(cross-posted from Existence is Wonderful)

Different existing, emerging, and potential technologies and techniques tend to have different motivations behind them, as well as different affected populations. And yet, frequently it seems as if these technologies, their agents, and their implications end up quite muddled whenever people start discussing bioethics. This analysis is an attempt to make sense of how to classify and coherently discuss some of the most relevant biotechnologies as well as their implications for different populations -- and for the future at large.

The diagram below represents a map of various means by which people might modify themselves and their offspring, or by which they might "configure" future generations. My intent in creating it was to provide a visual representation of how I imagine the "bioengineering topic-space" and the kinds of technologies that are often of concern to transhumanists, technological progressives, disability rights activists, life-extensionists, and various other interested parties.

 

Affected Entities

The main boxes in the diagram are titled Consenting Agents (blue), Non-Consenting Agents (violet), Pre-Potential Persons (red), and Potential Persons (green). Some of these list items are further clarified (via explanations in parentheses below the item). The blue, violet, red, and green boxes all overlap slightly; this is intended to indicate that there is a certain degree of fuzziness in delineating those categories.

Motivation and Rationale

Each list item in each box is assigned additional color-coded symbols indicating the motivations and reasons that tend to underly that item. These color-coded symbols are explained in the legend in the lower right-hand corner of the diagram. In the context of this analysis, "Lifesaving" (indicated by a red rectangle) means that a given action can be applied in the service of saving a life. Most of the time, the life being saved refers to the life of the person being modified (via surgery, drugs, etc.) -- however, in the particular case of "Potential Persons", the "Lifesaving" symbol refers to the life of either the mother-to-be, or of siblings or other persons whose lives will be saved due to the birth of a matching donor ("savior siblings").

"Enhancing" (indicated by a blue rectangle) in this context refers to an action taken to improve some aspect of a person's functionality, ability set, or other attribute. I take the position that all actions taken that change a person in some way are best described by the more neutral term "modification", however, the term "enhancement" here is being used to express that from the perspective of the person choosing a given modification, that modification is going to act in a positive manner.

"Cosmetic or Socially Motivated" (indicated by a green rectangle) in this context refers to an action taken to address an aesthetic/cosmetic preference or concern, or to satisfy a perceived social obligation or insecurity (which may relate to discrimination, economic factors, etc.). This category includes everything from haircuts to rhinoplasty to possible future actions people might take (e.g., adopting fur or feathers in an attempt to resemble one's favorite nonhuman animal).

"Life-Enabling" (indicated by a yellow rectangle) in this context refers to an action taken which allows a life to happen. Life-Enabling is distinguished from "Lifesaving" in that in order to save a life, you first have to have a life to save; fertility treatments, for instance, make lives possible but they cannot be said to be saving lives.

Concepts and Buzzwords

The pale cyan and pale orange squares in the "center field" of the diagram represent various concepts and buzzwords often associated with different modification/bioengineering types and the populations they apply to. The pale cyan square lists concepts primarily relevant to existing agents, whether they be consenting or non-consenting. It is placed closest to the "Consenting Agents" and "Non-Consenting Agents" blocks for that reason.

The pale orange square lists concepts primarily relevant to hypothetical beings and/or social frameworks and theories. It is placed closest to the "Pre-Potential Persons" and "Potential Persons" blocks for that reason. Note that the orange and cyan squares are not intended to group one set of concepts as being "good" and the other set of concepts as being "bad".

I may personally think that some of the items are worthwhile or problematic, but that isn't really the point here. Rather, these boxes are intended to show that there are some concepts that tend to be more relevant to hypothetical/potential beings, and other concepts that tend to be more relevant to existing beings.

It is important to make this distinction because of the common confusion in bioethical discussion that occurs when people attempt to equate an action performed on an existing person with an action performed in order to bring (or not bring) a certain kind of person into existence in the first place. I see that particular confusion as the result of what happens when people spend too much time banging abstractions together without remembering to acknowledge the real world now and then.

Consenting Agents

The notion of consent applies only to cases of existent persons -- that is, persons who either can render legible consent, or who cannot consent but who are nonetheless persons and who might at some point be in the position to comment on what has been done (or not done) to them. Consenting Agents are defined, for the purposes of this discussion, as individuals who choose a particular configuration according to their own functional or survival needs, wants, and/or desires to express their creative impulses through their physiology.

This category includes artificial limb users, feeding tube users, body-modification enthusiasts, fitness enthusiasts, voice-synthesizer users, would-be cyborgs, life-extensionists, and anyone who is in a position to choose between keeping or adding a particular configuration or trait, or discarding a particular configuration or trait. If an agent is defined as "consenting", it will be assumed that in order for any kind of modification to take place, the individual in question must not be coerced or pressured by outside agents, and that the individual is amply informed as to the possible ramifications of a given modification.

It is also assumed that social factors (such as discrimination) count as coercion, meaning that a person who is threatened with something like loss of employment if he or she does not undergo a particular procedure cannot be assumed to be truly consenting. (A literary example of this situation can be seen in Elizabeth Moon's novel, The Speed of Dark, in which autistic workers are "encouraged" to take part in an experimental procedure that would make them nonautistic, due to a perception that the company that employs them could cut costs through eliminating the accomodations provided to the autistics). Items in the Consenting Agents category are very much tied to the concept of morphological freedom.

These items are explained below:

Prosthetic Self Modification is defined here as being something "somatic" that does not affect the germline -- that is, it is something that a person might apply to themselves and that might alter their form radically, but that will not affect their gametes or be transmitted to their offspring. A prosthetic self-modification (as indicated by the color code) might be undertaken for lifesaving, enhancing, or cosmetic reasons.

Examples:

- A lifesaving prosthetic modification might be the installation of a breathing-assistance device, or a treatment intended to restore mobility to paralyzed chest muscles.

- An enhancing prosthetic modification might be the use of a drug that improves visual memory, or replacement of a biological limb with a mechanical one perceived as being stronger or more agile.

- A cosmetic prosthetic modification might be a rhinoplasty or something as simple as a haircut.

Prosthetic self-modification is an area where the concerns of transhumanists, "enhancers", progressives, and disability advocates ought to overlap visibly. These groups are heavily invested in morphological liberty and are dependent upon consistent defense of the right not to be normal. Additionally, these groups (particularly transhumanists and disability advocates) share common sentiments about the intrinsic worth of sentient lives, with transhumanists arguing in favor of radical life extension (because being old shouldn't mean your life stops being worth saving), and disability advocates making the point that no, they would not rather be dead than disabled.

Gene Therapy is defined as being a procedure intended to alter the genes of an individual (who is assumed in this case to have consented to this treatment, and who has not been coerced in any way). There is potential for this therapy to affect the individual's offspring via genetic transmission, however, there is no guarantee that it actually will.

Germline-Affecting Self Modification is defined as being a chosen modification that will affect one's offspring; that is, the person receiving it knows that his or her children are going to be different in some particular way as a result. The primary motivation behind this sort of self-modification is to modify the person who chooses it, however, any children born following the modification will exhibit characteristics consistent with that modification. This is the sort of bioengineering that I believe is most likely to contribute toward an eventual "speciation" of future persons; people will configure themselves as they see fit, and their children will reflect these choices.
And since parents generally like having children who resemble them in some way (since this makes them easier to relate to), this will not be considered a negative.

Germline-affecting self modification stands out as being an avenue by which the sentients of tomorrow may drastically differ from the sentients of today, but not due to any sort of "eugenics" regimen, coercion, or restriction of reproductive freedom. But does the person who modifies himself or herself in a way that affects his or her germline have any "obligation" toward his or her theoretical future children? Many would probably imagine so, and certainly, people can attempt to extrapolate from the present into the future and make the best possible choices they can according to the information they have available. But most people are likely do this anyway if they plan to have children at some point; I do not anticipate that many parents would choose a modification that would make their future children more susceptible to cancer, for instance.

Additionally, when considering any modified person, it would not be appropriate for states or other regulatory entities to restrict personal modifications on behalf of purely hypothetical future children. After all, if these restrictions applied to personal modification, should they not also then apply to career choice, hobby pursuits, and sporting activities (since all these can certainly affect the configuration of a future child, as well as the environment in which he or she is to be raised)?

Restricting the right of germline-modified humans to reproduce would be very similar from an ethical standpoint to restricting the right of disabled persons to reproduce. Such a restriction smacks of notions of "racial purity" and other unsavory concepts that we certainly do not want following us into the future.

Overall, the category of modifications likely to be employed by, and applied to, consenting agents is the one that is perhaps the least controversial (at least if you exclude the issue of safely and ethically testing all the modifications that might fall into this category; that is another topic entirely). The challenges in achieving an environment in which people can seek and enjoy these modifications (or not seek them, since having the freedom not to change is also an element of morphological freedom) are going to be primarily social.

