Artificial organs: Already the transplantation of organs, tissues, bones and other body parts has become so widespread that it is often called a new branch of medicine. Where there were formerly three ways to treat illness -- preventative, palliative and curative -- there is now a fourth: substitutive. "Conventional" organ transplantation is widely practiced (and demanded) and becoming more effective with new techniques for preventing rejection by the patient's immune system: Meanwhile three other approaches to substitution are progressing rapidly in their various ways -- competing revolutions treading on one another's heels:

	Mechanical prosthetics are the oldest type of substitution. Some of the future products will be improvements on the old ones -- better limbs, joints, pacemakers, implants and dialyzers -- but more spectacular breakthroughs are possible. There is, for example, work on artificial eyes and ears that will be not cosmetic substitutes, but actual working organs able to sense light and sound and transmit perceptions to the brain.
	Pigs, genetically modified to make their organs acceptable in human bodies, are being bred as sources of replacement hearts, livers, and kidneys. After a period of concern that such transplantations might carry the porcine endogenous retrovirus (PERV) into human beings, recent research into the history of successful past transplantations of pig tissues -- such as skin grafts and pancreas cells -- indicates that there is again reason to believe this may in future help meet the needs of the hundreds of thousands of patients (over 60,000 in the U.S. alone) awaiting organ transplant.
	Artificial tissues and organs -- in some cases created from the patient's own genes so that there is no problem of rejection -- now appear to be well within the realm of possibility. Artificial skin is already available for burn patients. A researcher recently created a blood vessel that was successfully implanted in the laboratory animal from whose genes it had been constructed. One team predicts an artificial heart within ten years.

These are promising developments, but they are also troubling ones. In a sense the best-case scenario is also the worst: The more successful such procedures become, the more intense will be the concern about their costs, their availability, their reliability, and the expectations they create.

The DNA information explosion: DNA evidence is in the process of transforming criminology. This is one more revolution among the others, and one that has yielded impressive results for people unjustly convicted of crimes and for society in general. But as genetic information becomes more comprehensive, complete and reliable there will be many serious problems concerning the ways such information may be used and the ways its very existence may threaten personal privacy. These concerns have been raised for some time in connection with the use of data indicating susceptibility to certain diseases or environmental hazards to deny employment or insurance coverage; they become more acute as it becomes possible to obtain a complete genetic "blueprint" of a living human being

Eugenics by germline intervention: Some foresee a new era of eugenics -- not directed by government, as in the familiar scenarios, but more of the do-it-yourself sort as parents make their own decisions about what kinds of children they want. Undoubtedly there will be much ethical discussion, government regulation, and probably -- in some places -- outright prohibition of such technologies. But present experience with drugs and surgical procedures indicates that, in an increasingly open global society, people who are sufficiently determined and wealthy will be able to gain access to them.

Pharming: The manufacture of medical products from genetically-modfied plants or animals may very well change both agriculture and medicine, and have powerful impacts on people and economies everywhere. At this point the most promising pharm products -- such as a sheep's milk containing a protein that can be used to treat emphysema and a goat's milk with a human antibody useful in cancer therapy -- are in the clinical testing stages. A few -- such as a sunburn preventative made from a genetically modified tobacco plant -- have reached the market. Among the most inventive, and most likely to make a difference to people in the poorer parts of the world, are the edible vaccines -- foods that can confer immunity to certain diseases.

Substitutes for agriculture: Cell and tissue culture are simpler in principle than gene splicing but no less impressive in results. Plant scientists can take a tiny slice from the leaf of a tree and, by cultivating it in a medium of hormones and nutrients, grow it into a whole tree -- or a million copies of a single tree. Another kind of culture involves growing only a certain part of the plant -- such as the edible fruit. This has great potential as an urban food production system; it also has the potential to undermine the agricultural economies of regions whose primary sources of income can be replaced by goods produced elsewhere. Already factories in industrial nations are manufacturing synthetic substitutes for sugar, cocoa and vanilla -- all of which have been key export commodities of developing nations. The history of the impact of aniline dyes on indigo agriculture -- a devastating blow to India and other countries -- indicates that such crop-substitution scenarios are not entirely fanciful.

