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3THE SPACE OF DISCOURSE
HOMO SAPIENS: FROM NATURAL TO ARTIFICIAL EVOLUTION?
(REVIEW ARTICLE)
Maria Polozhikhina
PhD (Geogr. Sci.), Leading Researcher, Department of Economics, Institute of Scientific Information for Social Sciences, Russian Acad-
emy of Sciences, Moscow, Russia, e-mail: [email protected]
Abstract. Modern Homo sapiens sapiens is the product of a long several million-year evolution. Despite the achievements of science, there remain many mysteries and "blank spots" in the process of anthropogenesis. At the same time, spontaneous changes in the human body structure at the micro level continue. This means that human biological evolution has not ended. In addition, the emerging innovative technologies and quickly developing regenerative medicine may soon lead to significant modifications in the human body. The accelerated pace of environmental changes and scientific and technological progress demand that humanity should choose the direction of self-improvement, which will determine both its future as a biological species and its technological prospects. The presented analysis of possible changes in the structure and functions of the human body promotes rational approach and responsible attitude to these issues.
Keywords. Homo sapiens; anthropogenesis; innovative technologies; technoman; posthuman.
For citation. Polozhikhina M.A. Homo sapiens. from natural to artificial evolution? (Review article) // Social Novelties and Social Sciences. A View from Moscow. - 2024. - N 1. - P. 9-27.
URL. https://snsen-journal.ru/archive DOI. 10.31249/snsneng/2024.01.01
Introduction
The concept of anthropogenesis, some issues of which were debated by philosophers of Ancient Greece, took shape only at the end of the 19th century - largely due to Charles Darwin and his foundational book "The Descent of Man: Selection in Relation to Sex" (1871), although there were even earlier studies on this topic. The issues of human biological evolution (its origin, development and changes) in retrospect and in perspective remain among the most controversial in the scientific community. There are different, often opposing views on this matter: from total rejection and denial of the continued human evolution as a biological species to futuristic forecasts about mankind, eugenics and transhumanism, the synthetic theory of evolution and other concepts.
Such divergence is quite understandable, since there remain too many "blank spots" unknown and incomprehensible in the process of anthropogenesis. Discoveries of paleoanthropologists, revelations of geneticists and other scientific achievements lead to periodic bursts of public interest to evolution and human modification. This topic has become especially relevant due to the development of artificial intelligence and robotics, the progress in biomedicine and neurophysiology. For example, consider the report "Converging Technologies for Improving Human Functionality: Nanotechnology, Biotechnology, Information Technology, and Cognitive Science", prepared by Mihail C. Roco and William Sims Bainbridge under the auspices of the US National Science Foundation [Roco, Bainbridge, 2003]. "The report is substantively organized not around a discussion of relevant technological problems, but in connection with the consequences of technological progress for society as a whole, education and management in particular" [Alekseeva, Arshinov, Chekletsov, 2013].
All those ideas and trends that previously were associated only with the realm of science fiction are becoming truly achievable. On the one hand, this opens vast prospects for the humanity, on the other hand, it causes natural fear and apprehension, since the cost of mistakes or possible abuses runs extremely high.
At the same time, according to the data available, scientists continue to change the "design" of a person at the micro level. Partial artificial improvements have been practiced for a long time, especially in the field of cosmetology and plastic surgery, prosthetics and transplantology. In some cases, there is a possibility to restore lost organs or functions; in others to transform human body for aesthetic purposes. It is obvious already that research will not stop there, and the associated risks are not insurmountable. Moreover, it may help to get rid of serious hereditary diseases and avoid unwanted mutations and defects in future generations. Or maybe even develop some new abilities?
It seems that, as a result of the accelerating pace of environmental change and scientific and technological progress, humanity now faces an extremely important choice the choice of direction, which will determine both its future as a biological species and its technological prospects. Scientists discuss the likelihood of the emergence of either a post-human, or a techno-human, and perhaps something in between during a consciously guided process of transforming the structure and functions of the human body. Naturally, the transition to such practices (and such innovations are gradually being implemented) is extremely important for society and is associated with great responsibility.
Perhaps the controlled modification of the human body will become commonplace in the near future and will replace spontaneous evolution. However, conscious intervention in the course of natural processes requires great caution and attention to potential consequences.
The topic of human biological evolution has many facets and affects specialists from various scientific fields: anthropologists and physicians, sociologists and lawyers, economists and psychologists, etc. It is associated with many theoretical and practical problems that are still under debate.
The purpose of this article is to present various scenarios and consequences of physical change (evolution, modification) in humans. It seems that a rational approach to these issues will support reasonable and responsible attitude to the inevitable changes.
Stages and mysteries of anthropogenesis
All people now living on Earth belong to one biological species, Homo sapiens sapiens (reasonable man), which is the only surviving representative of the genus Homo. The latter, in turn, belongs to the family of hominids (Hominidae), within which modern paleoanthropologists distinguish up to seven different genera and about twenty extinct species [Vishnyatskiy, 2010, p. 40].
