Thursday, November 17, 2005

Aging, logic and bioethics

It’s been said before, but worth repeating: the bioethical priorities and concerns of developed and developing nations are sometimes poles apart, revealing striking differences in mentality, values and power. A case in point is a recent article in The Journal of Medical Ethics, entitled “Life extension, human rights, and the rational refinement of repugnance”. In it, the author -- a self-described biogerontologist – claims that aging is “humanity’s foremost remaining scourge”, that we are “within striking distance” of curing aging, and that those of us who are wary of the idea of radical life-extension via biotechnology are simply backward. All of this may sound strange to those living in countries with scourges more pressing than aging, or rather, where many people die of preventable diseases before getting much of a chance to age.

Then again, the notion of ‘curing aging’ probably sounds strange no matter where you are. Aging to most people is as natural as being born; it is what people do, or what at least their bodies do, between being born and being dead. Most people don’t like it much, but it is accepted as part of the picture of what life is like, and what we have in common with other creatures as well as what we share with environmental cycles of growth, decay, death and regeneration. This is probably why it is unsettling to hear aging turned from a feature of the human condition into an affliction – like gonorrhea – that we might get rid of with injections and pills.

The author of the piece (A.D.N.J. de Gray) contends that we should all embrace radical life extension in so far as we embrace logic and human rights. We all – except perhaps death penalty advocates – embrace the right of a healthy human being to go on living, and it is simply a matter of logical consistency to then embrace the related right to cure aging through the use of biotechnology. Our moral intuitions about aging as a human condition will be overcome by rational argument, or at least that is the way things work in Cambridge (England) where de Gray is located.

According to the author, bioethicists have a special role to play in this debate. Being especially logical folks, and being independent of the politics that pervades science (at least in Cambridge), bioethicists are in a position to persuade the masses to give up their irrational attachment to aging. They can demonstrate through rational argument that, despite vulgar appearances, ‘going on living’ indefinitely by means of sophisticated drugs actually accords with our deepest moral values. In other words, bioethics can do humanity a service by doing PR work for the anti-aging enhancement industry.

But who knows, maybe bioethicists can play another, less slavish role. They could namely critically reflect on what living 150 years might mean for ordinary persons -- its impacts on core spheres of existence such as interpersonal relationships, family life, and work – and offer a nuanced opinion that neither glorifies nor condemns the possibility of extending lifespans. All this, while affirming something that every poor Malawian villager knows: that death, even in Cambridge, waits for us all.


Blogger Linda MacDonald Glenn said...

Indeed, Stuart, death waits for everyone -- your post reminds of the Emily Dickenson poem that starts:
" Because I could not stop for Death--
He kindly stopped for me--
The Carriage held but just Ourselves--
and Immortality."

5:31 PM  
Blogger Kevin said...

Actually Stuart,

No matter which way you look at it, moral, ethical, or practical, increasing the healthy human lifespan makes sense.

Evolutionarily speaking the rise of civilization and intelligence have been tied to longer lifespans.

We have solved many of the diseases of the young and it is now time to apply that same scientific vigour to solving the suffering of the aged.

It currently costs North America over 250 billion dollars to look after the decrepit elderly. What do you think a healthy population of 150 year olds would do with these funds currently earmarked to give our parents and loved ones some dignity and quality of life as they face increasing debilitation?

Maybe with a huge number of individuals who have lived long enough to realize that their quality of life is tied to the quality of life of their fellows, we would find that the human race may mature and learn how to share. Perhaps we would face some of the innumerable social and environmental problems brought about by applying short term perspectives to problems which require long term solutions. With longer lifespans maybe.. just maybe..

the human race would have a chance to grow up, instead of blow up.

I'm not much of an Emily Dickenson reader by I am reminded of a poem regarding this subject..

I am Not Resigned
I am not resigned to the shutting away of loving hearts in the hard ground.
So it is, and so it will be, for so it has been, time out of mind:
Into the darkness they go, the wise and the lovely. Crowned
With lilies and with laurel they go; but I am not resigned.
Lovers and thinkers, into the earth with you.
Be one with the dull, the indiscriminate dust.
A fragment of what you felt, of what you knew,
A formula, a phrase remains,--but the best is lost.
The answers quick and keen, the honest look, the laughter, the love, --
They are gone. They are gone to feed the roses. Elegant and curled
Is the blossom. Fragrant is the blossom. I know. But I do not approve.
More precious was the light in your eyes than all the roses in the world.
Down, down, down into the darkness of the grave,
Gently they go, the beautiful, the tender, the kind;
Quietly they go, the intelligent, the witty, the brave.
I know. But I do not approve. And I am not resigned.

Edna St. Vincent Millay

Long and healthy life to you and yours..

Kevin Perrott

4:47 PM  
Blogger FutureQ said...

I'm sorry but Stuart's logic is flawed. But he can't help it really. Like so many he's been raised with certain memes that seemed for millennia to be inviolable... until now.

We've accepted aging because it is all we've known. We've built up religions around dealing with what comes after the aging and all that investment in belief and dignity and social worth and peering peers holds us immobile and pardon the pun, deathly afraid to upset the apple cart and be seen as a maverick.

Why are there so few celebrities involved in the Life Extension movement? For the same reason but magnified and highlighted by the lens and the spotlight they live their lives under. What a tragedy and travesty to pass up such a monumental opportunity because one is worried what people will think!

But I believe it is that same fear that affects everyone so set in our ways when such a radical notion enters our meme space. We drag out excuses for refusing it that seem more socially palatable, like heart string pulling references to starving souls that could use the money instead rather than heaven forbid giving oldsters that have had their chance at life, how dare they ask for more, even more of it?! Right?

