Is More Life Always

Better?
The New Biology of Aging
and the Meaning of Life
by DAVID GEMS

The social consequences of extending the human life span might be quite bad; perhaps the worst
outcome is that power could be concentrated into ever fewer hands, as those who wield it gave way
more slowly to death and disease. But the worry that more life would damage individuals’ quality of life is
not persuasive. Depending on what the science of aging makes possible, and on how people plan their lives,

longer life might even facilitate a richer and deeper life.

He had passed that great meridian, the age of forty, nematode life were translated into human terms, this
when for every man the process of spiritual evolution would represent a lifespan of around 700 years.
stops, and he goes on thenceforward working out to the Common sense tells us that aging is universal, in-
end a character that has become fixed and evitable, and associated with gradual physical decline.
unalterable.”—G. Baker, in Tiberius Caesar But in this case, common sense is wrong. Some ani-
mal species, such as tiny betentacled hydra, do not ap-

T
he American biologist Andrzej Bartke recent- pear to age at all. 3 There exist, for example, individual
ly showed that a combination of genetic alter- colonies of corals that are over 20,000 years old.4
ation and nutritional restriction can increase What is more, within the last decade biologists have
the lifespan of a laboratory mouse by around 70 per- found that the rate of aging is remarkably easy to alter
cent.1 While control mice withered and died, the test in laboratory animals such as nematodes, fruit flies,
animals were still zestfully scurrying about, fleet of and mice. It is no longer far-fetched to think that one
foot with glossy fur and unclouded eyes, and appar- day it will be possible to retard the aging process in
ently as full of joie de vivre as any young rodent. Dis- humans and extend the human life span.
coveries of this sort are now far from rare. I recently Do we really want this research to succeed? Some
found that alteration of a gene called daf-2 can in- bioethicists have professed horror at the thought of
crease the maximum life span of male nematode dramatic life extension. Many recoil at the notion of
worms from 31 to 199 days—a 6.4-fold increase. 2 If a extending the lives of people undergoing irreversible
physical decline, like the senile and decrepit Struld-
bruggs in Gulliver’s Travels. Yet recent research shows
David Gems, “Is More Life Always Better? The New Biology of Aging
and the Meaning of Life,” Hastings Center Report 33, no. 4 (2003): 31- it may be possible not just to extend life, but to ex-
39. tend youth. What if each of us could live a longer life,

July-August 2003 HASTINGS CENTER REPORT 31

 in peak physical and mental health, in the 1940s by the British geneticistis unable to purge the Huntington’s
then suddenly shrivel away at the J.B.S. Haldane, working at University mutation from the general popula-
end, like Dracula when he is exposed College London, who was interested tion, what about mutations that do
to the sunlight? Would bioethicists in diseases caused by defective (mu- not strike until even later? Could it be
still be so dour? Perhaps so, yet it tant) genes. One such disease, Hunt- that aging itself is the result of muta-
would no longer be quite so clear ington’s, puzzled Haldane. Hunting- tions that strike very late in life, at an
why. There may be reasons to worry, ton’s disease attacks the nervous sys-age beyond the reach of natural selec-
but I want to suggest that aging re- tem, causing uncontrollable flaying tion? If this were true, then what we
search raises philosophical questions spasms (chorea), insanity, and death. now think of as the process of aging is
about the shape and purpose of life It is unusual in two respects: first, it
a form of late-onset, invariably fatal
that bioethics has thus far failed to does not strike until later in life—the
genetic disease caused by genetic mu-
address. mean age of onset is about thirty-five.
tations that natural selection has been
Second, the Huntington’s mutation is unable to purge from the population.
The New Biology of Aging dominant, not recessive. This means This idea is at the heart of the evolu-
that even people with only one copy tionary theory of aging. Its essence

