Recent Bioethical Ruminations on Longevity, Ranging From Sane to Offensive via Self-Parody

Here I'll point out a few recent papers from the bioethics community on the topic of longevity and medical science. We are approaching the advent of therapies capable of effectively treating the underlying causes of the aging process, and for reasons we all still argue about this seems to require a lot more wailing and gnashing of teeth than, say, the prospects of developing a cure for cancer or heart disease. You won't see deep soul-searching treatises on how terrible it would be it cancer were done away with, at least not from people who like to avoid mockery, but treatments for aging appear to be fair game.

I should say here that I don't think highly of bioethics. The modern institution of bioethics is much like politics, in that it is a parasitical line of business that exists only to divert resources away from productive uses. Bioethicists as a group thrive on slowing down progress and inflicting additional costs on development: their funding comes from manufacturing problems where no problems exist, and the incentives follow on from that in a very straightforward manner. In short, bioethics is unneeded. It has no useful role. Yet, like the roil of politics, there it is, a bunch of people devoted to making vital activities such as medical development harder and more expensive. (This stands in contrast with the past of medical ethics as largely pragmatic business of formalizing triage and experiment when you cannot save everyone. Unfortunately once institutions become well established they inevitably drift in the direction of securing growth and perpetuation at the cost of their original goals. Hence bioethics).

Some truly reprehensible concepts are trafficked around in bioethics circles regarding aging, longevity, and medicine. The duty to die, the "fair innings" argument for cutting off provision of medicine to the old, suppression of research that might extend life, and so on and so forth. Meanwhile the average fellow in the street is suspicious or disinterested in living longer for entirely different reasons, but were he born a century from now, he would accept his indefinite future healthy life span without question. It's all a matter of culture. When it comes to the talking heads, there is no status quo so horrible that it won't be defended. We don't have to look far to see that; just count the hundred thousand lives lost every day to aging, and the ongoing suffering of hundreds of millions of others that is swept behind the curtains.

Of course one can also find bioethics writers, usually not of the professional sort, who write more favorably on the topic of enhanced longevity through medical science. Even so, the framing of the discussion is all too often one of rules and allowances: who should be permitted, who should be forbidden. Freedom and choice is something of a lost art as our governments grow bloated and every aspect of life is regulated by disinterested bureaucrats. In medicine particularly all that is not explicitly allowed is forbidden, and the effects of the modern biotechnology revolution are muted and suppressed by the enormous and growing costs imposed upon turning laboratory work into therapies.

Longevity and compression of morbidity from a neuroscience perspective: Do we have a duty to die by a certain age?

The search for longevity, if not for immortality itself, has been as old as recorded history. The great strides made in the standard of living and the advances in scientific medicine, have resulted in unprecedented increases in longevity, concomitant with improved quality of life. Thanks to medical progress senior citizens, particularly octogenarians, have become the fastest growing segment of the population and the number of centenarians is increasing, even though in the last two decades, spurred by the bioethics movement, the priority assigned to the prolongation of lifespan has taken a back seat to the containment of health care costs.

Four Ways Life Extension will Change Our Relationship with Death

Discussions of life extension ethics have focused mainly on whether an extended life would be desirable to have, and on the social consequences of widely available life extension. I want to explore a different range of issues: four ways in which the advent of life extension will change our relationship with death, not only for those who live extended lives, but also for those who cannot or choose not to. Although I believe that, on balance, the reasons in favor of developing life extension outweigh the reasons against doing so (something I won't argue for here), most of these changes probably count as reasons against doing so.

First, the advent of life extension will alter the human condition for those who live extended lives, and not merely by postponing death. Second, it will make death worse for those who lack access to life extension, even if those people live just as long as they do now. Third, for those who have access to life extension but prefer to live a normal lifespan because they think that has advantages, the advent of life extension will somewhat reduce some of those advantages, even if they never use life extension. Fourth, refusing life extension turns out to be a form of suicide, and this will force those who have access to life extension but turn it down to choose between an extended life they don't want and a form of suicide they may (probably mistakenly) consider immoral.

Slowed ageing, welfare, and population problems

Biological studies have demonstrated that it is possible to slow the ageing process and extend lifespan in a wide variety of organisms, perhaps including humans. Making use of the findings of these studies, this article examines two problems concerning the effect of life extension on population size and welfare. The first - the problem of overpopulation - is that as a result of life extension too many people will co-exist at the same time, resulting in decreases in average welfare. The second - the problem of underpopulation - is that life extension will result in too few people existing across time, resulting in decreases in total welfare. I argue that overpopulation is highly unlikely to result from technologies that slow ageing. Moreover, I claim that the problem of underpopulation relies on claims about life extension that are false in the case of life extension by slowed ageing. The upshot of these arguments is that the population problems discussed provide scant reason to oppose life extension by slowed ageing.

Lastly, as for all political and philosophical fields of discussion there are bioethics debates that run right off the rails and into never-never land. At some point reality is left behind and those involved might as well be building their own sort of secular theology for all the relationship it bears to practical concerns. The paper referenced below is a particular egregious example, but there are many others that come and go on a regular basis.

