Framing an Aging Intervention (reflections 1)

For the past 15 years I have devoted a significant amount of my research to exploring the issue of how to frame, and morally assess, the social significance of an applied gerontological intervention.  

This topic is well off the beaten track from mainstream moral and political philosophy.  At the current moment you won't find the topic of aging, let alone anything informed by the biology of aging or the prospect of altering aging, among the current trends or central debates in mainstream bioethics or political philosophy.  But for me the prospect of altering aging is one of the most intriguing, significant and timely issues to address.  Two major developments this century warrant this focus-  (1) the aging of human populations (there will be over 2 billion persons age 60+ by the year 2050) and (2) the rapid pace of scientific innovation in the biomedical sciences, especially with respect to slowing the aging process.  Neither of these developments are featured in the evening news, or Twitter academic debates, which perpetuates their neglect.  But if you follow the scientific fields related to these issues you can appreciate how significant these developments are.  With sparse interlocutors from the humanities and social sciences to draw upon in my research, I have found the most formative sources and influences have come from interdisciplinary studies on aging, evolutionary biology and demography.  

There are many ways to "frame" the prospect of altering human aging.  For me the wrong questions to ask are:  "Would you want to live to 120+ years of age?" or "Would you like to be immortal?".  Even asking "Should we alter human aging?" is unhelpful as it is ambiguous what this really means (this will be the focus of post 2). 

I believe the correct question to ask is this:  "Should we reduce the risks of disease, frailty and disability in late life?"  And the answer is clearly "Yes, of course we should!".  This is what justifies every other public health measure, like vaccines, smoking cessation, exercise and a healthy diet.  

But even this obvious "Yes!" response will be subject to a barrage of knee-jerk objections and concerns:  "What if these health benefits are not immediately equally realized by everyone in the world?"  Or,  "How does this help us tackle climate change or overpopulation?"  Or "How can you talk about improving health in late life when there are young children who die prematurely?"  There are many distinct things going on in such responses.  Sometimes it is simple moral myopia, other times blatant ageism, and other times simplistic sequential reasoning (e.g. we can only do thing at a time, like either chew gum or walk, but not both!).

It is striking and surprising that such concerns are never raised as an objection to trying to cure cancer, or promoting smoking cessation or exercise.  Perhaps there are some who think that, because curing cancer would not solve climate change (but could actually exacerbate things) or  most early life mortality that we should simply tolerate 10 million annual cancer deaths per year (in the the hopes of preventing  250K deaths from climate change in 20 years time).     

There is something about the prospect of altering aging itself that triggers a range of negative emotive responses.  In my research I try to engage with these concerns and objections in a rational and cogent fashion.  A conclusion I have recently come to on this subject is that people's concerns and objections to slowing aging are not typically predicated upon empirically valid and morally sound judgments (what could justify forfeiting public health measures which help prevent disease, frailty, disability and death?).  Instead people often invoke different "sacred values", values they think should not be violated (e.g. equality) or traded off against (e.g. the environment).  And yet if any value was to be considered "sacred" you would think it is health itself.  But if you frame altering aging in the wrong way (e.g. by implying it is immortality) you activate this sacred value mindset.  And the quality of discussion and debate is derailed.   

Most critics of longevity science seem to have an innate conservative bias in favour of the current rate of molecular and cellular decline, as if evolution by natural selection (or some "Gaian-like" hypothesis) had preordained senescence (and its accompanying disease, frailty and disability) as part of the "natural order" of things and any suggestion of altering that rate of aging would erode this fragility and lead to some catastrophic outcome.   Rather than risk this deleterious societal outcome, these critics seem to think we should instead happily accept the current chronic disease burden, extensive caring burdens, and economic burdens of population aging with grace and acceptance. 

In my next post on this topic I will expand a bit on how to frame an aging intervention so that more rational and cogent discussions concerning the responsible use of such technologies can be had.

Cheers, 

Colin