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Is anti-ageing worth it?

The Telegraphs proclaims that Anti-ageing drugs 'will fuel euthanasia'. The origin of the story was a lecture by Dr David Gems at UCL. He pointed out that if people were to live much longer healthy lives more would choose to end them themselves, and that centralized control of birthrates might become necessary. Francis Fukuyama argued at a conference in Aarhus last week that life extension also implies problems with age graded hierarchies and generational turnover. Some people, like Fukuyama, find these potential social consequences serious enough that life extension research should be discouraged. But are they strong enough?

Gems argued in his talk that "prolonging life with anti-ageing drugs that could delay the
onset of age-related diseases such as cancer and Alzheimer's, was a moral
imperative comparable to the eradication of smallpox". Such drugs would lead naturally to extended lifespans: to say no to the drugs would mean accepting avoidable causes of suffering and death.

It seems very plausible than even a minor reduction in ageing would have significant positive health effects, since most major chronic diseases are due to or worsened by ageing. It may also help solve the economic problems of ever growing retired populations (assuming retirement ages could be changed). Notice that the benefits are not just individual but also social: a healthier, wealthier society where human capital exists for a longer time and has better chance of growing. Longer lifespans might even correlate with more concern for the environment (pdf).

But are these potential goods enough to offset the potential bad sides of longer lives? The problem is that the disvalue of having to accept euthanasia, birth control or increased retirement ages is not easy to compare to the value of a longer life, avoiding suffering or a more long-term oriented society. Many would say that allowing euthanasia for people who have no wish to live on should be allowed today and represent respect for the autonomy and dignity of these people – while others think it is the opposite. Can freedom from illness be compared with the need for a flexible society?

One answer is to look at how fundamental the issues are to people's lives. Some values trump other values: if we do not have freedom to control our own health it does not matter much if we have great economic freedom. Our direct social relations are more important to us than abstract properties of our societies. By this kind of reasoning it seems that people have a right to extend their lives (and end them) if they so wish: preventing it would impair their freedom, their ability to pursue their individual life projects and would place their bodies at the disposal of outside societal forces. Life extension is by no means atomistic: one of the reasons many people want to live longer is their social links to others, premature death hurts valuable social relations. Even if it causes adjustment problems in society or hard choices about family formation these can be dealt with: arguing that social mobility or continuing current high birth rates requires preventing certain medical treatments and accepting individual pain and death is backwards.

Underlying much of Fukuyama's critique of enhancement is the classic conservative argument that the current state of the world is complex and embodies much tacit knowledge and spontaneous orders that we mess with at our peril. Changing human nature will lead to bad consequences because we do not know enough to predict or avoid them. However, it both assumes that we do not know enough (which is often true) but also that we cannot find solutions after we discover the problem (which often happens). It seems hard to use this line of argumentation to argue for anything more than being  cautious, make sure experimentation occurs in smaller subsets of society and watch the outcomes, and allow spontaneous orders to emerge. The conservative argument also bites against proposed bans of life extension since they would also interfere with the tacit knowledge and spontaneous orders in our healthcare system.

Also, it assumes that the unspecified bad outcomes are bad enough to outweigh the gains (both deliberately sought and serependiptious). Historically we have seen many examples of profound changes in society or human conditions that were criticised on these grounds: the abolition of slavery, female suffrage or widespread pain relief. Some conservative criticisms were correct (abolition was bad for the slavery business and the stability of societies based on slavery), but all things considered I think we today regard these as very moral changes. Uncertainty makes the shadows of potential threats look more ominious than they actually are.

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