This was an essay I wrote last year about the ethics involved with curing the ageing process. A worthy topic of discussion, I hope you’ll agree. I thought it was alright, so here it is, sans references.

“O brave new world that hath such people in’t!”

Introduction

One way to define ageing is an increased chance of dying as time progresses as a result of cumulative natural changes and degradation of the body. Therefore a cure for ageing wouldn’t simply be a cure for all of the most common diseases associated with old age, such as cancer, heart disease and so on, but rather a cure for the underlying cause of the body being more susceptible to those diseases. Even if we could cure cancer or heart disease, the disease itself may not kill you, but something else would, as the body would still have accumulated years of stress and damage making it increasingly more likely to fail. Instead, a cure for ageing itself would mean prevention (and even reversal) of the ageing process, ensuring a state of perpetual youth for those that partake.

As such, the incredibly complex ethical considerations for such a cure are echoed throughout a number of social and political issues, calling into question the rights of the current generation over future generations, the rights of the individual versus the rights of the society and the purpose of life itself.

Overpopulation

The primary concern that springs to the mind of most people when the topic of curing old age is discussed is overpopulation. Already, the population is growing exponentially, even when the majority of people are dying before they reach 100. If people are living for double that amount of time and reproduction continues at its current rate, surely we will run out of room sooner than if people were dying before 100? It follows then, that we would exhaust that same amount of habitable space even quicker should life expectancy be increased further, to say 500 or in the thousands, provided that the rate of childbirth remained the same.
This idea of cramped living conditions conjures up an image of Victorian style slums or today’s “High Density Living” solution to the same problem in Hong Kong, where the concept of your own space outside has almost disappeared. Not only does that sound uncomfortable with a diminished sense of privacy, but the more people there are in any given area, the more easily and more likely it is that infectious diseases will spread. So how can this problem be resolved? By drastically reducing the birth rate.

Controlling Birth Rate

It would appear that the only option besides killing a large proportion of the population every so often is to place a limit on the rate of child birth for society as a whole. On the surface, this suggests that the generation that decides not to have children so they can extend their own life are making an immoral selfish choice, but let us first take a look at how society handles this issue today.

In 2004, the average number of children per married couple in the UK is approximately 1.8. It is important to realise that this is not a physical limit imposed by the human body, but an amount which is convenient. With the use of birth control and abortions, we can decide when it would be appropriate for us to have a child and how many children we have overall. The point here is that by choosing when to have a child based on factors such as financial stability, we already are being selfish when it comes to reproduction. The world at present is rife with examples of people putting their career (and hence their own satisfaction and financial gain) ahead of their future children, which we do not tend to see a problem with. This hypocrisy extends even further when it comes to the stigma of underage pregnancy – if we as a society should selflessly put our potential offspring before ourselves, surely we should be reproducing as early as possible, no matter what the cost to ourselves? Apparently not. What may seem selfish to some may be perfectly acceptable to others. Unfortunately, it is never clear where the line should be drawn with most ethical dilemmas, and this is no exception.

Selfish or otherwise, there are other pressing matters relating to this kind of population control that must also be discussed. For example, who decides who should reproduce and when? Even China’s notorious “One Child Policy” is not enough to curb population growth. According the British Medical Journal in 2006, “China still has one million more births than deaths every five weeks”, so to prevent overpopulation, the average number of children per family would have to be reduced to far less than one to even keep the population growing at the same rate as China’s is now. Since it’s not possible for every family to give birth to a rather low percentage of one child, the responsibility of deciding who could reproduce and when would have to fall to someone, or some specified group of people, leaving the potential system open to all manner of imperfections. This could include bribery, blackmail, human error and any other form of corruption, which is particularly important with matters as fundamental as this. My lack of faith in humanity being able to think up and implement the perfect system for this situation is still not the most important concern, however.

Assuming that some method of control was necessary and in place, some people would simply not be permitted to reproduce for the interests of society. Not just limited to one child, but not at all. Currently, though, people who decide not to have children, or limit the number they have, retain their right to choose, no matter who may think it immoral; but if society decided the majority wanted to live forever, and the right to reproduce was something worth sacrificing, the choice would then belong to the society and not the individual. Many people see the point of life as having children, and could imagine life as worthless and hollow in hindsight should they not have had their children. The idea of potentially removing what point a lot of people saw in life from those people is one big step up from allowing people to choose when they have children themselves.

