Richard Haubner and I submitted a long essay to be considered for inclusion in the first book. It was rejected, which was not a problem. The problem was that we were never informed of its rejection until I inquired after a very long wait. We didn't receive any feedback as to why it was rejected either, which makes it difficult to revise for the next edition. If we re-submit that essay (with some revisions) will we get a timely acceptance or rejection this time? Rich is up for tenure this fall. Another publication would certainly help him. Unfortunately, the essay is way too long for a journal. It has also been suggested that we publish our own volume, which is a real possibility. Can you let us know what you think? RON
===
Thanks, Ron.
Sorry for delay now and for the previous non-response concerning your
first submission.
Please send future correspondence to me at bjk@imminst.org to ensure
faster response
concerning your potential essay submission to the second book.
>>If we re-submit that essay (with some revisions) will we get a timely acceptance or rejection this time?
>>
I'll give you and Rich feedback as quickly as possible.
Bruce
http://www.imminst.org/bjklein
===
Thanks Bruce, here's the most current draft of our paper. Hopefully, the attachment kept everything intact. RON
====
LIFE-EXTENDING BIOTECHNOLOGIES AND ANTI-AGING MEDICINE:
THE SCIENCE AND ETHICS OF TURNING BACK OUR BIOLOGICAL CLOCKS
By: Richard Haubner, Ph.D. and Ronald F. White, Ph.D.
College of Mount St. Joseph, Cincinnati, Ohio
INTRODUCTION
All living organisms are subject to the temporal limitations imposed by what is often referred to as a “biological clock.” This mechanism has been an implacable tyrant that relentlessly ushers in successive stages of biological existence: birth, maturation, reproduction, senescence, and ultimate death. For us human beings, those latter stages have always been accompanied by the timed onslaught of the so-called “diseases of aging,” including: Alzheimers Disease, Glaucoma, Heart Disease, Diabetes, Osteoporosis, and Cancer. Although biomedical researchers have developed treatments for many of these degenerative diseases, they have not been able to stop, or even slowdown the biological clock. However, new and promising research involving genes, telomeres, stem cells, and caloric restriction may soon lead to not only cures for these seemingly intractable diseases, but perhaps even extend the maximum human lifespan.
Although, the stark, uncompromising reality of human mortality has always served as a prolific source of artistic, literary, and scientific inspiration, the moral question of whether we “ought” to passively accept this fate or not has always elicited heated debate. This essay will explore some of the very basic cultural, scientific, and moral aspects of the modern quest for immortality.
I. CULTURAL ATTITUDES TOWARD LONGEVITY
Back in 1966, Gerald Gruman observed that in Western culture, we can easily identify three broad themes that have endured over the centuries, which embody our most deeply rooted fascination with human longevity. They are the Antediluvian Theme, Hyperborean Theme, and the Fountain Theme (Gruman, Finley, Grant)
The Antediluvian Theme, which permeates the Old Testament genealogical record, documents the extraordinarily long lives of biblical characters, such as: Adam (930 years) Noah (950 years), and of course Methuselah (969 years). Although, Biblical longevity contradicts virtually everything we know about the evolutionary biology of the human species, the symbolism of these references reflects our longstanding fascination with extended human lifespans. Even today, our interest in extreme human longevity is reflected in the Guinness Book of World Records. Although, paled by Biblical standards, worldwide, there are at least ten authenticated super-centenarians alive today between the ages of 115 and 122 years.
The Hyperborean Theme embodies a collection of myths that refer to places located somewhere “beyond the north wind,” where human beings enjoy long and healthy lives free from the ravages of disease, conflict, and work. Exemplars of this theme include references to places like Shangri-la, a mythical land of peace and tranquility allegedly located somewhere in China, Nepal, or Tibet. In the nineteenth century, travelers described a similar paradise in southern Ecuador known as Vilcabamba, or the “valley of longevity.” Known even today for its extraordinarily large number of centenarians, scientists still study Vilcabamba hoping to uncover the unique environmental factors that contribute to the health and longevity of its inhabitants. (Leaf, 1973) The hyperborean myth still lurks in our cultural heritage as exemplified by the 1985 movie, “Cocoon,” which revived the vision of a place where older adults could go to live safe, enjoyable and illness-free lives. And of course, millions of Americans make their biweekly pilgrimage to health clubs and spas hoping to slow down their biological clocks.
The third theme is the Fountain Theme, which is based on the belief that there are substances in the world that we can ingest, bath in, or rub onto our skin that will either postpone senescence or expand human longevity. In the early sixteenth century, Ponce de Leon popularized this theme in his celebrated quest for the “Fountain of Youth.” Of course, Ponce de Leon never did find that magic fountain, but he did accidentally discover Florida, which ironically has become a modern-day Mecca for aging Americans. For better or worse, we can identify contemporary variations of the Fountain Theme nestled on the Internet, where entrepreneurs sell an astounding array of herbal remedies, vitamins, skin creams, dietary supplements, and other over-the-counter preparations that promise to restore the fading youth, vitality, and virility of the “baby boomer” generation.
Our longstanding fascination with stories of expanded human longevity remains deeply rooted in our culture via Biblical characters, mysterious places, and magical potions. But as our stories continue to sustain that vision of immortality, our biological clocks continue to tick away, and senescence and ultimate death still haunt the human condition. However, as we enter the twenty-first century, we can observe the early rumblings of a fourth theme that is beginning to appear in the pages of medical journals, newspapers, magazines, and stock reports. Let’s call it the Biotechnological Theme. It is rooted in the growing belief that scientific advances, especially in molecular biology, will inevitably lead to a radical increase in the maximum human lifespan. But is that something good?
Although the expansion of the human lifespan has been an enduring cultural theme, our oral and written documents also suggest a persistent ambivalence in regard to whether we actually “ought to” prolong human life beyond its natural boundaries. Again, Gruman observed two contrasting prescriptive attitudes toward life-extension: one negative the other affirmative. Apologism defends the belief that “extended life is neither possible nor desirable” (Gruman, Overall 16-21) It basically regards senescence and old age as inevitable natural phenomena. Apologists, therefore, aspire to “explain” human longevity, but resist any attempts to “control” it. Prolongevitism embraces the belief that the prolongation of human life is both possible and morally acceptable, if not morally required.
