Bioethicists Consider the Search for a Treatment for Aging

This press release from a UK bioethics organization announces a recently published and comparatively innocuous short PDF primer for policy makers on the present state of research into the treatment of aging as a medical condition. Innocuous or not, it still contains a fair dose of utter nonsense mixed in with its view of the field, as is fairly standard for this sort of thing. Professional bioethics, it has to be said, has done little to make itself useful in the past generation in my view, and in fact has used regulation to slow progress in those areas where bioethicists have attracted the most attention. It is a corruption of the older, actually useful field of medical ethics, which had the merits of being simple, valuable, and requiring little upkeep. Bioethics, on the other hand, has become a cancerous political institution, ever growing, and its practitioners ever incentivized to justify their budgets by making up obstacles where none actually exist.

Geroscience, also called biogerontology, is a field of research that is exploring the biological processes that underlie ageing. Researchers working in this field believe that intervening in these processes could be a more efficient way of increasing health span - the number of years we are healthy - than tackling each condition individually. Recent advances in the tools of research are likely to accelerate our understanding of ageing processes in the near future.

Compressing the period of poor health experienced by many in old age could have a transformative effect on the lives of older people and is widely considered to be the primary goal of geroscience research. Biomedical interventions, along with environmental, social and lifestyle modifications, have already contributed to the extension of human lifespan. Depending on other factors that could affect lifespan, ageing interventions could lead to a further delaying of death. Some suggest that a realistic target of geroscience research is to delay all ageing-related disorders by about seven years. Other commentators believe that scientific advances will lead to much more radical effects on ageing and human lifespan in the near future.

There are differences of opinion about the value and morality of extending lifespan, even moderately. Some philosophers believe that we think of our lives as having a certain shape, which underpins how long we think people should work and how long it is appropriate to be old. Increased longevity therefore might threaten the shape we envisage for our lives and our sense of personal identity. The benefits of experiencing the pleasures of life over a longer time period are used by some to justify life extension; others argue it is quality not quantity of years that matters. Some equate extending life with saving lives, and suggest there is a strong moral imperative to pursue treatment for disease, even if the side effect is an increase in lifespan.

A common concern of lifespan extension is that it would accelerate population growth, and that this would have a range of adverse consequences, particularly for the environment. However, one study suggests that population changes would be surprisingly slow in response to even a dramatic extension of lifespan and would not necessarily lead to overpopulation. It has also been argued that using finite resources in a nonsustainable manner is a problem that needs to be solved independently of how long people live.

Estimations of the impact of increasing health span on the economy are generally positive. For example, one analysis suggests increasing human health span would reduce healthcare spending and lead to significant economic savings. Another suggests that delayed ageing could mean increases in social benefit and public healthcare costs, but that these would be far outweighed by economic gains as a result of a healthier workforce who remain employed for longer and are given more time to save for retirement. These effects would depend on the relative increases in health span and lifespan that could be achieved by ageing interventions, which currently are highly uncertain.

Ageing interventions are likely to be available only through the private sector initially. As with any paid for therapy, it is probable that access to ageing interventions will be unequal, leading to an exacerbation of existing health inequalities according to income, socioeconomic status, and geography. In addition, personal choices about uptake of ageing interventions could have implications for entitlement to state care and health insurance. There are calls for government policies to ensure unequal access to ageing interventions is avoided. Global health inequalities present particular challenges in this context, given that the citizens of some countries still have low life expectancies owing to poor sanitation, nutrition, and healthcare provision. The duties of developed countries to put efforts into addressing these problems, in relation to the efforts put into research on ageing interventions, require consideration.

Some argue that the focus on finding medical treatments for ageing is unhelpful, in that it suggests ageing is a problem that requires fixing and reinforces negative views of ageing. There are parallels with how the medical community view frailty. Frailty is commonly regarded as a state of overall poor health, weakness and vulnerability, but diagnosing people with frailty may serve to marginalise them from society and unfairly label people as being destined to decline. There is also concern that other important elements of successful ageing, such as personal relationships, social position, physical environment and independence, are side-lined by geroscientists.

