Apr 1, 2002
by Anton Zuiker
It’s a common refrain in the medical literature reviewing the advances in fighting aging: Since the beginning, human beings have wanted a way to live longer. It’s been a pollyannish pursuit.
The difference today, says Dr. Eric Juengst of Case Western Reserve University, is that now “we have real science, real interventions.” Anti-aging drugs and gene therapies, a few available now and more on the horizon, may answer that age-old yearning to prolong our time on Earth. But, says Juengst, such medical miracles raise a host of other serious questions. In the end, living longer may cause more problems—social, economic, legal and medical—than you’d expect.
Juengst has persuaded the National Institutes of Health to fund a multidisciplinary group of thinkers at CWRU to ponder those potential problems. Its three-year, $800,000 NIH grant will allow the group—a medical philosopher, a lawyer, an Alzheimer’s expert, a religious scholar and a political scientist—to collaborate on a series of thought experiments. Carol Donley, a Hiram College literature professor who specializes in the mythical and literary treatments of immortality and the pursuit of youth, is one of many other academics advising the group. “We’re trying to take what we already know about the aging process and then extrapolate what the implications for the future would be if we were able to slow down that aging process,” says Juengst. That makes this research project somewhat unique, since the NIH prefers to fund laboratory research. “Presumably,” he says, “this [will be] more grounded than sci-fi speculation.”
When will we have a pharmacological solution to aging? “Don’t expect much in the next five years,” says Juengst, “except building hyperbole and claims of breakthroughs on the horizon.” The first treatments, already coming available, will be for common diseases such as Alzheimer’s and dementia. Experimental therapies include a new generation of drugs for treating memory loss; Cognex (tacrine hydrochloride), for example, helps temporarily restore memory to Alzheimer’s patients—though often only enough to allow those patients to remember that they have the disease, says Juengst. Genetic research also offers a solution. In February, scientists in Chicago announced that a woman had been implanted with an embryo specifically chosen because it lacked the offending early-onset Alzheimer’s-causing gene that has plagued her family.
With the near-term advances, “we won’t be as sick when we’re old,” says Juengst, “but we won’t live that much longer.” Other scientists, however, are already actively trying to lengthen the human life span. (Life span refers to the longest period a member of any species has lived. In humans, that’s about 122. Life expectancy refers to the average length of life; in the U.S., that’s about 73 for men and 80 for women.) This area of research is happening at the cellular level, and holds the promise of developing preventive gene therapies to “upgrade various systems in the body.” Some scientists, says Stephen Post, a CWRU bioethicist and religious studies scholar who is also an expert on Alzheimer’s disease and dementia, believe that in 20 to 30 years they will break through the human life span barrier by interrupting the aging process itself at, say, age 30.
Scientists have been able to triple the life span of certain roundworms and double the life of fruit flies. Some species of sea turtle, says Post, naturally live to 250 years without any sign of “osteoporosis of the shell,” and parrots don’t get gray feathers or other signs of decrepitude—one day they just keel over and die. So perhaps evolution doesn’t want humans to live longer? Numerous scientists assert that our bodies are mortal because it is our genes that are immortal , and anyway, aging is just too complicated to short-circuit.
Religions, too, have argued that. “Most mythology is cautionary, warning that we might not like what we find,” says Juengst. Post sees a day when anti-aging technologies have create a world divided in two, between those with dementia and those caring for the demented. “Already the aging society imposes vast new demands on Christian communities of care,” he writes in an as-yet-unpublished essay. “The idea that we have [God-given] stewardship over our human nature implies that we have duties to care for it and mitigate dysfunction through therapeutic novelty … [W]e must be aware of the arbitrary aspects of any one generation’s image of human betterment.”
The CWRU professors have structured the anti-aging drugs study in three levels: the personal (“If I have the opportunity, should I stop the aging process?”); the professional (“Is anti-aging a legitimate goal for medicine?”); and the social (What are the societal implications for longer-living people?”). Juengst hopes that by the end of the study, the group will be able to offer recommendations for professional ethics and public policy in the U.S. Along the way, Juengst and Post and the others (CWRU researchers Robert Binstock, Peter Whitehouse and Max Melbin) will touch on geopolitics, insurance rates, Olympic competition and faith in God.
If longer life is possible, Juengst asks, should every person be entitled to an equal number of extra years? In light of today’s revelatory discussions about Federal entitlement programs such as Medicare and Social Security, can our government afford a population that lives even longer? Similarly, says Juengst, if access to these therapies is simply through a market model, the way cosmetic surgery is today, the link between wealth and health, indeed long life, would become even more pronounced than it is now. “That would exacerbate the gap between the haves and have nots.” Already the life expectancy in South Africa and Afghanistan is less than 50 years. Would it be fair to lengthen American lives even as AIDS-wracked nations are struggling to stem their losses?
Even in the U.S., things aren’t exactly egalitarian in this regard: The infant mortality rate for black children is more than twice the rate for white and Hispanic children. Expensive new technologies and drugs beg the question: Shouldn’t we use our resources to improve public health with inexpensive therapies for nutrition, immunizations and physical fitness? And what will religion and ethics have to say about all this?
But there’s more. Might living longer begin to fundamentally alter the nature of human beings? Post, who studied under President Bush’s conservative bioethics advisor Leon Kass at the University of Chicago, worries about this. “Would people living longer be more loving and caring?” he asks. Some philosophers, he says, believe that it is our intergenerational relationships that make us creative. One might well ask, what would the function of healthy 120-year-olds be in society? Would centenarians still in their prime be unwilling to retire, blocking younger people from succeeding to positions of power? Might 100-year marriages be possible, or even desirable? Will young brides and grooms still be able to say “till death do us part” with a straight face?
Indeed, Juengst wonders how anti-aging drugs could affect the length of our reproductive years. Could you still be putting kids through college when you’re 112? Might their 80-something brothers and sisters be willing to lend a hand? Or will they still be living out some prolonged adolescence, waiting to claim their inheritance? For that matter, will healthy 100-year-olds who show few signs of aging be marrying 20-year-olds? And what implications could that have for their offspring?
“The biological revolution,” Post says simply, “is the most significant revolution of all time.” And that may be the understatement of the millennium.
So, while men and women continue to gather the world over in coffee houses and bars to bemoan the onset of old age, six men will be gathering once a month at CWRU to discuss the ethics of staying young. It’s a conversation that probably ought to be taking place in those coffee houses, says Post. “These are questions for everybody, without a doubt. You don’t want to leave this topic to bioethicists and scientists. It should be open to a widespread political discussion.”
Anton Zuiker ☄
© 2000 Zuiker Chronicles Publishing, LLC