 
Non-Consenting Agents

This is perhaps the most controversial of all categories presented in this analysis. Whenever there exists an entity who is clearly alive, but who is not considered to be in a position to make the ultimate judgement call as to what happens to their mind and body, there exists much in the way of potential for ethical quandary. The agents in this category might be infants, minor children and adolescents, or adults who are unable to communicate in such a way as to render consent.

Clearly, all these non-consenting agents have rights, however, they cannot be said to have the same exact set of rights as consenting agents do. This is not, of course, due to any moral failing or culpability on the part of the non-consenting agent -- but rather, due to their developmental, morphological, and/or neurological circumstances.

A seven-year-old child might vociferously protest upon being told he needs to get a booster shot, however, if a parent conceded that the child did not actually have to get the shot, that parent would (rightly) be looked upon as negligent. However, that same seven-year-old does have some right to bodily autonomy -- the question is one of how far that autonomy goes, and how much (if at all) perceived "parental rights" or "social obligations" ought to infringe upon this autonomy.

In this framework, babies (even newborns) are considered to be "agents" because their existence is no longer intrinsically linked to being situated inside the body of another person, whereas fetuses are not agents because (as residents of another person's body) their rights do not override those of the mother. This analysis argues that a pro-choice position with regard to a parent's right to terminate a pregnancy (for any reason) is fully compatible with a stance against infanticide, and with a stance in support of the notion of providing lifesaving surgeries to infants by default.

This stance removes the necessity of endless debates over the personhood, cognitive capacity, etc., of fetuses, which frequently tend to distract discussion participants from more pertinent issues (such as bodily autonomy and the "do no harm" mandate of medicine).

In the case of adults, an example of a non-consenting adult agent might be someone with a serious communication disability whose wishes cannot be understood by those around him or her. Until a viable means of communication can be established, it falls to the person's loved ones, family members, and friends to make important decisions on his or her behalf. Clearly it would not be acceptable to let a non-speaking adult suffer from a painful ear infection (for instance) simply because their consent to antibiotic treatment could not be established; there is definitely a great need to establish a coherent "ethics of treatment" for the particular case adults with communication-affecting disabilities.

The primary challenge here is avoiding both undertreatment (e.g., assuming an injury or illness isn't painful because the person is not complaining in a standard way) and overtreatment (e.g., sedating or physically modifying a patient for the sake of "convenience"). Ideally, in order to meet this challenge, every attempt should be made to establish a workable communication system for the disabled person. There are numerous (and under-utilized) alternative communication devices available on the market, some of which can be operated by individuals with very minimal motor capacities. It cannot be assumed in every case when a person is deemed "non-communicative" or incapable of complex thought that this is actually so; far more effort needs to be made in terms of providing opportunities for such persons.

Anne McDonald, who has severe cerebral palsy (and who was growth-attenuated through negligent dietary restriction as a child, though she later grew to adult size), writes:

My motor skills are those of a 3-month-old. When I was 3, a doctor assessed me as severely retarded (that is, as having an IQ of less than 35) and I was admitted to a state institution called St. Nicholas Hospital in Melbourne,Australia. As the hospital didn't provide me with a wheelchair, I lay in bed or on the floor for most of the next 14 years. At the age of 12, I was relabeled as profoundly retarded (IQ less than 20) because I still hadn't learned to walk or talk...At the age of 16, I was taught to spell by pointing to letters on an alphabet board. Two years later, I used spelling to instruct the lawyers who fought the habeas corpus action that enabled me to leave the institution in which I'd lived for 14 years. In the ultimate Catch-22, the hospital doctors told the Supreme Court that my small stature was evidence of my profound mental retardation. I've learned the hard way that not everything doctors say should be taken at face value.

One can only imagine how many more individuals like Anne McDonald end up languishing (in institutions or otherwise) for years because of the assumptions people initially made about their mental abilities; the difficulty in such cases has always been a combination of prejudice, ignorance, and the tangible technical uncertainties of establishing that a severely disabled person is actually communicating something in particular.

The bad news is that the prejudice remains difficult to root out (mainly because most people are horrified by the idea that their own views might be prejudiced, and have difficulty distinguishing between having this prejudice pointed out and having their character attacked.)

The good news is that the technical uncertainties and difficulties of determining a seriously communication or motor-disabled person's wishes, needs, and wants are capable of being remedied. Emerging technologies hold great promise here. Brain-computer interfaces in particular might very well end up enabling communication for persons who today cannot even make use of devices like eye gaze boards. By focusing on establishing communication, and directing research efforts toward the assistive-communication area of technological development, the problem of consent is more likely to be ethically remedied because the persons in question will have the means to communicate their own wishes and describe their sensations and thoughts. Imagine a world in which there is no way to tell whether a person you meet in Second Life is using a keyboard, a voice-activated control system, or a brain-computer interface -- this world might not actually be very far off, and "virtual communication space" could very well end up being a tremendous opportunity facilitator for severely disabled persons.

There are two items listed in the Non-Consenting Agents category: Externally Imposed Modification and Lifesaving or Basic Health Restoring Treatment.

Externally Imposed Modification is defined here as being modification that is not chosen or consented to by the agent receiving it (who may be a child or an adult). This type of modification is considered to refer to actions taken that are not directly related to lifesaving efforts. Examples of actions that would fall into this category range from "simple" modifications (like haircuts or ear piercing) to "complex" modifications ("enhancements", surgeries that would normally be considered elective, cochlear implants, cosmetic procedures, etc.).

Overall, modifications to non-consenting agents should probably be kept to a minimum, with more caution and hesitation occurring in proportion to the level of invasiveness of the procedure. Children and persons with disabilities represent vulnerable populations, and therefore require rigorous protections against abuse and untoward experimentation.

In the real world, modifying another person's body or brain through invasive or irreversible means is not in any sense trivial, and while I strongly support the rights of persons to modify themselves per their goals and desires (with very little regulation standing in their way), I assert that the notion of modifying others is heavily complicated by power relations and deserves very careful scrutiny.

Lifesaving or Basic Health Restoring Treatment is defined as being a procedure performed on a child, infant, or adult with the intent of saving their life or correcting a dangerous or painful health issue that directly and primarily effects the patient. Few would argue against this type of treatment, and in fact, one of the primary aims of disability advocates is to assure that all persons are accorded lifesaving treatment when necessary regardless of disability status.(1)

Since livesaving and basic health restoring treatments already exist in some forms, the "emerging and future technologies" aspect of these treatments applies mainly to the fact that we are developing new means every day to save people who would otherwise die. Just a few generations back, if your heart stopped, you were pronounced dead; then came the defibrillator. And additionally, now, people can be kept alive in comas or states of undetermined awareness for years -- this situation in particular might very well serve as a starting point for mainstream discussion of reanimating cryonics patients.

Pre-Potential Persons

A pre-potential person, for the purposes of this discussion, refers to the idea of a person and encompasses a particular action being taken that will affect or make existent a potential person. Examples of pre-potential persons are isolated male and female gametes (that may or may not be brought together to form an embryo), and the germ cells of individuals who would modify those cells with the intent of making their children come out a certain way (for example, deleting a familial gene sequence that makes carriers susceptible to a particular form of cancer).

The population of pre-potential persons is vast and practically unknowable at this point, since it consists of everyone who could or might be born in the future (or perhaps even created via non-biological means; I do not dismiss the possibility that sentient machines may at some point come into being, and when they do, they will need to have their rights taken into consideration as well). There are a lot of grand, overarching theories and frameworks that might be invoked in attempts to make a case for "engineering" a particular kind of future generation, however, I suspect that any single framework is likely to be unrealistic.

If you've ever lived in a gated community, you've almost certainly been subject to a lengthy list of rules and regulations regarding the appearance of your home -- no bright curtains, no garden gnomes, basically nothing that deviates too far from beige. These regulations are in place in order to maintain property values; difference is perceived as being something that degrades its surroundings. You might have access to manicured parks, golf courses, pools, shops, and other establishments -- all nestled behind the same stone, brick, or iron barrier. People living on the inside nurture a strange melange of security and paranoia.

The sense of being surrounded by a wall makes some breathe a bit easier at night, but at the same time, there's a kind of anxious undercurrent in how the neighbors relate. Everyone's house somehow manages to become a reflection of everyone else's house. Everyone somehow becomes perceived as responsible for the comfort and even the financial well-being of everyone else. And resentment festers beneath the din of neighborly small-talk, affecting the decisions people make, and quietly enforcing homogeneity over time, but never really coming to a head to be examined more thoroughly.

Of course, the above represents an exaggerated and stereotyped description of a gated community. But "gated community" is the image I frequently tend to get in my head while reading some people's notions of what the future ought to look like. It isn't exactly an encouraging image; in fact, I find it to be rather nightmarish. Yes, people might feel safer, and yes, some particular real risks might indeed be mitigated. But "gated community" thinking as applied to the future of sentient life seems to doom that future to a self-perpetuating cycle of suboptimization -- only "approved" configurations will be permitted to exist in the first place, and it will become more and more difficult not to see differences as defects.