The first hominids appeared, according to various estimates, from 4 to 7 million years ago1. Their main distinguishing feature is bipedality2. "In addition, a number of specific features can be traced in the evolution of hominids. This is, first of all, gradual flattening of the facial part of the skull and increase in its cerebral part (braincase), decreasing size of fangs, changing shape of the dental arch, which loses its angularity and becomes more and more smooth, parabolic, as well as change in the body proportions relative shortening of upper and lengthening of the lower extremities" [Vishnyatskiy, 2010, p. 41].
The course of anthropogenesis was not linear and has the appearance of a "bush" with several deadend branches, i.e. extinct species (Fig. 1).
1 The exact time boundaries of the stages of human evolution have not been established; the dating methods of different scientists differ greatly. Therefore, here and below, time periods corresponding to the most widespread views are given.
2 Bipedality, or bipedia, presumably appeared earlier than the emergence of the genus Homo. There are two dozen hypotheses explaining bipedality: bioenergetic benefits, the influence of environmental factors, the requirements of social behavior, etc. Discussion on this issue among experts continues.
Fig. 1. Diagram of hominin evolution1 from the Smithsonian Institution website
(https://www.si.edu)
Source: [Markov, 2009]
On-going search and new discoveries by paleoanthropologists, as well as the use of increasingly advanced methods of analysis (for example, genetic) make it possible to clarify and supplement the overall picture (Table 1).
Table 1
Main stages of anthropogenesis
№ Species of the genus Homo When lived Where lived Structural features
Human predecessors
1. Australlopithecus (including Sahelanthropa) 4.2-2.5 million years ago (Early Paleolithic) Africa Height 100-150 cm; body mass 2060 kg; brain volume 400-450 cm3
2. Homo habilis, or «handy man» 2.1-1.6 million years ago (Early Paleolithic) Africa Height 130-145 cm; body mass 2545 kg; brain volume 500-650 cm3
Archanthropes (prehistoric people)
3. Homo erectus, (including Pithecanthropus) 1.2 million - 400 thousand years ago (Early Paleolithic) Africa, Eurasia Height 150-180 cm; body mass 60 kg; brain volume 850-1100 cm 3
3а. Homo heidelbergensis, or "Heidelberg Man" 800-345 thousand years ago (Early Paleolithic) Europe, Africa, China Height 155-175 cm; body weight up to 65 kg; brain volume 1100-1400 cm3
Paleoanthropes (ancient people)
4. Homo neanderthalensis (Neanderthals) 350-40 thousand (Middle Paleolithic) Eurasia Height 160-170 cm; body mass55-70 kg; brain volume 1200-1900 cm3
1 Hominins (lat. Homininae) are a subfamily of the hominid family (Hominidae), which includes Homo sapiens, chim-
panzees (Pan), gorillas (Gorilla), as well as a number of extinct species. See. Hominins // Wikipedia. - URL. https;//ru.wikipe
dia. org/wiki/Hominins (date of access. 19.10.2022).
4а. Homo denisovans (Denisovans) 250-30 thousand years ago (Middle Paleolithic) Northern and Eastern Asia Data unavailable
Neoanthropes (modern humans)
5. Homo sapiens, or "reasonable man" (including Cro-Magnons) 200 thousand years ago (Late, or Upper Paleolithic) Africa, Eurasia, Australia and America Height 140-190 cm; body mass 50100 kg; brain volume 1000-1850 cm3
Source: [Khronologiya evolyutsii ... , 2G22; Evolyutsionnaya khronologiya ... , 2G22].
According to the latest data, man of a modern anatomical species (neoanthropus) appeared only 200 thousand years ago (see Fig. 1, 2). The time required for the evolution from the ape to Homo sapiens sapiens was at least 3.8 million years (and maybe more up to 6.8 million). 80-60 thousand years ago, ancient Homo sapiens sapiens had already settled throughout Africa and Eurasia, 65-40 thousand years ago they reached Australia, 35-30 thousand years ago they began to populate America. For some time in Eurasia, they (Cro-Magnons) co-existed with Neanderthals1 and Denisovans2 and even interbred with them. However, as a result of the so-called Upper Paleolithic revolution 40-50 thousand years ago, the technical and cultural development of this Homo species accelerated sharply. And about 30 thousand years ago this species remained the only representative of the ancient people.
How and why all this happened is still unclear. The main mysteries of anthropogenesis center around the following questions: [Kak na Zemle poyavilsya ... , 2020]:
• How exactly did Homo sapiens appear?
• Why did Homo sapiens appear during that specific period, and not earlier or later?
• Why was Homo the only one genus to become intelligent?
• Could intelligence appear in other biological species and in what form?
• Where has Homo sapiens come from?
