Issues Magazine

Living Forever: The Ethical Implications of Human Life Extension

By Brad Partridge

Stories about the fountain of youth and eternal life tap into some of humankind’s oldest desires. Will discoveries in molecular biology and genetics one day allow vast extension to life?

In Australia, today’s newborns can expect to live around 25 years longer than babies born a century ago. These increases in life expectancy are mostly the result of better sanitation, education, immunisation and developments in treating disease.

However, the biggest increases in longevity in the future might come from new technologies that slow, arrest or perhaps even reverse the ageing process. These technologies could increase not only how long we live on average, but also the upper limit of longevity (longer than anyone has ever lived, which is approximately 122 years).

As we get older we become more susceptible to a range of diseases, such as cancer and heart disease. Treating these diseases certainly helps us to live longer but it does not stop the background ageing process that causes our bodies to become frail and deteriorate until we eventually die. Controlling how quickly we age might therefore allow us to live many more years before this happened. But can anything actually be done to slow this process?

Biogerontology is the branch of science that seeks to understand how organisms age. New insights suggest that the ageing process (and, in turn, life span) might be open to manipulation like many other biological processes.

Laboratory studies with simple organisms have demonstrated that life span can be extended using a range of methods. For example, studies have shown that when the calorie intake of mice is restricted by up to 50% of their normal intake, they live up to 50% longer. Other studies with fruit flies, worms and yeast subjected to calorie restriction and genetic manipulation have also produced remarkable increases in longevity – anywhere from two to ten times the subject’s life span, which in human terms would be 250 to 1000 years!

These studies show that the life span of a number of species, and the rate at which they age, is not fixed. This has increased hopes that the length of the human life span may be dramatically extended also. Although this possibility is yet unproven, the search for a pharmaceutical pill that could mimic these life-extending effects is under way.

The research, development and potential use of life-extension technologies raises a number of important bioethical issues. Small increases in longevity may exacerbate the issues of an ageing population already confronting us, but vast increases in the human life span may result in a very different world. What would it be like to see 80-year-olds who look like 40-year-olds?

There is disagreement among bioethicists about whether life-extension would be a good thing. Studies conducted at the University of Queensland show that among members of the public are strong opponents and enthusiastic supporters of life-span extension. Ordinary people were often concerned about the same bioethical issues surrounding life-extension as many bioethicists.

Quality or Quantity?

One of the key ethical questions is whether a life-extension pill would extend our healthy years or simply prolong frailty towards the end of life. Better health and longer life would certainly be an attractive prospect for many people. If we were healthier for longer then perhaps we could achieve more of our ambitions and engage in the things we enjoy for longer.

But some people worry that our lives may be extended in a state of low quality of life rather than health. Although this is not the goal, critics worry that it might be an unintended consequence of intervention in ageing and longevity. As with all pharmaceuticals, both health benefits and risks need to be considered.

If life span could be extended a great deal – perhaps to 150, 200 years or even longer – then some other interesting issues might arise. For instance, would we simply run out of things to do and become bored? Even things that we enjoy may become stale after several centuries. How long would we have to work for? If our lives were 200 years long then it is unlikely that many people could afford to retire at 65. However, this may also present new opportunities such as having several different careers within a lifetime.

Life Extension and Society

Attention has also been given to the potential effects of life extension on society. Perhaps society would benefit from an increased level of knowledge and a more productive labour force that increases our standard of living. However, what might seem like a good idea for individuals may also lead to a number of societal problems, even to the point that the development and use of life-extension technologies is actually unsustainable and undesirable.

One of the most often mentioned potential consequences of life extension is overpopulation and resource strain. More of the population living longer would cause an increase in the total population, which could increase even more if people were able to have children at older ages because of relatively youthful reproductive systems. Thus there might not be enough to go around – our overall standard of living might actually decrease despite the appeal of life extension to each individual. Greater attention to how resources are allocated, and the impact of resource use on the environment, would therefore be required. Because we would live long enough to feel the consequences of long-term planning there may be a bigger push for policies of sustainability.

