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Are we emotionally prepared to cure old age?

Are we ready to accept the responsibility for our scientific inventions?

As the discussion of scientific and technological breakthroughs in medicine is becoming more mainstream, so is the criticism of life extension research. As our understanding of biological life is developing, and as our tools and methods become more precise in manipulating living organisms, we are touching on something that already has a reference in the popular mind, and it is not always positive.

Playing God

It is a common motif in religious texts and classical literature to regard immortality as a curse, something to be avoided. The ideological reason behind this is known - taking away an individual’s control over his death infringes on the very core of the principles of self-determination and responsibility for one’s actions. Denying one's right to end their life crosses into the realm of a person's identity where the most private decisions are made, and takes that autonomy away. From this perspective, when combined with invulnerability i.e. inability to be hurt, immortality trivializes our choices, and we recognize it as eternal confinement rather than life. By guaranteeing continuous survival such curse usurps the purpose of life and devalues the life itself. Removing the edge dilutes every moment: it makes mistakes less regrettable, triumphs less joyful, and choices less meaningful. Called “the God mode” in some computer games, immortality lowers the stakes, removes the challenge, and makes the game boring.

Are we ready to accept the responsibility for our scientific inventions?
Heracles and Geras. Geras was the
spirit (daimon) of old age, one of
the malevolent spirits spawned by the
goddess Nyx (Night).

Although poetic and inspiring, to gain some perspective, this invulnerability/immortality curse is an abstract thought experiment, not anything realistic. It presumes an external force that takes away one’s ability to make personal decisions, and that is where we see the moral problem. The scenario that this thought experiment highlights is not limited to hypothetical immortals - every individual, by definition, has to draw and maintain that line dividing the private, personal self that we are in control of, and the realm of the will of others. Although ending one’s life is the ultimate personal decision reserved for that private core, we regularly perform all sorts of lesser actions to continue existing as distinct individuals and to maintain sovereignty over our perceived self. Ability to make decisions to alter one’s self is the essence of free will, loss of which the religious thinkers wanted to warn us about. It should be noted that immortality is the promise of most of the world’s religions, and free will is often the mechanism of achieving it. The theological concern in the "curse of immortality" is with free will, not with immortality.

The comparison between the ideological, abstract immortality of the Bible and the extended lifespan achieved by means of technology is flawed, misleading, and falls apart with a little scrutiny. Curiously, even with that understanding, many of us are still disturbed by the idea of classifying old age as a disease, and treating it.

You bet it’s personal

Nobody dies of “old age” per se, rather because aged cells are more susceptible to diseases, we usually die from a range of rather ordinary infections or preventable mechanical defects such as the common cold or lack of oxygen. Modern medicine is ceaselessly working on tackling these, resulting in i.a. the world life expectancy roughly doubling in the last two hundred years.

Exponential growth/decay is a disposition of many natural processes
Many organic systems grow exponentially.
As science and technology advance
we should expect the
rate of life saving breakthroughs to
accelerate as well. That is to say that
some marked increases in the average
lifespan are unavoidable at this point.

Issues of life and death evoke themes of significance, high stakes and gravity. They reach into the realm of ethics and morality. These are not like flavours of ice-cream - we somehow sense that unlike with the flavours, we cannot change our position about charged moral issues on a whim. Such issues are sensitive and personal to us because, due to their subject matter, by making a judgement, and choosing a side, we commit our identity to align with a specific perspective, which we then defend as our own. This is the source of certitude and self-righteousness that we betray when regardless of what anyone might say, we “already know” that we’re right. Much like fans of competing sports teams, the spin doctor in our head is telling us that our team is better and more deserving to win. In the words of the psychiatrist Dr Mark Goulston:

Sure that what we want is best, we keep driving forward under the blinding confidence of our good intentions. We’re convinced that we don’t need to learn or hear more from others, that other options and alternatives don’t exist, that our agenda is the single best plan possible, and that we’re justified in using any means to achieve it. And we’re nearly always wrong.

With many charged issues, taking a side requires that one subscribe to an opposing set of biases. Limited to the ideological boundaries of the adopted position, we continue to apply our core values.

Concerned Citizens vs Prematurely Excited Scientists

Indeed, we may suggest that by classifying old age as a disease, we are labeling much of the population as “diseased” while many elderly lead healthy lives, and contribute to the society. Further, such classification would stigmatize the already vulnerable population. It would also adversely affect the younger generations by suggesting that we are all inevitably sliding towards disease as we grow older.

Such concern, rooted in virtuous compassion, nevertheless reveals skepticism as to the efficacy of the modern medicine. The affective impact of picturing duped and vulnerable elderly outweighs any potential promise of technologies that might not even exist yet. This is a personal judgement, and a clear decision for a layperson with a conscience.

