Saturday, November 9, 2013

Ethical Perspectives of Life Extension

Hundreds of thousands of people die in the world every day, two-thirds of them from ageing. Is this just life, the way things must be, or is it a problem to be solved? If, as the western tradition teaches, every human life is valuable in and of itself, shouldn't we be doing more to stop this appalling carnage?

(From The Sunday Times, "I'm going to live forever", March 13, 2005.)

So far as we know, the last hundred years have been the most radical period of life extension in all of human history. Life expectancy at birth in this country at the turn of the 20th century was nearly 50 years. According to the United States Census Bureau, it’s now over 78. And by 2050, it’ll be over 80. Others estimate it could be even higher. A 2009 report by the MacArthur Research Network on an Aging Society estimated that by 2050 “life expectancy for females will rise to 89.2-93.3 years and to 83.2-85.9 years for males”, mostly on account of improved sanitation and basic medicine. But life extension doesn't always increase our well-being, especially when all that's being extended is decrepitude. There's a reason that Ponce de Leon went searching for the fountain of youth---if it were the fountain of prolonged dementia and arthritis he may not have bothered.

Over the past twenty years, biologists have begun to set their sights on the aging process itself, in part by paying close attention to species like the American Lobster, which, despite living as long as fifty years, doesn't seem to age much at all. Though some of this research has shown promise, it's not as though we're on the brink of developing a magical youth potion. Because aging is so biologically complex, encompassing hundreds of different processes, it's unlikely that any one technique will add decades of youth to our lives. Rather, the best we can hope for is a slow, incremental lengthening of our "youth-span," the alert and active period of our lives.

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Not everyone is thrilled by the prospect of radical life extension. As funding for anti-aging research has exploded, bioethicists have expressed alarm, reasoning that extreme longevity could have disastrous social effects. Some argue that longer life spans will mean stiffer competition for resources, or a wider gap between rich and poor. Others insist that the aging process is important because it gives death a kind of time release effect, which eases us into accepting it. These concerns are well founded. Life spans of several hundred years are bound to be socially disruptive in one way or another; if we're headed in that direction, it's best to start teasing out the difficulties now.

But there is another, deeper argument against life extension---the argument from evolution. Its proponents suggest that we ought to avoid tinkering with any human trait borne of natural selection. Doing so, they argue, could have unforeseen consequences, especially given that natural selection has such a sterling engineering track record. If our bodies grow old and die, the thinking goes, then there must be a good reason, even if we don't understand it yet. Nonsense, says Bennett Foddy, a philosopher from Oxford, who has written extensively about the ethics of life extension. "We think about aging as being a natural human trait, and it is natural, but it's not something that was selected for because it was beneficial to us. There is this misconception that everything evolution provides is beneficial to individuals and that's not correct."

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Due to the lack of consensus among experts, and in spite of the fact that many scientists state that life extension and radical life extension are possible, there are still no international or national programs focused on radical life extension. There are political forces staying for and against life extension. In 2012 in Russia, and then in USA, Israel and Netherlands the Longevity political parties started. They aimed to provide political support to radical life extension research and technologies and ensure fastest possible and at the same time soft transition society to the next step - life without aging and with radical life extension and provide such the access to such technologies to the most of the currently living people.

Leon Kass, a prominent bioconservative ethicist, and chairman of the US President's Council on Bioethics from 2001 to 2005 has questioned whether potential exacerbation of overpopulation problems would make life extension unethical. He states his opposition to life extension with the words: "Simply to covet a prolonged life span for ourselves is both a sign and a cause of our failure to open ourselves to procreation and to any higher purpose ... [The] desire to prolong youthfulness is not only a childish desire to eat one's life and keep it; it is also an expression of a childish and narcissistic wish incompatible with devotion to posterity."

Kass is not the only commentator who has criticized prolongevity on ethical grounds. Another is Audrey Chapman. Chapman worries about the justice implications of investing in the quest for longer lifespan: isn’t it wrong to spend money on studying aging in a world where many people lack access to clean drinking water and basic health care?

Opponents of prolongevity, however, fail to offer a convincing explanation of why it would be ethically acceptable for society to be spending vast amounts on researching and curing particular diseases in an effort to extend healthy life for people in rich countries and yet unacceptable to conduct research into the biology of aging in order to develop more effective interventions to achieve the same aim.

Another problem for the justice objection to life-extension research is that one could argue in reply that if we want to do more to help the poor, we should surely sacrifice some less essential form of consumption rather than forego potentially lifesaving medical or biogerontological advances. It is unclear why aging research should be singled out for blame or special concern in this regard. Many factors contribute to global inequality, and spending on gerontological research is such a minute fraction of the financial outlays of wealthy nations that it seems a bizarre place to look for savings to transfer to the poor.

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For the most part, however, the critics’ concern is not so much the money we spend on aging research but rather the consequences if this research should succeed in extending healthspan. Some commentators have worried that longer healthy lifespans for people in the rich world would lead to increased pressure on the environment or, alternatively, that it would be intrinsically unfair for some people to live much longer than others. It is worth noting that this objection presupposes that biogerontology is a more effective means to extending healthy life span than are other kinds of medical research. If it weren’t more effective, then the objectors ought to favor focusing health care funding on biogerontology on grounds that this would be less likely to produce what they maintain is a negative outcome, i.e. longer healthspan for people in developed counties. In other words, those who believe that longer healthspan would be on balance bad should, in order to be consistent, prefer that money earmarked for medical research go to those research projects that are least likely to succeed in lengthening healthspan.

John Harris, former editor-in-chief of the Journal of Medical Ethics, argues that as long as life is worth living, according to the person himself, we have a powerful moral imperative to save the life and thus to develop and offer life extension therapies to those who want them.

Transhumanist philosopher Nick Bostrom has argued that any technological advances in life extension must be equitably distributed and not restricted to a privileged few. In an extended metaphor entitled "The Fable of the Dragon-Tyrant", Bostrom envisions death as a monstrous dragon who demands human sacrifices. In the fable, after a lengthy debate between those who believe the dragon is a fact of life and those who believe the dragon can and should be destroyed, the dragon is finally killed. Bostrom argues that political inaction allowed many preventable human deaths to occur.

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