The globalization of agricultural biotechnology: The development of new crop strains with increased yield, pest resistance, drought tolerance and nutritional qualities can be seen from one perspective as an enormously promising step toward meeting the needs of growing populations in environmentally-stressed regions. But the increasing global reach of international seed companies, the issue of seed patenting -- and in particular the idea of engineering programmed sterility into seeds -- have created great mistrust and controversy. Although use of the "terminator gene" in developing countries is now opposed by the Consultative Group for International Agricultural Research, the specter of monopolization of the world's farming by high-technology agribusiness promises to be a source of heated controversy.

Genetically modified food: Already 50 % of the corn and 40% of the soy grown in the U.S. is genetically modified for resistance to pests and disease, and researchers all over the world are working on further modifications aimed at improving nutritional or cosmetic qualities of foods, or strengthening resistance to drought, heat and salinity. Meanwhile, "Frankenfood" is the center of a heated battle in Europe, has become -- as one observer put it -- a lightning-rod for a whole range of fears and misgivings about science, progress, and technology. Will the European consumers' rebellion continue and spread? What is the role of governance institutions? Can corporations learn how develop and market products in this climate?

Reproductive technologies: Such methods as artificial insemination, in vitro fertilization and surrogacy have already changed the rules of human reproduction, created new industries and institutions, and given rise to worldwide ethical and political debates. Further refinements of these technologies are being developed in many laboratories. Some ethicists believe that human cloning should be regarded as an acceptable alternative in some cases. The possibility that this may indeed take place -- coupled with the news of women carrying babies at ages once considered far beyond the reproductive years, of children being conceived from the sperm of deceased fathers -- means that the rules will continue to change in profound ways. This is exciting to some, unnatural and repugnant to others.

The bio-industrial revolution: Other potential applications of genetic knowledge include new bioenergy processes, biomining (use of bacteria to leach minerals from soils), bioremediation of environmental pollution (which some see as a major future industry) and biomaterials. Among the promising contenders in the biomaterials category are BioSteel, which a Canadian company hopes to produce by using the spider-silk gene in transgenic milk goats. If the project succeeds, BioSteel may soon be used for a variety of applications, from medical sutures to bulletproof vests to space stations. In some ways this work recalls the dreams of the social philosophers of the early 1900s, who speculated about a shift to "biotechnic" industries in which biological production systems would replace the inorganic machines of the factory and end (or at least reduce) reliance on mineral-based materials. A bio-industrial revolution as predicted by some observers would undoubtedly yield many useful products -- but such revolutions invariably bring new waves of "creative destruction" along with their benefits.

Biowarfare and bioterrorism: There is no doubt whatever that many countries have acquired the capacity to kill millions cheaply with bioweapons, and that terrorist acts using disease agents instead of explosives are well within the realm of possibility. The only questions are: (1) how rapidly these capabilities will increase along with other advances in biological research, and (2) whether -- and where and when -- acts of bioterrorism will occur. How will global institutions, national governments and local communities cope with them?

All of the above technological revolutions may not, of course, unfold exactly as described here; but there are sound reasons to expect that they will, and that numerous others -- with impacts as unforeseen as was the impact of the personal computer a few decades ago -- will come along as well. The growing convergence between the life sciences and the information/communications technologies virtually guarantees it.. All of genomics -- the human genome project and the myriad other genome projects -- is based on this convergence, as is the growing field of bionomics. Its future progress will bring an explosion of biological information and a corresponding growth of capacity for storing, managing and transporting such information. People everywhere are already being affected by this new bio-information environment as they find themselves faced with bewildering new choices about such matters as reproductivity and disease protection; it appears highly likely that in the future most people will have more choices, but will not have the choice about whether or not to have more choices. Governments, NGOs, corporations and local communities will also have to learn new decision-making skills -- which will involve not only getting and using information, but learning how to avoid being overwhelmed by the volume of it, and learning that decisions are always made on the basis of less-than-complete information. We are moving rapidly into a global bio-information society, with very little knowledge of what that may mean, or how such a social order may function.

