The ethical implications of eternal youth

Originally published at The Benfell Blog. Please leave any comments there.

One of the newsletters I get is John Mauldin’s “Outside the Box”. It’s a free sign-up. And Mauldin passes along articles he thinks are interesting from time to time, along with some fairly blatant promotion for events he’s involved with. It’s all pretty much oriented towards investors who at least seek to identify with the relatively well off.

Mauldin is among those who see the federal debt as urgent, and says so in a sort of patronizing way that lets you know he’s worried about his kids. He rarely, if ever, acknowledges what Paul Krugman has to say, most recently here, that the debt is manageable–in significant part because the U.S. still controls its own currency.

It is pretty clear that Mauldin is a comfortable capitalist. He insists he isn’t completely heartless about the plight of the unemployed, but doesn’t obviously give it much thought.

Even so, he’s occasionally interesting. This week, he passed on an article from Stratfor that I have already republished here about Israel’s raid on a Free Gaza flotilla that resulted in at least nine deaths and the battle for public opinion that has ensued.

The last newsletter I received from him included an article by Patrick Cox on health care costs, that I republished here. Cox thinks that health care reform was botched, and that Social Security and Medicare are in trouble, in part because the designers of these programs failed to adequately account for longer lifespans.

And if Cox is right, lifespans may be about to get a whole lot longer:

An increasing number of scientists believe that regenerative medicine will eventually give us the ability to restore our bodies to a permanent biological youth, probably equivalent to about 28 years old. That is the point before our cells have started to lose function through loss of telomeres. Unfortunately, we’re not there yet and don’t know for sure when we will be.

This prediction is the the stuff of science fiction but, if accurate, would fulfill a quest that has been going on for far longer than the search for the Fountain of Youth. Cox even goes so far as to claim that healthy people actually have higher health care costs over the course of their lifetimes because unhealthy people die sooner. So he sees rising health care costs as a sign of a good thing. But more fundamentally, Cox is reiterating a view that affirms the status quo by alleging that things are getting better.

So let’s entertain the possibility for just a moment. Probably a lot of people will think that you can run but you can’t hide from death, that nature will find some other way of doing us in even if it isn’t able to take away our telomeres anymore. But let’s set that aside as well.

A first question that arises is, who will have access to this medicine? I recall some friends of mine pointing out that if some such treatment ever became available, it would have to be rationed, if for no other reason than that an already skyrocketing and unsustainable human population on this planet would even more quickly outpace our planet’s capcity to support it.

So, to repeat, who will have access to this medicine?

The logic of our capitalist system, which relies on scarcity to justify itself, suggests that the wealthy and powerful will have access to this medicine. Which suggests that they might never relinquish the reins of power, that even their own children would now be frozen out of power to the extent that scarcity imposes limits on opportunity.

Imagine, if you will, the likes of Jesse Helms and Strom Thurmond restored genetically to the age of 28. Imagine the likes of Leona Helmsley, the “Queen of Mean,” never dying. Fortunately, I’m not hearing that regenerative medicine yet proposes to raise the dead.

But still living examples abound. Perhaps Dick Cheney and other members of the Bush administration would live long enough to face a war crimes trial–if those in power for any reason ever ceased to protect them. George W. Bush might live long enough to see the consequences of his climate change denial, and could conceivably be called to account accordingly.

But more importantly, the ability of those in power, particularly in the corporate sector where term limits do not apply, to live indefinitely, to retain power indefinitely might lead to stagnation. If the treatment restored plasticity of bodies without restoring an even more youthful plasticity of thought, Richard Weaver’s “tyrannizing image” might never again fear a challenge from the young:

There is a center which commands all things, and this center is open to imaginative but not logical discovery. It is a focus of value, a law of relationships, an inspiriting vision. By its nature it sets up rankings and orders; to be near it is to be higher; to be far from it in the sense of not feeling its attraction is to be lower.

Weaver embraced neither diversity nor multiculturalism. As George Lakoff explains in Moral Politics, conservatives hold their own moral system as supreme; any action to promulgate it is justifiable and any challenge to it must be defended against. Weaver disdained objective data, placing it at the lowest of, as Foss, Foss, and Trapp describe it in Contemporary Perspectives on Rhetoric (3rd Ed.), “three kinds of knowledge or levels of conscious reflection.”

Following Plato, Weaver depicts truth as residing in the ideal at the third level of knowledge. Truth is the degree to which things and ideas in the material world conform to their ideals, archetypes and essences. He contends that “the thing is not true and the act is not just unless these conform to a conceptual ideal.” Truth, then, resides at the level of the metaphysical dream, not at the level of individual facts.

But if you’re a conservative, life would indeed be getting better. Of course, I’m making some assumptions. Perhaps some mechanism for handing down power might be arrived at, as a necessary adaption in consequence of this new technology. Perhaps those in power could regain a flexibility of thought that typically diminishes with age. Or perhaps the dichotomous morality of either providing universal access to this life-prolonging treatment at the cost of everyone starving to death or withholding it from all on grounds that such a treatment if provided to some, must be provided to all, would lead to it being discarded as a greater scourge on humanity than even the nuclear bomb.

Or, perhaps, a condition of receiving this treatment would be permanent sterilization, an agreement never to reproduce. It might be that the treatment is not a single shot deal, that those receiving it would have to return every month to preserve an anti-aging benefit. If so, rule breakers might surrender their access to this medicine. Or perhaps, in a reincarnation of eugenics, there would be an exchange of childbearing credits, where the rich could pay other, “less worthy” humans to forego their reproductive privileges–in essence to die out.

On the other hand, might it be possible to live a normal life, reproducing normally, until say, age 50, and then choose to forego the reproductive opportunity that would otherwise already be near (if not past) its end in exchange for what would surely seem like a second life, restored to the age of 28?

And having opened Pandora’s Box, that is, imposing conditions on the receipt of this life-preserving medicine, would the powerful see access to it as yet another means of manipulation, of enforcing compliance? Indeed, if you are an authoritarian, life would be getting very much better.

And if there was some social agreement that the cost of an indefinitely life-extending treatment included a substantial reduction of reproductive freedom, how would the burden of enforcement not fall disproportionately upon women? What would happen if instead of the reproductive freedom issue being about a woman’s right to terminate her pregnancy, it became about her right to bear a child at all? What would be the consequence for a culture that now sees children as a gift if it were compelled to confront them as a burden?

And again, once we have conceded that certain conditions must be agreed to in order to receive this life-preserving medicine, what will be a doctor’s ethical requirement as the natural end of life approaches, when a treatment is available that can not merely extend a patient’s life, but even restore its quality? And what would be the consequences should we alter that ethical rule in light of a necessity to restrain population growth?

I see far more questions than answers. But Cox’s article is not the first I’ve seen of these medical developments. For all the possible flaws in his thinking (which I noted in my reply at the end), he just might be right about this. And in our haste to embrace this technology, a holy grail of eternal youth, I haven’t seen–possibly because I haven’t looked in the right places–any discussion of these implications and others I haven’t thought of.

It might not be too early.