Should we cure ageing?

João Pedro de Magalhães, a molecular biologist and geneticist at Harvard University, asks Should We Cure Aging? in a recent issue of Ego magazine. Economists will be particularly interested in Myth #6, over the fold: Economic disaster would result with the collapse of healthcare. (Hat tip: 3 Quarks Daily).

Myth #1: Aging is natural and so we shouldn't fight it

First of all, aging is not universal. A number of complex species such as lobsters, rockfishes, some tortoises, etc. do not appear to age. Therefore, aging is not a prerequisite to life. Aging is neither inevitable nor universal.

Secondly, humankind is, in a sense, a struggle against nature. We have antibiotics and vaccines because we don't want to be sick, which would be the natural outcome for many of us. If we were to follow Nature's will, many of us wouldn't be here and wouldn't be reading these lines, on a monitor, over the Internet.

Myth #2: What's the point of extending life if we are old

This is a common misconception about research on the biology of aging. The ultimate goal of my work and that of many biogerontologists is to preserve health and life. Yet we aim not just to make elderly people live longer but to diminish, not extend, age-related debilitation (also see de Grey et al., 2002). What we want is to find ways to extend healthy life span by postponing disease and eventually eradicate all forms of age-related involution. In other words, to find a cure for aging, an intervention that permits us to avoid aging and all pathologies associated with it. Instead of improving the quality of life of the elderly, I want to avoid having elderly patients in the first place. People would still die from accidents, infectious diseases, etc. After all, children and teenagers die too even though they are not yet aged.

My calculations for a cure for aging yield an average longevity of 1,200 years. This is assuming one would be forever young in body and mind.

More over the fold:

Myth #3: A finite life span is best enjoyed

The ancient Greeks had a longevity of 19 years and I'm pretty sure we are happier than them. In fact, longevity increased 50% over the past century and even so quality of life has clearly increased. Entertainment evolves and social adjustments occur. A cure for aging would not mean an eternal life for one could still die. It would mean an average life span of 1,200 years but life would still be finite. In addition, people would always have a choice to end their lives. At present we don't have a choice of living past 122 years, which is the longest anyone has lived so far. With a cure for aging each of us would have a choice to live 100, 200, 1,000 or even more years.

Myth #4: Why should death be better than life

This is actually an interesting philosophical question. Many societies, including Western societies, valor death in some circumstances--e.g. death in combat, death to save other lives, etc. Other societies are even more extreme and you can always argue that I don't know what is it like to be dead. As an atheist, I clearly favour life to death. I won't feel death, no. Yet a good exercise is to compare death to its opposite. Personally, I always choose life. For those who disagree suicide is always a solution.

Myth #5: Not everyone would benefit from a cure for aging

The issue of justice is commonly raised when discussing life-extension. Of course it is impossible to predict the price a fictitious cure for aging would have. Yet a number of medical breakthroughs are not immediately available to everyone. The early antibiotics were available only to an elite and a number of present technologies, such as CAT scans or heart transplants, are not available to everyone. That is not a reason for us to ban pacemakers or regenerative medicine. We don't deny heart transplants just because they're not accessible to everyone. We can't deny health and life just because some people lack healthcare. Besides, even if curing aging is initially expensive, with mass production and widespread facilities one can expect it to be available to everyone, at least in industrialized nations.

When Vasco da Gama or Christopher Columbus explored the world they left death and injustice on the shores of their homeland. Neil Armstrong walked on the moon without world peace and Tim Berners-Lee didn't wait for an end of poverty to invent the Internet. Yet all the discoveries and endeavors of these men benefited their societies and humankind in general. There are no ideal circumstances. Setting new limits and making new discoveries eventually improves the lives of everyone.

Myth #6: Economic disaster would result with the collapse of healthcare

No, of course not. In fact, curing aging and extending healthy lifespan would be profitable for nations. The economic value of increased longevity is estimated at $2.4 trillion per year for the US alone (The Economist, 3 June 2000). The greatest burden on healthcare comes from the elderly and the trend is for expenses with old age to increase as the percentage of population above 65 rises worldwide (UN Programme on Ageing). If aging is not tackled, societies in the 21st will consist of a large portion of frail, elderly people, which will result in a serious financial burden (Schneider, 1999). Therefore, curing aging would be economically sound. People would live longer but also work longer and thus be more productive. Without the declining years of old age, healthcare and the economy would benefit from a cure for aging.

