Davis John K. - New Methuselahs: the ethics of life extension

Basic Bioethics

Arthur Caplan, editor

A complete list of the books in the Basic Bioethics series appears at the back of this book.

John K. Davis

The MIT Press

Cambridge, Massachusetts

London, England

2018 Massachusetts Institute of Technology

All rights reserved. No part of this book may be reproduced in any form by any electronic or mechanical means (including photocopying, recording, or information storage and retrieval) without permission in writing from the publisher.

Library of Congress Cataloging-in-Publication Data is available.

ISBN: 978-0-262-03813-3

Retail e-ISBN: 978-0-262-34723-5

Library e-ISBN: 978-0-262-34722-8

MITP e-ISBN: 978-0-262-34721-1

This book is about the ethics of life extension. By life extension, I dont mean end-of-life care for the elderly. I mean slowing or halting human aging. At its extreme, this would be endless youth, the sort of thing we know from myths and science fiction. Even if we didnt halt aging but merely slowed it down, we might look and feel youthful much longer than we do nowperhaps decades longer. Perhaps more.

Unlike most books about ethics and biotechnology, this book is about a technology that does not yet exist, and that requires an explanation. Why should we think life extension is plausible? Moreover, why would anyone think there is an ethical problem with keeping people youthful for longer? And why write about this now? Why not wait until life extension arrives and we know more about it?

To show that life extension is plausible, I must spend more time talking about science than is usual in an ethics book. (Most of that material appears in .) As wild as it may sound, many scientists now take life extension seriously. Gerosciencethe branch of biology that studies aginghas made dramatic strides over the last 20 years. Researchers have already slowed aging in several speciesincluding yeast, mice, and fruit fliesand learned that humans share many aging-related genes with those species. Many mainstream geroscientists now publicly declare that we may soon learn how to slow aging in humans. Some of them have even founded pharmaceutical companies to develop drugs for this. There is a rising sense of excitement among geroscientists and an increasing flood of reports about this in the media.

Geroscience is a young science, and research into ways to slow aging is in its infancy. However, we already know a few things about life extension. We know that the basic processes of aging occur at the cellular and molecular level and that slowing aging requires intervening in those processes, probably using drugs, possibly using genetic engineering (such as the new CRISPR method), and perhaps using stem cell transplants. We know from other medical contexts that those methods tend to be expensive, but we also know that new technologies tend to become automated and less expensive over time. Finally, we know that its hard to predict new technologies more than 10 or 20 years ahead, for we know that biotechnology has produced things that would have seemed impossible a generation or two earlier. The impossible is a moving horizon.

Still, methods for slowing human aging are years away, and halting aging is well beyond what scientists now forecast. Why write a book about life extension now? Aside from intellectual interest (a good reason by itself), one reason is that we are effectively making policy decisions about life extension right now. We are doing this by making decisions about how much to fund the relevant research. The more aggressively we fund such research, the faster we may learn how to slow aging. Suppose, for example, that we can discover a way to slow aging enough to gain an extra two decades of life. If funding life extension research aggressively would bring this about 10 years sooner than funding it at current levels, then funding it aggressively adds 20 years of life for those who are just young enough to use life extension technology by then and just old enough that 10 years later will be too late. We dont realize it, and it may seem silly to say this, but we are making decisions about geroscience research funding that may have life-or-death consequences for millions of people. Even if not funding such research beyond present levels is the right research funding decision, we need to think about the ethical issues in order to know that its right.

Throughout this book I refer to two research funding policies: Promotion, which consists of funding life extension research generously enough for it to progress as fast as it can, and Inhibition, which consists of funding it at some lower level. (I left out prohibiting such research because I dont think thats feasible and because the arguments for inhibiting it and for prohibiting it are much the same.) When I discuss considerations for and against life extension, I tend to present a choice between Promotion and Inhibition. That choice is meant as a stand-in for more general positions for and against life extension.

Very well, life extension is plausible and its time for a book about it. But why do we need a book about the ethics of life extension? What could , where I survey the ethical issues discussed in this book, but heres a general answer.

Despite its obvious appeal, life extension is controversial. Some bioethicists have serious concerns about it, and surveys reveal that many ordinary citizens share these concerns. (Their concerns are summarized in to these and related issues.

There are other issues I find more worrisome. The literature on life extension ethics is laced with comments about unequal access to life extension, dividing society into castes of mortals and near-immortals, making inequality worse, allowing dictators to live forever, and similar concerns. Many people also worry that halting aging, or even slowing it dramatically, will eventually push the worlds population into a Malthusian crisis. These topics are where the real problems lie, and I take these concerns very seriously. One of my major aims in this book is to shift life extension ethics away from questions about the desirability of extended life and focus more attention on issues of justice. This is the project of covers enhancement issues.

At the end of each chapter from , I list all the conclusions once again (think of this as an outline of the entire book) and restate the policies I propose concerning (a) whether and how much to fund life extension, (b) how to respond to the fact that many people will not be able to afford access to life extension, and (c) what to do about the possibility that making life extension available may eventually bring about a Malthusian crisis.

In the end I come down in favor of life extension, but only if policies are instituted to prevent a Malthusian crisis. However, I side neither with those who think there are no valid moral objections to it nor with those who think the moral objections are so strong that we should never develop it. I argue that developing life extension is, on balance, a good thing and that we should fund life extension research aggressively. However, I also conclude that some of the moral objectionsparticularly those concerning justicehave real weight. They deserve more careful answers than defenders of life extension usually provide. I hope Ive moved that discussion forward.

I thank John Martin Fischer, Benjamin Mitchell-Yellin, Heinrik Hellwig, and the Immortality Project, together with the John Templeton Foundation, for a grant that funded a semester away from teaching to work on this manuscript, and California State University, Fullerton, for funding another semester off for the same purpose. I also thank Michael Cholbi, Steven Munzer, Chris Nattichia, and James Stacy Taylor for helpful comments on earlier versions of some of the chapters. I thank Peter Brinson for his careful reading of the entire text. I owe a debt to Steven Austad and George M. Martin, noted scientists working on aging who happened to be at the University of Washington during my graduate studies in the late 1990s. They probably dont remember me, but I remember them for encouraging my interest and helping me to understand the science of aging. I also benefitted from a recent and very enjoyable conversation about these topics with Aubrey de Grey, who has done more to promote and encourage life extension research than anyone else. I thank Benjamin Mitchell-Yellin (again) and his students for useful feedback on some of the justice issues and for Bens steadfast encouragement and support. I received helpful feedback on various issues from audiences who heard my life extension ethics presentations at Cambridge University, Halle University, the Brody School of Medicine at East Carolina University, and United World CollegeUSA.