While, the moral debate has persisted for centuries, until recently, it has been mostly a hypothetical debate, promulgated primarily by science fiction writers. Given the new hope offered by the biotechnological theme, it now appears that the moral debate over the extended human longevity may soon have normative, “real life” implications. (Cohen and Kristol)
II. PROLONGEVITISM AND MODERN SCIENCE
The pursuit of prolongevitism via the biotechnological theme embraces the quest by scientists to develop theories that will enable sociologists and biologists to explain, predict, and control the human lifespan. Social scientists have already identified many of the environmental and social factors that profoundly influence human longevity.(Atchley, Morgan & Kunkel) We know, for example, that individuals can live longer by altering their lifestyles, which of course includes: eating right, exercising, reducing stress, driving carefully, and by not smoking. Communities can increase aggregate longevity by controlling air and water pollution, increasing access to health care, and by building safer highways. Although, there is much that can be done by both individuals and communities to advance longevity, lifestyle choices alone cannot halt the aging process. That’s because maximum human lifespans are determined by that biological clock.
The modern era of biological aging research begins with the pioneer work of Leonard Hayflick. (Hayflick, 1996) Back in 1961, Hayflick discovered that somatic cells divide a finite number of times before senescence and death take over. Although, the so-called “Hayflick Limit” is different for different kinds of cells and for different species, the basic idea is all living things seem to be subject to the dictates of a biological clock. Not all cells age. Germ cells and cancer cells do not age. Today, there are five major theories of why it is that we age: The Error Hypothesis, The Free Radical Hypothesis, The Cross-Linkage Theory, The Brain Hypothesis, and the Autoimmune Theory.(Fossel, 2003, 2004, Gavrilov 1996, Hall, Johnson, Klatz, Olshansky, Rose)
The quest for the “explanation” of natural events usually leads to the “prediction” and “control” of those events. Microbiologists can now explain many of the natural processes that are responsible for human senescence and mortality. Combined with advances in biomedical technology, it is not unreasonable to suppose that medical science will soon also be able to control the aging processes. As Michel Fossel put it: “There are two milestones in the story of aging: Len Hayflick’s proof that cells age, and the more recent discovery that they don’t have to.” (Fossel, 1996, p.3) This next section will outline some of the most promising lines of research into that may soon lead to a substantial increase in the maximum human lifespan.
III. SCIENTIFIC ADVANCES IN LONGEVITY:
WHAT’S OUT THERE AND WHAT’S NOT!
Currently, there are four promising areas of scientific research in the area of human longevity: genetics, caloric restriction, telomeres, and stem cells. With the exception of stem cell research, most of this research has targeted non-human research subjects, such as yeast, roundworms, fruit flies and mice.
A. GENETIC RESEARCH
In examining some of the advances in genetic research in solving the longevity puzzle, it is important to describe what genes are and what “longevity assurance genes” are and how those genes affect the organism. Genes are small pieces of DNA that determine an organism’s physical traits and personal characteristics and guide the physiological processes. Longevity assurance genes are variants of some genes that allow the organism to live longer. If an organism within a species inherits a longevity assurance gene, then that organism has the possibility of living longer and with a better quality of life than other organisms within the species that do not have the longevity assurance gene.
Twenty genes associated with longevity have been found in Baker’s yeast. (Jiang, Jaruga, Repnevskaya, 2000). And when caloric restriction occurs in yeast through reduction of sugar or amino acid content, life span increases. If the yeast is missing a specific longevity assurance gene, then the caloric restriction does not reduce life span (Sun, Kale, Childress, Pinswasdi, & Jazwinski, 1994). Another gene modifies the stress that yeast experiences under environmental conditions such as: heat, starvation, crowding and ultra violet light. (Jazwinski, 1996).
In genetic research the use of roundworms, C. elegans, has been very productive. The roundworm has a life span of 20 days, which is perfect for longevity research. (Arantes-Oliveira, Berman & Kenyon, 2003). Two genes were found that enhanced longevity. The first gene, when manipulated, increased the average life span of the roundworm by 65% and the maximum life span by 110%. The second gene, when activated, warded off physical stressors, such as ultra violet light, temperature, and light, which assisted in extending life (Tissenbaum & Guarente, 2001; Jiang et al., 2000; Parsons, 1996; Lithgow & Kirkwood, 1996; Dorman, Albinder, Shroyer, & Kenyon, 1995).
The use of fruit flies in genetic research on longevity has also been very productive. Fruit flies are excellent subjects for longevity studies because of their short life spans. The drosophilia melangaster fly has a life span of 10 days and the Mediterranean fly has a life span of 60 days. MacKay (1998) found two important results in her studies. First, she found a gender difference among the flies in the way the genes were expressed with regard to longevity. Second, groups of flies assigned to different environments had different rates of longevity. (Dye, 2004). Michael Rose, an evolutionary biologist at University of California, Irvine, is working in the area of breeding rather than the manipulation of gene expression. His latest research is the discovery of late-life mortality plateaus. This discovery indicates that as one gets older that chance of dying increases until around age 90 when the mortality rate levels out. This means that if an individual reaches 105, then the chances of dying are no more than that of a 95 year old. Through breeding of fruit flies, Rose is trying to reduce the mortality rate plateau to a younger age. The results of his work show that through breeding, fruit flies live 100% longer and, as the process of breeding continues, he is projecting 200% increase in life expectancy. (Rose) This could have implications life span extension in humans (Veggeberg, 1992).
A promising area in genetic research related to longevity is the utilization of drugs to extend the lives of fruit flies (Ainsworth, 2004). The drug, PBA, switches on numerous genes, one of which is the gene responsible for anti-aging effects (Kang, Benzer, & Min, 2002). Another important endeavor with fruit flies is the identification of an aging gene. This gene, dubbed the INDY gene in homage to Monty Python and the Holy Grail, was identified by Rogina, Reenan, Nilsen, and Helfand (2000). This gene is associated with how the body stores energy. The research examined the relationship among metabolism, caloric restriction and longevity. In the fruit fly study, when this gene was manipulated, life span was almost doubled (National Institute on Aging, 2000). An understanding of this gene can have an influence on human longevity.
A number of research studies were done on the longevity of mice. In one study, a gene was found that was responsible for protecting and repairing genes damaged by oxygen free radicals (Moskovitz, Yim, & Chock, 2002). Another study found a gene that was a regulator of the life span in mammals. Mice have two copies of this gene. When one copy of the gene was removed, life span increased 33% among female mice and 16% among male mice. Also, mice with a single copy of this gene were more resistant to oxidative stress (Holzenberger, M., Ducos, B., & Dupont, J., 2003). Other studies were done on hormones and reproduction in mice as well as other animals (Carey, Lido, Harshman, Zhang, Muller, Partridge, and Wang, 2002; Cargill, Care, Muller, & Anderson, 2003).
