Aging fosters sickness and disability, increases human suffering, and makes us more likely to die. Yet there are a number of possible objections to the endeavor of curing aging. Most of these are unfounded myths and hence easy to disprove. This essay draws on my own lectures on the subject and attempts to answer the most commonly raised questions and concerns about a possible cure for aging and the work of gerontologists.
Key words: ageing, biogerontology, anti-aging medicine, eternal youth, gerontology, life span, rejuvenation
First of all, and contrary to popular belief, aging is not universal. A number of complex species, such as lobsters, rockfishes, and tortoises, do not show signs of aging. Therefore, aging is not a prerequisite to life. Aging is neither inevitable nor universal.
Secondly, humankind is, in a sense, a struggle against nature. We have antibiotics and vaccines because we don't want to be sick, which would be the natural outcome in most cases. Yes, some people who drive cars, take medicines, wear glasses, receive e-mail, watch television, and don't have to kill their own dinner think life-extension is unnatural. I just think that life-extension is another adaptation of humans and one that, like many others, will make us live longer, healthier, and happier lives.
This is a common misconception about research on the biology of aging. The ultimate goal of my work and that of many biogerontologists is to preserve and extend health, well-being, and life, not age-related debilitation. We aim not just to make elderly people live longer but--by improving their health--diminish, not extend, their suffering (also see de Grey et al., 2002). What we want is to find ways to extend healthy lifespan by postponing disease and eventually eradicate all forms of age-related involution. In other words, to find a cure for aging, an intervention that permits us to avoid aging and all pathologies associated with it. More than improving the quality of life of the elderly, we want to avoid having elderly patients in the first place.
According to my calculations, if we were to cure aging that would result in an average longevity of at least 1,200 years in industrial countries. This assumes one would be forever young in body and mind. People would still die from accidents, infectious diseases, etc. After all, children and teenagers die too even though they are not yet aged.
The ancient Greeks had an average longevity of 19 years and I'm pretty sure we are happier than them. In fact, longevity increased 50% over the past century and even so quality of life has clearly increased. Entertainment evolves and social adjustments occur. A cure for aging would not mean an eternal life for one could still die. It would mean an average lifespan of 1,200 years, but life would still be finite. In addition, people would always have a choice to end their lives. At present we don't have a choice of living past 122 years, which is the longest anyone has ever lived so far. With a cure for aging each of us would have a choice to live 100, 200, 1,000 or even more years.
This is actually an interesting philosophical question. Many societies, including Western societies, valor death in some circumstances--e.g., death in combat, death to save other lives, etc. Other societies are even more extreme and you can always argue that I don't know what is it like to be dead. As an atheist, I clearly favour life to death. It's true I won't feel death. But if I compare death to its opposite, I always choose life. For those who disagree suicide is always a solution.
The issue of justice is commonly raised when discussing life-extension. Of course it is impossible to predict the price a fictitious cure for aging would have. Yet a number of medical breakthroughs are not immediately available to everyone. The early antibiotics were available only to an elite and a number of present technologies, such as CAT scans or heart transplants, are not available to everyone. That is not a reason for us to ban pacemakers or regenerative medicine. We don't deny heart transplants just because they're not accessible to everyone. We can't deny health and life just because some people lack healthcare. Besides, even if curing aging is initially expensive, with mass production and widespread facilities one can expect it to be available to everyone, at least in industrialized nations.
When Vasco da Gama and Christopher Columbus explored the world they left death and injustice on the shores of Europe. Neil Armstrong walked on the moon without world peace and Tim Berners-Lee didn't wait for an end of poverty to invent the Internet. Yet all the discoveries and endeavors of these men benefited their societies and humankind in general. There are no ideal circumstances. Setting new limits and making new discoveries eventually improves the lives of everyone.
No, of course not. In fact, curing aging and extending healthy lifespan would be profitable for nations. The economic value of increased longevity is estimated at $2.4 trillion per year for the US alone (The Economist, 3 June 2000). The greatest burden on healthcare comes from the elderly and the trend is for expenses with old age to increase as the percentage of people over 65 years-old rises worldwide (UN Programme on Ageing). If aging is not tackled, societies in the 21st will consist of a large proportion of frail, elderly people, which will result in a serious financial burden (Schneider, 1999). Therefore, curing aging would be economically sound. People would live longer but also work longer and thus be more productive. Without the declining years of old age, healthcare and the economy would benefit from a cure for aging.
