Aging: To Treat, or Not to Treat?
The possibility of treating aging is not just an idle fantasy
New Ethical Challenges
Although decelerated aging seems a goal that should be pursued, it still has some troubling features. One relates to a question that I sometimes get asked about mice whose life has been extended: What do they die of? The answer is a range of aging-related illnesses, similar to those afflicting the untreated mice. But if the mice still die from aging-related diseases, people ask, what is the benefit? All that has been achieved is that the diseases have been delayed for a while. It is quite true that decelerated aging is not predicted to reduce lifelong risk of terminal disease. Yet one has to put this into perspective. The fact is that no medical treatment reduces a person’s overall risk of dying. For example, it is logical to assume that the development of a cure for tuberculosis led to an increase in the frequency of Alzheimer’s disease. It must have since it raised the proportion of people living to ripe old ages, when the erasing hand of Alzheimer’s strikes. Sadly, the probability that each of us will die as the result of some severe pathology is 100 percent, and this can never change. So it goes, as Kurt Vonnegut, Jr., used to say. Ultimately, the success of any medical treatment should be gauged in terms of the degree to which it extends a healthy lifespan. Viewed against such a moral yardstick, one can see that decelerated aging would be of great benefit.
Here’s another worry, though. I argue for the recognition of an imperative to seek treatments that decelerate aging in order to alleviate late-life diseases. But at what point would such an imperative be fulfilled? Although decelerating aging would postpone the illnesses of aging, it would not make them any less awful. This means that achieving decelerated aging would not lessen the imperative. We would only be compelled to decelerate aging further, and then further still. Here the ethical calculus seems to set us inexorably on a road to ever-greater life extension. Could any sane authority ever opt to force others to forego treatment and suffer from avoidable age-related disease? Surely not.
So it is that decelerated aging would force a dilemma upon us. Should we alleviate suffering on a large scale and accept life extension? Or should we allow an immensity of avoidable suffering in order to avoid extending life? To my mind, the only reasonable course is the first. In fact, we should pursue it energetically, and begin to prevent illness as soon as is feasible. If not, we risk the fury of future generations for dithering. As for life extension, we will just have to take that on the chin. If we can prepare for it socially, politically and institutionally, and if we keep birth rates low, we should be able to ensure long, healthier, happier lives for our children and for our children’s children.