To answer these questions different hypotheses are proposed. According to the monocentric theory, initially in a certain region of Africa (most often East Africa is mentioned), a small tribe of intelligent people arose, who then multiplied, migrated to other continents and ultimately created human civilization [Kak na Zemle poyavilsya ... , 2020]. The savannah hypothesis, first formulated by R. Dart in 1925, explains that the mind emerged through adaptation mechanism of the ancestors who lived on trees (i.e.,
1 "130 thousand years ago, those Homo heidelbergensis who lived in Europe gradually turned into Neanderthals.
Strictly speaking, there is no boundary between Homo heidelbergensis and Homo neanderthalensis, but the classical Neanderthals who lived 70 thousand years ago differ significantly from their predecessors. They have a very large brain - weighing on average 1400 grams, or even 1500, i.e. more than the average for a modern person <.> From Europe, Neanderthals moved on to the Middle East and further into Asia, approximately to the Altai mountains. In the Middle East, they encountered Homo sapiens, which appeared in Africa later (not everyone left Africa with the first waves of migration, and those who remained gradually turned into Homo sapiens)" [Drobyshevskiy, 2015]. See also: [Vishnyatskiy, 2010].
The human remains found in Altai in the Denisova Cave (the first discoveries were made in 1984) revealed that the DNA (from the teeth and phalanx of a finger) differs from both the DNA of modern humans and the DNA of Neanderthals. It turned out that some Denisovans lived in East Asia [Drobyshevskiy, 2015]. Denisovan people became the second species of extinct hominin after Neanderthals for which complete mitochondrial and almost complete nuclear genomes are known. For the first time, a new species of humans was isolated solely on the basis of genetic research. See: Denisovsky man // Wikipedia. -URL: https://ru.wikipedia.org/wiki/Denisovsky_chelovek (date of access: 17.09.2022).
monkeys who acquired certain anatomy and behavioral skills), to life in the savannah, where they ventured to hunt herbivores. The alternative aquatic ape hypothesis, originally proposed by A. Hardy in 1960, links the evolution of apes to adaptation to an amphibian lifestyle. The polycentric hypothesis suggests the existence of several centers of origin (Africa, Southeast Asia, East Asia and Europe) of Homo sapiens sapiens from different ancestral forms of the genus Homo. However, none of these hypotheses explains everything, so the search continues.
A) Sahelanthropus
B) Pithecanthropus
C) Neanderthals
D) Cro-Magnons
Fig. 2 The most famous ancient representatives of the genus Homo and its presumed
ancestor
Source. [Prichalo, 2021]
For example, it may be necessary to carefully explore the evolutionary role of viruses that are able to overcome barriers between different biological species and become embedded in genes. Sometimes the ingenious hypotheses are put forward regarding the influence of viruses on the anthropogenesis [Kak na Zemle poyavilsya ... , 2020], but there is clearly not enough serious scientific research as yet. Since some modern epidemics were caused by the transfer of viral infections from animals to humans (for example, avian flu1), this issue becomes particularly relevant.
1 The first infection with a virus that was transmitted from sick birds to humans (strain H5N1) was recorded during an outbreak of influenza in poultry in Hong Kong in 1997. 18 people became ill and six died. By August 2005, 112 human cases of avian influenza had been reported in Vietnam, Thailand, Cambodia and Indonesia, of which 64 were fatal. According to the
14
Irrespective of the cause and process of anthropogenesis, physically a modern man was formed about 40-45 thousand years ago (including a decrease in hair growth, an increase in height and other characteristics) see Fig. 2. Since then the appearance of modern humans has remained virtually unchanged despite the immeasurable socio-economic and technical transformations. This is precisely what justifies the assertion that the natural biological evolution of humans has stopped. But has it? And what does the future hold for us?
Mechanisms of anthropogenesis
It is believed that in the past anthropogenesis occurred under the influence of the following biological and social mechanisms and factors:
1. Variability, heredity, struggle for survival (competition, cooperation, symbiosis) and natural selection (i.e. survival of those most adapted to environmental conditions).
2. Mutations, genetic drift, isolation, population "waves".
3. Work activity and lifestyle.
All these mechanisms are ultimately related to adaptation to the environment. Are these mechanisms still in play? It should be noted that modern humans can live in certain environmental conditions: pressure, temperature, humidity, oxygen content in the air, etc. Humans can withstand only minor fluctuations in some parameters. For example, if the human body is able to withstand temperature changes from -40°C to +40°C, then a decrease in the oxygen content in the air from the usual 21-18% to 10% or lower is fatal.
It should be remembered that the Holocene climate (period which began about 12 thousand years ago and continues today) is relatively warm and stable compared to previous eras. In the previous era the Pleistocene there were periods both much colder and with large air temperature fluctuations (see Fig. 3).