Recently, researchers examined human centenarians to determine why these individuals live extremely long lives and why diseases such as heart disease, stroke, cancer, Alzheimer’s disease and other diseases associated with age are either postponed or do not occur at all. In their studies they discovered a region on Chromosome 4 where the exact gene or genes is located, and it is this gene or group of genes that is believed to be responsible for extreme longevity. Once the specific genes in this area are identified in the centenarians, then interventions can be developed to address longevity and chronic disorders affecting many adults in the older age category (Puca, Daly, Brewater, Matisse, Varrett, Shea-Drinkwater, Kang, Joyce, Nicoli, Benson, Kunkel, & Perls, 2001).
B. CALORIC RESTRICTION RESEARCH
Numerous studies on caloric restriction have been done with yeast, worms, flies and especially with rats and mice with excellent results. Those animals that were on calorie restricted diets lived longer than those who were on normal diets and unrestricted diets. In 1986, Weindruch, Walford, Fligiel, and Guthrie (1986) conducted a study related to dietary restriction of mice. It was found that the groups of mice with restricted diets demonstrated a 35-65% increase in life span, and were more energetic and less susceptible to tumors. Restricted diets provide support for anti-aging as suggested by other studies (Su-Ju, Kaeberlein, Andalis, Sturtz, Defossez, Culotta, Fink, and Guarente, 2002; Bluher, Kahn, & Kahn, 2003). In another study related to food restriction, Bluher and his colleagues (2003) wanted to find out whether or not a reduction in fat mass among mice without caloric restriction enhances longevity. They used mice that were missing the fat-specific insulin receptor. These animals had reduced fat mass and were protected against obesity, even though their food portions were normal. Mean life span increased approximately 134 days or about 18%. The results of the study indicated that it was leanness not food restriction that was a key factor to longevity (Bluher, Kahn, & Kahn, 2003).
Since the late 1980’s the National Institute on Aging has been conducting caloric restriction research on Monkeys. Although, the research is ongoing, it is apparent that monkeys that are fed 30% less food are much healthier and have about half the death rate of monkeys that eat as much as they like. Although, few American’s would be willing or able to sustain such a harsh dietary regimen, researchers believe that they will soon be able to develop a pill that would physiologically restrict the body’s ability to process calories. (Lane)
C. TELOMERE RESEARCH
Telomeres are specialized segments of DNA found on the tips of the chromosomes. They serve as a cap for the chromosome, preventing it from attaching to the ends of other chromosomes. Each time the cell divides, telomeres shorten. To reduce the telomere reduction process, the protein, telomerase can be used. This protein can re-lengthen the telomere. It was found that telomere length is a predictor of longevity and physical health of the individual over 60. People with shorter telomeres did not live as long as those individuals with longer telomeres.
Also, people with shorter telomeres were much more likely to get heart disease and infectious disease such as pneumonia than those with longer telomeres, and had a higher risk for head, neck, bladder and renal cancer cells. When cancer cells develop, they turn on the telomerase gene and in essence become immortal, increasing the magnitude of the disease. Understanding the mechanisms that underlie the telomerase gene is essential in developing interventions that greatly reduce or eliminate some of these chronic diseases.
Although there is some disagreement among researchers about telomeres and the aging process, there is general support for telomere shortening as a fundamental process of aging. Consequently, through the understanding of the mechanisms for telomere shortening, medical interventions could be developed to extend the life span of humans (Cawthon, Smith, Obrien, Sivatchenko, & Kerber, 2003; Wu, Amos, Zhu, Zhao, Grossman, & Shay, 2003; Wong & DePinto, 2003).
D. STEM CELL RESEARCH AND CLONING
Stem cells are living cells with the ability to make identical copies of the cells indefinitely and to produce the many different types of cells in the body. Two types of stem cells are pluripotent stem cells and adult stem cells. Pluripotent stem cells are stem cells that give rise to new cells in the three germ layers in our bodies. For example, the internal layer consists of areas such as the pancreas, thyroid, and lungs. Examples of the middle layer include the heart, gut, skeletal muscle, blood, and kidneys, while the external layer includes areas such as skin, brain and pigment. These pluripotent stem cells are harvested from embryonic stem cells and embryonic germ cells.
Embryonic stem cells are extracted from embryos through different surgical techniques. The embryos used are often those that are no longer needed in fertility clinics, many of which are discarded. The embryonic germ cells are extracted from fetal tissue. Both embryonic stem cells and embryonic germ cells are cultured in a dish and then readied to be used for therapeutic purposes.
Adult stem cells are cells that are found in the body such as skin, blood and brain, and can reproduce the specific tissue where the adult stem cell was extracted. There are some difficulties with adult stem cells. First, adult stem have not been found in all tissue. Second, they are often present in small quantities, may decrease in number with age, have less capacity to proliferate, and may be difficult to extract from a person’s body due to the availability of the cells. Third, they may contain more DNA abnormalities due to the toxins in the environment. And finally, research on early stage development of adult stem cells, in order to better understand the cells functioning, may not be possible. (NIH, 2001).
However, some researchers are trying to coax adult stem cells to act like embryonic stem cells. Catherine Verfaille of the University of Minnesota Medical School isolated a cell in the bone marrow of a mouse and has injected the cell into the mouse embryo. She and her team found that the “cell’s decendants were in almost in every tissue including blood, brain, muscle, lung and liver” (Yuehua, Balkrishna, Jahagirdar, Reinhardts, Schwartz, Keene, Ortiz-Gonzalez, Reyes, Lenvik, Lund, Blackstad, Du, Aldrich, Lisberg, Low, Lasgaespada, & Verfaille, 2002, p.4).
There are three benefits of pluripotent stem cell research. First, pluripotent stem cells provide researchers with the possibility to engage in basic research in order to understand the underlying functioning and mechanisms of stem cells. This needs to be accomplished first before an attempt to develop therapeutic interventions, so that these interventions are provided in a safe and effective manner. Second, the use of pluripotent stem cells could change the way in which drugs are developed and tested. The efficacy of drugs could be tested and their potential for toxins identified. This would be a more accurate and effective method for evaluating drugs, and it would eliminate or greatly reduce the need for animal studies. A third benefit is the development of therapeutic strategies to address the major chronic diseases such as, Alzheimer’s disease, Parkinson’s disease, spinal cord injury, rheumatoid arthritis, cancer, heart disease, and others.