In Episode 11 of the podcast, I attempted to explain why I thought the notion of a "genetic divide" was frankly absurd -- not because we don't have other kinds of divides that truly do exist and that need to be addressed (we certainly do), but because attempting to frame genetic (or other) diversity as inherently divisive between the "haves" and "have-nots" is a practice that masquerades as empiricism, but is fundamentally tainted with normative bias.

In order to truly make ethical, appropriate use of emerging biotech, this bias needs to be rooted out and exposed wherever it exists. Otherwise, we could very well end up with a future in which progress actually slows (and I mean progress in both the ethical and the technological sense) because people become too fearful of novelty and atypicality. I am quite certain, for instance, that some of the resistance to radical life extension that persists today is due to people being terrified of a future in which old people stick around much longer, in which "retirement" is replaced with "periodic hiatus", and in which the whole concept of getting one's "inheritance" is thrown out the window. People who think they are being progressive by advocating maxims that are unapologetic about preserving the status quo under the guise of "eliminating suffering" are effectively shooting themselves in the foot, so to speak.

So when thinking about the space of pre-potential persons, it is perhaps important to make sure that you are not committing the "gated community fallacy" and assuming that one single, well-controlled idea about what the future should look like is going to somehow be able to dominate. The future I imagine, analogy-wise, looks basically nothing like a "gated community"; instead, homes vary widely in size and appearance. There are cottages, ancient preserved and renovated mansions, gutted office buildings filled with colorful blanket forts. There are brick homes, metallic domes, and dwellings made entirely of Lego blocks. There are some clusters of houses that might look homogenous, but not because some housing association insisted on it; some people just happen to like the same look. There are cabins and trailers and tents. There are caves and hobbit-holes and tiny, floating islands. There are chic apartments atop barbershops and restaurants. There are dormitories. There are old hotels. There are three-story Victorians. There are synthetic igloos. Etc.

Potential Persons

Potential persons are distinguished from "pre-potential persons" in that the potential person is "further along" the process toward possible incarnation as a person. Additionally, once an entity reaches the potential person stage, certain variables and conditions have been "set" to an extent that is not true for pre-potential persons. Pre-implantation genetic diagnosis, for instance, deals with embryos -- embryos are potential persons rather than pre-potential persons because they represent a particular joining of gametes, and at the same time, embryos are potential persons rather than actual persons (or "agents") because they are not conscious and cannot be said to have interests of their own.

I would also classify fetuses as potential persons up to a certain point, however, I do think that some distinction needs to be made between a very early-term fetus and a late-term fetus, since the latter is at least more capable of feeling pain than the former. And I also realize that consideration of fetuses may change drastically as better incubators and "artificial wombs" are eventually developed; the "can survive outside the [natural] womb" criterion for viability may soon be a thing of the past, which will certainly bring up new debates.

Additionally, when discussing procedures and philosophies that apply primarily to future hypothetical generations, it is important to take into account what motivations underly these procedures and philosophies. While it may be true that there is nothing wrong with advising expectant mothers to practice good nutrition and get regular checkups to monitor her health and the health of the fetus, there is a definitive difference between recommending common-sense care and engaging in scaremongering about the "burden" of "suboptimal" children.

We are entering an era of greater ability to exercise choice with regard to the configuration of future generations than ever before, and discussing the implications of this increased range of choice for marginalized populations should not be mistaken for "conservatism" or technophobia. Alice D. Dreger writes in the Bioethics Forum article, Liberty and Solidarity: May We Choose Children for Sexual Orientation?:

Sure, it ought to be the case that defending the rights of parents to use this technology doesn’t ultimately undermine queer rights, but it seems hard to believe that in practice it won’t lead to support of the idea that one ought to try not to have a gay child – just as in practice the prenatal test for Trisomy 21 (Down Syndrome) has led to a general attitude (at least among the vast majority of my very “progressive” childbearing acquaintances) that one ought to try not to have a child with Trisomy 21. I have a friend whose young son has Trisomy 21. This friend was out and about with her son one day, when another woman looked at her and her son and – recognizing that the son has Down Syndrome – scolded my friend with the question, “Didn’t you get the test?!” I can fully imagine a scenario where, thirty years from now, a woman tells a friend her son has come out as gay, only to have the friend respond, “Didn’t you get the test?!” Could we really imagine that offering such a test would have no negative impact on how an already-homophobic culture views people who are gay (and their parents, for that matter)? In that sense, can we really imagine that supporting parents’ right to choose against homosexuality supports the message that gay people are as good as straight people?

Perhaps the best guide to the application of these emerging technologies is found in studying historical context; since banning these technologies outright is both undesirable and impossible (the "genie is out of the bottle", so to speak), it is important to attempt to guide their application while keeping in mind lessons of the past. In particular, it would be prudent to look at how things that seemed "normal" or fashionable in the past are now looked upon as ignorant, silly, or cruel.

People living in any given era tend to have difficulty thinking outside their own temporal and cultural box; things that are actually quite malleable are assumed impervious, and prejudices are mistaken for logic. By looking at the prejudices of the past and how they managed to fuel pseudoscience and oppression, we can work toward making sure that new technologies will be applied in ways that truly do contribute toward a more humane and healthy world. I am entirely optimistic that this is indeed possible, but it will require constant ethical vigilance, democratic considerations, and a healthy respect for pluralism.

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(1)Transhumanists and technological progressives will be in a position to fight a very similar battle when modification technologies become more widely integrated into common use, since modified humans and cyborgs may still be considered monstrous, grotesque, and "unnatural" by some at that point. There may be a need for anti-discrimination laws pertaining to proper medical treatment of the modified, particularly if one's modifications are directly responsible for maintaining one's life in the first place -- right now people who depend on ventilators or feeding tubes are unfortunately still subject to "yuck factor" reactions and statements along the lines of, "Well, I wouldn't want to be kept alive artificially!" Tomorrow's cyborgs will almost undoubtedly face similar challenges, particularly if the trend toward biology-hardware integration continues.

It seems that quite frequently, whenever someone lives to be 100 or 110 or some other impressive number, they tend to be celebrated and interviewed by newspapers and asked enthusiastically what their "secret" is (that is, how they were able to live so long in reasonable health). But then, when the idea of making it possible for everyone to live to 110 or beyond in good health is suggested, many people will claim that this is a bad idea or that it "diminishes what it means to be human"!

So, why the double standard here? Why is it considered good for particular individuals to lead long, vital lives but not for everyone to have the opportunity to do the same? I have never in my life come across an article featuring a centenarian or supercentenarian on his or her birthday that suggests that the specific person in question is somehow "taking up too much space" or that their time on earth is (or should be) drawing to a close; rather, such articles seem to reflect a very positive attitude about the person. This is good! This is exactly the sort of thing that we want to perpetuate -- that is, the celebration of long and interesting lives and the people who live them.

But why can't this attitude manage to carry over into general attitudes toward the elderly? If a person is valuable (which all people are), then why should we not be doing everything possible to assure that they have access to the finest and most appropriate medical care? With the kind of cognitive dissonance one encounters when reading an article about a specific centenarian followed by an article about why it's supposedly bad to support life extension, one might imagine articles with titles like, "Happy Birthday! Now, Drop Dead!" to be commonplace -- thankfully this is not the case. But still, it is rather unnerving to see some supercentenarians apologizing for their own longevity. Tomoji Tanabe, who recently turned 111 (and who is currently the world's oldest male of verifiable age), supposedly said recently:

“I have been around too long,” he joked, “I am sorry.”

Considering that the article linked above began with a statement about "Japan’s welfare system buckling under the demands of an ageing society", one can only hope that Tomoji Tanabe's joke has nothing more ominous than a note of dark humor behind it. The same man stated in another article, "“I don’t want to die,” and I sincerely hope that this statement is taken altogether seriously! Saying that elderly people are somehow "supposed" to die, or that longevity medicine undermines humanity, is a cop-out -- not to mention an insult to people who are still alive long when most would have already succumbed, and who (uneasily?) joke about possibly having overstayed their welcome while at the same time expressing that no, they are not gung-ho about seizing the grave. Being alive and sentient is about a lot of things.

Why must death, specifically age-related death (of all things) be singled out as some sort of cosmically significant defining factor of what it means to be a person? There are so many things in life that one might garner meaning from, after all -- art, beauty, love, friendship, creativity, excitement, learning, awe, wonder, and even the constant and unrelenting struggle to make meanings in a universe that frequently seems to be patently absurd. To deny the possibility of continued existence to full, valuable, loved individuals on the basis that this might somehow undermine the significance of life and personhood is beyond discriminatory. It is beyond presumptuous. Why not let people determine for themselves what it means to exist rather than presuming to decide for them on the basis of outmoded notions of everyone needing a guaranteed (probably age-related) end in order to truly appreciate and participate in life?