10 15 10 s A|e(ky<
Fig. 3. Air temperature changes over 20 million years based on data obtained from
Greenland ice cores
Source: [Mapping post-glacial expansions, 2017]
World Health Organization, from February 2003 to February 2008, of the 361 confirmed human cases of avian virus influenza, 227 were fatal. In 2013, 453 cases of influenza caused by the H7N9 strain were reported in China. 175 people died from this flu, etc. See: Bird flu // Wikipedia. - URL: https://ru.wikipedia.org/wiki/nTHHHH_rpHnn#3apa®eHHe_™geH (date of access: 19.10.2023).
Moreover, nowadays people live not in a natural, but in an artificially created environment. Apartments, houses, cities and various equipment (in the broad sense of the word), domestic and cultivated plants and animals provide a more comfortable and safe lifestyle, which requires much less physical efforts from a person. The diet has also changed the form, type and range of products, their nutrient content, etc. (for more details see. [Dobrovolskaya, 2009]). All this is very different from the natural conditions in which the species Homo sapiens has evolved.
In accordance with the provisions of evolutionary theory, a biological species changes when there appear factors that require such change (i.e., there is influence from the environment). Currently, the changes in human living conditions are becoming more and more significant. The artificial environment is beginning to increasingly influence its creator. In addition, significant climate changes are possible (although scientists' views on this differ greatly).
Thus, there is no reason to claim that evolutionary mechanisms have ceased to operate. The rate of these changes is very slow, especially compared to the human lifespan. "The fact that over the last 30-40 thousand years Homo sapiens has practically not changed in appearance, in general, does not prove anything. This period is too short for evolution, and besides, in the history of other hominid species there were also periods of stagnation, when over the course of not only tens, but also hundreds of thousands of years, no anatomical transformations occurred, judging by fossil bones." [Vishnyatskiy, 2004].
The direction of anthropogenesis may also change, although there is still little evidence of that happening. Nevertheless, according to available data, the microevolution of the human body continues. Experts note the following transformations (see Table 2).
Table 2
Changes in the human body over the past 100 years
№ Changes Supporting Observations
1. Persistent median (axillary) artery in the area of the axilla (upper limb) The proportion of owners of an additional vessel has increased by 20% over the last century. If the trend continues, then in 80 years most people will have it.
2. The appearance of the fabella a small bone that covers the back of the knee joint At the beginning of the last century the bone was found in approximately 11.2% of the population; by 2018 it was already observed in 39%. In a hundred years the majority of people on Earth may possess it.
3. Loss of third molars ("wisdom teeth") and reduction in jaw size Almost 20% of Europeans are already missing third molars. In future third molars may disappear altogether as unnecessary.
4. Decreased body temperature Over the past 150 years, humans have "cooled" by about 0.4°C. Men born in the 2000s are 0.59°C colder than those born at the beginning of the 19th century. The temperature of modern women is 0.32°C lower than that of those born at the end of the 19th - beginning of the 20th century.
Source. [Enikeeva, 2021].
Currently specialists discuss gracility of the modern Homo sapiens skeleton (a decrease in bone mass in relation to body weight) and a decrease in bone strength [Pichugina, 2020], which contributes to growing number of musculoskeletal disorders.
The intestinal microflora of urban residents has become much poorer compared to rural ones. The 2013 study of the intestinal microbiota in the Russian population living in different regions revealed that the microbiota of rural residents is represented by bacterial taxa associated with a "healthy" intestine. In the urban population, the microbiota profile was less diverse, which is most likely due to a different diet [Yudin, Egorova, Makarov, 2018]. It should be noted that changes in intestinal microflora directly affect the digestion process and human immune system, and affect the occurrence and development of chronic diseases.
From the second half of the 20th century researchers recorded noticeable acceleration and an increased height of new generations compared to previous ones. However in the 2000s these processes practically stopped.
Historically, the average height of a person has varied in different ways. It is believed that Cro-Magnons were almost the same height as modern people. The average height of the Altai Afanasievo people (representatives of the South Siberian archaeological culture of the Bronze Age, III-II millennium BC) reached almost 189 cm (see Fig. 4). They were the tallest among their contemporaries. The height of the ancient Chinese, who lived five thousand years ago in the territory of modern Shandong province, exceeded 180 cm [Urmantseva, 2017].
A) the Altai Afanasievo people, 3-2 thousand years BC B) ancient Chinese, 5 thousand years ago C) medieval knight, XIV century D) people in the XVII century E) modern man, late XXth century
Fig. 4. Changes in height in people of modern anatomy over 5 thousand years
Source: [Urmantseva, 2017]
Subsequently, the average height of people began to decrease. According to available data, in the 56th centuries average height was 172.3 cm; in the 11th century - 170.4 cm; in the 12-15th centuries -
169.4 cm; in the 17-18th centuries - 169.0 cm; in the 19th century - 167.0 cm. The increase in average human height (the total population of men and women) began in 1896, reaching by the middle of the 20th century 173.0 cm [Kak menyalsya sredniy rost ... , 2020]. However, the average height of residents of different regions of the world varies significantly, and the height of women is shorter than that of men.
