ESRC Seminar Series 2009-2011
Seminar 4: Living longer: Should we try to live forever?
Held on Wednesday 26th January 2011

The fourth seminar of the ESRC series;“The ‘New’ Ageing Populations” took place in Lecture Theatre One, at King’s College on the Guys’ campus. These presentations provided a lively exploration of  the implications of longevity and whether or not we should be trying to live longer.  It proved to be an afternoon of contentious brilliance, including robust audience participation.

Professor Bryan S. Turner, Leeds and Cambridge educated and currently at The City University of New York and whose areas of expertise span the sociology of religion, citizenship and human rights, and social and political theory, was first on the podium. The title of his remarks, A Modest Proposal of Geriatric Storage, was an evocation of Jonathan Swift’s 1729 treatise, but it wasn’t until his conclusion that his reasons were for this were evident.

He began his presentation by telling us that after several stints in Asia, he was now living in the US and spending $1K/mo on health insurance at the same time that last year, his medical expenses exceeded $30K. With this as the backdrop, he commenced a measured delivery of what living forever in a time of scarcity looked like. He first posited that the social construction of ageing is only applicable to young people, given that ageing deals with real medical problems, such as diabetes; issues that social construction does not confront. He continued with the observation that because individuals are motivated by self interest, when ageing is under consideration, social construction does not allow for any distinction between individual and collective rationality. He used the example of the Eskimo’s, who abandon their old and infirmed, to reinforce his point that in times of scarcity, any interest that an individual had in living longer automatically went unfulfilled because of the negative impacts that decision would have on the collective society.

Meanwhile, in modern, western society, most humans enthusiastically embrace the possibility of living longer, but not indefinitely, especially if infirmed. Therein lies the moral dilemma. Medical science and the technological imperative has provided some of us with the means for indefinite survival, though not necessarily allowing for us to be totally “well”, at the same time that a collective problem of scarcity exists.  He was unambiguously, unapologetic for his assertion that there was only one solution to this conundrum.

He then explored the delicate question of existence vs. life to probe into whether or not indefinite life might become crushingly boring. With medical interventions changing the definition of what constitutes a meaningful or rewarding life, assumptions about QOL (quality of life), if life has no fixed limits, calls human rights into question. If life can be extended and improved, the normative argument suggests that we have a right to life. However, in conditions of scarcity, this turns into a question of should there be a right to health care but perhaps not a right to life.

With no easy answer there, the focus shifted to the profit driven nature of medicine in the west; whereby GP’s decisions are ultimately influenced by the power of the insurance and pharmaceutical companies in the medical industrial complex. He made the point that because disease is so economically productive, there is no benefit to eradicating it. Keeping people alive but sick, indefinitely, is more profitable than keeping them alive and well. The baby boomers as a group, give longevity full support. As breakthroughs in the genetics of ageing in areas including stem cell, cryogenic research and organ transplantation gains momentum, the continued exploitation of the global South by the global North also accelerates and leads to greater health inequalities between the two. He was particularly concerned that the issue of resource allocation was still not being addressed and that finite resources meant that the majority of people in the world were still being condemned to short lives.

He concluded with arguing that the extension of life required justification and that justification should be measured by moral, ethical and social contributions so that entitlements from society would correspond to inputs to society.  How this might be achieved or measured was not obvious and Professor Turner’s conclusion was a suggestion that we should …“deep freeze the elderly and keep them in large vats” to await rejuvenation as an all well work force”.  In the Q & A that followed, a debate about gender differences in old age ensued along with Professor Turner’s generally dystopian view that despite the fact that longevity is a mark of success, current social policy does not encourage longer lives. He finished up by reiterating that with scarcity, inequalities are stark and older people have been marginalized, without opportunities to make their lives meaningful.  

Next, Aubrey de Gray stepped up to the microphone. Also Cambridge educated,  Aubrey de Gray is the Chief Scientist of the SENS (Strategies for Engineered Negligible Sensescence) Foundation. His research focuses on the accumulating and eventually pathogenic molecular and cellular side effects of metabolic ageing and how regenerative medicine can thwart the ageing process.  He commenced his remarks with an acknowledgment that he had abandoned his earlier prepared remarks; Longevity as a side-benefit of truly good health: what’s the problem? and intended to pick up where Bryan had left off.  This was the last time they could be perceived to have been on the same page as he commenced what he promised would be a spectacularly dismal rebuttal.