This is perhaps one of the most confounding things for me in terms of arguments against the idea of healthy life extension -- the idea that somehow, the "wisdom of nature" suggests that we are all part of some grand circle that demands our demise within but a few decades of our birth. Some make arguments along the lines of, well, we all need to consume things in order to survive, so when we die, that's our way of "giving ourselves back to the earth" -- and that trying to remove ourselves from this cycle signifies dangerous and ignorant hubris. Much of the intent behind appeals to "nature" as justified architect and destroyer alike seems curiously similar to the archaic, almost alchemical awareness that the existence of one thing (or one person) effectively cancels out the potential for another.

Do some people feel guilty for holding their own form, and dread having to explain their own existence eons into the future, when they might be long past the age that would have meant the certain demise of all their ancestors? Do these same people feel that the pattern that makes up each of us -- that traces the thread of our awareness through spacetime -- is predetermined to persist for around 80 years, pushing beyond that fate only at the expense of other, possibly "better" patterns?

If so, I would seriously advise such people to stop playing the would-be martyr and get around to the business of living their lives, of trying to use their accumulated experience and knowledge and sensory input data to explore the depths and heights of being -- and to help allow others to do likewise. You exist. Existence is a pretty reasonable deal, all things considered. Stop feeling guilty about being alive, stop feeling like the world would be better if someone other than you were breathing "your" air and eating your food and stepping where you walk. Instead, take joy in the fact that of all the patterns that could have been, you ended up falling out of the aether and into conscious awareness.

This is not selfishness. It is not egoism. It is simply the rational acknowledgement that just as you are no "better" than your friends, family, neighbors, or ancestors, no "hypothetical" future-being or ungerminated embryo somehow has more claim to a portion of the universe's resources than you do. Certainly, we should all keep sustainability in mind and use our resources as wisely as possible. But there is absolutely no reason to think that somehow, you don't deserve to exist past a certain point in time because you need to eat plants and such to survive -- some trees live for thousands of years, and some marine animals are thought to be capable of living indefinitely; surely, no-one would accuse these life forms of taking the place of something else that "should" exist in their stead. Not to mention the fact that aging is only one of the possible things that could kill you -- there's no way to guarantee absolute invulnerability, and we certainly wouldn't "lose" the uncertainty inherent in existence if the single variable of age-related death were somehow mitigated! It is perfectly possible to acknowledge the preciousness and fragility of life, and the vulnerability and struggle and uncertainty that come as part and parcel of biological existence, without making appeals to some divine "circle of life" that demands the sacrifice of individual minds for the sake of making fertilizer.

This is yet another area in which I see a strong overlap between longevity advocacy and disability rights. Many elderly people are disabled, and many disabled people face the same exact challenges as the "average" elder: wondering if they are a "burden" to their families, wondering if their existence is too expensive to justify, and having no idea if the folks at the hospital will even bother trying to save them if they get into an accident or suffer a fall. I don't see any philosophical distinction between a dying elderly person and a dying person with a serious disability; both are people, both are valuable, and both deserve the best in lifesaving care regardless of their age or configuration.

In the ideal hospital, a person's age should not matter with respect to whether their life is considered worth saving, just as their disability status should not matter. The fact that resources are an "issue", that they are limited, and that we humans haven't done that great of a job with this whole "sustainable living" thing just yet should not negate the fact that it is wrong to kill people, and it is wrong to let people die if there is any shadow of a chance of preventing that death. If resources are a problem, we need to work on solving that problem in ways that do not demand sacrifices in the manner of some bloodthirsty ancient idol. So, next time you come across an article about how radically extended lives would "undermine" what it means to be human, try recalling (or looking up) articles about individual centenarians and supercentenarians. Note the differences in attitude when individuals are discussed, versus where "demographics" are discussed in the abstract. I'm guessing the results will be quite telling indeed.

 That is no country for old men. The young In one another's arms, birds in the trees (out of a --Those dying generations -- at their song, The salmon-falls, the mackerel-crowded seas, Fish, flesh, or fowl, commend all summer long Whatever is begotten, born, and dies. Caught in that sensual music all neglect Monuments of unageing intellect.  From, Sailing to Byzantium, William Butler Yeats (1927) 

Is the modern world still "no country for old men"? Is it still almost universally believed that if one desires to find life, one must look to the cycles of birth, animation, and decay that characterize the unaltered natural world?

Like Yeats, many would probably still suggest that permanence (or at least a semblance of it) is only achieved in the creation and appreciation of objects and structures not subject to the sort of aging that biological bodies are.

And while Yeats makes no apparent apology for bodily senescence in Sailing to Byzantium (in fact, one might even argue that the poem ends on a rather transcendent note), he does not question its inevitability, either. And no wonder: the prospect of real, non-metaphorical, empirically-demonstrable means of intervening in the aging process is so new that at times it seems trapped somewhere in the shadows between science and mythology. Over the past few years, however, the increased visibility of key players in longevity science as well as successful and highly public fundraising efforts have helped draw the international longevity discussion further and further toward the "science" side of things.

While some today probably still believe unquestioningly that humans will continue to live to a maximum of no more than 120 years or so into the indefinite future, more and more are beginning to see the shadow of aging's destructive, clockwork inevitability fade. Effective longevity medicine may not yet exist, however, there have been some promising results in the area of calorie restriction), as well as mainstream attention to the potential for humans to live to unprecedented ages.

Clearly, the attitudes of individuals (and, by extension, cultures) toward death and mortality are facing the prospect of requiring extensive adjustment. Modern psychology, for instance, has plenty to say on the matter of existential dread and the various paths one can take toward managing it -- as well as on the various pathologies that can supposedly emerge as part of the ego's defense against ideas of personal nonexistence. From the "circle of life" cliches one finds in popular articles on explaining death to children, to academic treatises on Terror Management Theory, humans demonstrate a clear and obvious fixation on mortality awareness and its implications. And as a result of unmistakable longevity gains over the past few generations in the developed world, the questions at hand are many.

What sorts of attitudes are developing as emerging technologies make it possible for more and more people to live longer, healthier lives? Are people holding unyieldingly to old, possibly outmoded attitudes, or adopting new ones? What sorts of news items and/or scientific breakthroughs help to shape people's attitudes regarding how long they might live, and what they imagine the shape of their future will be?

A Small Survey of Attitudes

The intent of the informal Existence is Wonderful Death Poll was to examine some of the precursor attitudes to these emerging questions. The poll surveyed various attitudes toward death and longevity research -- both in terms of desirability (of either eventual death or of longevity medicine) and in terms of feasibility (e.g., are we likely to achieve marked levels of life and health extension, and if so, will this occur within "our" lifetime?).

While this was not a scientific poll, its results still proved very interesting, and will be taken into account in considering future philosophical writings and advocacy efforts. In any advocacy movement, it is important for the movement to self-examine continuously in order to avoid ideological "tunnel vision" and alienation of newcomers or persons unfamiliar with the idea of healthy life extension. Hence, as well as considering a primary respondent demographic of pro-longevity individuals, the poll also included several items deliberately intended to prompt responses from those not necessarily in favor of life extension. It was thought that in this way, a maximally representative sample pool could be obtained -- one consisting of people likely to read about longevity research and advocacy, or who are at least willing to follow links to sites that discuss these topics.

The poll asked:

Which of the following statements (you can choose more than one) most closely match your thoughts on the subject of death?

Responents were provided with the following options (from which they could choose as many as applied to their position):

1. Death is natural. Death is as much a part of life as being born is. Therefore, it is something to be respected and not necessarily fought.

2. Death is an outrage -- it destroys people, no matter what the cause, and is therefore obviously something to be challenged and resisted. I fully support all serious scientific research efforts devoted to helping usher in longer, healthier lives for all.

3. I don't really think about death much -- I just try to live my life and figure that if I do die at some point, it doesn't matter because I'll never know it anyway.

4. I believe in a supernatural afterlife, and that when I die I will enter this afterlife and exist there for all eternity.

5. I have never liked the idea of death, but I am very reluctant to even let myself think that it might be possible to do something about it.

6. Death is something that we all have to come to terms with -- people who can't or won't accept their inevitable mortality are just living in a fantasy world.

7. I don't think people should have to die, and I am in favor of research to arrest the aging process, but I am firmly convinced that my generation was born too soon.

8. I think that there are many social problems we ought to think about trying to fix before considering radical longevity to be a worthwhile pursuit.

9. I do not consider it farfetched to imagine that someone alive today might live to be 200 years or older in reasonable health.

10. I DO consider it farfetched to imagine that someone alive today might live to be 200 years or older in reasonable health.

Results are summarized in Figure 1. Respondents were allowed to choose as many of the statements as they felt applied to them and their views. Note that the total number of votes for all options (which was 393 at the close of the poll) does not refer to the number of individuals who answered the survey, but rather, to the total number of votes received for all poll items combined. The per-item vote count is shown in red for each item in Figure 1; comparison of these individual vote counts allows for an overall picture of which items in the poll were most and least frequently selected.