According to scientists, changes in the average height of people are determined primarily by nutrition and the frequency of diseases. Poor nutrition and lack of vitamins in conditions of constant hard physical labor, stress and illness result in declining height. Conversely, better nutrition and healthcare contribute to its increase. "Genetics also has an influence, but it explains only 24% of differences in height" [Karasev, Nurgalieva, 2021]. And, most likely, there is a natural upper limit to the average height of a person [Kak menyalsya sredniy rost ... , 2020] - about 190 cm, due to the strength of the bones and skeleton. It is known that many people taller than 2 m experience great problems with the musculoskeletal system during their lives.
In general, over the past 50-70 years, people have become fatter and weaker, i.e. muscle mass decreases, being replaced by fat. This trend was supported by the results of monitoring the physical condition of adolescents aged 15-17 years in Russia. Over the 34 year period of observations (1970-2004), hand grip strength decreased in boys by 27%, and in girls by 33% [Yampolskaya, 2007].
The above list points at the developing neutral and negative trends for human health, which contribute to the spread of some chronic diseases (diabetes, allergies, musculoskeletal disorders, etc.). Although people live longer now than in earlier periods, they are becoming weaker and less healthy. And this is a worrying direction of change.
What are we dealing here with. is this a degradation of humanity or its adaptation to the artificial environment? And won't the transformation processes accelerate?
Attempts to imagine what people will be like in the future were made repeatedly. For example, the Russian scientist A.P. Bystrov included in his book "The Past, Present and Future of Man" (1957) several drawings depicting a hypothetical man of the future - Homo sapientissimus, or "wise man" (see Fig. 5). This creature is characterized by a huge toothless head, a degenerated chest, a developed pelvic girdle and long limbs [Vishnyatskiy, 2004]. True, the author doubted his own prediction about the emergence of Homo sapientissimus. However, "it is apparently not worth asserting that further natural evolution of man is impossible in principle" [Vishnyatskiy, 2004].
According to some experts, humanity has reached the maximum levels of height, strength and endurance that are possible for the biological species Homo sap1ens (and is also approaching the threshold in life expectancy). People cannot become taller, faster and stronger without additional technological devices or chemical stimulants. Moreover, attempts to overcome these limitations by the body's resources, as it turns out, lead to its destruction [Enikeeva, 2019]. This is clearly shown by the current situation in
high performance sports, where doping (i.e. using chemicals to enhance physical performance of athletes) is becoming more common.
Fig. 5. Homo sapientissimus from the book «The Past, Present and Future of Man» (1957)
by A.P. Bystrov
Source. [Vishnyatskiy, 2004].
In this regard, ideas and technologies for targeted physical improvement of people are becoming more popular (same as at the beginning of the 20th century)1.
Artificial modification of the human body
It should be emphasized that humanity has been engaged in artificial body enhancement for a long time. The oldest trend is prosthetics, the modern trends include implantology and transplantology, and plastic surgery. Thanks to new technologies, significant progress has been made here.
Plastic surgery. The development of plastic surgery was initially driven by the needs of the postwar period. Many wounded in battles of the First and then the Second World Wars wanted to get rid of their disabilities. The first plastic surgery was performed in 1917. The English surgeon Harold Gills performed a skin transplant on the British sailor Walter Yeo, who received terrible injuries in 1916 during the Battle of Jutland2. Subsequently, other goals received priority - people sought to meet the beauty standards promoted by cinema (primarily Hollywood film studios) and fashion magazines.
Experts believe that currently more than 11 million plastic surgeries are performed annually around the world. "As data from the International Society of Aesthetic Plastic Surgery shows, in 2019 the leaders in operations performed were Brazil (1.5 million), the USA (1.4 million) and Mexico (581 thousand).
1 In the first decades of the 20th century eugenics, or the doctrine of human selection and improvement of hereditary abilities, was very popular. However, later this concept was discredited by ties with Nazism. Representatives of Russian cos-mism, a 19th century philosophical and cultural movement (A.V. Sukhovo-Kobylin, V.S. Soloviev, N.F. Fedorov, K.E. Tsi-olkovsky, N.G. Kholodny, A.L. Chizhevsky, D.L. Andreev et al.), also thought about the future of humanity.
2 The largest naval battle of the First World War, in which the German and British fleets clashed. Occurred in the North Sea near the Danish Jutland Peninsula, in the Skagerrak Strait.
Russia ranks fourth with 483 thousand operations, ahead of India (395 thousand), Turkey (352 thousand), Germany (336 thousand) and Italy (314 thousand). The society reports that the number of such operations in the world has increased by 7.1% since 2018, and by 20.6% since 2015. The most common operation in the world is breast augmentation, accounting for 15.8% of the total operations performed. Slightly less popular are liposuction (15%), eyelid surgery (11.1%) and tummy tuck (8.1%). Among men, the most popular surgical plastic surgery was gynecomastia (breast surgery), accounting for 17.9% of all operations among men" [V kakikh stranakh ... , 2021].
