The world’s most complete bionic man is currently an exhibit at the Science Museum, following his creation for a Channel 4 documentary screened in February.
Robotics company Shadow, with the support of the Wellcome Trust, used nearly $1million worth of state-of-the-art limbs and organs to build the bionic being. These were the product of billions of dollars of research, borrowed from some of the world’s leading laboratories and manufacturers.
We have the technology...
As a whole, the exhibit illustrates the very latest techniques in prosthetics and robotics. The bionic man’s organs signify enormous possibilities: a spleen that uses nanotechnology to replicate the action of the human organ; a kidney the size of a fist that encapsulates the technology of a full-sized dialysis machine; an artificial pancreas, developed at De Montford University in Leicester, which responds to the body’s glucose levels to regulate insulin supply.
He sports a fully mobilised knee joint, the Genium, so advanced that it can enable the user to ski, climb ladders and walk backwards; and hands with independently controlled fingers, which allow the wearer to grasp and twist objects and use them like a normal hand. Some of the organs are still in development; others, such as the windpipe and heart, have been given to patients to help them function while donor organs are sought – sometimes for a number of years.
Richard Walker of Shadow says: “This is a showcase for prosthetic parts, it show exactly where we’ve got to in being able to replace parts of a human.” While it raises the expectations and possibilities for those who need prosthetic limbs or replacement organs, it undoubtedly opens up thorny ethical issues: might we be facing a future in which we can elect to replace parts of our bodies with ‘superhuman’, or bionic, prosthetics, which could function better than our own?
Prosthetics through the years
Dr Patrick Finlay FIMechE, Chair of the Institution’s Engineering in Medicine and Health Division (EMHD), offers insight into the past and current state of robotics and what the future may hold for patients and wearers of prosthetics.
Patrick reveals that there is no legal definition of a robot, but that in people’s common perception, a robot would have multiple joints and be able to move around. Artificial organs are not generally defined as robotic, but anything that is a replacement for an existing body part – a prosthesis would be considered robotic if it featured powered joints.
When artificial limbs first were used, in the Napoleonic era, they were made from wood and leather, and although their creators were undoubtedly proud of their achievements, users would remove their prosthetics as the pain of wearing them was often not worth the benefit.
“The development of prosthetics,” Patrick says, “tends to experience a leap in advancement following disasters or large-scale traumatic events. It’s an uncomfortable observation, but in the 1960s, for example, following the Thalidomide scandal, public sympathy was awakened and research into prosthetics benefitted. Then, Vietnam veterans, many of them seriously wounded, returned to America, prompting a significant response to the needs presented there. Now, as soldiers return from conflicts in Iraq and Afghanistan with landmine injuries which cause – sometimes multiple – loss of limbs, we are seeing another spike in development.”
There has certainly been a growing public awareness of prosthetic limb users, not solely due to battle injuries but also thanks to the achievements of London 2012 Paralympic competitors and the endeavours of some of the torch-bearers, who were taking part with the benefit of prosthetics. And that awareness translates into two big areas for development: para-athletes and war veterans.
The psychology of prosthetics
Patrick works at MediMaton, a company involved in medical robotics, whose remit he defines as “understanding the unmet needs that clinicians have in trying to improve their patients’ lives and transforming those needs into an engineering application that can meet those people’s requirements.”
“Experienced practitioners in prosthetics find”, says Patrick, “that people who lose a limb in an accident generally say that they would like a replacement limb that looks normal, while those born without a limb seek functionality over appearance.”
Psychology is an enormous driver in the development and use of prosthetics. Although these days, physical levels of discomfort associated with wearing an artificial limb are at their lowest, and the limb-wearer’s acceptance of a prosthetic is far higher, there is still a way to go to achieve all-round acceptance.
Patrick says that it is very common for a person who suffers a stroke, and who loses the use of their arm, to dissociate from the ‘useless’ limb. They may even give it a separate identity. The same is true of a robotic arm: the wearer may find it difficult to use at first and gain little function from it. Initially, it is common for such a patient to behave in the same way as the stroke sufferer: Patrick says, “when we see a person, over time, come to accept and name their new limb as ‘part of me’, that’s a huge leap.”
‘The uncanny valley’
The term ‘uncanny valley’ was coined by Japanese Professor Mori to explain the dip in the graph below: as a robot – including a prosthetic arm – becomes increasingly lifelike, its acceptability to other people (labelled as ‘familiarity’ on the graph) initially improves, but then takes a sudden dive as it becomes too lifelike, leading to a sense of revulsion when the observer realises they have been ‘taken in’. This may occur during a handshake, for example, or when allowing more than fleeting study of a stranger. Patrick sums up, “That is pretty well where we are with the best prosthetic limbs now: the challenge is to improve their lifelikeness further so they cross the valley, and become wholly acceptable.”