Preparing for the Bio-information Society

It is possible to create any number of scenarios of what may happen over the next ten to twenty years. It is also possible -- and a good deal more to the point -- to state clearly what will not happen. Put simply, biotechnology is not about to go away, and neither is intense public involvement in it. We are dealing not only with an explosion of scientific and technological revolutions but also with what political scientist James Rosenau calls a "skill revolution," as more and more people learn how to mobilize, form coalitions, use information/communications technologies, and influence public opinion. And, although it might seem obvious that neither biotechnology nor activism is about to go away, the secret hope that one or another might -- that we might somehow turn back the clock to an era of simpler approaches to medicine and agriculture, or that researchers and industry might be able to go about their business with less public scrutiny -- clearly animates the thoughts of many people. That hope is born of a reluctance to comprehend the true scope of the transition that is now underway.

It is hardly surprising that many people and organizations feel such reluctance. The transition is altering basic patterns of personal and family life, challenging traditional concepts of nature, and -- perhaps most troubling of all -- forcing us to think about how responsibly to exercise power that we would prefer to believe we do not have. Collectively, the human species is being confronted with increasing evidence that the evolutionary future of the planet and all life on it will be determined by our actions and not by the impersonal workings of Darwinian evolution. The British evolutionist Julian Huxley perceived this decades ago, and declared in no uncertain terms that "mankind is in point of fact determining the future direction of evolution on this earth . . . and the sooner he realizes it and starts believing in it, the better for all concerned." More recently other observers -- such as biologist Peter Raven and political commentator Francis Fukuyama -- have said essentially the same thing. This does not, of course, imply complete control of all life on earth or even of human biological evolution; the word "governance" -- with connotations of information feedback and the means by which a society steers its course -- is much more appropriate than "control" for understanding the new responsibilities that the human species has assumed. But -- however we may choose to define it -- this recognition calls for a larger, more expansive vision of what we are doing now and making possible in the future.

We propose that it is only through a disciplined effort to comprehend the implications of the age of biological revolutions, anticipate some of the specific forms it may take, and create a new and widely understandable vision of its possibilities, that the transition can be made peacefully and equitably.

The Meridian Project on Bioscience and Society: Framing a Larger Picture

The Meridian International Institute is preparing to launch a program of social learning and visioning. Its first step will be to bring together an ongoing roundtable of highly-qualified people of divergent backgrounds and perspectives to think broadly and in depth about the challenges of multiple bio-information revolutions.

This project will utilize and integrate skills developed in a number of different fields, including futures-scanning methodologies -- such as scenarios and technological forecasting -- in combination with dialogue and group-process approaches we have used successfully in other contexts. Its goal will be to construct a larger vision of the evolutionary transition that is now underway -- not through an exercise in undisciplined imagination, but rather through an integrative process that continually and deliberately shuttles between large ideas and specific factual cases.

Learning together involves more than merely exercising the imagination, and more than merely taking in new information. It also involves forming common perceptions of the world -- shared and communicable visions of the emerging landscape within which people of different interests and values can debate and innovate. As players in the new world of information-age politics proliferate, the need for such shared frameworks of thought becomes more critical to the governance of all societies and all organizations. And it becomes less likely that such frameworks will be automatically furnished by culture or tradition.

This is a difficult situation, but far from hopeless. There is a sizable body of knowledge about how to study and extrapolate scientific and technological change, and there are reliable methods for creating learning environments within which people can systematically construct frameworks of interpretation in order to understand the world in new ways.

The work of this project will involve constructing such a framework of interpretation, built upon factual material and forged in a process of intensive dialogue. Such a framework, once created, can then be used as a basis for the setting of new agendas, including:

	public policy agendas for governance
	strategic agendas for business and industry
	action agendas for nongovernmental organizations
	educational agendas for schools and universities
	research agendas for science
	program agendas for grantmaking institutions
	reportorial and analytical agendas for the communications media

The project may also generate other materials such as:

	reports on specific future scientific/technological developments and their possible impacts
	subconferences for dialogues among different groups or communities
	studies and policy papers regarding specific issues or subjects
	psychological/philosophical studies on human responses to technology, change, nature

The specific outputs may cover a number of different subjects, be addressed to different groups or communities. The larger objective remains the same: to think big and think ahead, and to ensure that the transition now being revealed to us in the thousand revolutions proceeds with the maximum benefits for the maximum number of people.