A revolution has occurred in the bi-

ology of aging, trans-
forming a sleepy backwa-
of the mutation will get the disease. can be distilled into a single phrase:
the force of natural selec-
tion decreases with in-
ter of research into a
rapidly advancing disci-
U p until about fifteen years ago, creasing age after the onset
of reproduction.
pline. 5 Up until about fif- An elaboration of the
teen years ago, research
research into the causes of aging was a evolutionary theory of
into the causes of aging aging, proposed by
was a somewhat disrep- somewhat disreputable activity George C. Williams, sug-
utable activity occurring gests that aging may result
at the fringes of biology. occurring at the fringes of biology. What from mutations that in
Although the researchers early life enhance fitness,
working on aging were changed everything was the but that have harmful ef-
few, the number of theo- fects later in life—the
ries they managed to gen- development of a theory of the trade-off theory. 8 Because
erate were many—by one of the relative unimpor-
estimate, over 300.6 Not evolution of aging with real explanatory tance of events later in life
many of these theories to reproductive success, a
have proved useful. The small early advantage may
Russian immunologist
power and conceptual beauty. outweigh a later catastro-
Elie Metchnikoff believed phe. These two theories
that aging resulted from have been tested experi-
toxins released by bacteria in the in- Generally, one would expect that mentally, and the balance of evidence
testinal tract. He suggested that a yo- dominant mutations causing fatal dis- favors the trade-off theory over the
ghurt diet would extend human life eases would quickly disappear from simple mutation accumulation theo-
span to 200 years. Another early the- the population. But as Haldane saw, ry.
ory had it that aging in men resulted the awful thing about Huntington’s is While the evolutionary theory of
from a reduction in the level of secre- that by the time the disease strikes, aging explains why aging occurs, it is
tions from the testicles. This led to a most people have already had chil- not able to explain how it occurs—
craze in the 1920s for surgically im- dren, to whom they have passed the what exactly happens when we age,
planting the testicles of goats or mon- Huntington’s gene about half of the and what controls how fast it hap-
keys into the scrotum of the recipient. time. Thus dominant, lethal muta- pens. To try to answer this, many bi-
These crank theories have often tions can be maintained in a popula- ologists who study the genetics of
found an audience among aging souls tion at a high frequency, so long as aging work with animals with very
all too eager to grasp at the hope of their effects are delayed until after re- short life spans in order to save time.
cheating death.7 production. Haldane’s insight solved Like a number of others in the field, I
What changed everything was the the evolutionary puzzle of Hunting- work with a tiny nematode worm
development of a theory of the evolu- ton’s. called Caenorhabditis elegans—C. ele-
tion of aging with real explanatory But instead of stopping there, Hal- gans for short. These little creatures
power and conceptual beauty. The dane went on to make a further bril- age and die after a mere two to three
essence of it was originally seen back liant observation. If natural selection weeks. The whole of the C. elegans

