Tuesday, May 10, 2011

Life Extension, "Sacred Values" and Taboo Tradeoffs

New substantive posts have been light these past months due to a very busy teaching and admin term. Attention is returning to research so I hope to add a series of new substantive posts over the coming months.

Here I will offer a few more thoughts on "sacred values" and how this pertains to my research on longevity science. A post on sacred values in political philosophy more generally is in the works.

For the past few years I have published a series of articles (see here, here, here, here, here, here, here and here) addressing the ethical and social challenges which the field of biogerontology faces.

Reflecting back over this work I think it is accurate to say that, for the past 5 years or so, I have devoted the bulk of my time and energy contemplating the following question- why hasn`t humanity undertaken an ambitious effort to advance the science that could help us redress the single leading cause of disease and death in the world today- namely, *biological aging*?

What I have found most surprising, and alarming, in my teaching and research on this topic is the extent to which people will go to justify their intuition that we should not aspire to modify the current rate of the molecular and cellular decline of humans. These reasons typically range from sentiments like “aging is natural“ and “doing so will exacerbate inequality“, to “it will cause overpopulation“ and “it will cause ecological disaster“.

And yet no one raises these same objections when the discussion is about supporting the science which could help redress just one specific disease of aging- like cancer, heart disease or stroke. No one objects to medical research on stroke by claiming “a disturbance in blood flow to the brain is natural“ or “preventing or curing strokes will exacerbate inequality“ or “all those people who would be saved from strokes will cause overpopulation or ecological disaster, so it is better they suffer a stroke“. Why not? Why is it that different moral sensibilities tend to be activated when the topic turns to modifying aging?

In this paper I suggested that prospect theory provides a plausible answer- we value the prevention of losses much more than we value perceived "gains". Dying of a specific disease of aging is commonly construed as "a loss", while dying of "aging" or "old age" is viewed as something that transcends our "aspiration level for survival" and thus its prevention is not accorded a high priority. So I think insights from human psychology can go a long way in terms of helping us understand (a) why we currently ignore the ultimate causes of disease and death and (b) why people tend to have a negative knee-jerk reaction to longevity science (what Miller called "gerontologiphobia").

Many of these problems could perhaps be remedied if the death certificates of people over age 60 identified both the proximate and ultimate causes. So the former would read: CAUSE OF DEATH: STROKE, HEART DISEASE, CANCER, etc., And the latter would read: CAUSE OF DEATH: EVOLUTIONARY NEGLECT. And most obituaries in the local newspaper would read something like the following "John Smith died Sunday after a painful but brave struggle against [insert chronic disease of aging] which he developed in late life because natural selection prioritized John's ability to reproduce over his ability to stay healthy for a long time".

Acknowledging the ultimate cause of disease and death would help people understand that, because natural selection does not apply to the post-reproductive stage of the human lifespan, their loved ones will most likely suffer prolonged periods of chronic pain, suffering and disability in late life. And we should all want to prevent or ameliorate that tragic state of affairs.

My interests in the neglect of biogerontology have also helped me reflect on methodological issues in political theory and philosophy. Why is it that political theorists interested in creating a more fair and humane world neglect the fact that a significant portion of human suffering in the world today is caused by the biological clocks we have inherited from our Darwinian history?

Lately I have been reading up on the topic of "sacred values", and thinking about how social-cognitive research on sacred values might help explain some of the challenges that face the field of biogerontology. Tetlock defines sacred values as "those values that a moral community treats as possessing transcendental significance that precludes comparisons, trade-offs, or indeed any mingling with secular values" (320). There are many different sacred values that people champion- libertarians take liberty to be the most fundamental value and are thus very sensitive to any government action (e.g. re-distributive taxation) that is construed as any incursion on liberty. The same could be said about egalitarians and other political ideologies (e.g. environmentalists).

So one reason that biological aging and the science that might help us modulate the rate of aging is neglected by political philosophers who trade in the intuitions of sacred values is that the stakes involved in such research do not easily map onto the sacred values the field concerns itself with. Aspiring to modulate the rate of human aging doesn`t activate the same moral sensibilities (e.g. concerns of equality, liberty, etc.) that aspiring to re-distribute wealth and income, for example, activates. Hence why most political philosophers in the past 4 decades have conceived of social justice as being primarily concerned with the patterns of wealth and income rather than being concerned with the advancement of knowledge and the fair diffusion of the benefits of technology.

As for the different kinds of objections that often arise in debates concerning life extension, many (though I concede not all) of these objections are little more than knee-jerk reactions of moral outrage (or repugnance) to a perceived threat to a sacred value. So egalitarians, for example, object to a new technology that they perceive would exacerbate inequality between the rich and poor. And many of the concerns about the environment and overpopulation are predicated on similar intuitions rather than actual factual empirical projections and a judicious balancing of the stakes involved.

So how can social-cognitive research on sacred values help us overcome the opposition to longevity science? What that research tells us is that people object to taboo trade-offs, which are trade-offs that pit sacred values against secular ones. When combined with insights from prospect theory, I believe this means that when the stakes involved in modulating aging are described as "life extension", "longevity", etc. they are likely to be construed as secular rather than sacred values. And when there is a perceived conflict between the goal of life extension and a sacred value (e.g. equality, the environment, etc.) this will result in moral outrage and thus opposition to the former. People will not want to entertain the question "what constitutes a reasonable balance between these values?"

There are number of ways of trying to overcome this impasse. One strategy is to frame the stakes at risk with biogerontology in terms of "sacred values". Other areas of the medical sciences, like research on cancer, AD, or stroke already enjoy the benefits of this. Preventing or curing specific diseases resonates with people because keeping people alive and healthy is a "sacred value". This tells us that describing an anti-aging intervention as "life-extending" versus "live-saving" or "health promoting" really matters. So the framing of the issues at stake for biogeronology is especially important. Framing the stakes so they resonate with sacred values will help quell the moral outrage against this science.

I have tried to do this in a variety of papers I have published on this topic. Framing an aging intervention as helping to "prevent a loss", for example, or as being a requirement of equality, helps people internalize the justification for aspiring to modify the inborn aging process in a way that coheres with their sacred values. So rather than opposing the science that might help keep the world`s aging populations healthy, people might actually start supporting it and demand a greater portion of scientific funding be devoted to this field.

The reality is that today's aging populations face what is called a "tragic tradeoff". Such tradeoffs pit sacred values against one another. This means it is extremely difficult for society to have a reasonable discussion about healthcare. One way of justly navigating this dilemma is to aspire to modulate aging itself. This would be a more humane and cost-effective strategy than trying to redress each specific disease of aging, which is the current course of action. But the current course of action has traction because it coheres with sacred values. So a great deal of thought must be given to contemplating how this situation can be overcome.