, believing that thought controlled exoskeletons will be more appealing. He writes: “If I want a really really strong arm, rather than having it attached to my body, it would be much better if it was just alongside me and just moved when I moved and did whatever I wanted. I think you might see that.” I’m inclined to believe that those with chronic injury or illness (affecting any part of the body), whether Transhumanist or not, are more likely to feel positively towards elective amputation, since they appear, in general, to have a better understanding of not only the limits of native biological systems, and their vulnerabilities, but the impedance an (undesigned) body has on subjective well-being and function.

Although the appeal of future amputation technology itself, in terms of aesthetics and functionality, will play a substantial role in generating a desire to electively amputate, amputation is a very serious endeavor, physiologically and psychologically, and thus it is reasonable to assume that forming a preference for it, and actually making the decision to amputate, will depend upon many additional and contextual factors. I propose that elective amputation is unlikely to be broadly adopted without:

-an explicit and holistic disposition towards enhancement

-a recognized branch of psychology adept in the relevant counseling

-a visual culture of rich, realistic imagery

-well regarded advocacy groups

-esteemed early adopters

-a wealth of detailed and varied autobiographical accounts

-a group of reputable physicians known for performing impressive “enhancement” operations

-favorable inclusion in popular literature and media

-and more

Put another way, although the prosthetics themselves may only be one to two decades away, very few can be thought to possess a teleology consistent with elective amputation, and what exists in terms of cultural infrastructure is only a mere skeleton of what one would anticipate necessary in order for amputation to be thought of as ‘low risk’. It is perhaps interesting to note that today’s most famous futurist, Ray Kurzweil, does not include elective amputation (explicitly, at least) in his list of predictions, nor does he discuss it – further exemplifying just how distant the landscape is from one that will foster humans with bionic limbs.

Although the media descended voraciously on Oscar Pistorius, with more than a few articles no doubt questioning a hastening era of elective amputation, it’s good to keep in mind that we are still a decent ways away from bionic limbs superior in all ways to real ones, and even further perhaps from a society supportive of, let alone embracing such an endeavor.