However, two major challenges have to be overcome before therapeutic interventions are developed. The first challenge is the need for basic research to understand the process and mechanisms that lead to cellular specialization. Second, challenge is to overcome immune rejection of the stem cells. Sometimes, the immune system rejects embryonic stem cells. To address this second challenge, two approaches may be considered. One approach is to develop a tissue bank that would consist of common histo-compatibility profiles. This would assist physicians in identifying compatible tissue.
A second approach might be the use of Somatic Cell Nuclear Transfer. This is a type of cloning called therapeutic cloning. The purpose of this procedure is not to create another human being but to create stem cells for the treatment of disease. This occurs when the nucleus of a donated unfertilized egg has been removed and replaced with a body cell of the person with a disease. The egg is then stimulated to produce stem cells. The stem cells would then grow into the appropriate tissue for the disease. There would be little chance for rejection since the tissue DNA is the same as the person with the disease. This technique has great promise in the treatment of numerous chronic diseases.
Another strategy in using embryonic stem cells in addressing Parkinson’s disease in rats was developed by McKay and his team of the National Institutes of Health. He and his team incorporated a gene into embryonic stem cells that keeps producing the correct nerve cell, dopamine. The animals with Parkinson’s disease recovered from the disease process and survived for a long time (Kim, Auerbach, Rodriguez, Velasco, Favin, Lumelsky, Lee, Nguyen, Sanchez-Pernaute, Bankiewicz, & McCay, 2002).
One of the difficulties in using embryonic stem cells in humans is the moral issue generated by individuals who believe that life begins at conception, meaning the fertilization of the egg. Stem cell researchers have been getting their supply of stem cells from germ cells gleaned from aborted fetuses at abortion clinics; and zygotes leftover from IVF at fertility clinics. Therefore, in the United States, stem cell research has been stymied by religious groups and others who believe that “life begins at conception.” Individuals committed to this belief system support research with adult stem cells but reject any research utilizing embryonic stem cells. However, most scientists are not convinced that a clump of cells is morally identical to a human being; and, there have been serious technical problems associated with the use of adult stem cells. Nevertheless, there has also been some progress being made in this area (Yuehau et al., 2002).
In addition, researchers have been able to somewhat bypass this moral issue through the process of parthenogenesis. In this process the egg is intact and is either electrically or chemically stimulated, causing it to behave as if it were fertilized. After about 5 days or so of embryonic development, the stem cells can be harvested and used for therapeutic purposes. Advanced Cell Technology has already created embryos using a human egg cell without the use of sperm or cloning (“We Grew A Human”, 2003).
E. SUMMARY
This section explored four areas of ongoing research that can enhance the longevity of the human being. The first area discussed was genetics. The latest research with animals, yeast, roundworms, fruit flies and mice, was examined. Twenty genes identified in yeast and two genes in roundworms have been associated with longevity. Also, genes in both yeast and roundworms, when activated, have been found to influence physical stressors within the environments of the two animals.
In the fruit fly research a number of important findings have emerged. First, the way fruit flies express their genes varies according to gender. Second, the environment of the fly affects its longevity. Third, through the breeding of flies, a late-life mortality table was discovered which states that about age 90, mortality rates level out. Fourth, a new drug was found that switches on numerous genes responsible for anti-aging effects. And lastly, the INDY gene was discovered that when manipulated among flies can double life span.
In longevity studies related to mice, a gene was found that protects and repairs other genes from free radicals. Also, a gene was identified in mice as a regulator for life span. In addition, a region on chromosome four was discovered as the area responsible for extreme longevity.
The second area addressed was caloric restriction. Two important findings related to longevity were identified in this area. The first finding stated that mice with restricted diets lived 35-65% longer than those mice who ate normally or who unrestricted in food intake. This finding is the one finding today that most agree will extend life, even in the human population. A second finding suggested that body leanness was a key to longevity rather than food restriction.
The third area discussed was telomeres. Telomere length was found to be a predictor of longevity in those over 60. People with shorter telomeres did not live as long as those with longer telomeres and were more likely to experience heart disease and infectious disease such as pneumonia. Cancer, in particular, turns on the telomerase gene and, in essence, the gene becomes immortal, increasing the magnitude of the disease. Telomere shortening is a fundamental process of aging. Controlling the mechanisms of telomeres could extend life.
The fourth area addressed in this chapter is concerned with stem cells and cloning. Advancements in both embryonic stem cells and adult stem cells can be a major source of therapeutic interventions for many of the major chronic diseases, once the basic research has been completed and the mechanisms of cellular functioning and specialization understood. Some advances have been made in the area of adult stem cells whereby researchers developed techniques to coax adult stem cells to act like embryonic stem cells. In addition, advances are being made in therapeutic cloning. Somatic Cell Nuclear Transfer and parthenogenesis are being refined to create embryonic stem cells for therapeutic purposes. With these advances in the science of longevity, it hoped that the quality of life of many elderly and disabled individuals will be enhanced.
Having said this about the science of longevity, at some point, we must decide whether or not longevity research is morally justified. Before this can be done, there are barriers that must be addressed related to longevity research. They consist of the myths of longevity barrier, the credibility barrier and the status quo barrier, and are listed as follows:
1. Myths of Longevity Barrier. There are several myths that have been around for centuries. Myths, such as the anti-deluvian myth, the hyperborean myth,and the fountain of youth myth, suggest that extreme old age is a norm that we somehow lost and need to recapture, that there is some place in the world, that we will not have to age and die, and lastly, there are waters that have special powers in restoring our youth. These are incorrect notions even though they are so prevalent throughout the world. The problem with these myths is that they provide people with false hope and a sense of magic, which lead to unrealistic expectations.