In fact, plastic surgery has mutated from a branch of medicine into a profitable business. Plastic surgery is performed mainly in private clinics, although, for example, in Brazil, many aesthetic operations to improve appearance have been included in free medical care since 2012. Thousands of people are already employed in this industry. For example, over 30 thousand specialists work in the top 8 countries with the highest level of development of plastic surgery [V kakikh stranakh ... , 2021].
Russia ranks eighth in terms of the number of plastic surgery specialists, between India and Mexico [Geroeva, 2020]. "According to Vademecum, in 2017, Russian surgeons performed almost 158 thousand plastic surgeries for a total amount of 12.3 billion rubles. <...> According to GuideMarket's calculations, based on Rosstat data, the volume of the plastic surgery market in 2019 in Moscow and the Moscow region alone amounted to 7.5 billion rubles, an increase of 2.3% compared to the previous year" [Geroeva, 2020].
The coronavirus pandemic has stimulated demand for the services of plastic surgeons around the world. For example, in Russia in the spring of 2020, the demand for such services from private clinics increased by an average of 20% compared to 2019. "Specialists explain this phenomenon, in particular, by the fact that many are not satisfied with their image on the Internet, where professional lives of millions of people have shifted" [Geroeva, 2020].
As experts emphasize, "outpacing the growth rate of the global aesthetic industry, Russia clearly follows international trends that have emerged within certain types of operations" [Voblaya, Koroleva, Moreeva, 2020]. At the same time, "equipment and consumables for work are almost entirely imported" [Geroeva, 2020]. "Russian surgeons are refocusing on quick operations that do not require deep anesthesia and a long hospital stay: blepharoplasty, lipofilling, cosmetic injections" [Voblaya, Koroleva, Moreeva, 2020]. However, the arsenal of plastic surgery also includes such radical technologies for changing appearance, such as removing ribs or filing them in several places to shape a thin waist.
According to experts, the demand for plastic surgery is growing due to the achievement of an acceptable price-quality ratio, as well as an increase in the level of safety and reliability of the operations performed. But these modifications do not yet go beyond traditional ideas about the beauty and harmony of the human body. Although the changing aesthetic preferences and consumer demand affect the range of services provided.
Implantology and transplantology. Transplantation has long been the main technology for both plastic (aesthetic) and reconstructive surgery. But later these fields separated, and organ and tissue transplantation became an independent medical (clinical) area.
"The very idea that a damaged organ or part of the body can be replaced has existed since ancient times. But only at the end of the 19th century. medical researchers have come very close to the fact that it is possible to separate a tissue or even an organ completely and transfer it to another organism" [10 sobytiy ... , 2020]. The formation of transplantology as a scientific discipline and successful practice was facilitated by the work of a number of remarkable foreign and domestic specialists [Khubutiya, Ka-banova, 2011].
From the second half of the 20th century. Transplants of the heart and other organs and even complexes of organs have become widespread in many countries of the world (USA, Israel, Turkey, India, South Korea, Spain). However, transplantation still remains an elite branch of medicine, the technologies of which are inaccessible to many people on the planet due to high cost. The level of its development in different countries largely depends on the scale of healthcare expenditures (per capita) and the availability of medical personnel. A specific factor in the spread of organ transplantation is the availability of donor material - both from deceased and living donors.
Russia, "as Vademecum monitoring shows, in terms of operations per 1 million people, remains catastrophically behind the United States and some European countries with a developed donation and transplantation system. In 2018, this figure was 15 versus 92 in the USA, 53 in the UK and 104 in Spain" [Goncharova, Maloroev, 2019]. Experts note that Russian society does not understand and is afraid of transplantation, which negatively affects the supply level of donor organs. The mistrust is related to possible abuses during collecting donor material. There are other problems, primarily of moral, ethical and legal nature, that hinder the development of this area of reconstructive surgery.
In turn, implantation, or embedding artificial materials into the human body, causes less negativity and has a longer history. For example, back in Ancient Egypt, attempts were made to replace lost teeth with artificial structures. Modern implantology began to take shape at the beginning of the 20th century, and its development accelerated significantly in the second half of the last century due to new materials. The greatest successes have been achieved in dentistry (dental implants) and cardiology (pacemakers, artificial heart valves, etc.).
As experts note, implantology "has come a long way and has changed to achieve the best aesthetic and functional results. It is closely related to materials science, as numerous studies are still ongoing aimed at improving the characteristics of existing materials and coatings, changing the rate of osseointe-gration1 and achieving optimal biocompatibility of implants with the human body. Surgical methods for
1 Integration of the implant into bone tissue
inserting implants are also constantly being modified in order to reduce the overall rehabilitation time for patients. <.. .> Today, dental implants are the optimal treatment method for missing teeth, and most likely it will remain so for a long time" [Kratkaya istoriya ... , 2020]. Implants have great prospects in cardiology; work is also underway to create an artificial kidney using bioengineering methods.