The Tortoise Transformation as a Prospect for Life Extension

The value of extending the human lifespan remains a key philosophical debate in bioethics. In building a case against the extension of the species-typical human life, Nicolas Agar considers the prospect of transforming human beings near the end of their lives into Galapagos tortoises, which would then live on decades longer. A central question at stake in this transformation is the persistence of human consciousness as a condition of the value of the transformation. Agar entertains the idea that consciousness could persist in some measure, but he thinks little is to be gained from the transformation because the experiences available to tortoises pale in comparison to those available to human beings. Moreover, he thinks persisting human consciousness and values would degrade over time, being remade by tortoise needs and environment. The value available in the transformation would not, then, make the additional years of life desirable. Agar's account does not, however, dispose of the tortoise transformation as a defensible preference. Some people might still want this kind of transformation for symbolic reasons, but it would probably be better that no human consciousness persist, since that consciousness would be inexpressible as such. Even so, it is not irrational to prefer various kinds of lifespan extension even if they involve significant modifications to human consciousness and values.
Comments

You or I may have no use for Bioethicists, but I don't see them going anywhere any time soon or doing anything other than mucking up the rate of progress due to debates on desirability. I'm sorry, but when people ask "is an extended life desirable?" it infuriates me. If it's available and I have the means to do it, I will want life extension... that doesn't mean everyone else will. Different people want different things, I don't know why anyone has the right (or thinks they have the right) to make that decision for anyone else, or even suggest it. People like Ezekiel Emmanual who suggest people should be dying on time should take their own advice when the time comes. I'll be damned if the government is going to mandate my demise at a set time.

Maybe average people (and Bioethicists) just aren't giving regenerative medicine a fair shake as something possible, and they just look at the continually rising healthcare costs for the 65+ crowd? Maybe that's why people have the gall to say that people should die on time? Or maybe people just assume that life extension would just be extending the later years in frailty and decline, and not keeping people healthy and productive? That's what my bet is, but who knows...

Money drives the world, and you would think an opportunity to slash medical costs (not having to pay tremendous amounts of money over the long term due to treating multiple chronic diseases) by keeping people healthier and productive for longer would be appealing to most people. Instead we get BS ethical and moral debates... and the proponents of life extension get called selfish for wanting to live longer. How dare you want to live longer? People act like you get more than one life, and you should be happy and willing to throw it away on time. Like I said the other day. I have no doubt that we'll get to the scientific breakthroughs. I have serious doubts and concerns about society allowing it though. Unless it comes as a side effect of curing a major disease, that is.

Here's a link I found today... an exoskeleton that mimics things that come with aging. Looks fun, right? Not. Yeah, lets not try and slow down or reverse aging and just let it be. It's natural. (sarcasm, just in case it wasn't obvious)

http://www.dailymail.co.uk/sciencetech/article-3194823/Old-age-suit-reveals-s-like-PENSIONER-Futuristic-exoskeleton-mimics-arthritis-hearing-loss-blindness.html

Sorry if it seems like a rant, I just got frustrated between reading some of the articles linked in the post and the comments section on some other articles.

Posted by: Ham at August 12th, 2015 5:37 PM

Ham, definitely it must be done by philantrophy. We can't hope anything from governments or companies. They are both too short-sighted and risk-averse. Today I obtained some unexpected money and will donate it to research.

Posted by: Antonio at August 13th, 2015 9:59 AM

Yeah I donate to SENS monthly, and the amount will continue to increase as time goes on. But even if it's done by private companies and philanthropy I'm sure there will still be tons of red tape and backlash from the general public and bioethicists alike. Not to mention regulatory bodies. It's just so depressing the general view on the field in general.

Posted by: Ham at August 13th, 2015 10:14 AM

@Antonio some companies are working towards longevity too, I believe the technology will arrive via philantrophy and private enterprise

Posted by: Steve H at August 13th, 2015 12:51 PM

Steve: Most LE technologies aren't ready for making profit yet. They are at a too basic level now and will need philantrophy much before they can be sold. Also, big pharma is much more interested in making small modifications to existing drugs than in developing radically new drugs or therapies. You have read this, I assume: http://joshmitteldorf.scienceblog.com/2015/07/23/funding-policies-distort-science/

Posted by: Antonio at August 13th, 2015 3:54 PM

I may be biased, but I think it will be a snowball effect. As medical technology becomes cheaper and information regarding longevity becomes more widespread, more common people will be seeing AND acknowledging the feasability of longevity.

As several examples. 5 years ago, driverless cars were mostly out of the public eye. Now, we are expecting them on the road within 5-10 years for the average person. Another example is the sudden use of 3-D printers, not only for printing trinkets at home, but the possibility of body parts and organs. This was not in the mainstream 5 years ago. Another example is the exoskeleten. Now, we expect this to be common for physically handicapped people within a few years. Don't discount the exponential effect of medicine and even people's changed perception.