2. The Credibility Barrier. This barrier consists of four components: hucksterism, association, scope and reputation. Once we accept the myths of longevity, then there is a tendency to do something about it. People buy products that make claims and promises for eternal youth or at least a youthful appearance. Many products claiming to have anti-aging effects have never been tested and the claims are not supported by the research. Therefore, a large market exists that is being exploited by false advertising claims and even outright fraud. In fact, three researchers in aging, Olshansky, Hayflick and Carnes (2002) have stated the following:
The hawking of anti-aging “therapies” has taken a particularly troubling turn of late. Disturbingly large numbers of entrepreneurs are luring gullible and frequently desperate customers of all ages to “longevity” clinics, claiming a scientific basis for the anti-aging products they recommend and, often, sell. At the same time, the Internet has enabled those who seek lucre from supposed anti-aging products to reach new consumers with ease. (p.92)
However, one of the difficulties with anti-aging organizations is the association of these organizations with advertising that suggests or makes claims of therapies that haven’t been proven. The American Academy of Anti-Aging Medicine is in this situation where they state that they do not sell or endorse products but yet they use advertisements on their Website that do make those claims (Binstock, 2003). For credible research to take place, there cannot be an association between unproven anti-aging claims and the work of serious scientists.
Another issue related to this area is the scope of the research. Not many credible scientists believe in immortality. This myth is based in some degree on the anti-deluvian myth. Even if immortality were possible, through some type genetic manipulation, accidents of nature and microbial infections would still summon that “Grim Reaper.” Moreover, the quality of life of the individual would have to be taken into consideration. Today, we see many individuals who live to an older age, the 80’s and 90’s, who do not have a good quality of life. When we discuss issues in longevity, quality of life is an important area of concern.
A last issue related to this barrier is that of reputation. Biogerontologists and aging specialists have worked hard and diligently over the years to develop a large body of knowledge based on credible research. It would be foolhardy for researchers to associate themselves with non-scientific claims, which undermine their own credibility as scientists. Hence, if the term “anti-aging” becomes associated with unsupported claims and hucksterism, the term itself will become a non-credible label.
3. The Status Quo Barrier. A major question here is listed as follows: Does an organism change over time? This question is addressed from an evolutionary perspective. All animals, human and non-human, have changed overtime. Another question that we can ask is whether or not this change or development of humans over time enhances the lives of humans? We know that life expectancy and life span have increased as along with the advancement of Science. The question posed is whether or not we ought to be tampering with human biology in pursuit of longer lives, and to reduce or eliminate many of the diseases that deter us from living to our maximum life span? Many researchers within the traditional gerontological community believe that we should not tinker with life expectancy and life span issues, whereas members of the American Academy of Anti-Aging Medicine believe that life expectancy for adults can be significantly prolonged (Olshansky, Hayflick & Carnes, 2002). One role of the scientist is to ask the question, “What if?” It is the responsibility of science to explore these issues in order to better understand the species and to enhance the lives of its members. Having said that, it is important that the research be conducted in way that provides respect and dignity to members of the species and will benefit members of the species.
Again, is longevity an appropriate area for biotechnological research? In answering this question, one must look at the benefits of the research. One benefit in conducting longevity research is the development of a greater understanding of the aging process and the mechanisms by which we function. A second benefit is to achieve knowledge of the disease process and in doing so, developing therapies that will enhance the lives of people. A third benefit is to obtain a better understanding of the prevention of chronic diseases so that we can live a healthy and productive life for a longer period of time. The fourth benefit is the potential contribution that the research will make to society as a whole.
III. MORAL ARGUMENTS FOR AND AGAINST PROLONGEVITISM
Both scientific arguments and moral arguments play out in theoretical contexts. There are three different types of moral theory that underlie all moral arguments. They are: teleological theories, deontological theories, and virtue-based theories. (Rachels) In the “ideal world” occupied by philosophers, these four theories are usually portrayed as, foundational alternatives; but in the “real world” of normative decision making, most of us mix and match these theories. Even scholarly works tend to draw moral arguments from multiple theoretical bases. Nevertheless, the analysis of these three theories, or lines of moral reasoning, goes a long way toward understanding the issues and arguments raised by apologists and prolongevists.
A. TELEOLOGICAL MORAL THEORIES
Teleological moral theories are “goal-directed” theories that locate the “moral good” in the consequences of our actions. Consequences are deemed “good” if they bring about more pleasure than pain, and “bad” if they bring about more pain than pleasure. The balance between pleasurable benefits and painful costs is expressed in terms of a cost/benefit ratio. So according to teleological reasoning, the moral value of persons, acts, and/or things, is measured via cost-benefit analysis. The staunchest teleological moral theorists argue that everything in the universe, including human beings, has extrinsic value, with the sole exception of pleasure (or happiness) itself, which is good for its own sake and possesses intrinsic value. From a teleological perspective the morality of extending human longevity would lie in future consequences.
Teleological moral reasoning assumes that we can measure and predict the manifestation of pleasure and pain. Back in the eighteenth century, Jeremy Bentham devised a hedonistic calculus intended to objectively measure the various dimensions of pleasure. He proposed six basic parameters: intensity, duration, certainty (or uncertainty), propinquity (or remoteness), fecundity, and purity. He thought that each parameter was objectively measurable and more or less predictable. Based on the calculus, one would probably conclude that, ideally, the “good life” would be one of eternal duration, seasoned with intense pleasures and the absence of pain and suffering. The prototypical “bad life” would be a short and painful life void of all pleasure. In the real world, most lives fall within these extremes. On average, short lives would score low in duration, but could conceivably make it in terms of intensity, certainty, etc. Bentham also believed that there are no qualitative differences between pleasures, only the quantitative differences expressed in the calculus.
So the basic form of teleological arguments entails the formation of conditional statements, which take the form "if P then Q," with "P" as the antecedent and "Q" as the consequent. Teleological defenders of life-extending biotechnology would argue that the cost/benefit ratios contained in the consequences, or "Qs," which are located in either the short-term or long-term future, will be "good" and, conclude that we ought to embark upon this line of research. Critics argue that the "Qs" will be "bad." Therefore, if we deliberately fulfill the antecedent "P," over the long-term, individuals and communities will be on a "slippery slope" toward these bad "Qs."
There are two competing formulations of teleological moral theory. Egoism identifies the moral good with the maximization of the pleasure of the individual. Social Utilitarianism (or simply “utilitarianism”) finds moral value in the maximization of the aggregated pleasure of communities. In economic theory, egoism and social utilitarianism are often portrayed as representative of two opposing schools of economic thought: individualism and collectivism.
