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. | 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. |
Research and diagnosis will become more efficient. | 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). |
Small medical devices can be implanted permanently. | 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. |
More medical problems will be prevented. | 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. |
New diseases will be stopped quickly. | 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. |
Diagnosis and treatment may be semi-automated. | 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. |
Health will improve and lifespans increase. | 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. |
MM will facilitate genetic therapy. | 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. |
Some organs will be replaceable. | 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. |
Systems can be individually improved. | 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. |