A much longer-lived society might also exacerbate inter-generational problems. Those with extended life-spans might be able to maintain their positions in society and build wealth to a greater level, possibly making it harder for younger people to establish themselves. Younger people may face a more difficult entry to the workforce if they must compete with older people who are unlikely to retire for many decades (and who need to continue to work in order to pay for their own longer lives).

Access to Life-Extension Technologies

Who would get to use life-extension technologies in the first place? A drug that could slow ageing might be unaffordable for many people. Already, many medical treatments are available only to some of the population simply because they can afford them. Technologies that slow ageing to extend life span would most likely be used by, and targeted at, people who are already healthy and relatively long-lived.

Life-extension technologies strike some as an unfair pursuit given that so many people around the world cannot access even basic health care. It seems unfair to give some people the chance to live to 150 when millions are lucky if they get to 50.

However, to prohibit the development of life-extension technologies on these grounds would mean that no one would get the chance to use them. Is it fair to deny everyone access to life-extension technologies simply because universal access cannot be guaranteed? This is not to say that inequities in basic health care should not be addressed and there is a need to allocate resources in a fair way. Pursuing life-extension does not have to detract from these goals.

Would It Be Unnatural?

Slowing ageing might seem like an extravagant luxury for already healthy people, and this highlights other ethical issues. Using medical technologies to treat disease is indeed a worthy goal, but how do we know what counts as a disease in the first place, and is it okay to use medical technologies for things that aren’t diseases? Alzheimer’s disease, stroke, and cancer are all diseases more likely to occur as we age, and we all agree that treating them with medical technologies is a good thing – but what about ageing itself? Should ageing count as a disease too? If we say yes, then ageing should also be treated using medical technologies just like any other illness, and the development of age-slowing technologies should receive greater priority.

Although the ageing process contributes to the development of a number of diseases later in life, many would argue that ageing itself is not a disease. After all, everybody naturally gets older.

Some claim that trying to interfere with processes such as ageing is unnatural and therefore shouldn’t be allowed. However, there are many natural processes that we find it acceptable to alter using technologies, and even if ageing does not count as a disease there still may not be any reason to prohibit efforts to slow it.

Some opponents of life extension believe that something valuable about experiencing ageing might be lost if we were to develop age-slowing drugs. Perhaps ageing and present life span give a sense of meaning to life that we might not have if we never aged or lived to 1000 years. Would we still have a sense of urgency in life? Would we still appreciate life itself?

Autonomy to Choose

Human capabilities have clearly been changed throughout history with the advancement of technology. Of great importance is the ability of people to freely make informed decisions about what they value. If life extension is valuable to individuals then they should be able to choose that if they wish (while not infringing the autonomy of people that do not wish to extend their own lives). Thus if age-slowing technologies can offer a healthier, longer life, then denying people the opportunity to use them without good reason would be difficult. There is not necessarily a duty to develop or use life-extension technologies but it seems important to give people the freedom to do so if they wish.

Technological Uncertainty

Because the science of life extension is at a relatively early stage, some issues are uncertain. For example, if the ability to slow ageing requires currently controversial methods such as gene therapy or the use of stem cells, then the particular ethical issues surrounding those technologies would also require attention.

Present uncertainties of the technology might also lead us to consider other problems. Would a life-extension technology only be effective once a person had reached adulthood or could ageing in childhood be slowed down too? Or perhaps in order for the technology to result in an extended life, it might have to be taken during childhood. Interfering in childhood development might strike many people as morally problematic.

Suppose the treatment to slow ageing, and extend life span, was a one-off procedure whose effects could not be reversed. What measures might we need to take to ensure that people were fully informed of the permanence of their decision? Would it be acceptable for parents to make this decision on behalf of their children? How would society treat people who choose to age naturally?

While these are speculations, it is not too early to begin to consider the broad implications of life extension. As with many other biotechnologies, how quickly they are brought into reality may rest upon whether or not people actually want to use life-extension technologies, whether they support their development, and whether the issues of importance to them are addressed.