Of course we are still waiting for the cure for cancer, but I think that is coming with CRISPER, Immunology, and nanoparticles, though.

Posted by: Robert Church at August 13th, 2015 4:05 PM

Robert,

I really hope you're right and more people will eventually think its feasible. I think those are good examples, but they seem to have a different public perception and face a different type of opposition than life extension. Things like self driving cars and 3d printing have their detractors because of potential safety reasons, privacy violations, and putting people out of work (which, depending who you listen to, is going to happen sooner rather than later anyway) amongst other things. I think 3D printing is going to be disruptive and hopefully very beneficial to the masses. The exoskeletons look cool, but I've read they'll probably be pretty expensive initially. CRISPR seems like it has potential to be amazing, and I really hope we see actual therapies coming from that soon. It seems like progress in that area is getting better all the time. I want to believe in the exponential effect of medicine, and all of these potential great things, but regulatory bodies and the excessive amount of red tape make it hard sometimes.

On the other hand though, life extension gets opposed for things like overpopulation, wealth inequality, resource consumption, being unnatural (the appeal to nature arguments are one of my favorites), selfishness, and the list goes on and on. It seems like people just view life extension as simply extending life, not health... but even then people ask "but then what does a healthy person die from?... we'll be overpopulated then!!!" The people with the overpopulation view seem to be the hardest to convince that longevity is a good thing. It seems like there is also a fairly large group of people that think it will be possible but don't support it, because they insist it will be for the "wealthy elite" only.

Posted by: Ham at August 13th, 2015 4:54 PM

"Nicolas Agar considers the prospect of transforming human beings near the end of their lives into Galapagos tortoises, which would then live on decades longer."

Tonight I dine on turtle soup! (Sorry, had to.) And that guy's selling that for 40 bucks?

Also, Ham, there's an old saw: The dogs bark, but the train moves on. Nearly all of that is inconsequential yammering. It only becomes a problem when there's enough of it to clog the system (as the "organic" cartel has financed against GMO growers). I can't see an explicitly pro-death movement getting that kind of traction.

Posted by: Slicer at August 14th, 2015 11:53 AM

You'd be amazed what kind of stupidity gets traction. I love the TMNT reference haha.

Posted by: Ham at August 14th, 2015 12:51 PM

My hope for a killer app is nanoparticles. If we can get them programmed safely AND satisfy gov reg, the sky is the limit on this option. But, I think it could be out a couple decades.

But as people see a real possibility for living longer AND healthier, they will request it. From what I read, we can handle much more people on this planet if we plan well. Technology will help with energy and food. We, as a species need to allocate space better. If/when we have safe flying cars, we can live on 3d space (like the jetsons) instead of on a level playing field.

As word gets out and explained to the average person that we can handle increased demand for energy, food, space, and waste (recycle), I think people will want and EXPECT to live healthier and longer.

Plus, if we can have a robotic society where we are not expected to work at all or relatively little, the desire to live longer becomes more intense. But, that is another subject. I think the rich will get the latest and greatest, but it seems that as time goes on, the trickle down effect seems to go faster. And, as they say, the product gets the bugs work out before the average guy gets it. I think this also applies to medical research too. Who wants to be a guinea?

Posted by: Robert Church at August 14th, 2015 6:31 PM

The nanoparticles do look incredibly interesting. I think (and hope) you're right on the technology helping with food and energy though. For every scientist that says we're not overpopulated and we could feed more people etc, theres another that has the opposite stance... much like every other topic. You would think that most people would like to live longer, even if all the needs you mentioned were met, but a quick read on the comments section on other articles paints a different picture... but maybe when real treatments are staring them in the face, they'll sing a different tune.

I'll be a guinea pig 30-40 years from now on aging treatments if there's still nothing commercialized, for sure.

Posted by: Ham at August 14th, 2015 7:12 PM

"Who wants to be a guinea?"

I'll immediately get in line to start wheeking in a clinical trial, and I'm not even old yet.

Posted by: Slicer at August 15th, 2015 9:02 PM

Slicer, unless you have a life threatening disease, I am not sure it is good to be one of the first to go on a new drug.

My ex-wife was obese and they came out with Fen-phen in the 90's that worked great to reduce weight, but later found out it causes heart problems and the FDA pulled it from the market. Thank goodness my ex-wife was not interested in this, though I encouraged it at the time.

Posted by: Robert Church at August 15th, 2015 10:27 PM

I have often thought that if some entity could get in EARLY ENOUGH in the political or ethical game, they could alter the strategy that the politico/ethicists operate within, and thereby POISON their well - so to speak. An example would be, if someone had insisted EARLY ENOUGH in American Politics that a law destruction committee was set up, then that committee would ALSO be self-perpetuating, but useful. Similarly, a group of ethicists whose sole raison d'etre was to examine the ethical costs of delaying research, with research awards established for the best papers, could swamp the bioethicists work.

Posted by: Benjamin at August 16th, 2015 6:03 PM
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