An important question for geroscience research is whether potential interventions should be tested in younger people, before biological ageing has started, or in older adults already experiencing symptoms of ageing. In the past, involving older adults in research was thought to be difficult and of no benefit to them. This view has broadly changed. The challenges of research have been found to be much the same whatever the age of the participant, and medical interventions in people aged over 80 can have beneficial effects on their health. In addition, 'older adults' are a diverse group and generalisations about people's ability and willingness to take part in research should be avoided.

Link: http://nuffieldbioethics.org/news/2018/live-research-treatments-ageing-examined-council-briefing-note

Comments

These people are anathema to everything I do.

Posted by: Steve Hill at January 11th, 2018 6:25 AM

In my parents home there is a book written by norwegian bioethicists in 1994. Its like reading something you feels belongs to 19th century. And believe me norwegian bioethicists are more conservative and outdated than americans.

Posted by: Norse at January 11th, 2018 6:50 AM

My favourite country is Singapore. Their founder wanted to make better and smarter humans with genetic engineering and Singapore might be first to do so with germline engineering. The population are very pro all sorts of tech advancements and not reactionary.

Posted by: Norse at January 11th, 2018 7:47 AM

"There are differences of opinion about the value and morality of extending lifespan, even moderately. Some philosophers believe that we think of our lives as having a certain shape, which underpins how long we think people should work and how long it is appropriate to be old. Increased longevity therefore might threaten the shape we envisage for our lives and our sense of personal identity. The benefits of experiencing the pleasures of life over a longer time period are used by some to justify life extension; others argue it is quality not quantity of years that matters. "

All of these things that are mentioned here should not be decided for people by others. Especially not these nameless and faceless "bioethicists". Why again does it matter to me that some people view their life (and life in general) in a certain arc or narrative that can't be disturbed? Generally speaking, someone's self identity isn't the concern of anyone else. But I'm sure in some way, they'll have influence on these things though. I've long said that I thought if there was a treatment for aging that it would be tied up unnecessarily long by these people. I have a bad feeling that these ethicists will be the reason why we end up with a logans run scenario, or John Harris' generational cleansing idea. Or not released at all because "inequality" and because it's "immoral".

Posted by: Ham at January 11th, 2018 9:07 AM

I see these bioethicists arguments about inequality, overpopulation, compression of morbidity, aging is good, ... as something similar to what happens with NASA and Mars settlement. NASA has been arguing repeatedly in the last half century against human Mars missions, saying that traveling to Mars is too expensive, too dangerous due to radiation, zero-g, solitude... and similar nonsense, holding exploration back since then, until a private actor (Musk) decided to do something about it himself and is now near reaching it. Similarly, SRF and related startups are sidestepping the NIH, the NHS... and their bioethicists and making progress to obtain antiaging therapies regardless of what they say.

Posted by: Antonio at January 11th, 2018 9:12 AM

Every second we argue with these people, a person will die of old age. Every f****** second.

Posted by: Antonio at January 11th, 2018 9:17 AM

These people...Steve, I really really sympathize.

Warning, long post incoming, I'm running out of patience with these knuckle-dragging-mouth-breathers.

On the good news front, our own people are pushing back. Jim Mellon is hitting this out of the park lately. I'll put in some links.

https://mega.online/articles/live-long-and-prosper/
Mega is produced in partnership with Pictet Asset Management. Pictet manages almost HALF A TRILLION in assets. No, I didn't type that in wrong, That's Trillion with a T. Mellon is certainly not wasting any time by going after the small players. You can bet there are talks in place for some interesting investments.

https://www.businesswire.com/news/home/20180108006587/en/Juvenescence-Closes-Seed-Participation-Seasoned-Biotech-Investors

Jim just closed the initial seed round of financing. 12.5 million does not sound like a lot, and it isn't. But there are some things most people not familiar with finance might miss here.
1) it was oversubscribed. ( They had to turn people away for the seed round), I'll tell you why in a bit more detail.
2) This was more of a 'friends and family' round. Its supposed to be small.
3) I suspect that Jim is looking to get a valuation on this and the IP he is building before he opens it up for more rounds (And he will, I'm pretty sure we will see a round A in the next few months, once he starts getting his patents and IP in order, this money is basically 'Lawyer money'.).