 

A more detailed analysis of respondent demographics was obtained through evaluation of the response sets of 116 individual poll respondents (1). A response set is defined for the purposes of this analysis as a single respondent's answers to the poll. Some respondents chose only one item, however, the vast majority chose multiple items. The three-part series of writings to follow will examine the patterns revealed by these representative response sets as well as the implications of these patterns.

It's A Circle Of Life (Death)?

Of the poll items chosen for the sake of revealing respondents' primary philosophical attitude toward death (items 1, 2, and 3), Item 1 was the second most frequently chosen. Figure 2 shows the distribution of how other poll items were selected among those respondents of the representative 116 who chose Item 1 ("Death is natural. Death is as much a part of life as being born is. Therefore, it is something to be respected and not necessarily fought.").

 

A somewhat intriguing finding was that the majority of persons who indicated that they saw death as a "natural" and possibly even desirable event were nonetheless cognizant of the prospect of effective longevity medicine being developed within the next few decades. 15 out of 25 respondents who chose Item 1 also chose Item 9 ("I do not consider it farfetched to imagine that someone alive today might live to be 200 years or older in reasonable health.").

At least in the context of respondents to this poll, it seems that a belief that death is "natural" (and not necessarily an outrage or even a particularly bad thing) does not necessarily preclude at least some degree of optimism regarding the progress of longevity medicine in coming decades. On the other hand, however, it could very well be that acknowledging the likelihood of expanding lifespans does not necessarily represent optimism at all, but simply a judgement regarding the apparent rate of medical progress into the near future.

Either way, it is well worth examining some of the potential reasons behind the popularity of Item 1. Must anything in the world be respected simply because it is "natural"? It seems that the only rational answer to this question must be a resounding "no" -- after all, very few humans would even think of declining to treat fatal cancer or AIDS on the basis of either of these conditions being "natural".

Nevertheless, it seems that plenty of people still see death (perhaps, in particular, age-related death) as a special part of some great cosmic cycle of emergence and renewal. The story of birth, growth, decline, and death is a powerful one, and one that (at least for all of human history up until now) has united every being ever to experience consciousness. Death as a "natural" event is not, then, romanticized merely because it is natural, but because it is perceived to be of some objective value -- for many, it serves as a poetic symbol of each person's place in the grand scheme of all life.

Among longevity advocates, some would suggest that the romanticization of death is simply a kind of rationalization, an existential palliative of sorts. That perhaps some of the power in the "story of death" is rooted primarily in a deep sense that nothing can be done about it -- after all, so far, nothing tangible has been done about it. To quote Dr. Aubrey de Grey,

At root, we all know aging is really horrible, whether for us or for our loved ones, but we have also grown up in the rather firm knowledge that it is immutable. And when one is faced with a fate that is both horrible and immutable, it makes abundant sense to find some way -- any way, however illogical -- to put it out of one's mind and make the best of what time one has left, rather than spend that time preoccupied with something one cannot affect.

The school of thought that seeks to define the "death is natural, we need to accept it" attitude as evidence of a "pro-aging trance" asserts that if only people could be "awakened" from this trance they would realize how horrible death was and would start making more active attempts to promote research into allowing people to escape it for as long as possible. The logic of this school of thought is quite straightforward: why should we be comfortable with death due to aging when we are loudly and emphatically uncomfortable with death due to war or famine or epidemic?

The fact that so many people are comfortable with age-related death as opposed to death through other means seems to indicate that there is something about age-related death that allows cognitive compartmentalization. This "something", as de Grey notes above, is probably the fact that age-related death has indeed been "horrible and immutable" all throughout human history so far. It makes psychological sense to come to terms with something and perhaps even weave it into one's default worldview as a net positive if there is truly nothing a person can do about it, but as biotechnology advances, humanity is going to be faced with more and more questions regarding whether a given phenomenon ought to be intervened in as our capacities increase.

Certainly, we ought not to assume that any particular thing ought to be changed simply because it can be changed. However, when it comes to matters of literal life and death, one would think that the ethically consistent position would be the one that seeks to promote and preserve the wanted, valued, individual lives of our fellow persons. It is one thing to assert that certain evolved properties of human existence ought not to be meddled with, however, it is quite another to assert that the "natural" -- the unconsciously evolved -- ought to be granted special privelege over the invented and chosen. In developing a coherent set of future ethics, it seems that an ever-improving ability to make reasonable judgements regarding the appropriateness of particular interventions into default states is critical.

Given the current (nascent) state of true longevity research, it remains to be seen whether tangible advances in life extension medicine will result in the depopularization of the "death is natural" argument. Either people will decide that their sense of identity requires the "aging into death" story lest they risk profound existential confusion, or they will concede that, now that we can actually "do something" about aging, they're not actually all that keen on undergoing senescence.

From the standpoint of longevity advocacy, the second outcome is certainly the preferred one -- for the same reason that most of us would consider it better for a friend contemplating suicide to determine that life is worth living after all and not go through with the act of killing himself. When a person has spent enough time in the healthy life extension community, it is quite likely that even poetic-sounding arguments like "death is natural, it's part of the circle of life" will start to sound indistinguishable from statements like, "I have a death wish for myself and everyone else in the world".

Against the Dying of the Light

Item 2 ("Death is an outrage -- it destroys people, no matter what the cause, and is therefore obviously something to be challenged and resisted. I fully support all serious scientific research efforts devoted to helping usher in longer, healthier lives for all.") was, predictably, the most frequently chosen of the primary attitude items (1, 2, and 3). Of the representative 116 response sets, 72 included an affirmative response to Item 2. Figure 3 shows the response data for those respondents who chose Item 2 (though it does not include the three respondents who also selected Item 1; that data is shown in Figure 2.) Only three Item 2 responders also selected Item 1, indicating that in general, there was not much in the way of overlap between those responders who held the "death is natural" view and those who are more supportive of life extension efforts.

 

Respondents who chose Item 2 tended to have very straightforward views on the subject of death and longevity research -- these individuals only rarely chose items in addition to Item 2 and Item 9 ("I do not consider it farfetched to imagine that someone alive today might live to be 200 years or older in reasonable health."). 15 respondents selected only Item 2. 53 respondents -- a significant majority -- selected Item 9 along with Item 2, indicating a strong correspondence between enthusiasm for life extension and some degree of optimism with regard to its near-term development. None of this was particularly surprising -- the primary readership of most Internet sites dedicated at least partially to discussion of healthy life extension consists largely of individuals who found these sites through association with the healthy life extension community (e.g., individuals coming from a background of transhumanism, biogerontology, cryonics interest, calorie restriction, etc.) due to personal and/or altruistic interest in the subject.

Advocacy, Faith and the Altruistic Imperative

Two interesting observations of note with respect to the response set including selection of Item 2 are:

(a) Longevity advocacy is attractive to at least some persons with theistic leanings -- five respondents choosing Item 2 also chose Item 4 ("I believe in a supernatural afterlife, and that when I die I will enter this afterlife and exist there for all eternity."),

and,

(b) Longevity advocacy and some degree of optimism regarding its likely development in coming years (indicated by positive responses to Items 2 and 9) can coexist with a perception that one will not necessarily personally benefit from life-extension treatments (indicated by selection of Item 7 -- "I don't think people should have to die, and I am in favor of research to arrest the aging process, but I am firmly convinced that my generation was born too soon."). 10 respondents who selected Item 2 also selected Item 7 -- not a majority by any means, but enough to be worth discussion.

Observation (a), while it only concerns a small set of respondents, at least indicates that a belief in an afterlife does not always go along with a rejection of "worldly" goodness or bodily life on Earth. Some transhumanists see no necessary conflict between capacity-enhancing uses of science (that could involve life extension) and religious belief -- for example James Hughes writes in On The Compatibility of Religion and Transhumanism:

Transhumanism appears to be especially compatible with religious traditions that emphasize human agency and evolution to a transcendent state, such as Buddhism, or that have incorporated Enlightenment values, such as liberal Christianity. But elements of the transhumanist worldview and enhancement technologies are compatible with one element or another of most world faiths, even the most fundamentalist.

There are even transhumanist groups (such as the Mormon Transhumanism Association) that explicitly espouse such notions as, We Must Use Modern Science to Advance the Lord's Work. Clearly, atheism is not a pre-requistite for longevity advocacy, and perhaps longevity advocates should avoid getting drawn too heavily into religious arguments, for simple reasons of logistics and energy distribution. After all, if (by analogy) a child was trapped in a building ready to burn alive and someone came along with the capacity to rescue that child, it would not make much sense to insist that the rescuer favor (or reject) a particular spiritual paradigm in order to be permitted to assist!

Observation (b) reveals the fact that longevity advocates are perfectly capable of acknowledging the fact that they themselves might not be around to partake of the benefits of future longevity research. That is, involvement in longevity advocacy need not be (and probably is not usually) a primarily self-serving gesture -- wanting to save lives and help people maintain their health is recognized as being inherently good even in the absence of assured personal superlongevity. These results seem to, at least in the context of the segment of the healthy life extension community responding to the poll, confirm that the notion of the "selfish life-extensionist" is a myth and a damaging stereotype. Just as a doctor working to cure a particular strain of cancer does not place her willingness to work on this cure as contingent upon her own guaranteed benefit from it, the longevity advocate does not place an absolute premium on individual survival. Certainly, one can hope for individual survival, but its guarantee is by no means a requirement.

