Strive to Live or Strive to Die, But at Least Do Something, Show a Little Agency in the Matter

There will always be naysayers when it comes to the prospects for enhanced health and longevity: people who claim that they want to die younger than they might, that they don't want to do anything about the aging process, and that they'll be content with a lifespan that is the same as their parents and their peers. They tend to say all this while materially benefiting from medical technologies that didn't exist for their parents and grandparents, and the fact that a great many people presently say that they don't want to extend their lives through advances in medicine has a lot to do with the fact that the necessary technologies don't yet exist. They are just around the corner, a few decades away, something that needs work and advocacy and funding support to come in to existence.

If rejuvenation treatments after the SENS model existed in the clinic, providing accessible ways to turn back aging and live in good health for decades longer, then I think that the number of naysayers would be much smaller. Consider the modest population of people who today refuse a range of effective, proven forms of medical care for religious or other reasons and suffer as a consequence. They are very much in the minority. That is the future for people who decide not to undertake treatment of their aging process: there won't be many of them once rejuvenation treatments are a reality for all the same bland cultural reasons that exist today. It is done because most people do it, and that is the way of things whether it involves helping yourself with medicine or hurting yourself with cigarettes and too many calories.

All of this presents quite the obstacle when we are right on the verge of promising new medicine to address aging, standing at the point at which support is needed for rapid progress towards the creation of effective treatments capable of reversing the specific root causes of age-related disease. All too few people are willing to stand up in public to say "go for it!", and for every one of those someone else dolefully touts the path of resignation, relinquishment, and aging to death on a predetermined schedule. It is probably extremely charitable to believe that any of these people would hold the same views were they born fifty years later: they'd be using health assurance treatments that repair metabolic damage to hold back aging and maintain youthful health and vigor just like near everyone else.

Still, there will always be naysayers. Just not so many of them as there are today. The fellow quoted below seems to me to be touting a position that is the result of a profound failure of the imagination and ambition. He fails to see that the current state of medicine for the elderly is the outcome of failing to treat the causes of aging, but rather just trying to shore up the consequences. That never works well: you can't make a failing machine work well unless to address the cause of failure. He fails to mention that the field is changing to move in that direction: the future of treatments for age-related disease and trends in healthy life span will have little to do with the past. A discontinuity is coming as the result of a change in fundamental strategy coupled with a sudden leap in the capabilities of biotechnology over a few short decades. Further, I really have to complain about anyone who claims that refusing medical care in late life equates to "going quietly." That the unassisted end of life is a simple fade to black is a malicious lie propagated by those who, for often petty reasons, like to keep the suffering in this world behind curtains and out of sight. The end of old age is painful, bloody, drawn out, and horrible. Many of the options include some of the worst things that can happen to anyone, and that process as a whole happens to everyone.

Why I Hope to Die at 75

That's how long I want to live: 75 years. I am sure of my position. Doubtless, death is a loss. It deprives us of experiences and milestones, of time spent with our spouse and children. In short, it deprives us of all the things we value. But here is a simple truth that many of us seem to resist: living too long is also a loss. It renders many of us, if not disabled, then faltering and declining, a state that may not be worse than death but is nonetheless deprived. It robs us of our creativity and ability to contribute to work, society, the world.

I am talking about how long I want to live and the kind and amount of health care I will consent to after 75. Americans seem to be obsessed with exercising, doing mental puzzles, consuming various juice and protein concoctions, sticking to strict diets, and popping vitamins and supplements, all in a valiant effort to cheat death and prolong life as long as possible. This has become so pervasive that it now defines a cultural type: what I call the American immortal. I reject this aspiration. I think this manic desperation to endlessly extend life is misguided and potentially destructive. For many reasons, 75 is a pretty good age to aim to stop.

Once I have lived to 75, my approach to my health care will completely change. I won't actively end my life. But I won't try to prolong it, either. Today, when the doctor recommends a test or treatment, especially one that will extend our lives, it becomes incumbent upon us to give a good reason why we don't want it. The momentum of medicine and family means we will almost invariably get it.

Doctors wanted to extend life. Instead they extended death

There's this idea that as we grow older we'll be healthier. I call it the rectangularization of life. You go on as healthy as you've always been and then at the end you just fall off a cliff and die of a heart attack or stroke or something. But over the last 30 years the data has said the opposite. As we add years of life we're adding more years of life with disabilities. We are saving more people who have strokes. That's a triumph. But the consequence is people are living after strokes and they typically have disabilities - they have speech problems or cognitive problems. There's a tradeoff. We have extended the dying process.