One good book debating the economic impact of extreme life extension is:
Coping with Methuselah: The Impact of Molecular Biology on Medicine and Society, edited by the Aaron, HJ and Schwartz, WB (2004). Brookings Institution Press, Washington.

Myth #7: Overpopulation would be a problem

When talking about life-extension it is intuitive we consider overpopulation as a possible problem. In the 1970s there was a current of thought known as the Mathusianism that predicted major problems due to overpopulation by the year 2000. These predictions failed miserably because their proponents did not take into account technological progress made in agriculture, etc. Therefore, we cannot see breakthroughs in aging research as isolated events but rather consider these in the overall evolution of the social organism. The world's population increased almost four-fold in the past century and yet today we have a life quality unparalleled in human history. In fact, population growth with a cure for aging should still be slower than during the baby boon.

Overpopulation in some regions of the world, such as southeast Asia, may be aggravated by a cure for aging. Yet letting people die to control overpopulation is morally repugnant. If we cure aging and overpopulation becomes a problem in some regions, then we must find other solutions besides letting people die.

Myth #8: Human trials would be dangerous

This problem occurs with any other medical breakthrough. Following animal tests, human trials begin in a few people. Only after the security and quality of the product being tested is assured can the company commercialize it. Certain products can escape these regulations using a variety of legal stratagems, but that is a general problem in the biomedical industry, not specific of anti-aging research.

Myth #9: Humankind as we know it would change

Certainly, but that is not necessarily a "bad thing". Humankind changed considerably since the Roman Empire and yet it were those changes that now allow us to live longer, happier lives. A cure for aging would reshape society but nothing suggests such changes would be negative to humankind. People do not exist to serve society. Society exists to serve people, to make people happier and fight solitude (Hobbes, Leviathan). In the same way the world is a better place to live in due to the many changes that occurred in the past centuries, a cure for aging would make it an even better place thanks to the decrease in suffering and the increase in health. Although no-one can foresee the long-term consequences of a cure for aging, and there are potential problems such as intergenerational differences in wealth and status, society could profit. And people would certainly profit.

Myth #10: We should have other priorities on earth

Of course there are many problems and injustices in our world. Many nations face hunger, poverty, and widespread disease. Yet, as mentioned in regard to the justice issue on myth #5, this does not mean industrialized nations must abandon expensive medicines. Besides, the technology to solve poor countries' problems is already here--i.e. sustainable agriculture, vaccination, birth control, etc.--and it is up to these nations to implement them.

Aging is the major problem we face in our society. It is or will be the major cause of suffering and pain for me and the ones I love. This holds true for industrialized nations and Western civilization and that is why aging must be a top priority.

Myth #11: Overall, curing aging is ethically wrong

Not so. According to the principles of bioethics, curing aging would benefit people, not harm them. Anti-aging therapies would serve to the beneficent amelioration of the many diseases for which old age is the major susceptibility factor. On the contrary, having a cure for aging and refuse to make it available to patients would result in pain and injury, clearly in contradiction with the principle of nonmaleficence. Even if we cure aging, individuals will still be able to choose whether they wanted to age or not, in respect for each others autonomy. If someone wants to continue aging despite a cure for aging being available, no-one can force him or her not to age. Likewise, if a cure for aging is proven safe and efficient then it should be available for all of those who wish to benefit from it.

Comments

[Roehlano Briones]

My biggest "objection" to eliminating ageing: childbearing and rearing will become a scarce commodity. This is merely a sentimental complaint and probably won't prevent me from drinking from the fountain of youth, or me encouraging my loved ones to do so. Still, it's a thought.

[Edward Hugh]

"My biggest "objection" to eliminating ageing: childbearing and rearing will become a scarce commodity"

I think this is more than sentimental, I think increasing life expectancy and declining fertility are somehow connected. No, ageing is not something to fear, we just need to get the institutional arrangements right, and at present we aren't addressing this anything like seriously enough.