So why did he close the financing at 12.5 million? Well, he probably has an IP and he wants to get its valuation in before you open it up to round B (In fact we know he has IP from InSilico, this is no secret). Now I still have to do my Due Diligence on the other players in the Founder role, but usually when you see this, its about dilution. These are the founding members and every time you agree to take capital from someone, you lose a number of your own shares. If you are building a company you FEEL in your GUT that is going to be massive, you want to make DAMN SURE that the other people yo are getting into bed with are going to be OK with the overall plan and the dilution of their shares going forward. Basically, everyone needs to be on the same page. He hand picked all these people for a reason. My next side project is to find out why. Bailey is a great pick. Doogan is another. The rest, Foresite Capital, Karim Hakimzadeh, Andrew Banks, and Christian Angermayer's Apeiron Investment Group, I need to look into, but there is a reason they went with them.

OK, next up. The investor class is killing the Tithonus myth. He's actually starting to get through to them.
https://moneyweek.com/the-11-investments-our-experts-would-buy-now/

I'd like to draw attention to this part...

Jim M: But the most important shift is that life expectancy is about to take off. There's been a hiatus in the last couple of years because of the opioid epidemic in the US. But I'm convinced that life expectancy in the UK will rise to 110 or 120 within 30 years. And that will change everything. It will transform financial services - for instance, the pension-fund model is finished. Consumption patterns will change too, because older people are not going to go to night clubs or bars as frequently.

Lucy: Maybe they will? When we think about everyone living longer, we assume they're all going to be the same as old people are now. But is that really true? Are we not buying the same Adidas trainers now as we did in our 20s?

Jim M.: That's a good point. People will be robust rather than frail in old age. But in any case, it throws up two main points. What do older people spend money on? Leisure and travel. So the big players in the cruise industry - Royal Caribbean, Norwegian Cruise Line, Carnival and the like - are great long-term investments. And the longevity industry itself will be huge. Biotech has seen major shifts in the last ten years, from small molecules to biologic drugs, and now cancer immunotherapies, which will be a $50bn industry within three to four years.

But the really big prize will be when a company can say: I can give you this drug and you will live for another ten, 20 or 30 years, and be in better health than you would have been in your grandparents' or parents' day, and it's going to cost you 5% of your income. That's where the real money will be. For now, most of those firms are private, but a slew of them will come to the public markets in the next few years. The best of the big drug companies in this area is Swiss giant Novartis (Zurich: NOVN), which has a reasonable dividend yield, a solid balance sheet and a very good suite of new products coming out. It's a long-term keeper.

Ok, so Lucy is getting it, and the word is spreading. She challenged Jim on it! Guys, that's progress. That's progress at the level we need it the most!

OK, making another post because I really hate walls of Text. But I have more ideas and help for Steve.

Posted by: Mark Borbely at January 11th, 2018 10:15 AM

The only valid ethics are those that center around self-ownership and check for informed consent in a state of sound mind, nothing more than this. This principle of self-ownership extends to sexuality, abortion, drugs and all areas of life. It is the foundation of ethics and these bioethicists continuously violate this fundamental human right with their nanny state, control freak interference.

Posted by: Nathan at January 11th, 2018 11:04 AM

Once more thing from the Moneyweek article. Jim is also trying to kill the 'Only for the rich' argument. Although he does say its gong to be primarily for developed countries, he's also pushing higher corporate taxes and a UBI to pay for a lot of this. He's right to. Its a possible solution. And here's the rub, he's offering SOLUTIONS. These bio ethics numpties offer NOTHING. And here's where we challenge them. Invite them come up with SOLUTIONS to these PROBLEMS.