Equality & Prejudice

A further ethical topic in need of discussion is just how widespread this cure for ageing would be. The two factors that determine just how far we can expect this cure to reach are choice and availability. The former addresses the question of whether or not the choice would be left up to the individual or decided by the majority.

If it is a majority that decide the fate of quite possibly all of human kind, this decision and all of its implications as outlined here could have a profoundly negative impact upon that minority, however small in number they may be. That minority that would have normally refused treatment if the decision was up to the individual could still be forced not to reproduce by the government for example, as mentioned previously. If the majority voted against it, there would no doubt be ways that particularly rich and powerful people could still acquire the treatment.

If the decision was left up to the individual, some people opting for extended life and others not, it is easy to see how society as we know it may be torn in two in a fashion not too dissimilar to Aldous Huxley’s Brave New World: a completely state-controlled “utopia” on one side, and the “savages” on the other, who opt out of the apparent benefits that such advances may bring. It is not too far fetched to imagine health care for the elderly refused with treatment being the only option, or perhaps a lack of work or housing. We already fear prejudice and ill treatment as a result of genomic sequencing, something that can be kept a secret, but whether or not you’ve taken a cure for ageing could not be hidden. There is an incentive for companies to hire employees who have taken the treatment over people who have not – no pension plans, a reduction of staff turnover, a continued increase in skills without the need to retrain new people. One person doing one job for 150 years will likely be a lot better at that job than someone who has done it for only 50 years, so why wouldn’t companies discriminate against those that opt?

The second factor, availability, needs to be thought about at an international level. Already, the availability of drugs in industrialised nations far exceeds that of developing countries, with over a third of the world’s population having no access to essential drugs. There is no reason to suggest availability of a cure for ageing would be any different, driving the wedge between the rich and poor even further. A possible result could be war for land or resources between both sides of this divide once the need for population control and limited space become a factor for those with the cure.

Dying Peacefully

One topic we’ve not touched on so far is death. If we remove the natural cap that the aging process forces upon us, then there won’t necessarily be a maximum age we can live to. However, death from anything not related to age would still occur. Currently, we think of death as an inevitable natural process although the causes of death can be many and varied. When asked to think about death and how they would like to die, the majority of people hope for a peaceful death during their sleep, at the end of a long and fulfilling life, and without pain. As we’ve already discussed, how fulfilled your life may be could already be compromised by denying you the right to bear children, so what about the rest of our ideal scenario? A long life? Yes. But pain-free in your sleep? That’s another story.

After dying of old age, the only causes of death that remain involve accidents, murder and other diseases that can affect anyone, not just the elderly. Discounting instantaneous (but still gruesome) death, any other situation in which a life is about to be ended will undoubtedly be accompanied by fear and pain. This is not to suggest that fear and pain are not part of dying of old age, but any hopes of peacefully dying in your sleep would be shattered. As people get older, the thought of death becomes more and more a factor in their life as something they have to come to terms with, but this will no longer be the case. Death will only be associated with terror and pain; with lying in hospitals fed through a tube; certainly without peace.

Legalising and actively supporting euthanasia, on the other hand, would be the only acceptable solution to this problem. Only then would the problem of the perception of death being necessarily negative be alleviated, but this raises yet more ethical problems, particularly among religious communities.

Conclusion

A cure for old age may bring with it the promise of an undefined limit to humanity’s lifespan, allowing us to do more than we ever thought possible; read more books, watch more films, and finally build that shed you’ve been talking about, among other things. On the surface, this seems idyllic, but only when you begin to scratch the surface do you reveal a swamp of ethical concerns that muddies this picturesque vision of the future. Living forever may require our lives to change so significantly that life might not be worth living in the first place.

It would seem that having our cake and eating it is simply not feasible. Would you really want to live forever if you could never eat cake again?

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I’d love to hear your comments and opinions.

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