In a certain sense it isn't really ageing at all (my latest conclusion) since what it is is a redistribution of the life history/life cycle over a larger age range. The proportion of your life you get to spend as 'old' may remain the same.

Like with flexible working, the complicated part is our adapting tot he reality.

[Edward Hugh]

The part people don't seem to like is when they hear this:

"Ok, so you're going to get to live 1,200 years, so that means you will retire in 3,150."

[Edward Hugh]

Also, on the population dynamics, remember we aren't talking about something overnight here, this is a process. In a certain sense we are already curing ageing, that is slowing it down. We have been doing so since the industrial revolution. And as we live longer, less children get born.

I don't know whether people will ever live 1,200 years and above (although I agree with him, I see no reason in principle why not) but we will be centuries getting there (12 of them at least), and meanwhile children will continue to be born.

[Ninjaplease]

How about Mr. Microbiologist cures cancer first? Then when he's done with that work on AIDS, when he's done with that, work on fixing nerve damage so there will be no people in wheelchairs, after that how about he cures blindness? After that how about curing deafness?

Curing aging could be a lucrative proposition since the rich want to live forever at any cost.

[Lord]

I believe accidents would limit life expectancy to around 600 years. Still, 600 years and nothing to do, or nothing to do but what you have done for the last 500. Most aren't cut out for it.

[Unpolitik]

We live during an information age. Human capital and knowledge becomes increasingly important (e.g. increasing returns to scale). As people die, latent social wealth is lost. Some knowledge is never written down, some technologies are trade secrets. Even when information is well-known, some people have elaborate skills that take years to master. Prolonging the time people work, everyone will benefit from a sort of compound interest on the aggregate human capital. Imagine having access now to the likes of daVinci, Einstein, Darwin or Columbus. More great teachers and more great co-workers would transform society for the better. We go to museums and study old documents to learn about the past but without aging much of the past would be in the present among us. Even if some great people die through other means, they would live longer on average, pass more knowledge down and discover more inventions, while alive.

[Roehlano Briones]

Unpolitik,

Ah but plummeting birth rates will shrink the pool of new talent - possibly greater than Einstein, Shakespeare, or Mozart.

[KIM HAYNES]

I know that God will not allow those of you or your children to go unpunished that seek to inhibit the cure to aging.

[hahahaha]

i think if we do figure out how to live forever the first thing we should do is rid the world of economists.
really economists and there ilk should have no so in the future of the world.
if there is a satan he is the one responsible for economists.

[EndAgingNow]

I find many benefits to ending aging. we save lives, we reduce emotional and physical suffering, we save alot of money on healthcare... theres so many benefits. alot of people ive debated with are worried about overpopulation, but there are other options then just letting people die off in huge numbers to keep a good population.
the reason why our population is going crazy right now is due to poverty, incase you haven't noticed nations with high levels of poverty generally have very high birth rates and they have to LOWEST life expectancies.
nations such as hong kong and england aswell as much of europe have lowest poverty rates average lifespans ranging from 76-80+ yet the birth rates there are between 1-2.

when radical life extensions come out, the age at which people begin to bare children will be later in life.

Other technical advances will allow us to be able to sustain a larger population when our population continues to grow, such as vertical farms will replace horizontal farming, renewable energy to replace fossil fuels which will run out soon.
the idea that ending aging will cause the population to go off like a ticking time bomb is actrually very unlikely.

[EndAgingNow]

There's really absolutely no reason why we shouldn't find a cure to aging and other diseases.
One of the things that aging shares with other causes of death such as malaria and cancer is that It kills people, and causes great emotional suffering to those around and physical suffering to the victem. The only truelly large difference is that aging is responsible for 2/3s of all deaths in the world.

We invest heavily on saving lives, cancer reseach, ending HIV. We invest to save lives and end suffering. I agree that these are very smart investments, but what about aging? the main killer. Why ignore the big elephant in the room?

We have a moral obligation to continue the war against disease. against death. We have to save as many lives as possible.

[DudeyouphailLOL]

According to UN estimates, global population is expected to begin to decrease in 2050. In result, we will have far higher percentages of frail elderly people, much higher then today. If aging aka growing old is not tackled, the elderly population will be a heavy burdon on the working class and tax payers.

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