Bias, Realism, and Existential Freedom

Despite the positive implications of the fact that most poll respondents were emphatically in favor of longevity research, the healthy life extension community must remain cognizant of the potential to become too self-confirmatory and self-referential. It is important for longevity advocates to stay as informed as possible regarding the relevant science -- both so that we can take advantage of opportunities to help as they present themselves, and so that we can develop the ability to access and point to real data (or at least strong scientific precedence) in support of the feasibility of longevity medicine.

It seems reasonable to suggest here that longevity advocates should endeavor to expunge common cognitive biases from our minds -- in particular, we need to be very careful of falling prey to confirmation bias and overconfidence on the one hand, and to groupthink-induced (and possibly unjustified) pessimism on the other.

There's a scene in the film Fight Club in which the lead character is, none too gently, advised: "First you have to give up, first you have to know... not fear... know... that someday you're gonna die."

The rest of the film (as well as the Chuck Palahniuk novel on which it was based) certainly seems to be at least in part a study in the implications of acknowledging one's mortality, albeit one with a decidedly nihilistic slant. Later in the story, a group of men struggling to delineate their identities in the face of the ultimate absurdity that comprises their existence are famously told:

"You are not special. You are not a beautiful or unique snowflake. You're the same decaying organic matter as everything else."

In the world of Fight Club, pain and violence act as existential catalysts in what is arguably a debiasing process; the story ends only when the lead character has managed to shed his last remaining defense. Reality, with all its harsh and glaring angles, is thrown into sharp relief and can finally be looked upon without rationalization.

The admonitions in Fight Club given to the characters about their mortality, their non-uniqueness in the grand scheme of things -- these sentiments did not emerge from a vaccuum in order to drive a particular narrative along. Rather, they are products of a particular cultural definition of adulthood -- a state of being which demands an acknowledgement of mortality, of the ultimate, eventual, and inevitable destruction of the individual. In short, only by stripping away every internal defense, every shred of wishful thinking and every carefully-laid ego-preserving illusion can a person achieve the ability to pursue tangible, real-world goals.

The question begged by this conclusion in this particular context, however, seems to be that of what place extreme longevity might have within -- or outside -- the overall set of tangible, real-world goals. Among those interested in studying or pursuing advanced longevity, opinions vary widely on this question. The collaborative writing project Overcoming Bias, orchestrated by Oxford's Future of Humanity Institute describes itself as "A forum for those serious about trying to overcome their own biases in beliefs and actions." Aside from the occasional meta-speculation on the question of the utility of overcoming bias in the first place, those who write for Overcoming Bias apparently work under the general presumption that it is better to know what is true than to be comforted by what is not true.

While the writing on Overcoming Bias is not always specifically applicable to the case of death, that subject has certainly been touched upon; in the short piece You Will Age And Die, Robin Hanson writes, "Rage if you will against the dying of the light, or take a chance with cryonics, but believe it: you will most likely age, become infirm, and die." This attitude was reflected in the poll by Item 6 ("Death is something that we all have to come to terms with -- people who can't or won't accept their inevitable mortality are just living in a fantasy world."). While only a very small number (4) of the respondents who market Item 2 also marked Item 6, it is apparent that at least some of those generally supportive of longevity efforts also feel strongly that it is important for people to distinguish between efforts to extend the healthy lifespan and efforts to "become immortal".

Returning for a moment to the respondent set which selected Item 1 (indicating sympathy for the notion that death is a natural, acceptable phenomenon), it is worth noting that 8 of 25 respondents who chose Item 1 also chose Item 6. Compare this to the fact that only 4 of the 69 response sets that selected Item 2 ("death is an outrage") but not Item 1 also selected Item 6. These data seem to indicate that at least among respondents to this poll, the "death is natural" attitude is more strongly correlated with an insistence on ultimate mortality acknowledgement than the "death is an outrage" attitude is. The implications of this difference in correlation cannot be precisely extrapolated given the small sample size, however, it seems clear that a different mindset underlies the longevity advocate's choosing of Item 6 versus the "death is natural" sympathizer's choosing that same option.

While non-advocates might see the inevitability of death (particularly age-related death) as being inextricably intertwined with the "natural-ness" of death, longevity advocates who also promote explicit mortality acknowledgement probably see this acknowledgement as part of what it will take to actually assure development of effective longevity medicine. To quote Robin Hanson again, "Our terror of death is one of our most reliable sources of bias." Even the most scientifically literate person can still possess intrinsic human tendencies toward magical thinking -- and when you are still young and vigorous, it can be easy to fall into the trap of believing that everything is going to turn out all right in the end regardless of what you do (or don't do), or that you can somehow induce positive outcomes simply by visualizing them. Therefore, it is logical to make every effort to strip away one's confirmation biases and comforting visualizations of an imagined idyllic future if one wants to be able to see what truly needs to be done in order to realize highly optimistic outcomes (such as effective longevity treatments).

Nevertheless, not all longevity advocates see this level of intensive "debiasing" as necessary. Since future progress is impossible to predict to absolute certainty, those who do not make a point of expressing their absolute acknowledgement that they (and their loved ones) "will age and die" might feel that it is best to simply make every effort to keep living and help assure that others may continue to live as well. While it might be psychologically difficult to come to a position in which both wishful/magical thinking and unwarranted pessimism are avoided (since the human mind struggles greatly with uncertainty), it is by no means impossible to come to such a position.

An ability to fully acknowledge one's vulnerability and fragility need not entail an absolute conviction that one will necessarily succumb to aging -- most, if not all, serious longevity advocates are fully cognizant of the frailty of their bodies and the strong likelihood of eventual accident or mishap. Just as the end point of a successful personal expedition into existentialism is a sense of tremendous freedom to make one's own meaning in life, so is the realization that longevity is a good thing to work toward even though there can be no guarantees of its ultimate success. If a person can answer the question, "Why live at all?" for herself, then the answer to the question, "Why try to live as long as you can and help to assure that others can do the same?" is obvious.

"Immortality", Feasibility, and Optimism's Limit Case

In any discussion of longevity and attitudes toward it, making the distinction between radical longevity and immortality is important -- both for the sake of clear communication and for the sake of widening the sphere of individuals willing to take part in serious discussion of longevity research and potential treatments. Within the healthy life extension community, the utility of the word "immortality" is certainly contested. Some suggest that making references to "immortality" specifically is unwise due to the associations with mythology and a sort of comic-book grandiosity that it tends to imply. Others, however, feel that longevity advocates have little chance of succeeding unless immortality becomes socially acceptable as a goal, and therefore, the word itself ought to be used unashamedly.

For the purposes of the Existence is Wonderful Death Poll, the word "immortality" was purposely excluded from the phrasing of the poll items. Regardless of its tentatively-acceptable status within the aforementioned "healthy life extension community", the connotational baggage of the word immortality is frequently so profound as to make use of it highly impractical, if not downright damaging. The Death Poll was not geared only toward people who would even consider themselves in favor of life extension -- a link to the poll was provided to a number of people not known to be regular readers of longevity literature, and therefore, it seemed appropriate to present the question of longevity feasibility in terms of a scale most people would consider reasonable.

Items 9 and 10 in the poll asked the respondent to select based on their sense of whether it seemed plausible that a person alive today might live to be 200 years of age or older in reasonable health. The number "200" was chosen because it represents an age far in excess of the average modern lifespan, but not an age that suggests or approaches "immortality". The intent in this case was to avoid "turning off" potential respondents who see the notion of immortality as too ridiculous for consideration, thereby acquiring a sense of how a more ideologically diverse population perceives the prospects of longevity medicine over the next few decades.

An impressive majority of respondents (79) in the representative group of 116 selected Item 9. A minority (8) selected Item 10, and a larger minority (28) selected neither Item 9 nor Item 10. Clearly, there is a general perception among poll respondents (regardless of their value judgements associated with death and life extension) that medical progress is being made, and that the prospect of effective longevity medicine being developed in the next few decades is more than mere fantasy. A larger-scale poll of a more varied and general population might reveal a different pattern, however, the fact that value judgements did not seem to notably affect a person's level of optimism regarding medical progress could indicate, at the very least, that this level of optimism is not necessarily based in "wishful thinking".

Nevertheless, the popularity of Item 9 cannot be taken to indicate anything about the actual state of scientific progress regarding the development of effective longevity medicine. Just as non-advocates can sometimes fall into the trap of believing aging to be absolutely immutable based on folk wisdom as opposed to scientific data, members of the healthy life extension community must take care not to overestimate near-term future progress based on a poor understanding of the relevant biological principles. It can be quite easy to believe that something is possible when you don't have much in the way of a detailed understanding of how it might be accomplished, after all.

