Tuesday, July 01, 2008

EMBO Reports Paper

My article "A tale of two strategies: The moral imperative to tackle ageing" is now published in the latest issue of Nature's EMBO Reports. Here is a sample:

...another disagreement now embroils researchers studying ageing: the debate about how they should frame the moral imperative to retard human ageing. Is ageing actually a disease? If so, should we invest more public money to find a cure for it, or are the medical interventions that could retard ageing best classified as 'enhancements' rather than therapies? Does this really matter and, in any case, do the answers to these questions have an impact on the prioritization of research into human ageing?

This ethical and social debate is mostly confined to the field of biogerontology. Scientists who are working on applied research to find treatments for cancer or Alzheimer disease, for example, seldom find themselves pressed to offer a rationale for why they are doing so: it is apparently self-evident that a cure for cancer or Alzheimer disease is desirable and important. Yet, research into ageing pushes the medical orthodoxy in ways that research into treating a particular disease does not. This explains the interesting and spirited debates among biogerontologists about how to pitch the importance of their research to the general public and policy makers, and how to make a compelling case for diverting a greater share of public funding into ageing-related research.

.... the aspiration to find a reasonable balance between tackling ageing itself and the diseases that are associated with ageing stands a chance of being proportionate only if all of the advocates of scientific research are playing by the same rules—in terms of the promises made and timescales estimated when appealing for public funding. This is where the second strategy appears to be too conservative and, hence, problematic. To achieve proportionality, policy-makers and the general public need a sense of the magnitude and likely timescales of the benefits that could be delivered by intervening with the biological processes of ageing versus those promised by the strategy of tackling one disease at a time. The greater the magnitude of these benefits—even if one abandons the 'ageing is a disease' premise—the greater the portion of public funds that should be invested in ageing-related research.

....asserting that the aspiration to retard human ageing is a moral emergency does not mean that the interests of those who are currently afflicted with the pathologies that accompany ageing have no moral weight. Yet, modern medicine is severely limited in terms of the substantive health benefits that it can confer on those who already suffer from these afflictions. Now that we have good scientific evidence for believing that we could alter this situation—so that future generations do not suffer the same fate—we have a moral obligation to humanity to respond in a fair and proportionate manner, and to mitigate the biological vulnerabilities that we have inherited from our evolutionary history.