This is a view of a future of stasis. If you think that it is going to be more of the same, forever and always, then one might ask what the point of it all is. Nihilism starts with "why live longer," and moves on to "why live at all," but people making arguments like those quoted above are to my eyes living in an incoherent half-way house somewhere distant from any point of actual conviction. Live if you want to live. Die if you want to die. But above all do something about it, don't just lie back in your chair and exist or fail to exist at the whim of fate and the machinations of your own cells. Show some agency.


I am interested and excited about potential aging treatments and longer lifespan. But at the same time I am also wary of the hype. It's a little self-serving to expect this stuff to happen in our lifetime, dont you think? Like we're the generation that got lucky. I doubt we're that lucky.

Posted by: InternetStranger at September 22nd, 2014 6:53 PM

@InternetStranger: The world doesn't care about how we feel or whether we benefit. Luck is a perception, not a reality. Technology is technology: it is either possible or it is not possible.

My evaluation of the field is that it is possible for some of those people alive today to get onto the curve of longevity escape velocity, but only if repair-based research and development strategies such as SENS are pursued aggressively and soon. Other courses will produce knowledge but no great gains in longevity.

Posted by: Reason at September 22nd, 2014 7:07 PM

In my city, this past weekend, I printed-off two dozen SENS donate posters (see the SENS donation page). I placed these in ATMs and taped them inside bus shelters (did it at night with few people around). It's my small part to raise funds for and awareness of the SENS effort. As Reason has stated, every small gesture/donation at this point slowly builds the snowball and pushes it closer to the edge...

Posted by: BB at September 22nd, 2014 7:32 PM

@BB: That's the spirit!

Posted by: Reason at September 22nd, 2014 7:37 PM

I've always thought the longevity aspect has been the wrong focus. Even if you were to do one thing in SENS well society would look a lot different, even with death from other age related diseases.

Posted by: Michael-2 at September 22nd, 2014 7:57 PM

25 years ago he would have written with the same conviction: "Why I hope to die at 65", and 50 years ago, "Why I hope to die at 55". Even without a rejuvenation breakthrough, in 25 years he or his replacement would write "Why I hope to die at 85" and in 50 years "Why I hope to die at 95".

Posted by: Hervé Musseau at September 23rd, 2014 1:13 AM

"That's how long I want to live: 75 years."

Tell me that when you are 74 and I will believe you.

Posted by: Antonio at September 23rd, 2014 4:31 AM

It was very long, I didn't read everything. But I read enough to know his logic is flawed. I think his perspective is skewed by his personal situation, he is 57, but looks 65. At the rate he is going he will look 85 when he turns 75. I think his fear is, and it may be a valid one, that a way to greatly slow down the aging process will become available while he is in his 70s and he will be doomed to live out eternity in the body of an 80 year old. Although on one hand he says this is only his decision, much of the blog post reads as if he is trying to sell this viewpoint to others, which is somewhat of selfish motive.

Posted by: JohnD at September 23rd, 2014 12:10 PM

@JohnD: to be fair, one rarely takes the initiative to publish a piece without having the intent to sell one's viewpoint to a greater audience.

But I agree with people here that this person is just trying to rationalise something he has no control over, and something he *doesn't want to try* having control over: "You don't want how you died to become the narrative of your life." [Vox article]

Ha ha. However one dies will always weight on someone's history. He claims that he wants to die completely unassisted by any "life-extending medical intervention" including antibiotics: there will most likely loved ones who will regret this decision of his; this relative or this friend pondering over the "what if" of a potential reversal of opinion. All the more in a future where medical advances will permit more personalised and more effective treatments.

Posted by: Nico at September 23rd, 2014 7:27 PM

No, both Ezekiel's parents are in their 80's. Despite his elderly appearance, he has good genes and will most likely enjoy being an octogenarian.

Ezekiel is not merely rationalizing his own eventual death.

He is taking the standpoint of a member of an elite who expects to live longer than average. That's *good enough* for him. He's rather be the one-eyed man among the blind than see everyone conferred with full eyesight.

Posted by: Cahokia at September 23rd, 2014 9:36 PM
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