Wrong, the technologies that will cure aging are the same that will help the 3rd world climb out of many of their problems. In fact one of the more radical of them, nanotechnology, will have the power to transform seemingly overnight every 3rd world nation to a 1st.

Another few questions need asked and answered by everyone. Has technology advanced in your lifetime? Do you know how unique that is in the scope of all of human history for the lives of most people throughout our history?

Throughout most of human history the average person could expect to never see a world changing technological change. If some did even then it was few and far between per the span of their lifetime. Now consider how many world shaking advances have happened in just the 20th century alone! How about in just the last decade?

I think it is extremely stupid and arrogant and shortsighted to think that a cure for aging is something that could never happen. It is still real dumb and tunnel-visioned to expect it won't happen soon.

So what is the upshot to this? If people wised up and looked closely at the mathematics, the statistics of the pace of change, they would have to admit that at the very least it WILL HAPPEN someday. So if they are actively pooh poohing it what are they actually doing to themselves and others? They are working to forestall something that inevitable and very probably screwing themselves out of a chance to benefit!

Way to go Stuart. Way to look after your own survival and that of your family and umm, mine... and yours all you watching this discussion. Be sure to thank him for holding your best interests in mind.

9:20 PM  
Blogger Stuart Rennie said...

Dear Linda and Kevin, thanks for your comments and your wonderful poems. I had never read the one by Edna St. Vincent Millay before, and it powerfully expresses our hatred of death -- not just for ourselves, but especially for those we love. The idea of my five-year old son dying -- even dying of old age after I am long gone -- is a terrible thought.

As for the more conceptual points, Kevin, you are right to point out some of the potentially positive points to life extention, though I am not sure that the biotechnical ways of trying to extend lifespans is rightly called a natural process of evolution (rather than just manipulation pushed by biotech industries) and like all new developments, life-extention would have its downsides too. And besides, having more time in principle to live does not mean that you are going to live forever, and longer lifespans offer more of the downside of human life -- more chances of being raped, abused, insulted, dumped, killed, or suffering from diseases or disabilities. These technologies would extend life, not escape the human condition as we know it.

As for the less-than-poetic ramblings of futureq, what I see is heavy on speculation and low on detail. Your love of technology is apparently unconditional and selective, applauding only the victories and forgetting the challenges. HIV/AIDS has not been cured despite billions of dollars and the best minds of biomedicine. And there are new, resistant viruses on the way that are here not despite technological advances, but partly because of them. And as someone who works in the developing world, it is not very encouraging to think that yet another magic bullet is on its way (nanotechnology, flavor of the month) to save the natives, since some of our past 'solutions' have magnified their problems.

I'm willing to admit the possibility of curing aging (it is up there with the possibility of interaction with aliens from other planets) if you are willing to admit that immortality as a human being on this particular planet might not be all its cracked up to be, and therefore we should reflect on its human significance and not just gawk at the glossy brochure.

12:03 PM  
Blogger Kevin T. Keith said...

I have just finished a long chapter (hopefully forthcoming in press, but no word yet) on the life-extension projects of de Grey and his colleagues, and the anti-life-extension position of their critics. I agree that the "repugnance" positions of the Kass/Fukuyama crowd seem to be little more than a clinging to the familiar out of fear that an embrace of the new would introduce values incompatible with their own. I think that, as with any powerful and pervasive technology, life extension will bring many benefits and many disruptions, and with it some unforeseen consequences we will come to regret - and also that, as with any such new technology, these consequences will not by themselves discourage us from adopting it.

That being said, though, it would be a mistake to downplay the ramifications of a significant extension of healthful human life. Increases of a few decades would probably cause notable social shifts and some economic impact, but a doubling or more of human life (to say nothing of the thousands of years' span de Grey blithely predicts) would completely remake society. Almost every aspect of society - childrearing, the educational system, marriage and family relations, the work environment and career paths, to say nothing of the medical, retirement and leisure, and financial industries - is in some way predicated upon a human lifespan of under 100 years. The consequences when education must prepare one for a work life extending perhaps 200 or 300 years, when retirement lasts possibly that long again, when families consist of 10 or more generations co-existing simultaneously and inheritances are (or are not) split up among that many survivors, when youthful workers must support 5 or 10 generations of retirees, or when the elderly lack resources for retirement and must work to support themselves for half a millenium: these and other social patterns will create a world that is unrecognizable from today's perspective. This is not necessarily a bad world, but it will be qualitatively different - not just longer-lasting - in every important respect.

Further, there is no way to predict what patterns actually will develop before the technologies that will trigger them have begun to be employed. Much depends on exactly how much life extension is possible - 25 years?, 100 years?, 1,000 years? - and how vigorous that life will be - 200 years of strong young adulthood, or 200 years of decrepit senility? Much depends, too, on how willing and able we are to remake social patterns to, say, allow 500-year-old geezers to compete for jobs with 25-year-old graduates, or to force aged CEOs and grandparents to step down to allow the younger generation a chance to make their mark before they, too, are 500 years old.

It is perfectly possible that life extension will be the gateway to a golden age of effortless, indefinitely prolonged bliss. It is also possible that it will lead us into a Malthusian coffin-corner in which we discover, only after we get there, that long life does not include lengthy health and strength, and that it is mathematically impossible to build an economy that supports 20 generations of elderly citizens on the labor of two generations of workers. I am am optimist on the matter, but I do not believe that good outcomes are guaranteed.

3:28 PM  
Blogger Stuart Rennie said...

Thanks for your thoughtful comments, Kevin. Please write and say where your piece eventually gets published.

One comment: according to de Grey and company, there is no need to worry about 200 year old geezers competing with 25 year olds for jobs. In his view, there will be no geezers: by 'curing aging' he means there will be no physiological difference between the 200 and 25 year olds.

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