One problem with this line of thinking is that a layperson lacks the competence to make judgements on efficacy of medical treatments, and to override conclusions of the doctors and scientists that designed them. Regardless of the layperson’s competencies, as long as the question boils down to the reliability and success of the medical procedures, the discussion is no longer about the nature of aging, and the only possible objection could be that the longevity extending scientists are making premature claims, with many treatments still experimental, and no infrastructure to distribute the “cure” to the general public. Again, a virtuous concern. The logistics of updating medical procedures, introducing new technologies, and continuously training personnel may or may not be prohibitively expensive. In either case we would do good to support the research and integration of the new technologies to minimize the difficulties that are associated with their adoption.

Old age is one of the foundational structures that this culture rests upon. In our view of the world, aging is constant and inevitable; it’s practically synonymous with “time”. It shapes our families and dictates our tasks. As a class, the elderly sustain frameworks of traditions, instill values, and prepare the younger generations to assume their roles in the society. Moreover, the elderly offer a unique and valuable perspective on the society - because they are not bound by future goals, they focus more on the present. It is possible that as aggressive anti-aging therapy becomes more common, the public attitude toward the elderly will shift as well, affecting the society as a whole. As some customs and behaviours associated with old age will have to be adjusted, the world may have to change in major ways.

These concerns are real and sound - extreme “external” changes to a culture such as even a mere possibility of a virtual dissolution of a social class, may damage it beyond repair, as we have witnessed in numerous indigenous populations where advanced technology had been introduced. One important distinction is that the technological progress in these societies didn’t originate from within i.e. the Stone-Age Australians couldn’t have possibly invented the steel axes at their level of development. It might also allay some fears to realize that the values, canons of behaviour, even accents remain around longer in areas with higher average age. Healthier elderly have more opportunities to pass on their experience and provide the younger generations with expertise that areas of lower longevity may have simply lost.

Theories of organizational unlearning usually assume that unlearning i.e loss of knowledge is followed by acquisition of more useful knowledge. Although this holds in many scenarios, our society, as an informational entity, is continuously losing knowledge that is not shared before the carriers of this knowledge depart. Instead of being replaced with something more useful, that lost knowledge, however trivial, will have to be acquired anew only to melt away again condemning the next generation to performing the same labour of relearning. It is important to note that this applies to more than just recordable information such as knowledge of weather patterns or cooking recipies, the other type of procedural knowledge that we generally have to learn without a teacher is in decision making strategies, tactics, various aspects of social intelligence, and perhaps in revelations about the nature of human experience. Populations with longer living active adults will benefit from their experience longer. Cultures with higher life expectancy experience quicker technological progress while retaining customs for longer.

Mental Gymnastics

In these, and similar cases we fall in the trap of accepting the premise that we, representing some segment of the population, ought to soften the blow for them, a disadvantaged segment, by conspiring to abbreviate and euphemize the true nature of their condition. Here is a potent quote on such use of euphemisms from George Orwell -

The great enemy of clear language is insincerity. When there is a gap between one’s real and one’s declared aims, one turns as it were instinctively to long words and exhausted idioms, like a cuttlefish spurting out ink.

Our very desire to distort/soften the blow for them requires the mental gymnastics of creating the two classes, and forgetting that most of us are either already or will become them at some time. Thinly veiled, as well, is the presumption that they should lack the education and intellectual capacity to appreciate and observe that the medical science employs the same methodology in approaching their condition as real sickness. With the elderly being the fastest growing segment of the population, in many areas it may soon become the largest. At this point, exposed for the double standard in the medical treatment received by the seniors, the notion that we should just let them “age and die with dignity” will quickly fall apart. Bioethicist Dr. Arthur Caplan asks:

Why are the physiological changes and deteriorations that are associated with ageing considered to be unremarkable natural processes whereas similar debilitative changes are deemed critical diseases when they occur in younger people?

It is unethical to promote suffering and glorify ill health instead of exercising equal dedication when treating people of different age. A common practice, after a certain age, regardless of any medical issues, one is simply no longer eligible to receive transplants. Is there a utilitarian agenda quietly prompting us to assign value to persons’ lives depending on their potential future contribution to the society? Could it be that, unconsciously, we act as callous enforcers of a culturally assigned standard of merit? We gamble that a young person will do more good than damage compared to an elderly person. Recognizing that the younger individuals might procreate, which is key to the survival of a species, we give their health a higher priority. It is impressive that we can seemingly apportion our compassion, and adjust our morality depending on the context. This extreme moral flexibility involving the profound issues of life and death speaks to the evasive nature of our identity, which in this situation appears to be configured to propagate the species.

Nature’s Mistake Fallacy

If there should be one thing that makes most people marvel, it’s the intricacy and sophistication of Nature. Besides being the source of inspiration and awe for the eye, one ceases but to wonder at the perfect utilitarian economy and balance in the interplay of various processes in Nature. Our modern science is only beginning to understand some basic phenomena, and much hasn’t even been discovered yet. It is likely that amid discussions on curing aging, the popular mind conjures up images of other areas where Man went against Nature - environmental disasters, climate change, and of course the nuclear explosion mushroom. This makes for quite a potent deterrent and a serious warning.