Egoism, or individualism, is associated with both teleological and deontological moral theories. In its teleological formulation, descriptive egoism expresses the empirical “fact” that individual human beings tend to pursue their own pleasure, often at the expense (or cost) of the pleasures of others. Prescriptive egoism says that this fact is also morally good. Many egoists such as Jeremy Bentham, Ayn Rand, F.A. Hayek, and Robert Nozick swing both ways and claim that the pursuit of rational self-interest maximizes not only the pleasure of individuals, but also that of the community.(Rand, Hayek) Beginning in the 1970s, descriptive egoism was explained in terms of the “selfish gene” theory of biological evolution (Dawkins). Most egoists today argue that given our natural propensity to maximize self-interest, any collective attempts to prescriptively institute “ideal altruism” into human societies via social learning is doomed to failure. Hence, egoists tend to defend controlled social anarchy and criticize big government.
Based on egoistic principles, it is clear that most individuals would “prefer” to live longer lives, if and only if, the best evidence suggests that their lives would yield positive utility ratios. Indeed, most of us would prefer shorter lives of great pleasure over long lives of unabated extreme pain and suffering: hence, the distinction between “quantity of life” and “quality of life.” This observation is clearly reflected in higher suicide rates for those who suffer the interminable pains wrought by the diseases of aging and our mostly positive attitudes toward euthanasia. Other apologist critics argue that, at least for many human beings, substantially longer lives would merely extend boredom, which of course is true. Clearly, quality of life involves more than the manipulation of the biological forces that affect health, vitality, and personal longevity. Most of us, for example, would refuse extended lifespans for ourselves unless those technologies were also available to our families and friends.
The social utilitarian tradition within teleological theory is grounded, primarily, in the writings of John Stuart Mill.(Mill) For a social utilitarian, the “moral good” resides in the future social consequences (ends) of our actions, which means that a “good person” must be able to predict how his/her actions distribute pain and pleasure. The main difference between an egoist, like Bentham , and a social utilitarian like Mill, is the intended beneficiary. Social utilitarians insist that cost/benefit ratios must bring forth pleasure, not only to self-interested individuals, but also for the community. So moral acts are marked by the anticipated preponderance of aggregated communal pleasure (Good) and immoral acts by the anticipated preponderance of aggregated communal pain (Bad).
Reasoning about social utility entails not only the ability to measure the intensity, duration, certainty etc. of pleasure and pain over the short-run and the long-run, but it must also deal with distributions of pains and pleasure within communities. Therefore, as a moral theory, utilitarianism raises empirical issues concerning both the objectivity of measuring aggregated utility ratios, and the reliability of short-term and long-term predictions. Utilitarianism also raises moral issues when it runs roughshod over the pursuit of pleasure by individuals and sub-communities, in pursuit of “the greatest happiness for the greatest number.” Egalitarians, like John Rawls therefore, conclude that utilitarian principles invariably lead to social injustice. (Rawls)
Utilitarian critics of life-extension argue that the new technologies would yield negative social utility ratios in the present or in the near and/or distant future. Living longer does not necessarily imply living better or worse lives given that these determinations are measured in terms of multi-dimensional ratios of pleasure and pain experienced over time, and not just years. Egoistic utilitarians would reject life-extending biotechnologies if they have reason to believe that those extended lives would be more painful than pleasurable. Social utilitarians could justify the prolongation of lives with negative cost/benefit ratios for individuals, if and only if, extending those lives paid off for the community over the longer run. Critics of social utility, especially egalitarian and libertarian deontological theorists, are repulsed by the injustice of forcing individuals to sacrifice their individual interests for communal interests. They call it the “tyranny of the masses.”
Utilitarian moral reasoning about biotechnology requires us to predict how scientific advancements affect human communities. The history of technological innovation is especially fraught with off-based predictions and unanticipated consequences. Those who are opposed to life-extending biotechnology and anti-aging medicine often warn of an impending “slippery slope.” They argue that negative utility ratios will follow: if scientists pursue these lines of research, if patients elect to utilize these technologies, if biotech corporations or governments fund this research, and/or if Wall Street invests in these biotech stocks.
Aubrey De Grey points out that when we look at the cost/benefit ratios associated with anti-aging medicine, we already have a huge downside. Says De Grey:
It’s true that we risk looking foolish if our optimistic predictions are not borne out by the rate of future progress in developing truly effective anti-aging medicine. But we risk being responsible for the deaths of over 100,000 people every day that this technology is not developed, if we fail to speak and act to bring it into existence as quickly as possible. I know which risk I prefer to take. (De Grey 2003)
Daniel Callahan, a critic of life-extending biotechnology and anti-aging medicine and longtime proponent of reducing health care expenditures for the elderly, wants scientists to reflect on consequences.
For the scientists and their followers who welcome efforts to directly understand the mysteries of aging, and to take up decisively effective arms against them, two considerations need to be confronted. One of them is this: it is irresponsible to continue pushing for a cure to aging without thinking through the likely consequences. It is not enough to believe that all the problems will be taken care of in due course. They might indeed—but poorly for lack of serious prior reflection. It is not good enough to pursue ever-longer life just because many people want it. People want lots of things that are not good for them or those around them. Desire alone has never been an adequate guide to a life worth living. (Callahan)
Works of both science and science fiction are notorious for hatching dire off-base short-term predictions of social disutility, as illustrated by works such as Paul Ehrlich’s, Population Bomb (1971) and George Orwell’s 1984 (1949). Indeed, scientific predictions of large scale social utility over the short-run are notoriously complex and therefore highly fallible. But estimating long-run social consequences is even more complex and predictions are often way off base. With this in mind, it’s hard to place much credence in the musings of scientists or science fiction writers that predict either social disaster or eternal bliss over the next 300 years.
Slippery slope artists typically ignore or underestimate the magnitudes of future pleasures, such as: longer healthier life spans, and longer lasting personal relationships. What is most often underestimated is the potential health care and social welfare savings that might be gained by conquering senescence and the so-called diseases of aging. On the other hand, we also have a variety of life-extension zealots blind to the potential long-term costs of life-extension. They naively insist that only good can come from this kind of research. Instead of a slippery slope, these eternal optimists envision a ladder ascending to a rosy “Shangra-la-like” future characterized by long happy lives. To an objective utilitarian both “Anti-Science” and “Scientism” are equally untenable.
