A March 2003 staff working paper of the US President's Council on Bioethics reflects its chairman Leon Kass's lack of enthusiasm for the prospect of preventing and reversing the aging process.
4. Attitudes toward Death and Mortality: An individual committed to the scientific struggle against aging and decline may be the least prepared for death, and the least willing to acknowledge its inevitability. Therefore, given that these technologies would not in fact achieve immortality, but only lengthen life, they would in effect make death even less bearable, and make their beneficiaries even more terrified of it and, in a sense, obsessed with it. The fact that we might die at any time could sting far more if we were less attuned to the fact that we must die at some time. In an era of age-retardation, we might, in practice, therefore live under an even more powerful preoccupation with death, but not one that leads us to commitment, engagement, urgency and renewal.
5. The Meaning of the Life Cycle: There is also more to the question of aging than the place of death and mortality in our lives. Not just the specter of mortality, but also the process of aging itself affects our lives in profound ways. Aging, after all, is a process that mediates our passage through life, and that gives shape to our sense of the passage of time and our own maturity and relations with others. Age-retardation technologies at once both make aging more manipulable and controllable as explicitly a human project, and sever age from the moorings of nature, time, and maturity. They put it in our hands, but make it a less intelligible component of our full human life. In the end, they could leave the individual unhinged from the life-cycle. Without the guidance of our biological life-cycle, we would be hard-pressed to give form to our experiential life-cycle, and to make sense of what time, age, and change should mean to us.
Kass and company apparently believe that if our bodies don't grow old we will become even more fearful of death. He also thinks we will feel unhinged and lack the sense of purpose that supposedly comes with growing old. I don't personally derive a sense of meaning and purpose from growing old (except that as more years go by I try harder and harder to encourage others to support anti-aging research - so maybe he's right). Aging seems like an entirely undesireable process. Wisdom and understanding would come with the passing of the years even of one didn't grow old.
What would be wrong with having many generations at the prime of their lives for many decades? These ethicists are arguing as if we need really old and the children around to give the middle aged people someone to boss around. Oh great. Couldn't this need be satisfied by getting really obedient dogs, border collies perhaps?
1. Generations and families: Family life and the relations between the generations are, quite obviously, built around the shape of the life cycle. A new generation enters the world when its parents are in their prime. With time, as parents pass the peak of their years and begin to make way and assist their children in taking on new responsibilities and powers, the children begin to enter their own age of maturity, slowly taking over and learning the ropes. In their own season, the children bring yet another generation into the world, and stand between their parents and their children, helped by the former in helping the latter. The cycle of succession proceeds, and the world is made fresh with a new generation, but is kept firmly rooted by the experience and hard-earned wisdom of the old. The neediness of the very young and the very old put roughly one generation at a time at the helm, and charge it with caring for those who are coming, and those who are going. They are given the power to command the institutions of society, but with it the responsibility for the health and continuity of those institutions. In a society reshaped by age-retardation, generation after generation would reach and remain in their prime for many decades. Sons would not surpass their fathers in vigor just as they prepared to become fathers themselves. One generation would have no obvious reason to make way for the next as the years passed. The succession of generations would be obstructed by a glut of the able. The old would think less of preparing their replacements, and the young would see before them only layers of their elders blocking the path, and no great reason to hurry in building families or careers. Families and generational institutions would surely reshape themselves to suit the new demographic form of society, but would that new shape be good for the young, the old, the familial ties that bind them, the society as a whole, or the cause of well-lived human lives?
2. Innovation and change: The same glut would likely affect other institutions, private and public. From the small business to the city council, from the military to the Fortune 500 corporation, generational succession would be disrupted, as the rationale for retirement diminished. With the slowing of succession cycles might well also come the slowing of the cycles of innovation and adaptation in these institutions. Innovation is often the function of a new generation of leaders, with new ideas to try and a different sense of the institution’s mission and environment. Waiting decades for upper management to retire would surely stifle this renewing energy and slow the pace of innovation—with costs for the institutions in question and society as a whole.
They also bring up a fallacy about a loss of the ability to innovate with the passing of the years. If a person's mind didn't age and it stayed as keen as a mind is when it is young then the person will have a longer run at being creative. With no loss in the ability to concentrate or to form new memories will come a greater ability to sustain creative output in many fields.
If there are too many people in a corporation at the top who never retire then one can just change jobs to a company that is growing and promoting people. Or one can become self-employed. Most people aren't going to become senior managers anyway and yet the failure to reach senior management level does not rob a life of meaning.
Along with aging reversal therapies will come the ability to boost intelligence. With youthful smarter minds and energetic bodies people will become far more creative. The result will be a cultural renaissance.
People who think like Leon Kass are fighting a losing battle. Biotechnology will continue to advance and its rate of advance will accelerate. The only question is how long will we have to keep ourselves alive before the technology becomes available to make our bodies young again? Will the technology come soon enough to help those who otherwise will die of old age in 20 years? Or do you need to make it another 30 or 40 years to survive to see the day when it becomes possible to have one's body rejuvenated and returned to a state of youthfulness?
The ethics of using biotech enhancements to slow the aging process were a focus of the Council's March 6 meeting. "Is it reasonable to think that the biological processes of aging are rightly regarded as analogous to a model of disease, to be studied and modified?" chairman Leon Kass asked to launch the topic.
Members chewed over his question and most agreed that aging is a natural part of the life cycle, not a disease.
The problem with this line of reasoning is that many conditions that are now called diseases are essentially the product of aging processes. For instance, what is heart disease? If cells in a heart are very aged the heart will show the symptoms of heart disease.
In fact, as University of Idaho gerontology researcher Steven Austad explained to this bioethics panel the vast bulk of diseases increase in incidence with age.
And the last point is that slowing aging is really a much more effective approach to preserving health, than is the treatment of individual diseases, and I'll give you the rationale for that in this slide here, which shows that these are major causes of death. And you can see that virtually all of them increase exponentially with age. And one of the consequences of the analyses that Jay Olshansky will, no doubt, talk about later, is that curing each of these individual diseases has a surprisingly small impact on life expectancy. But more important, curing one of those diseases does not take care of all of the other disabilities that may be associated with aging, because of other disabilities, such as chronic arthritis, the decline in sensory capacity. These things also increase exponentially in aging, getting rid of one cause at a time, basically leave people who may be alive, but may be very disabled. By slowing down the aging rate, we basically delay the onset and the progression of a whole host of mortal and debilitating diseases.
Slow aging and the onset of a large number of illnesses will be delayed. Reverse aging and the onset of many illnesses will be entirely avoided. Can a biological process lead to disease and yet not be a disease process itself? One can debate the question philosophically but regardless of whether aging is classified as a disease the most effective way to prevent most diseases is to slow and reverse aging.
University of Utah aging researcher Richard Cawthon makes a similar argument.
According to some estimates, slowing the rate of aging just enough to postpone the age of onset of multiple age-related chronic diseases by two to three years would save hundreds of billions of dollars in health care costs. Furthermore, lowering age-specific mortality rates from multiple causes by slowing the rate of aging may be easier to achieve than lowering them to the same extent by developing a separate, more specific intervention for each of a multitude of age-related life-threatening diseases of which atherosclerotic heart disease, cancer, stroke, lung infections, and chronic obstructive pulmonary disease are among the most common.
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