But regardless of the actual state of longevity science at present, it cannot be disputed that if medicine were able to develop techniques and treatments capable of allowing a person born in 2007 or earlier to live to age 200 in reasonable health, this development would represent an impressive accomplishment. Not just because it would mean that aging had been proven at least somewhat mutable, but because that healthy 200-year-old would presumably be alive in an era of even greater medical skill and anatomical knowledge than the present boasts. Achievement of the condition described in Item 9 might then be said to represent a condition that is necessary for, but not sufficient to achieve, functional "immortality" -- at least for people who already exist. But it is not necessary to "believe in immortality" (by any definition) in order to believe that life and health extension are inherently good and worth working toward.

Perhaps rather than campaigning for the re-introduction of the word "immortality" into the set of things considered to be realistic, scientifically achievable goals, longevity advocates should focus more on pointing out that the entire goal of medicine is to sustain life and that "life extension" medicine is fundamentally no different from medicine in general in terms of its function in the world. The notion of a limit case for optimism does not even need to come into play in this scenario; we are not, after all, thinking in terms of solving age-related death in one fell swoop, but rather, through an incremental series of breakthroughs and achievements that each build upon the set of previous accomplishments.

Indifference and Variety: Outlier Responses

Of the representative sample set (consisting of 116 responses) 22 respondents selected neither Item 1 nor Item 2. Of these 22 (whose responses are shown in Figure 4), only 7 chose Item 3 ("I don't really think about death much -- I just try to live my life and figure that if I do die at some point, it doesn't matter because I'll never know it anyway."). This was somewhat surprising; it was anticipated, based on informal discussion of life extension with members of the general populace over the past few years, that Item 3 would be far more popular among poll respondents than it actually turned out to be.

The relative lack of popularity of Item 3 seems to indicate that the vast majority of poll respondents have settled on a value judgement with respect to death. Items 1 ("Death is natural. Death is as much a part of life as being born is. Therefore, it is something to be respected and not necessarily fought.") and 2 ("Death is an outrage -- it destroys people, no matter what the cause, and is therefore obviously something to be challenged and resisted. I fully support all serious scientific research efforts devoted to helping usher in longer, healthier lives for all.") both clearly represent value judgements; Item 3 represents an attitude to be sure, but not one that judges the perceived goodness or badness of death. Instead, Item 3 describes a state of mind in which a person believes death to be largely irrelevant to their existence.

Out of the 116 representative respondents, a total of 14 selected Item 3. Figure 2 shows that three of the Item 1 responders also selected Item 3. Figure 3 shows that four of the Item 2 responders also selected Item 3. In both cases, responses to Item 3 represented a minority, possibly indicating that when a person makes a definitive value judgement on the subject of death, that person is then less prone to indifference regarding the influence of the idea of death on their existence. Or, more likely, it could simply be that the overall paucity of responses to Item 3 indicate that most poll respondents, regardless of whether or how they make value judgements about death, do live their lives with some consideration or "background awareness" of their potential mortality.

An item that might be construed as expressing a particular manifestation of this "background awareness" is Item 5 ("I have never liked the idea of death, but I am very reluctant to even let myself think that it might be possible to do something about it."). Item 5 was the least popular of all items -- even when including all the data from Figures 2, 3, and 4, only two respondents in the sample set of 116 respondents chose Item 5. It was thought that this option might appeal to those who liked the idea of life extension but who were too afraid to embrace efforts toward it for fear of personal disillusionment or social ostracism, etc. -- and perhaps it might -- but apparently, not very many such people responded to the poll. This is certainly not a negative indicator.

Figure 4 includes, in addition to responses which selected Item 3 (but not Items 1 or 2), responses that did not select any of the first three items. Six of these responses consisted only of Item 9, indicating that these respondents had an opinion on near-term feasibility of longevity medicine, but not much in the way of value judgements or thoughts on the social or philosophical implications of mortality or longevity. Two respondents selected only Item 7 ("I don't think people should have to die, and I am in favor of research to arrest the aging process, but I am firmly convinced that my generation was born too soon."). One respondent selected only Item 8 ("I think that there are many social problems we ought to think about trying to fix before considering radical longevity to be a worthwhile pursuit."). One selected only Item 4 ("I believe in a supernatural afterlife, and that when I die I will enter this afterlife and exist there for all eternity.").

Not much can be extrapolated from most of the responses depicted in Figure 4; since these responses are relative outliers with respect to the strong pools of respondents choosing either Item 1 or Item 2, all that can be taken from this data is a sense of the magnitude of the variety of different people's attitudes toward death and mortality. Some individuals not included in the major "trends" revealed by the poll (that is, people who selected either Item 1 or Item 2) expressed simple, single-issue sentiments (e.g., belief in an afterlife or a commitment to fixing the world's "other problems" unrelated to longevity). Others expressed more complex views (such as respondent 99, whose response set indicated indifference toward death coupled with vague discomfort, along with a desire to solve other problems before longevity, as well as pessimism toward the prospect of healthy 200-year-olds living in the near future).

This variety alone reminds us, whether we support longevity advocacy or not, that as sentient entities presently existing under the spectre of an expiration date, we are capable of coming to various different positions on the subject of mortality. Understanding this diversity of thought is important not just in terms of advocating from the pro-longevity point of view, but in terms of periodically re-assessing our goals and arguments, and certainly in terms of continuing to refresh and update our knowledge and understanding of both science and the ethics of scientific methodology and practice.

 

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(1)The total number of responses was greater than 116, however, some of the details regarding the first few responses were lost due to technical difficulties with the response notifications, which were provided via e-mail by the polling service. Additionally, one response set was discarded from the individual-response analysis set because mutually-exclusive poll items 9 and 10 were both marked.

(adapted and cross-posted from http://rationallongevity.blogspot.com)

The notion that some creatures on the Earth are here specifically for humans, for our use, and exploitation, is quite distasteful to me (and smacks of a misinformed application of the Anthropic Principle), but it cannot be denied that humans do benefit from the existence of, and the destruction of, certain other organisms. The psychological "toll" of sentience is, perhaps, knowing that by virtue of our own continued existence, we are exerting dominion over the life and death of other organisms with varying degrees of sentience. We kill multitudes of bacteria whenever we clean our bathrooms, we unwittingly (or intentionally) step on ants, we burn fuel, we create waste.

Some take this acknowledgement and use it as a basis for a particular brand of self-loathing that manifests in such doctrines as original sin and deep ecology, as well as everyday, garden-variety statements to the effect of, "Well, we're all part of the intricate web of nature, and we should make no heroic attempts to stave off our own deaths, because obviously if everyone lived forever we would be upsetting the balance of existence."

By this doctrine, death is an equalizer and a judge: either in the sense that it brings a person passage to either paradise or damnation, or in the sense that oblivion is justice served for a few decades of knowingly exerting one's influence on the universe. There are a number of ideological traps that can keep people confined to this mode of thinking, and, more frighteningly, compel such people to assert that their views are more important than the survival of those who disagree.

These doctrines and statements are possibly an expression of deep guilt on the part of sentient beings at realizing they exist, and knowing that in continuing their existence, they must necessarily consume resources, change their surroundings, and destroy other organisms.

If one finds tragedy and horror in the mechanisms of unaltered nature, and yet believes these mechanisms to be part and parcel of a proper and even sacred existence, one must remember that these supposed horrors -- parasitism, predation, decay -- would occur even if there were no humans or sapient nonhumans on the planet.  And arguably, we might suggest that our presence as conscious beings has the potential to make this sort of thing happen less frequently, thereby decreasing the net amount of suffering and misfortune on the planet.

Simply by virtue of existing, and knowing of the sometimes-cruel modes by which the evolved biosphere operates, we are not somehow ourselves being cruel.  One ideological trap in the all-things-must-die paradigm is a failure to distinguish between a noble effort at reducing the destructive effects of one's existence and undergoing an involuntary and permanent loss of sentience. Sentience brings with it responsibility, and the superficially "unselfish" suggestion that one needs to die, like everything else, does not speak to me of strength of character -- rather, it speaks to me of a lack of a sense of self-worth.

Customs such as the avoidance of "speaking ill of the dead" are evidence of a human tendency to equate death with innocence, even vulnerability. No matter what one does while alive, death and oblivion absolve all guilt, all responsibility, and all accountability. I personally have no beliefs in a supernatural afterlife, but for those that do hold such beliefs, it seems that quite a few might take comfort in the fact that at some point, they won't need to wonder anymore how they're going to be judged -- in a sense, this is not much different from taking comfort in the notion of pure oblivion. In either case, there comes a point in existence after which a person is no longer responsible for changing or evaluating their self-made nature or their behavior.

Conversely, as long as a person is alive, they are accountable for their actions and responsible for what they know and how they use this knowledge. I am not one to use "greater good" as an argument, however, I would definitely disagree with those who insist that the development of healthy life extension technologies would inevitably result in social discord and destruction.

