TCS Daily

Death Be Not Proud

By Glenn Harlan Reynolds - June 23, 2004 12:00 AM

A few years ago, promised cures for baldness, impotence, and old age shared a common image as fraudulent and vaguely pathetic, the illusory straws grasped at by the desperate and gullible. Now, with Rogaine and Viagra offering relief to the hairless and the limp, it's even starting to look as if treatments for aging may offer hope to the wrinkled. That has produced both excitement and, from some, unhappiness.

I've written columns on the subject over the past couple of weeks (you can read them here and here). Recently I interviewed (via email) the influential Cambridge University biogerontologist Aubrey de Grey. De Grey is working on what he calls Engineered Negligible Senescence, and has some very interesting thoughts on what's to come in terms of aging. Or, perhaps I should say, in terms of not aging.

I think that this subject is on the technological (and political) cusp, and that we'll be hearing a lot more about it. Following is our Q&A, unedited except for the removal of a couple of typos.

Q: What reasons are there to be optimistic about efforts to slow or stop aging?

A: The main reason to be optimistic is in two parts: first, we can be pretty sure we've identified all the things we need to fix in order to prevent -- and even reverse -- aging, and second, we have either actual therapies or else at least feasible proposals for therapies to repair each of those things (not completely, but thoroughly enough to keep us going until we can fix them better). The confidence that we know everything we need to fix comes most persuasively from the fact that we haven't identified anything new for over 20 years.

Q: What do you think is a reasonable expectation of progress in this department over the next 20-30 years?

A: I think we have a 50/50 chance of effectively completely curing aging by then. I should explain that I mean something precise by the suspiciously vague-sounding term "effectively completely". I define an effectively complete cure for aging as the attainment of "escape velocity" in the postponement of aging, which is the point when we're postponing aging for middle-aged people faster than time is passing.

This is a slightly tricky concept, so I'll explain it in more detail. At the moment, a 50-year-old has roughly a 10% greater chance of dying within the next year than a 49-year-old, and a 51-year-old has a 10% greater chance than a 50-year-old, and so on up to at least 85 to 90 (after which more complicated things happen). But medical progress means that those actual probabilities are coming down with time. So, since we're 50 only a year after being 49, and so on, each of us has less than a 10% greater chance of dying at 50 than at 49 -- it's 10% minus the amount that medical progress has achieved for 50-year-olds in the year that we were 49. Thus, if we get to the point where we're bringing down the risk of death at each age faster than 10% per year, people will be enjoying a progressively diminishing risk of death in the next year (or, equivalently, a progressively increasing remaining life expectancy) as time passes. That's what I call "escape velocity", and I think it's fair to call it the point where aging is effectively cured.

Q: What sort of research do you think we should be doing that we're not doing now?

A: Well, there are several approaches to curing aspects of aging that I think are very promising, but which most people seem to think are too hard to be worth trying. One is to obviate mitochondrial mutations, by putting suitably modified copies of the 13 mitochondrial protein-coding genes into the nucleus. This is hard -- some of those suitable modifications are hard to identify -- but it's definitely feasible. A second one is to find enzymes in bacteria or fungi that can break down stuff that our cells accumulate because they can't break it down, like oxidised cholesterol. The idea here is to put such genes into our cells with gene therapy, thereby enabling them to break the stuff down. If we could do that, it would virtually eliminate strokes and heart attacks; and similar approaches could cure all neurodegenerative diseases and also macular degeneration, the main cause of age-related blindness. A third one is to look for chemicals or enzymes that can cut sugar-induced cross-links (advanced glycation endproducts): one such compound is known, but it only breaks one class of such links so we need more, and no one is really looking. And maybe the biggest of all is to cure cancer properly, by deleting our telomere-maintenance genes and thereby stopping cancer cells from dividing indefinitely even after they've accumulated lots and lots of mutations.

Q: Some people regard aging research, and efforts to extend lifespan, with suspicion. Why do you think that is? What is your response to those concerns?

A: I think it's because people don't think extending healthy lifespan a lot will be possible for centuries. Once they realise that we may be able to reach escape velocity within 20-30 years, all these silly reasons people currently present for why it's not a good idea will evaporate overnight. People don't want to think seriously about it yet, for fear of getting their hopes up and having them dashed, and that's all that's holding us back. Because of this, my universal response to all the arguments against curing is simple: don't tell me it'll cause us problems, tell me that it'll cause us problems so severe that it's preferable to sit back and send 100,000 people to their deaths every single day, forever. If you can't make a case that the problems outweigh 100,000 deaths a day, don't waste my time.

