Fight Aging!

A fair number of people stand opposed to efforts to extend human life. A wide variety of reasons are given, including variants of the mistaken belief that life extension must mean some form of maintaining old people in increasing infirmity and pain for longer. In other words that improvements in human longevity will look just like those obtained from the past few decades of progress in medicine, expensive and ultimately futile attempts to patch over age-related conditions without doing much - or anything - to address their root causes. Daniel Callahan, who regular readers will recall has opposed efforts to extend longevity for some time, apparently holds this view.

On Dying After Your Time

Modern medicine is very good at keeping elderly people with chronic diseases expensively alive. At 83, I'm a good example. I'm on oxygen at night for emphysema, and three years ago I needed a seven-hour emergency heart operation to save my life. Just 10 percent of the population - mainly the elderly - consumes about 80 percent of health care expenditures, primarily on expensive chronic illnesses and end-of-life costs. Historically, the longer lives that medical advances have given us have run exactly parallel to the increase in chronic illness and the explosion in costs. Can we possibly afford to live even longer - much less radically longer?

This is not exactly correct. From an individual perspective the outcome of modern medicine is a longer life spent with less chronic illness. A rise in counts of age-related dysfunction is the result of many more people living longer - and this is a good thing. Those people enjoyed more years of active, healthy life before becoming sick. But the opening sentence is true: modern medicine is indeed good at keeping people alive when they would have died in past decades or centuries, and maintaining a heavily damaged system of any sort is an expensive proposition.

But that is today, not tomorrow. The root of Callahan's erroneous view of the future of medicine lies in thinking that future attempts to extend life, deliberately and by targeting the root causes of aging, will in any way be the same as past medical development. In the past, no efforts were made to address the underling causes of age-related degeneration, and all therapies ameliorated or patched over damage after it occurred, with treatment usually taking place in the very late stages of dysfunction. As an approach this is doomed to be both a failure and expensive. Yes, it provides considerable benefits in comparison to doing nothing, but it is a world removed from actually going after and removing the root causes of aging and age-related disease, such as by repairing the cellular and molecular damage that causes aging. This shift in focus from merely patching over to effectively addressing root causes is the greatest and most important change of our time in strategies for medical research and development. Comparing it to the importance of the advent of germ theory is not an exaggeration.

Callahan looks at what is and projects it into the future: the same fundamental failure that bedevils most prognosticators. You have to have a better grasp of what is taking place in the aging research community in order to see that the next generation of medical development to treat aging will be fundamentally different from what has come before. The scientists have been saying this for years, but all too many people are not listening.

Wesley J. Smith is another writer opposed to life extension - and indeed to pretty much all transhumanist projects aimed at overcoming the present limitations of the human condition. He critiqued the above piece by Callahan, pointing out a little of the double standard inherent when someone who is taking full advantage of modern medicine encourages others to die on a shorter time frame. It is probably the only thing Smith will scribe any time soon where I actually agree with some of what he is saying. This seemed a rare enough event to point it out.

Time to Prevent Elderly From Living Too Long?

Contrary to the transhumanist eschatology, Callahan doesn't believe that extending the length of lives will also mean extending their vitality. I tend to agree. But he doesn't exactly practice what he preaches. Callahan could have refused that expensive treatment. I don't say he should have, but no one forced him to spend all that (presumably) public money on care.

He does ask a valid question, I think, about the wisdom of pouring resources into radical life-extending research (at least public money). However he also seems to assert that the elderly be somehow prevented from living longer. What does that mean? Some kind of Logan's Run scenario? Callahan isn't that type. But he should have specified what he meant. As I read him, he seems to be proclaiming some kind of a moral duty of the elderly to die.

Or it could mean refusing efficacious medical care to the elderly that the younger would be able to obtain. In less genteel hands than Callahan's, it could mean something even more insidious.

There are factions who are quite willing to be up-front about plans to limit medical care for the elderly, though this is usually a dialog that takes place in the context of the huge mess that is government-funded provision of medicine. The most effective way to turn an economic benefit (longer lives, with more time spent in health) into an economic liability (destruction of currencies, economies, and rational behavior through inflation while promising future obligations that cannot be met) is to create a free commons of entitlements with a decoupling of services from costs. The inevitable results are rationing, poor service, research and development grinding to a halt as the incentives to improve vanish, and, ultimately, running out of other people's money to the point at which you see a collapse of the sort that ended the Soviet Union, or which is ongoing now in Venezuela.

Even aside from this, however, there are those who oppose even free and open efforts to extend healthy human life. Environmentalist movements are perhaps the most prevalent of these. All in all there are few topics beyond life extension that are so able to bring otherwise sensible, ordinary people to espouse hideous philosophies, such as demanding that the current toll of suffering and death, 100,000 lives lost to aging every day, while hundreds of millions suffer age-related pain and dysfunction, continue without any attempt made to improve the situation.