The main factors limiting the availability of this type of medical care for the population are the lack of donor organs and the high cost of implants. However, the emergence and implementation of such innovative technologies as growing individual organs and their 3D printing largely removes existing obstacles to the development of implantology.
Prosthetics. It is estimated that "more than 1 million amputations are performed worldwide every year: in the USA - more than 185 thousand, in Russia - more than 70 thousand. Mainly amputations are caused by diabetes and injuries, but there are also those who do not have limbs from birth" [Zuykova, 2021]. To return such people to normal life, prosthetics have long been used, and these technologies are constantly being improved.
"The first prosthetics appeared more than 3 thousand years ago, in Ancient Egypt. These were wooden toes that protected against calluses when walking in sandals. <.> In 1958, the first microelectric hand was developed in the USSR. <.> The first bionic hand in the modern sense of the word was made in 1993 for John Campbell. It was driven by sensors connected to the brain and hidden under a cap. <.> In 2007, the Canadian company Touch Bionics introduced 1-limb, the first widely available bionic prosthesis. This hand weighed 25 kg, had thin fingers and opened up more opportunities for fine motor skills: from working with a computer mouse to tying shoelaces. The prosthesis is attached to the sleeve and is easily screwed on and off. The first widely available prosthetic leg, the Symbionic Leg, was released in 2011 by the Icelandic company Ossur. In 2013, the company added microprocessor control to the model: now the prosthesis adapts to the gait of its owner. <.> In 2018, the first prosthetic eyes appeared - Argus II. They helps partially restore vision by electrically stimulating the remaining cells. <...> Modern prosthetics rely on the developments in robotics, are able to imitate individual gestures, and transmit tactile sensations" [Zuykova, 2021].
a) i-limb - prosthetic hand controlled by smartphone b) Bionic Hand - hand prosthesis with tactile sensation
Fig. 6. Modern prosthetic hands
Source: [Chudo protezirovaniya ... , 2014]
Bionic prosthetics continue to be improved. Modern bionic limbs achieved improved tactile sensations and are controlled directly by mental efforts.
"Bionic prostheses allow limb amputees to live normally. But in fact, only 10% of the amputees have a chance to use prostheses. According to the research company Grand View Research, the global market for robotic prosthetics in 2016 was $790.8 million. The forecast for 2025 is up to $1.75 billion. The market is growing following the technological developments, as well as the number of amputations and their sponsorship by NPOs. According to the American analytical company Frost & Sullivan, the average price of modern advanced prostheses varies from 5 to 50 thousand dollars. The Bebionic prosthesis costs more than 10 thousand dollars, 1-limb - from 60 to 120 thousand dollars, the Argus II bionic eye -about 150 thousand dollars. In Russia, a bionic hand will cost from 100 thousand to 1.5 million rubles. So far, prosthetics have not become widespread, and their development is quite expensive. Prosthetics are created individually each time. the sleeve to which the bionic arm or leg is attached must be ideal in shape and size. Sometimes this requires making several prototypes, while training and rehabilitation take weeks. Perhaps 3D printing can improve the situation. it can be used to create inexpensive prosthetics, taking into account all individual characteristics, and decorate them to individual taste. In addition, they are also very light-weight. Such a prosthesis costs up to 10 thousand dollars" [Zuykova, 2021].
Work to reduce the cost of bionic prostheses is being carried out and with some measure of success. For example, in 2013, 15-year-old Indian Shiva Nathan, using the MindWave Mobile1 kit, created a fully functioning prosthetic arm, which was controlled by the "power of thought," or more precisely, by a brain waves reading system [Chudo protezirovaniya ... , 2014].
c) Shiva Nathan and a prosthetic hand from the MindWave d) exoskeleton "exoatlet"
Mobile set, controlled by the "power of thought" Source. Artemy Lebedev Studio website. - URL.
Source. [Chudo protezirovaniya ... , 2014] https.//www.artlebedev.ru/exoatlet/ (date of access.
10.05.2022)
Fig. 7. Bionic posthetic arm and exoskeleton
"At long last, exoskeletons have appeared. They can be considered a transitional stage. they not only replace lost limbs, but also complement and expand human capabilities. With their help, people
1 Device for meditation and creating simple games for iPhone
23
without special physical training can lift weights, and paralyzed people can move" [Zuykova, 2021]. Such exoskeletons are used not only in medicine for the rehabilitation and restoration of vital functions of people with disabilities, but also business to enhance the physical capabilities of healthy people (in construction and warehousing), as well as in law enforcement agencies and even in the entertainment sector.
Consider, for example, the Russian R&D exoskeleton project for the rehabilitation and social adaptation of people with impaired locomotor functions of lower extremities, as well as modifications for emergency and rescue operations. It was initiated in 2013 by "ExoAtlet" LLC based on models by the Research Institute of Mechanics of Moscow State University named after M.V. Lomonosov. First samples were produced in 2015, in 2016 sales of exoskeletons to clinics began, and in 2019, production was moved to a site in Ramenskoye, Moscow Region, and expanded. Its current capacity is about 100 exoskeletons per year. Currently, more than 80 medical centers in Russia are using this equipment1.
