Dementia? I've got a pill for that!
What if we found a treatment that would prevent diseases of the brain like Alzheimer’s Disease? Should we make it widely available? That’s an easy ‘Yes,’ right?
A decade ago, scientists at the University of California, San Francisco set up a lab to explore the possibility that a hormone called Klotho could be an effective treatment for dementia and other brain disorders. In one study, they determined that Klotho protects mice with Alzheimer’s symptoms from cognitive decline. So, they decided to breed mice with extra Klotho to see if they could prevent the disease entirely. To their surprise they found the Klotho-enhanced mice lived 30% longer. During their extended lives they also did better than their non-enhanced brethren on learning mazes and other cognitive tests. Yet to be explored: the potential benefits of extra Klotho in human beings.
In ways we take for granted, we have always taken advantage of opportunities to enhance our performance. In my just-release novel, The Awakening of Artemis (which takes place in 2049), the mastermind of a nefarious plot reminds the hero:
“We’re all enhanced, Diana. And, we have been for centuries. We drink coffee to stay alert, wear glasses and contact lenses to focus our failing eyesight. In the 20th Century, we developed knee replacements and pacemakers. In this century, we’ve added embedded chips to improve the reflexes of people who want to remain productive in their later years – the Secretary of Defense for example.”
So, if a treatment developed from Klotho to treat dementia also enhanced our performance and lengthened our lives, is it ethical to make it available to everyone? Should Medicare, Part D include it in the formulary?
Before you say “yes” consider this: although we’ve always considered disease treatments to be positive, we take a dim view of enhancements. Athletes who take steroids to hit more homeruns or win the Tour de France have not earned our respect; they have earned our scorn. If Klotho becomes a standard treatment for dementia – like a pill we might take to lower our cholesterol – it will be both a disease treatment and a performance enhancer rolled into one.
So, if the drug were denied to those not suffering from dementia, those who receive it may be able to outperform and outlive people who don’t.
In Aldous Huxley’s master work Brave New World, people were bred for a purpose, categorized by social class which extended to privilege and opportunity. Those not in the upper tier were denied treatments that might enhance their performance.
If a Klotho-based treatment one day prevents dementia, there may be no way to enjoy those benefits without also accepting its use as a brain enhancement.
Perhaps that will be our brave new world.