Finally, social utility raises puzzling questions concerning the scope and composition of the moral universe. Where are the parameters of the moral community: individuals, ethnic groups, religious groups, cities, states, civilizations, the human species, or all sentient creatures (mammals)? Universalistic utilitarians argue that the utilitarian calculus ought to include, at least, all human beings. Many also extend cost/benefit analysis across generations. Therefore, even if our generation ultimately benefits from the conquest of senescence and mortality, it may turn out that generations in the near or distant future may suffer the negative consequences. “The chickens will come home to roost!” These chickens might include negative utility ratios wrought by: overpopulation, epidemics, depletion of natural resources, increased pollution, distorted sex-ratios, long-term dictatorships, impenetrable traffic jams, high unemployment, boredom, and eternally tenured gerontology and philosophy professors.
Apologist critics often argue that this “problem of future generations” looms ominously over life-extending biotechnologies that involve germ-line genetic interventions. Who knows how genetic manipulation of the human genome today will effect generations in the near and/or distant future? Prolongevitists respond by saying that we really don’t know the long-term consequences of anything we do! If we halted all scientific research out of fear of how it will affect distant future generations, there will be no science or biomedical technology.
Other utilitarians are primarily concerned with “bang for the buck” in terms of any public funding that goes into life-extending biomedical research. Is it really worth spending billions of dollars, now, on increasing maximum human longevity if it means cutting back on research into infectious diseases such as AIDS and influenza? Although scientists are confident that they will, eventually, be able to control human longevity, we’ve all heard those unfulfilled promises before in regard to “magic bullet” cures for cancer, aids, and influenza. Moreover, there is also great utilitarian irony in the fact that as we stand poised to spend more public and private research dollars money on life-extending biomedical technologies, as a society we still smoke tobacco, catch the flu, shoot each other on the streets, drink and drive, over eat, and go to war.
In the final analysis, the basic problem with utilitarianism is the inherent complexity and fallibility of all long-term social planning. Who knows what the world will be like 300 years from now, if there will be a world, or if that world will even include the human species? Rationally evaluating any technological innovation via cost-benefit ratios is enormously complex. It is difficult enough calculating the cost/benefit ratios of already existing technologies. Are automobiles, cell phones, cable television, and computers justified based on their preferable utility ratios? In our own individual lives it’s easy to overlook the subtle disutility of traffic jams and accidents, loss of privacy, sedentary lifestyles, and spam. Imagine the mind-boggling complexity and fallibility of calculating the future social utility of those technologies over the next 300 years.
On the other hand, considerations of social utility will certainly undermine one class of notoriously bad arguments offered against prolongevitism. These bad utilitarian arguments include: 1. Researchers ought-not pursue prolongevitism because it will put a whole class of professionals out of business including: gerontologists, cancer specialists, hip replacement technologists, hospice workers, funeral directors, pharmacists, and home health care professionals. 2. Researchers ought-not pursue prolongevitism because it will undermine longstanding social institutions that have served the elderly, such as: nursing homes, hospitals, AARP, and shuffleboard manufacturers.
In sum, serious utilitarians that seek to avoid both anti-science and scientism will find prolongevitism to be a supremely challenging moral puzzle.
B. DEONTOLOGICAL THEORIES
Beginning in the 1970s, utilitarian moral theories began to wane in popularity and deontological theories took center stage, thanks to philosophers like John Rawls and Robert Nozick (Rawls, Nozick). Deontological moral theories reject the moral relevance of teleological moral theories, especially their hedonistic and consequential elements. Deontological moral theories emphasize the fulfillment of duties and the respect of individual rights. This often entails ignoring the maximization of either individual or collective pleasure in order to do what is right, fair, or just. These theories usually associate moral value with good intentions and conformity to universal and absolute moral rules. There are three classic forms of deontology: Divine Command Theory, Egalitarian Theory, and Libertarian Theory.
Divine command theories justify moral rules based on the “Word of God” as revealed by the interpretation of scripture, personal revelation, and/or the authority of church leaders. In pluralistic societies, like the United States, there are many different religions, scriptures, revelations, and authorities. Of course, some religious traditions are more hospitable to life-extending biotechnology and anti-aging medicine than others. On the accommodating end of the spectrum, Judaism has always been a supporter of modern medicine and a proponent of prolongevitism, while Islam and Christian Science have always been much less accommodating. Roman Catholicism has embraced much of what modern biomedical technology has to offer, but draws the line at most reproductive technology. It is not yet clear where the Pope might stand on life extending biotechnologies that do not involve the destruction of human embryos.
Divine command theory, is often grounded in “natural law theory,” which identifies the moral good with handiwork of Mother Nature. “What is natural is good.” Theists argue that God is an omnipresent, omniscient, omnipotent, and good God that intentionally created the world. Hence, natural order is really divine providence. In terms of longevity, divine command theorists and natural law theorists observe that God and/or Mother Nature enforce a maximum lifespan. In the Judeo-Christian tradition, for example, Psalm 90, verse 10 states that: “The days of our years are threescore years and ten; and if by reason of strength they be fourscore years, yet is their strength labor and sorrow; for it is soon cut off, and we fly away.” Interpreted as a command, this injunction which roughly corresponds to the “Hayflick Limit” which suggests that, on average, human beings are “intended” to live 70-80 years and that this limit is “Good.” Therefore, the extension the human lifespan beyond that limit violates the commands of both Mother Nature and God.
However, natural law theory is usually invoked rather selectively. Generally speaking, divine command theorists tend to give credit to God and/or Mother Nature for the good things, but do not blame her for the bad. If God is indeed omniscient, omnipresent, omnipotent and good, then why would God allow natural disasters, wars, disease, and famine to kill of human beings prematurely? In the case of human aging, why would God and/or Mother Nature command or allow human beings to suffer from the diseases of aging as they approach the Hayflick limit? Or better yet, if senescence and death are so good, why would God and/or Mother Nature give us a cerebral cortex capable of transcending the Hayflict Limit through the use of biotechnology?
Divine command theory plays an essential role in forging human morality in all societies, especially in the United States. But when democratic societies base public policy on divine command theory, competition for political power between various religious groups reduces morality to political machination. Serious problems arise when individual religious groups monopolize the coercive power of government in the service of their own divine commands. Over time, as the political fortune of various religious authorities wax and wane, the foundations of economic freedom, freedom of inquiry, and freedom of (and from) religion are easily eroded.
Many deontologists, therefore, reject divine command theory as the foundation for public morality. There are two Enlightenment-based deontological theories that frame the Western liberal moral and political tradition: egalitarianism and libertarianism. Both traditions seek to emphasize “justice” in the distribution of “Social Goods.”
