Life and death in the 21st century. Parts 1-3.

Part 1: Living Forever. This begins with the story of an 85-year-old Texan oil millionaire who refuses to accept death as inevitable. He offers a fortune to anyone who can prevent it. Research into progeria (premature ageing) has already discovered the molecular basis of ageing, and laboratory experiments in genetic engineering indicate that the process could be arrested but human trials are still a distant prospect. It is suggested that eventually it will be possible to turn off the ageing process at the embryonic stage. Tissue regeneration is another field of eager competition. Mammals have lost the ability to regrow tails and legs but an accidental discovery with laboratory mice showed that an incomplete immune system, usually existing only in the embryo, produces stem cells which spontaneously repair or replace damaged or missing body parts and organs. Stem cells also occur in a certain kind of cancer tumour. In pioneering work at the University of Pittsburgh stem cells extracted from tumours were transplanted into the brain of a patient suffering stroke damage, with encouraging results. As for cloning, it is suggested that people will be able to have their cells stored for use in case of accident or disease, once a way has been found of controlling the growth of cloned cells.

Part 2: Future Plague. The post-war development of antibiotics promised the control and potential eradication of all major diseases. But as we enter the 21st century it is clear that old diseases are returning in more virulent forms and new ones are emerging for which antidotes are yet to be discovered. Tuberculosis, AIDS and Ebola fever are examples of this. Changes in social conditions and environmental use are releasing and spreading dangerous organisms which quickly become resistant to antibiotics and can even evolve with the genetic characteristics which provide resistance. Hospitals are particularly vulnerable to such infections. Methicilyn resistant staphylococcus aureous (MRSA) is now a major problem both in hospitals and in the outside world. Analysing the genes of bacteria speeds up the creation of new antibiotics but bacteria respond with new strategies, so the battle is only briefly won. Drug-resistant tuberculosis in Russia is treated by a return to surgery. New York enforces detention in an isolation hospital where this is deemed necessary and health authorities in London have also exercised powers of detention. Vaccines which alert the immune system to early recognition of foreign organisms may succeed where antibiotics fail, but this strategy is still at the research stage. The search is also under way for the unknown factors which increase susceptibility to heart disease in some, and protect those whose lifestyle would appear to make them vulnerable to this condition.

Part 3: Designer Babies. It is already possible to select the sex of a prospective child - but how much power should parents have over the genetic make-up of their offspring? The technique of preimplantation diagnosis is available to parents who risk passing on genes which would result in a severely impaired child. Should the technique be limited to such cases? Preimplantation diagnosis can only be used to select embryos with inherited genes; it cannot be used to design babies. But implanting genes is a prospect that may become a reality in a few years and must be considered now. Gene implantation could correct genetic diseases at the embryonic stage but once this is done, it will be in demand for reasons other than the screening out of serious diseases. Dolly the sheep was the result of cloning, but many lambs were lost in gestation before the success of Dolly. Cloning and genetic implantation raise medical and social issues for which guidelines must be prepared while there is still time.

United Kingdom : BBC TV, 2000.

1 DVD (150 min.) : sound, color, PAL.

A trilogy of programmes setting out some of the hopes, fears and problems associated with the outlook for medical science in the 21st century.

BBC TV.

BBC TV