Q: What are some arguments in favor of life extension?

A: I only have one, really: it'll save 100,000 lives a day. People sometimes say no, this is not saving lives, it's extending lives, but when I ask what the difference is, exactly, no one has yet been able to tell me. Saying that extending old people's lives is not so important as extending young people's lives may be justified today, when older people have less potential life to live (in terms of both quantity and quality) than younger people, but when that difference is seen to be removable (by curing aging), one would have to argue that older people matter less because they have a longer past, even though their potential future is no different from that of younger people. That's ageism in its starkest form, and we've learned to put aside such foolish things as ageism in the rest of society; it's time to do it in the biomedical realm too.

Q: Do you see signs of an organized political movement in opposition to life extension?

A: No, interestingly. I see people making arguments against it, and certainly some of those people are highly influential (Leon Kass, for example), but really they're just using life extension as a vehicle for reinforcing their opposition to things that the public does realise we might be able to do quite soon if we try. They get the public on their side by exploiting the irrationality about lifespans that I've described above, then it's easier to move to other topics.

Q: For that matter, do you see signs of an organized movement in support of such efforts?

A: Oh yes. There are really only isolated organisations so far, but they are increasingly co-operating and synergising. The older ones, like the cryonics outfits and the Life Extension Foundation are as strong as ever, and they're being joined by other technophile groups like the Foresight and Extropy Institutes and the World Transhumanist Association, plus more explicitly longevity-centric newcomers such as the Immortality Institute. Quite a few blogs are helping this process along nicely, especially Fight Aging! and Futurepundit, and I really appreciate that you're now among them. And of course there's the organisation that I co-founded with David Gobel a couple of years ago, the Methuselah Foundation, which funds some of my work through donations but whose main activity is to administer the Methuselah Mouse Prize.

Q: What might life be like for people with a life expectancy of 150 years?

A: Well, we won't have a 150-year life expectancy for very long at all -- we'll race past every so-called "life expectancy" number as fast as we approach it, as outlined above. So maybe I should give an answer to the analogous question regarding indefinite lifespans. Life will be very much the same as now, in my view, except without the frail people. People will retire, but not permanently -- only until they need a job again. Adult education will be enormously increased, because education is what makes life never get boring. There will be progressively fewer children around, but we'll get used to that just as easily as we got used to wearing these absurd rubber contraptions whenever we have sex just in order to avoid having too many kids once infant mortality wasn't culling them any more. Another important difference, I'm convinced, is that there will be much less violence, whether it be warfare or serious crime, because life will be much more valued when it's so much more under or control.

Q: What is your response to concerns that life extension therapies might be too expensive for anyone but the rich?

A: This is a very legitimate concern, which society will have to fix as soon as possible. Since 9/11 we all know how bad an idea it is to make a lot of people really angry for a long time -- if the tip of that anger iceberg is willing to sacrifice everything, lots of other people lose everything, too. Since rich people will be paying for rejuvenation therapies as a way to live longer, not as a way to get blown up by poor people, everyone will work really hard to make these treatments as cheap as possible as soon as possible. That'll be a lot easier with a bit of forward-planning, though -- e.g., an investment in training a currently unnecessary-looking number of medical professionals. But one way or another these treatments will definitely become universally available in the end, probably only a few years after they become available at all, even though the cost of doing this will be staggering. The only way to have a sense of proportion about this period is to remember that it'll be the last chapter in what we can definitely call the War On Aging -- people worldwide will readily make the same sort of sacrifices that they make in wartime, in order to end the slaughter as soon as possible.

Q: Leon Kass has suggested various items of literature as cautionary tales. What literary or science-fiction stories might you recommend for people interested in this subject?

A: I used to give the obvious answer to this -- Heinlein. But now I have a new answer. Nick Bostrom, a philosopher at Oxford University here in the UK, has written a "fairy tale" about a dragon that eats 100,000 people a day and its eventual slaying. It's been published in the Journal of Medical Ethics, but it's also online in a great many places, including his web site. It's absolutely brilliant.


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