Egalitarian moral theory is most often associated with the moral system pioneered by the eighteenth century Enlightenment philosopher, Immanuel Kant and the late, John Rawls . If divine command theorists justify moral rules based on the authority of God, a Kantian justifies moral rules based on certain features of human nature; most notably: rationality and freedom of the will. For an egalitarian, moral rules are based on universal human equality as embodied in “Golden Rule.” Egalitarians are defenders of moral absolutes as embedded in the concept of justice and universal human rights.
In terms of life-extension biotechnology, egalitarians are primarily concerned with two main issues: “fairness” in the treatment of research subjects being utilized by scientific researchers and the “fairness” in the distribution of life-extending biotechnologies.
Utilitarian theory can sometimes justify the coercive exploitation of research subjects based on the promise of rosy future utility ratios for future generations. If a few research subjects are harmed by one particular line of life-extending research, say cloning research, those costs would be justified if that research leads to longer and more pleasurable lives for everyone else. Egalitarians, however, eschew all forms of exploitation and cannot treat persons as the means to a social end. Some egalitarians and some divine command theorists that believe that zygotes and fetuses are persons, and therefore, voice moral concerns over stem cell research. Most egalitarians are concerned with the moral status of clones, and whether we ought to be producing “headless clones” as organ farms, or as disposable research subjects.
In egalitarian societies, biomedical research is carefully regulated by government. Of course, this raises serious questions concerning the regulation of coercive and exploitative research conducted by multinational corporations that operate in non-egalitarian countries.
The second concern voiced by egalitarians over life extending biotechnologies is over how those technologies will be distributed. Again, utilitarians would be satisfied if more individuals benefit from those technologies than do not. Egalitarians, however, would be willing to support life-extending biotechnologies, if and only if, the “least advantaged” had equal access to those biotechnologies. Hence, egalitarians probably would not support a market-based distribution of life-extending biotechnologies and would insist on social distribution via national health care systems.
Egalitarians tend to value global equality and the protection of human rights over intra-national equality. If life-extending biotechnologies are developed, they will probably be pioneered by “First World” researchers. Based on the principle of universal human equality, egalitarians would insist that life-extending biotechnologies be available to the “Third World,” and perhaps even distributed by international agencies like the World Health Organization. However, universal access to life-extending biotechnologies raises serious utilitarian and Malthusian concerns in terms of the environment’s ability to support exponential human population growth and the First World’s ability to thwart world hunger through international relief programs.
Another issue for First World nations concerns the fact that many Third World cultures distribute resources unequally between men and women. Therefore, egalitarians would also insist upon gender equity in the distribution of not only health care, and education, but also in the social distribution of any life extending biotechnologies that might be developed in the future. Other societies would also distribute life-extending biotechnologies unequally based on social class, race, and or tribal affiliation.
The other strain of Western deontology is libertarianism. It is associated with the writings of John Locke, John Stewart Mill, and Robert Nozick . As a form of liberalism, it agrees with much any of the egalitarian view of human nature (individuality, freedom of the will, and rationality). Libertarianism, however is based on egoism, and therefore emphasizes individual rights, especially property rights. It is usually depicted as a political philosophy rather than a moral system. Libertarians do not aspire to enforce any one single view of the good, but seek to allow individuals to decide what they think is good. Hence, libertarians believe that research subjects, researchers, patients, physicians, and biotech corporations, ought to be free to make their own self-interested decisions, free from the coercive power of government.
In the context of both biomedical research and biomedical treatment, libertarians focus their energy on matters involving informed consent. Research subjects and patients must be given enough information to make rational self-interested decisions in respect to life-extending biotechnology. Most libertarians, therefore, are willing to use the coercive power of government to insure that researchers and corporations that develop and sell these new technologies do not violate the rationality and free will of research subjects and patients by withholding information or outright lying. Of course, in the absence of any global enforcement agencies, the Internet is fertile ground for pseudoscience and fraudulent products of all types.
Libertarians defend both “freedom of religion” and “freedom from religion” and therefore, vigorously oppose governmental enforcement of divine commands that are based solely on religious authority. So in terms of biotechnology, “anything goes,” as long as everyone respects each others life, liberty, and property. (Bailey)
The main point of contention between egalitarianism and libertarianism is over how resources are distributed. For a libertarian, all rights are negative rights, or rights of non-interference. In a libertarian society, all individuals would have the equal right to compete for the research dollars, and positions that will be opened up by the new technologies; and everyone would a negative right to purchase life-extending biotechnologies, but no one would have the positive right to actually get those dollars, jobs or enjoy those technologies.
Against a rising tide of religious conservatism in the United States, both egalitarians and libertarians agree that the only way to preserve the free market, Science, and religious freedom in the United States is to defend a line of demarcation between church and state. If “freedom of religion,” implies the freedom of church leaders to enforce church doctrine, “freedom from religion” implies the freedom of individuals to reject and/or abandon those religious traditions. In practice, this means that religious groups may “rightfully” command whether their members ought to be involved in anti-aging research, whether they ought to utilize the forthcoming fruits of that research, and whether they ought to invest in biotech corporations that fund that research. But they may not employ the coercive power of government to force their commands upon the rest of society.
C. VIRTUE-BASED MORAL THEORIES
Historically, virtue-based ethical theories were first developed in Ancient Greece, but were displaced by Judeo-Christian divine command theory, which in turn, was unseated by Enlightenment era deontological theories. However, in recent years virtue-based moral theories have been staging a comeback. Much of this comeback can attributed to what many “communitarian” philosophers consider to be their compelling critique of deontological theories.(MacIntyre, Forst) The primary target of this critique is the egalitarian notion that moral decisions ought to be made on the basis of impartiality and their insistence upon holding the line between legality and morality.
Virtue-based theories find moral goodness in proximity to standards of human excellence. The secular virtue-based system embraced by the Ancient Greek tradition, most notably by Aristotle, was hedonistic, and therefore rather worldly. Of course, Aristotle believed that there is a qualitative distinction between lower bodily pleasures and the higher intellectual pleasures. Aristotle also distinguished between intellectual virtues, or excellence of thought such as wisdom, understanding, and prudence; and moral virtues, or excellence of character such as courage, temperance, and justice. Moral virtue, according to Aristotle, lies within a “golden mean” between the vices of excess and deficiency. Th
