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Apparently it’s that moment when publishers see fit to shine light (or blow heat) onto the topic of biogerontology.
Well and good. Now the question to be asked is not, “Is it possible to radically extend human lifespan?” In my view, anything not specifically outlawed by the laws of physics (as we understand them) is in the end necessary to keep the shadow game up and running. There are prophecies that need fulfilling, after all. And there’s nothing in the second law of thermodynamics that says keeping a body running indefinitely — let’s drop ‘forever’ as a metaphysical conceit — is impossible. Just very hard perhaps. Fine, then, our cathedrals no longer aspire to the sky, but show themselves on the gels and microarrays run everyday around the world. The effort is there. How hard this task will be does not allow easy prediction.
So what’s the end result? Let’s imagine a scenario, conservative by the standards of Aubrey de Grey/Ray Kurzweil and their clique, that future technologies extend the human lifespan to several hundred years. Now, the limiting cases are 1) these treatments are widely available and hence adopted OR 2) the treatments are extremely expensive and judged ‘elective’ and hence only available to a small fraction. Now, the first essentially demands the radical restructuring of society as we know it to avoid a Malthusian outcome. I don’t think you have to be a Maoist to agree that the only way (short of colonizing other planets) to hold off a total catastrophe in this scenario would be to have strong (read: involuntary) limits on human reproduction. Malthus may have been wrong, but at some point the planet’s carrying capacity does come into play. De Grey apparently admits as such (listen to the link above for a take on this) though he adds some kind of utopian spin whereby we all agree to such restrictions voluntarily. A total joke, obviously, in any real scenario, which in this view resembles Brave New World or Children of Men much more than our present-day.
I think we can agree the second outcome is the more likely of the two, as currently even life-saving HIV drugs are in short supply for those who can’t get insurance coverage or pay the exorbitant fees for them. This possibility, the “conservative” one, means that the human race splits in two, bringing inequality to its apex.
So whence medical ethics here? Western medicine has as its goal the delay of death for as long as possible. There is a point where life-preserving technologies may be withheld, but not in general, and death is not included in our conceptions of medicine. This gap is brought to its extreme when we consider the actual possibility of immortality. Is immortality a medical or cosmetic procedure? What if curing cancer (for instance) implies life extension. Is it ethical for only those at the top of the pile to have access then? Or in the other case, must we commit collective suicide to ensure some kind of equality? There is no answer within the present constellation. Medical ethics will eat itself.
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