*graph taken from Wikipedia
Refining robotics, or creating ‘superhumans’?
The conventional artificial hand cannot sense how hard it is gripping something. Eggs are liable to crack; heavy objects can slip or be dropped. Recent developments have put sensors into the fingers, so that the prosthetic hand can grip. The sensors – which include a microphone – perceive slipping and automatically tighten the hand’s hold on an object, increasing the grip as necessary. So technology is trying to match the sensors that a natural connection between brain and hand would operate.
Patrick suggests that ‘bionic’ is itself an interesting label. “In terms of the performance of robotic, artificial or prosthetic body parts, does bionic mean superhuman? Exoskeletons, which are powered protective and/or supportive outer-wear, can enhance a soldier’s duties on the battlefield, and some have noted that it gives them a feeling of being ‘superhuman’ – they feel stronger, powerful and more resilient. There are other applications for exoskeletons, such as in construction and rescue work and even for the elderly, that could, in some cases, help prolong life.”
Implications for the future
Life-saving operations, rehabilitation and assistive technology are among the main areas for the future of robotics. Patrick sees organ transplants as part of bio-medical engineering which, he argues, has a role within the great remit of engineers. Bio-medical engineering commonly includes mechanical electrical and software engineering disciplines, for example.
Rehabilitation engineering, which is to do with recovering lost or damaged function, (rather than making sick people better) has the broadest reach. And there is assistive technology, concerned with replacing missing function, seen in the Paralympics, where running blades and other prosthetic limbs were put to incredible use and appreciated by such a wide audience.
Already in progress and sure to escalate in the future is the debate about ethics. Social psychologist Berthold Meyer, who himself uses a prosthesis as he was born without a left hand, took part in the Channel 4 documentary, How to Build a Bionic Man.
He predicts huge ethical issues surrounding prostheses as they begin to outperform human body parts. “Should I be allowed to cut off my real hand and replace it with something; does that gives me an unfair advantage over people who cannot afford this? I’m not saying that is going to happen but these are questions that should be on the table before that technology becomes available.”
Robotics and health
In addition to counteracting the effects of war injuries and high performance assistive technology, there are other health issues in which the field of robotics is increasingly likely to provide solutions. One of these is the growing population of ‘meta-stable’ elderly people. Their physical mobility may be OK in usual circumstances but in more difficult situations, such as when rushing, or stressed, they can be liable to fall and sustain injuries. Robotic solutions can be used by this social group to retain independence. These might be a mechanism to increase grip in the hands, or even a variation on the exoskeleton, to strengthen the legs of a person who is unstable or even wheelchair-bound.
Currently, exoskeletons are quite obtrusive and futuristic-looking, rather like a large pair of metal ‘walking trousers’, and in some cases a power supply is required, but in time, Patrick says, they will become simplified and subtle and far more ergonomic in design. “The exoskeleton will increase people’s mobility, stability and strength, improve coordination and function. It’s a device that will aid people to stand and move about, worn just like a pair of trousers, really.”
Technology that helps people retain independence for longer is a growth area and will be very big business in the future. It’s an extension of the idea of hip replacement, but more mechanised and even reaching into mental health. Patrick illuminates: “A serious issue for many elderly people is memory loss and confusion, particularly worrying when people have to take medication. There are robotic medical devices in development which can monitor a patient, despatching the right amount of medication at the appropriate time. This can be life-changing, reducing stress and potential health hazards.”
Robotics, engineering and medicine
MediMaton is involved in medical robotics, designing robots for surgery, including brain and keyhole surgery and a robotic device for patient lifting among other projects (lifting patients causes long-term back pain in 10% of nurses and carers).
“One of the most stimulating aspects of my work is when I organise brainstorming sessions between clinicians and engineers,” says Patrick. “Every time, we listen to the clinicians talk about the issues they are facing; and then we listen to the engineers explaining the technologies they are developing, and the doctors say, ‘we had no idea you could do that’ and the engineers say, ‘we had no idea that you needed it’! Together we are trying to build the right applications to help patients live better lives.”
For more information
Visit the science museum until 11 March to see the bionic man, in the Who Am I? Gallery: http://www.sciencemuseum.org.uk/
http://www.shadowrobot.com/
If you would like further information about the Technical Activity Committees, Board or Engineering in Medicine and Health Division, please contact Alison Roddam on +44 (0) 20 7304 6829 or health@imeche.org
Images courtesy of the Science Museum