I would like to offer up two apt Klingon Proverbs for this scenario.

1) Only a fool fights in a burning house.

2) Sometimes it is enough to show teeth, but when you bite, bite deep.

Ok, right now we are fighting in a burning house.

If these ethereal big-thinkers want to exist, lets give them something to chew on. An open letter from the community is in order.

Our social structures will collapse for not only our elderly, but everyone else in it.

- State pensions die around 2035 give or take depending on country. Is it better to have healthy individuals who do not need state assistance? Or elderly who are in pain, frightened, and a burden to all society?

- Health care systems aren't set up to deal with the asteroid heading for them. AD alone will bankrupt the system. Will pontificating about these possible theoretical issues help younger generations when healthcare is rationed for all? What will the rationing of health care do to life expectancy for younger generations going forward? We've already seen what healthcare for the rich looks like in the US, we don't have to argue the ethics on that. It's not hypothetical. Its happening now. How will pontificating on life extension technologies and delaying their deployment affect inequality to health care access for younger generations? Once again, is it better to terminate the old?

- Automation is going to take between 30-50% of all jobs out of the workforce by 2035. With the reduced tax-base, the funding shortages are only going to get worse. Would it not be better to find ways to keep people of all ages healthy and find ways to fund it rather than having an increasingly sick population eat away what few dollars remain?

I could come up with a zillion of these issues that come into cold hard numbers and facts. When we press the 'ethics police' with numbers, your going to see them look up with a lot of blank stares. Its quite simple really, this situation we are in is really a 3 phase switch. There's no tinkering around the edges with this one. Demographics are destiny.

1) Make the older population more robust and healthy. Everyone wins.
2) Put grandma in the woodchipper. (This argument is an instant loser for an ethicist, if they argue for death, the backlashh... ohh.. the backlash will be so sweet).
3) The old are left on their own to whatever fate has in store for them. (Another loser, leaving the most vulnerable in our society to fend for themselves certainly doesn't pass the ethics test).

Biting deep is asking a pontificator for actual possible solutions to the problem. When framed in that context, they are screwed. They will likely try to re-frame it, because the solutions can't be argued in a format they can work with. That's when you call them out, stating we are trying to find solutions for these very tough problems and if they have nothing to contribute other than delay, we remind them that the clock is ticking and we don't have time to debate things that will result in a lot of near-term suffering by a great number of people. That part is not arguable. These are brutal things to confront when you have to provide a tangible fix for them, they aren't equipped to deal with them.

I love this kind of stuff, they usually get so contorted in their arguments they don't even hear the trap snap shut.

Posted by: Mark Borbely at January 11th, 2018 11:13 AM

Bioethics is not ethical.

Posted by: bmack500 at January 11th, 2018 2:54 PM

I love this part:
"Some argue that the focus on finding medical treatments for ageing is unhelpful, in that it suggests ageing is a problem that requires fixing and reinforces negative views of ageing. There are parallels with how the medical community view frailty. Frailty is commonly regarded as a state of overall poor health, weakness and vulnerability, but diagnosing people with frailty may serve to marginalise them from society and unfairly label people as being destined to decline."

So, presumably by that reasoning we should stop trying to find treatments for HIV, multiple schlerosis, rabies, ebola, malaria and hepatitis, as we wouldn't want to marginalise people with those conditions, would we?

Posted by: Arcanyn at January 12th, 2018 4:06 AM

Thoroughly agree with you there. Paper shuffling pontificating waste of resources.

Posted by: Neal Asher at January 12th, 2018 6:31 AM

The argument about the rich is a weak one. Like not every person in the world can afford electricity.. so should we shut off everyone's electricity?

What we did is there was public funding for rural electrification where the economies of it didn't make sense.. this extended the power grid to people who were left behind.

Then there was still some people who were too poor to afford electricity. So we put in place various subsidies and social assistance so they could use electricity too.

Posted by: aa3 at January 14th, 2018 9:23 AM
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