Such a merging of complex mechanical devices and the human body is interpreted by some experts as the possible cyborgization of humanity and the emergence of techno-people (for more details, see. [Alekseeva, Arshinov, Chekletsov, 2013]).
It should be noted that the above-mentioned technologies (transplantation, implantation, prosthet-ics) are mainly aimed at replacing lost or inadequately functioning human organs in order to maintain life, i.e. duplicate existing parts of the human body. In recent years, healthy people have begun to use some of them, and for purposes not related to restoring their health. For example, enthusiasts use implants to ensure constant communication with gadgets.
The progress in biomedicine and genetics has led to fundamentally new opportunities for improving the human body. For instance, gene editing technologies open up the ways to get rid of numerous genetic (hereditary) diseases caused by mutations - defects and disorders in the hereditary cell apparatus. So far, these technologies are largely experimental. But it is already clear that editing the genes in an adult is significantly more difficult than carrying out the corresponding manipulations with a human embryo. However, the latter raises very serious ethical and legal problems.
Currently, gene editing technologies may be justified by the desire to rid humanity of some existing diseases and preserve the health of new generations. At the same time, gene editing underlies attempts at creating a posthuman, i.e. "a person physiologically extremely modified at the genetic and nanotech-nological levels, who has fundamentally surpassed natural human capabilities" [Belyaev, 2011, p. 23] or even acquired new abilities.
Finally, human cognitive abilities (e.g. memory, speed of thinking, etc.) can be improved by certain psychological and pedagogical methods. In addition, neuropharmacology is developing fast. The latter
1 See. About the project. - ExoAtlet. - URL. https.//exoatlet.ru/o-kompanii/ (date of access. 10.05.2022).
24
can be treated differently, but even here there is a certain positive potential for enhancing (stimulating) human reactions.
Thus, to date, technologies have emerged (of varying degrees of development) that make it possible not only to duplicate (replace) existing organs, but also to improve them, as well as expand the capabilities of the human body. This looks especially attractive in light of the critical views expressed on the structure of modern man. Thus, the American scientist Gary Marcus calls the human body a "kludge", i.e. "a ridiculous, clumsy, but effective design from an engineering point of view." He offers some examples to illustrate the imperfect human architecture:
- "the spine is a disgusting solution to the problem of maintaining an upright position - since such structure leads to disorders in the musculoskeletal system;
- the eye retina that perceives light is located backwards and faces the back of the head, not the front. As a result, everything appears to people in a special way, in particular, in each human eye has blind spots - areas that are not sensitive to light;
- the trachea, being the vocal tract, performs double function - sometimes with fatal consequences (risk of suffocation); breathing and speech could rely on different systems;
- highly efficient brain neurons are connected to their neighbors by strikingly inefficient synaptic clefts, which transform effective electrical activity into less effective chemical compounds, and the latter, in turn, waste heat and lose information;
- memory is contextually dependent and this makes it unreliable and inaccurate;
- the brain is a conglomerate of many conflicting systems. In the course of evolution, the hereditary reflexive system was created first, and systems of rational conscious thinking developed later, but the reasoning and hereditary systems are not synchronized" [Marcus, 2011].
As G. Marcus writes, "in the end, evolution does not strive for perfection and beauty but for adequacy and practicality. Kluges can give us ideas about how we can improve ourselves. By looking at ourselves honestly in the mirror, recognizing our strengths and weaknesses, we have a chance to achieve more" [Marcus, 2011]. Will people dare to deliberately interfere with the course of their evolution?
Conclusion
Many scientists agree with the thesis that modern man appeared in the course of natural evolution, which continues until now (although there are other points of view). At the same time, the artificially created habitat causes a certain physical degradation of the human body and the spread of chronic diseases.
Today, innovative technologies to replace or improve the functioning of human organs have been developed and are being implemented. Moreover, these technologies may cause humans to radically change. We can say that humanity is now participating in a global project to test new life-sustaining technologies. And the accumulating effects can no longer be ignored.
Humanity is facing a choice - which direction should receive priority: cyborgization, gene editing, improvement of cognitive abilities - or some such combination? And is it at all possible to make a rational optimal choice? What should be the goal: maintaining the flexibility and adaptability of the species Homo sapiens or striving for perfection?
The question of whether the potential of new technologies will be used to artificially enhance humans seems rhetorical. The course of events is going exactly in this direction. Therefore, humanity should seriously think about setting goals and ideals, as well as their possible consequences.
It seems that much also depends on which technology turns out to be not only the most effective and reliable, but also economically effective. After all, everything costs money - both the research and the application of new technologies. In addition, it is important to create not only adequate formal, but also informal norms that would minimize risks and optimize the potential of new technologies for the better of humanity.
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