One rule I live by, in part inspired by my committment to avoid death for as long as possible, is that of not doing anything I'm likely to regret later on. Anything I do, I figure I'm going to have to remember for as long as I am conscious. I've made a concerted effort to attempt to imagine how I will feel following any particular action -- and how that action may affect my environment. This has nothing to do with any sort of quasi-religious notion of having to "earn" my existence or perform certain actions so as to avoid negative judgement, but rather, a notion of taking responsibility for my conscious existence.

Those who choose to live a very, very long time are going to have to live with themselves for a very, very long time. I see nothing noble in the notion of getting "out of the way" for someone to take your allotment of air and space -- in a sense, this mindset suggests thinking of death as an escape from responsibility. The base assumption that your very existence represents an imposition on reality (and therefore ought to be subject to involuntary termination) serves no "greater good" unless you have no intention of continuing to self-examine and better yourself accordingly. However, as a supporter of healthy life extension measures, I take the position that one can almost certainly have a more positive influence on reality by continuing to live than by ceasing to exist.

A person who considers it necessary and proper to "get out of the way" rather than use his / her accumulated wisdom to help make reality better for all the conscious creatures in it is no more noble than an airline pilot who considers it necessary and proper to jump out of a plane on the assumption that one of the younger passengers should have the chance to figure out how to land.

While there is much merit in learning something from the ground up, on one's own, there are plenty of cases in which experience can serve as a foundation on which much greater discoveries and endeavors may take place. The diversity of human thought and ideology suggests a future society in which the old (and healthy) can instruct and enlighten the young and less experienced, while at the same time taking plenty of opportunity to go off in new directions that would not have been remotely possible without 100 or more years of experience.

Remember that even as our presence might result in choices made that result in some disharmony, we also have the ability to create stunning works of beauty and complexity. Our sentience allows the construction of castles and sculptures and difference engines wrought of Lego bricks. We have learned to identify and protect endangered species, to extend rights to those marginalized in the past, and to in many cases take responsibility for helping create the future we would like to inhabit. Clearly, there is more to sentience and conscious experience and living than mere guilt-inducing destruction. Conscious beings have every bit as much potential to do good as they do to foster destruction.

On Saturday, May 27, 2006 I attended the Saturday session of the Institute for Ethics and Emerging Technologies' "Human Enhancement Technologies and Human Rights" conference.

I am in the process of writing up my impresssions, interpretations, and responses to what I heard and saw; this is being posted to my blog:

http://rationallongevity.blogspot.com/

The actual report will take a while to write in full, however, I have placed the first two entries pertaining to this event here:

Preliminary Report

Comprehensive Report Part 1

Comprehensive Report Part 2

Comprehensive Report Part 3

Comprehensive Report Part 4

Comprehensive Report Part 5

I took notes throughout the entire day (that's about 13 hours of information input) so there will be plenty more coming as I manage to transcribe my notes and describe my responses to the ideas presented.

All in all, I am extremely glad I attended on Saturday and would certainly consider attending similar events in the future.

EDIT: 6/02/06: Part 5 has now been posted. Further reflections will probably be forthcoming in the context of my "normal blogging activity", but my series on reporting specifically on this concept is complete. Thank you for reading!

One notion that comes up occasionally in the discussion of radical life extension, or superlongevity, or whatever one might call it, is that of possible "cultural stagnation" or some sort of suppression of evolution.  A commenter named Josh on the IEET's posted version of Mark Walker's "Universal Superlongevity -- Is it Inevitable and Is It Good?" paper:

http://ieet.org/index.php/IEET/more/walkersuperlongevity

suggests that, "The individual is by design a temporary entity manifested out of inherited diversity to temporarily express possible solutions to currently relevant hindrances to evolution.  Technology is just such an example of a solution.  A deathless society is not."

The entire fulcrum of this comment seems to be the notion that individuals must necessarily be sacrificed so that some central tenet of nature may be upheld for the "greater good".  I question the notion that a maximally "good" and ethical society must condemn people to death, despite the possibility of developing healthy life-extending technologies.  Though some people certainly garner meaning and motivation from awareness of their own mortality, this is not true of all people.  I do not see why the "death is meaningful" folks should get to decide the lifespans of those who disagree.  As far as I am concerned, people who want to die are welcome to do so, but those who would rather stay around longer should have that option.

However, I do think that the "stagnation" argument has some merit to it, in the sense that new generations do tend to produce fresh perspectives, and indeed, aside from a few "dark age" periods in recorded history in various regions of the world, there has been an overall upward trend in terms of potential quality of life.  

But it is my impression that part of this "quality of life" made possible by evolving ethical realizations and technological advances stems from the tendency of these forms of progress to enhance the individual's ability to lead a self-directed existence.  The commenter quoted above seems to think that evolution and death of individuals are inextricably linked, and that if you take death out of the equation, evolution will cease and this will lead to some sort of diminishing of the "greater good".

What is being missed here is the fact that this is only one person's conception of a possible "greater good".  Certainly, as technology continues to allow lifespans to increase and human abilities to be enhanced, it seems that cognitive flexibility and the capacity for innovation could very well be one of the targets of enhancement interventions.  And there does not seem to be anything inherent in the definition of "evolution" that necessitates the destruction of individuals.  Biological evolution involving the diversification of expressed genetic traits through the lives and reproductive cycles of generations that die is only one possible evolutionary scenario.  Ideas and philosophies have been said to "evolve" -- however, this does not mean that the ideas of one generation are destroyed to make room for the next.  If there is some sort of merit to the preservation of an idea, then it will simply be incorporated into new models of a particular philosophy -- not unchanged, but not destroyed either.  It makes little sense to place arbitrary limits on the brains of posthumans in terms of the ability of these brains to enjoy a degree of plasticity and flexibility often considered the exclusive province of the young and new.

I think that the same could be said to be true of people.  I imagine that if there were any humans alive today (with intact memories) who were born 500 or 1000 years ago, these people, far from being seen as evidence of "stagnation", would almost certainly be sought after for their ability to offer a long-range perspective.  The ability to look at physical phenomena (such as layers of rock and crumbled architecture left by ancient civilizations, ice sheets, etc.) and determine patterns in weather and ecology and social / economic trends has not devalued science -- in fact, an entire branch of science could be said to consist of pattern-analysis.  We seek to simulate a long-range perspective such as that which might be held by the very, very long-lived by indirect observation and what amounts to a sort of forensics -- but imagine if this perspective were direct, rather than indirect?  It does seem that being able to observe patterns and fluctuations in natural and sociological phenomena over eons might at least be worth trying out.

I do not think there is much danger of a society in which no babies are ever born -- and even if there was, I do not see a pressing ethical problem with perhaps altering our evolutionary path so that it begins to occur through creative means that are nonbiological in nature.  There is nothing inherently "good" about a species that has as many babies as possible and makes sure to kill off the parents every few years or so.  This may indeed lead to a particular form of biological evolution, but if our own human evolution has led us in a direction that allows for different pathways to the future (not necessarily along purely random biological vectors), then perhaps it is only "natural" that we at least explore these new pathways on the basis of experimentation.  When discussing the "greater good", it seems ethically irresponsible to dismiss a particular potential pathway out of hand without even trying it.  For all we know, superlongevity could lead to forms of "greater good" we cannot even imagine at present.

Further discussion on this matter would be greatly appreciated, since the "stagnation" argument against radical life extension seems to be nearly as frequently encountered these days as the "overpopulation" argument. 

I very rarely go to anything termed an "event", however, since this one is coming up:

http://ieet.org/index.php/IEET/HETHR_schedule/

(May 26 - May 28, 2006)

and it's local to me (since I live in the San Jose, CA area), I figure that if anything is going to get me out of the apartment, it's going to be something like this.  I've been reading about transhumanism online for about 7 years now, and have been interested in human enhancement and longevity since early childhood -- but overall I've tended to be much more of an observer than someone who interacts much.

I've never been to anything remotely like this, so aside from the fact that I am likely to hear interesting people talking about interesting things, I'm quite honestly wondering what to expect. 
I'm very close to just registering and attending to see what it's like, but I honestly don't do well in unfamiliar social situations.  I'm not too concerned about having things to talk about -- I imagine the attendees are certainly likely to be the sorts of people I'd be inclined to converse with on the basis of common interests.  But are there any "rules" about attending transhumanist-type events?  What sort of a turnout is likely? 

If I do go, I am going to only attend the Saturday session on May 27 (2 days of social exposure would be too much, but given the sheer number of input I'm likely to get on Saturday alone, I anticipate it would be well worth the $170!).  I'm just trying to make sure that my impressions of what this event is likely to be like -- a group of smart people behaving themselves and learning about fascinating things -- are valid.

All in all, I am quite excited about the prospect of getting to listen to so many interesting speakers.  I figure that opportunities like this do not come along very often.

Is anyone else on Betterhumans planning on attending this conference?  If so, have you been to anything like this before, and what was it like?