Although absent universal consensus, some scientists are warning that the last time species were disappearing at the same rate was during the end-Permian extinction, otherwise known as the Great Dying when all life on Earth came close to being annihilated. With toxic oceans and unbreathable air, Nature had to start almost from zero. Humans evolved a lot later. Having sacrificed much in motor agility to carry around such a large brain, the flexibility afforded to us by the ability to survive through learning, and to adapt beyond the limitations of our vestigial defences is part of what makes us different from animals, and possibly the only chance for life itself to not perish in the next extinction event. Considering that there is a number of global catastrophic events that can happen at any time, the sentiment that we should not be adapting to the environment by increasing our survivability may be an indication of a logical fallacy, a reasoning error since we have no gain in our own extinction. Providing us with intelligence, Nature thought it not necessary to cloth or arm us. Invention, and learning how to survive just a bit longer is what carried us in our struggle to exist as a species, and it indeed permeates most of our actions. It is therefore entirely natural to use all of our human capacities, tools included, to survive. It appears that the real source of the unnaturalness concern in curing old age is the feeling of unpreparedness and inertia. The use of the “unnaturalness objection” in this case is fallacious: curbing our drive to survive and adapt may be even more unnatural than using science to extend life.

Most objections are off the mark, being about the faulty implementation scenarios that the critics assume will take place. Others are easily dispelled leaving the underlying cause of the negative sentiment still unstated. It is interesting to observe that the negative assumptions seem to be already there, and the shaky objections are merely tacked on top. Statements like - “I am against it because it won’t work!”, “It’s wrong!” or “We’re not ready for this!” are not scientific evaluations, off topic, and as personal opinions they may speak more to the person’s attitude towards change in general, or perhaps towards the elderly as a class. Maybe we could attempt to read between the lines, and discover the driving ideas of the statements above - “I am against it because it seems too big, and I don’t know how I will fit in this new system,” or “I am against it because I do not trust science to care about my interests,” and so on. The statements are largely expressions of concern for the well-being of the family and the self.

And the Winner Is…

Are we ready to accept the responsibility for our scientific inventions?
© 1996-2014 ArtMagick

We cannot escape our nature as students and explorers of life. Over one million years of continuous use of tools has shaped our brains to excel at just that - creating and using tools. This determines the trajectory of our evolution. The ever-present concern is that our advancements may function as a magnifier to our inflexible emotional responses. Our inventions let us wield forces on a scale that makes mistakes more costly, while relying on guidance from the parts of the brain that evolved ages before those inventions were conceived. Themes of controlling one’s emotions and wielding too much power run deep in all cultures - they are part of the human experience. Even animals demonstrate restraint: it is a necessary control to maintain social structures and exercise planning. Yet we witness wars, market crashes and environmental disasters even today. The further we evolve the greater the damage our unchecked primitive emotions can potentially cause. It is uncanny then that the impulse to halt scientific exploration is itself rooted in emotion, mainly in social fear. The ethical dubiousness of inventing the atom bomb is categorically different from a determination to extend human life, and while every medium sized nation state thinks itself emotionally stable enough to possess nuclear weapons, most are not emotionally ready to demystify human nature and physiology. Perhaps, we are not ready to pull the veil of euphemisms and double standards off of old age, but we are getting there fast. Much like the atom bomb, we cannot “uninvent” cures. We now live in the world where nuclear war is a possibility. We can feel the weight of responsibility that that invention had placed on the shoulders of all the generations to come. As our species insists on progressing and evolving technologically, our ethical obligations grow with our progress, and we have been managing that responsibility ever since our ancestors started using stone tools. With this in view, we always do best when we step up to the responsibility, and cultivate a balanced perspective allowing us to maneuver around illusions and distortions left by our sometimes unruly emotions.

Clearly, emotional maturity in collective decisions is the trait to be cultivated if humanity is to survive consequences of our own actions. It will let us organize sufficiently to survive natural catastrophes, and to prevent the man made ones. As new science is making radical suggestions regarding the nature of life, new perspectives are quickly emerging to integrate these possibilities and findings into the popular mind. Witnessing the changes around us, our attitudes about basic human interactions accommodate the new reality. This is the way mankind historically embraced the fruits of innovation, making it our own, be it the wheel, the light bulb or nanotechnology. One constant, however persisted: innovation always came from within the cultural context, and it addressed an actual and ongoing issue. Such innovation allowed for the cultural values and social structures to integrate the changes harmoniously. We accepted the responsibilities, and embraced the novelty because of the edge it has given us. Technological advances of the last few decades made this world small enough for our social minds to care, and to participate in events anywhere on the planet. Such emergent universal accessibility of information is the necessary foundation for a global knowledge processing structure that will ensure that, established by free exchange of values and opinions, the global society can face challenges and answer the tough questions as the revelations of the ever accelerating technological progress continue to shake up our world.