Fight Aging!

When technology provides the choice to live longer in good health, we should not forget that this is in fact a choice for the individual, no different from many other choices about medicine and life that already exist. It is civilized to respect those who decide that further time or improved health isn't their cup of tea, but as the debate over euthanasia illustrates, respect for self-determination really isn't something that comes naturally to those in power. It is one of the great failings of human nature. I point out this article as a catalog of the major categories of mistaken viewpoints and debates over extending human longevity from someone who has listened to the arguments and chosen the other path. Insofar as the end result is a personal choice to live longer or not, then that should be respected. The problems start when people work towards forcing that choice on others, by halting research or blocking availability of new technologies likely to extend life; fortunately we've seen much less of that sort of rhetoric now that scientists are closer to realizing ways to slow aging or produce rejuvenation in the clinic.

For my part, I'd say that the thing that turns people from life isn't time or cynicism, it is the burden of accumulated loss and pain: the friends no longer there, the debility and disease that encroaches year by year. That growing weight produces a great weariness, ultimately turning every simple act into a gray struggle. Even before that point it is unpleasant. This burden will be lifted through the application of better medical technology in the decades ahead; preventing the death of friends; removing the causes of pain and disability; restoring the resilience of youth in mind and body. Regardless of the plausible future, or the availability of specific therapies in any given year, it is still the case that individual choices in this matter should be respected.

At age 74, I have already experienced many of the indignities of aging and before very long will also confront the inevitability of death. Although neither prospect is particularly pleasant, I strongly believe in the normality and necessity of both. Claims that science will soon prevent aging and dramatically prolong life strike me as irresponsible hype and false hope. I am all for efforts to expand our healthspan, but see little value in prolonging our lifespan, and little possibility that we will soon discover a fountain of youth. My grandson, home from college for Christmas break, disagrees with what he regards as my sentimental and regressive attachment to the status quo. He is participating in stem cell and genetics research and believes that it is feasible and desirable to double the human lifespan and make aging just another curable disease. He has no qualms about this research and regards my doubts as technically naive and ethically unnecessary.

I say that the world is already terribly overpopulated and is rapidly becoming even more overpopulated. Malthusian dynamics ensure that providing a longer life for some must be purchased at the high cost of a more brutal life for the many - a life threatened by even more wars, migrations, famines, and epidemics. My grandson says that overpopulation is best solved by reducing birthrates. This has already been done with great success almost everywhere in the world except Africa and the Middle East. It will be a better, more mature, and healthier world if people live longer and have fewer diseases and fewer children. A longer lifespan will make people wiser, more future oriented, and less willing to take foolish risks in the present. This could lead to more rational decisions on how best to preserve our planet as a decent place to live.

I say that curing disease is the primary goal of medical science. But aging is not a disease - it is an entirely expectable wearing down, an expression of biological entropy that cannot be reversed. We should certainly target the diseases that occur in old age in an effort to extend the average human healthspan. Success will improve the well being of the elderly and have a small subsidiary effect on lifespan - e.g. more people living into their 80s, 90s, and 100s. But we should not expect that better treatment for diseases will allow people to live to biblical ages. My grandson says that it is far too early to tell whether aging in humans is more a reversible disease or an inescapable degenerative process. But since aging is caused by biochemical processes, it most likely can be prolonged by biochemical interventions. We can't decide the question based on values and reasoning - only by actually doing the aging research will we learn whether aging is preventable. And sure it may take many decades, but that's precisely why we have to allocate the resources now to get the project off to a fast start.

I say that only the rich will be able to afford new products that prevent aging and promote longevity. The resulting caste system based on lifespan will be even more unfair than our current divisions based on wealth and power. My grandson says that the distribution of benefits that will accrue from aging research is a political, economic, and ethical question, not a scientific one. Given human nature and existing institutional structures, the benefits will almost certainly be enjoyed in a markedly unequal and unfair fashion - greatly favoring the rich and powerful, with only a very slow trickle down to the population at large. This inequity has accompanied every previous technological advance in the long march of human progress and is not specifically disqualifying to progress in slowing aging and death.

I say that there is something arrogant and unseemly about tampering with anything so fundamental to life as aging and death. Their inevitability has always been an essential element governing the ebb and flow of all the species and all the individual organisms that have ever lived on our planet. Why assume that we have the right, or the need, to tamper with such a basic aspect of nature? My grandson says that scientific progress has always challenged conservative values based on a sentimental attachment to the past. He says that I would probably have worked hard to convince the first agriculturalists that they were breaking some sacred and natural code when they chose to settle down in one place rather than continue following the hunt. There is no inevitable, inexorable, over-riding, and natural law defining and governing one correct path of human destiny.

My grandson is much more optimistic than I that we will soon have the technical means to prolong youth and postpone death - and that we should use them. I am more accepting of the limits of life - eager to improve its quality, rather than expecting to extend its duration. My grandson trusts scientists to make scientific decisions. I believe that scientists have conflicts of interest that make them uniquely unqualified to judge the ethical implications of the scientific opportunities open to them. If scientists can do something, they will do it - fairly heedless of unintended consequences. My grandson has the optimism and enthusiasm of the young. I have the pessimism and caution of the old. In a final flourish, My grandson trumped my argument that aging and death are somehow natural to the evolutionary scheme of things with the paradox that evolution has also given us the power to control aging and death and that surely we are programmed to use it. He is probably right. I don't think our debate will be settled on ethical or theoretical grounds. History provides precious few examples of a society voluntarily rejecting the application of a powerful new technology - e.g. China burning its navy in the fifteenth century; Japan banning guns in the seventeenth. But both were closed societies whose conservative decisions were governed by internal political concerns; they were much less responsive than ours to economic and scientific competition and pressure. My guess is that scientists will be given the freedom and the funding to follow every possible path to the fountain of youth and to doubling the lifespan. Although our knowledge base is increasing exponentially, the more we learn about the body, the more we appreciate how difficult it is to translate basic science into clinical application. Our bodies are remarkably complex and carefully balanced machines. Scientists can tinker with them, but I suspect that the basic cycle of life and death will be very hard to change.

Link: http://www.huffingtonpost.com/allen-frances/a-debate-on-the-pros-and-_b_13843296.html