One good book debating the economic impact of extreme life extension is:
"Coping with Methuselah: The Impact of Molecular Biology on Medicine and Society" edited by the Aaron, HJ and Schwartz, WB (2004). Brookings Institution Press, Washington.
When talking about life-extension it is intuitive we consider overpopulation as a possible problem. In the 1970s there was a current of thought known as the Mathusianism that predicted major problems due to overpopulation by the year 2000. These predictions failed miserably because their proponents did not take into account technological progress made in agriculture, etc. Therefore, we cannot see breakthroughs in aging research as isolated events but rather consider these in the overall evolution of the social organism. The world's population increased almost four-fold in the past century and yet today we have a life quality unparalleled in human history. In fact, population growth with a cure for aging should still be slower than during the "baby boom."
Overpopulation in some regions of the world, such as southeast Asia, may be aggravated by a cure for aging. Yet letting people die to control overpopulation is morally repugnant. If we cure aging and overpopulation becomes a problem in some regions, then we must find other solutions besides letting people die.
This problem occurs with any other medical breakthrough. Following animal tests, human trials begin in a few people. Only after the security and quality of the product being tested is assured can the company commercialize it. Certain products can escape these regulations using a variety of legal stratagems, but that is a general problem in the biomedical industry, not specific of anti-aging research.
Certainly, but that is not necessarily a "bad thing." Humankind changed considerably since the Roman Empire and yet those changes now allow us to live longer, happier lives. A cure for aging would reshape society but nothing suggests such changes would be negative to humankind. People do not exist to serve society. Society exists to serve people, to make people happier and fight solitude (see Thomas Hobbes's Leviathan). In the same way the world is a better place to live in due to the many changes that occurred in the past centuries, a cure for aging would make it an even better place thanks to the decrease in suffering and the increase in health. Although no-one can foresee the long-term consequences of a cure for aging, and there are potential problems such as intergenerational differences in wealth and status, society could profit. And people would certainly profit.
Of course there are many problems and injustices in our world. Many nations face hunger, poverty, and widespread disease. Yet, as mentioned in regard to the justice issue on myth #5, this does not mean industrialized nations must abandon expensive medicines. Besides, the technology to solve poor countries' problems is already here--i.e., sustainable agriculture, vaccines, birth control, etc.--and it is up to these nations to implement them.
Aging is the major problem we face in our society. It is or will be the major cause of suffering and pain for me and the ones I love. This holds true for industrialized nations and Western civilization and that is why aging must be a top priority.
Not so. According to the principles of bioethics, like the principle of beneficence, since curing aging would benefit people, not harm them, it is not ethically wrong. Anti-aging therapies would serve to the amelioration of the many diseases for which old age is the major susceptibility factor. On the contrary, having a cure for aging and refusing to make it available to patients would result in pain and injury, clearly in contradiction with the principle of nonmaleficence. Even if we cure aging, individuals will still be able to choose whether they wanted to age or not, in accordance with the principle of respect for autonomy. If someone wants to continue aging despite a cure for aging being available, no-one can force him or her not to age. Likewise, if a cure for aging is proven safe and efficient then it should be available to all of those who wish to benefit from it.
Some bioethicists, such as Leon Kass and Francis Fukuyama, argue life-extension is immoral. Of course, since longevity increased 50% in the past century, we may already be living immoral lives just for opposing bacteria, viruses, and cancer when we should let them eat us alive. As I hope I made it clear above, curing aging is ethically the right thing to do.
A number of other authors have recently argued on ethical and moral aspects of extreme life-extension (for instance, see Post, 2004). In fact, two books have been recently published on the subject:
"The Fountain of Youth: Cultural, Scientific, and Ethical Perspectives on a Biomedical Goal" edited by Post, SG and Binstock, RH (2004). Oxford University Press, New York.
"The Scientific Conquest of Death: Essays on Infinite Lifespans" edited by the Immortality Institute (2004). Libros En Red, Buenos Aires. A book for which I contributed a chapter.
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