He began by establishing the fact that no one in the audience, except for himself, had already signed up to be cryogenically preserved.  He also offered an aside that an Australian life insurance company had declared that life insurance policies would not pay out or be construed as valid for anyone who had agreed to be cryo-preserved on the grounds that they were not in fact, dead. With this in mind he suggested that this was potentially the optimum solution, that the decision to be frozen should optimally be made before death. He used the example of Ronald Reagan who was already neurologically dead from the ravages of Alzheimers. He also shared that the trend in cryo-preservation was to end ones life prematurely rather than succumb to dementia and that techniques to be frozen, pre-diminished capacity, was not as ridiculous or satirical as had once been thought.

He then explained his original interest in this field stemmed from his work as a biologist. He has become fascinated with a notion that did not even exist 15 years ago; that it was realistic to bring ageing under some degree of individual control. He began with the premise that ageing is as complicated as being alive is in the first place. He looked at the way different species aged and developed a plan to extrapolate from these findings in an attempt to postpone the ill health of old age. His work is based on tweaking the human metabolism by intervening in the chain of events and repair any molecular or cellular damage that regularly occurs in the normal ageing process. By making these repairs along the way, damage is kept sub-pathogenic and people can therefore avoid the infirmity of old age. His hope and the goal of regenerative medicine, is to stop people from getting sick, from getting Parkinson’s or Alzheimers and to give humanity of the future the ability to make this choice.

Reminding us of Bryan Turner’s resource argument, Aubrey took a different tack. He argued that given the fact that worldwide, every day, more than two times as many people are born than die, that if we were to halve the birthrate, a commensurate decline in the global population would result. He believes this gives people who are already alive, better options. He used the example of manipulating the female reproductive system so that there would be no menopause. In this scenario, women would decide when they wanted to have children so that they could be in a position to do other things with their lives. He sees this as another way of eliminating the overpopulation problem.

Following on from Bryan’s argument on the profitability of modern medicine, Aubrey believes that his therapies are a sound investment because frailty is a spectacularly expensive to society in terms of not only direct costs but also productivity.  Under his continuous, across-the-life-course therapy regime he maintains that keeping people healthy is also an expensive proposition and that administering these therapies and the periodic maintenance involved in tracking individuals guarantees that there will be no shortage of work for doctors. He went further to argue that unless these maintenance therapies could be designed to be free at point of delivery, it would be “economic suicide” because it would be impossible to care for an increasingly unhealthy population at the same time as you were offering metabolic maintenance protocols. He is of the opinion that the pervasive societal pessimism about the unavoidable, inevitability of ageing has created a society where the sword of Damacles hangs over our entire lives. He wants humanity to be in a position to be able to choose.

He is realistic about the adoption of his ideology. There are many who don’t find ageing to be such a bad thing and he knows that public opinion dictates policy, which in turn dictates funding. However, he also believes that people don’t want to get arteriosclerosis, diabetes or dementia and that preventative geriatrics is the way forward. Looking at the theological implications, he is of the opinion that it would be a sin not to defeat ageing, given that the process of ageing causes suffering. He reiterated his assertion that the only reason anyone wants to die is if they were to get irreversibly sick but if we can remain healthy, human beings will always choose life.

He is convinced that a proof of concept for these therapies is possible within ten years at which point, public expectations for healthy, not infirmed longevity will rise rapidly. He admits that his aims don’t address scarcity or redistribution and that this is a fix for the developed and not the developing world.  It was this point that sparked controversy in the audience. Aubrey was staunch in his defense of keeping people alive in a fit not frail state of physical well-being.

The lecture concluded and a wine reception followed.

Both presentations gave a fascinating glimpse of potential future scenario’s with compelling views from opposite ends of a continuum. Bryan Turner was steadfast and decidedly pragmatic while Aubrey de Gray countered with his bounded utopia. I was left with the overwhelming perception that cryogenics would only succeed in suspending the inevitable.

If living forever is going to be a viable option, it will present extraordinary challenges for those who plan to remain on our resource constrained, fragile, undemocratic and increasingly gerontocratic earth.

Any questions or comments, please use the comment facility below or  contact Deborah directly.