32 H A S T I N G S C E N T E R R E P O R T July-August 2003
genome has been sequenced, and a promising and exciting areas of work funded research is successful.
high proportion of C. elegans genes in biology, yet biologists are strangely BBSRC-funded work has involved
have equivalents in humans. Thus, if reluctant to advocate the extension of treatments that dramatically increase
the genes controlling aging in C. ele- human life, or sometimes even to lifespan in nematodes, fruitflies, ro-
gans are found, they could potentially admit that life extension may be a dents, and yeast. Yet it is easy to un-
be used to identify genes controlling consequence of their work. Consider derstand how we have arrived at this
human aging. the following justifications for aging peculiar attitude of denial. Treating
In classical genetics, the art is to research grant applications in the the aging process would have two
identify genes that control the forma- United Kingdom: major consequences. First, it would
tion of any particular facet of biology dramatically reduce the incidence of
“Unless we can identify ways
by looking for instances where a sin- many of the principal killer diseases
through which healthspan can be
gle gene has malfunctioned (mutat- of the developed world, such as car-
increased as we age, the strain on
ed), producing a defective animal. diovascular disease, cancer, diabetes,
healthcare costs owing to the vol-
The geneticist then works back to Alzheimer’s disease, and Parkinson’s
ume of age-related pathologies will
infer the normal function of the gene. disease. This is because what really
be enormous.”
For example, to understand how puts us at risk of these ailments is get-
genes specify the fur color of mice, ting old. It has been said of cancer:
“The results of the study will guide
one might study albinos. Similarly, to “advancing age is the most potent of
our future ideas about the nature
understand how genes are related to all carcinogens.” 12 This being so, why
of the ageing process. This knowl-
aging, one would look for mutants invest all the effort into investigating
edge provides an important base-
where the normal aging process was these diseases piecemeal, if there is a
line from which more applied
interrupted, resulting in an increase chance that by finding a treatment for
studies to design ageing interven-
in lifespan. Surprisingly, nobody aging one could get the lot in one
tions can be launched.”
thought to take the classical genetic swoop?13 As an argument to convince
approach to aging until the 1980s. a grant assessment committee to sup-
“We believe that our findings will
But in 1989, Thomas Johnson at the port a proposed programme of re-
eventually have an impact on
University of Colorado made a re- search into aging, this is pretty un-
human health and quality of life.”
markable discovery. He showed that a beatable.
mutation in a single gene, which he “Healthspan,” “human health,” But lurking in the shadow of this
named age-1, increased average life “quality of life”—but not longevity. first consequence of treating aging is
span in C. elegans by 65 percent.9 Some researchers of aging even ex- the second: enhanced longevity. And
Since that time, geneticists have dis- plicitly deny that their work is aimed here some brows start to furrow. Un-
covered many life span genes, not at extending life. Publicity material derstandably, biogerontologists prefer
only in worms, but also, more recent- from the recent U.K. Biotechnology to be associated with medical research
ly, in fruitflies10 and mice.11 and Biological Sciences Research rather than with a field whose history
Evolutionary theory shows us that Council (BBSRC) Experimental Re- involved goat testicles and yoghurt
it is wrong to think of aging as an in- search on Ageing initiative reads as diets. Yet it is probably also true that
evitable consequence of the inherent follows: biologists, like many others, are un-
limits to the durability of biological settled by the possible consequences
Experimental Research on Ageing
systems. Rather, the reasons for the of increased longevity.
(ERA) is a new programme being
occurrence of aging are starkly banal:
launched to fund a broad range of
it is merely a by-product of the Worrying about Living Longer
science projects on the biology of
process of evolution. It is about as im-
normal ageing. The aim of ERA is
portant in terms of adaptation and
evolutionary fitness as nipples on
men. Life span potential and the rate
to understand the basic biology of
healthy ageing. It is hoped that
S urely the possibility of longer life
is something wonderful. Yet not
only bioethicists are sighing and
such information could eventually
of aging are genetically controlled grinding their teeth: within popular
lead to new treatments that could
traits, like height, sex, or eye color. debate about the possibility of life ex-
reduce age related decline and thus
The secrets of aging and how to block tension there are a number of recur-
increase ‘healthspan’ and improve
it lie in the genes. The new genetics of rent worries. Uppermost is the possi-
quality of life for the elderly. ERA
aging is starting to reveal these secrets. bility of huge overpopulation. This
is not aimed at lengthening lifes-
could indeed be a consequence—but
pan.”
Why Biologists Are Cagey not necessarily. In much of the devel-
The last remark is particularly star- oped world birth rates continue a

T he genetics of aging is widely re-

garded as one of the most
tling, given that lengthening lifespan
is exactly what will happen if ERA-
long decline, and in some countries
the death rate now exceeds the birth

July-August 2003 HASTINGS CENTER REPORT 33

 rate, and only immigration prevents back to health, and enhancement halved the rate of aging and doubled
population decline. To maintain a technologies, which go beyond treat- lifespan—as some mutations do in C.
steady population each woman must ments to make us more than well. Ex- elegans—Mao Tse Tung might still be
bear, on average, 2.1 children; yet in amples of enhancement technologies alive. He would be the equivalent of
many developing countries, the birth include cosmetic surgery (face lifts, fifty years of age, and might not be
rate is less than this— in Italy, for ex- breast augmentation, and so on), the expected to die a natural death until
ample, the actual number of children use of antidepressants such as Prozac 2059. Worse still, Joseph Stalin
per woman was recently estimated at to alter personality (so-called cosmet- would be “sixty-three” and would live
only 1.2.14 Such trends could, in the ic psychopharmacology16), and the until 2027. Do we really want anti-
long term, bring about a global de- use of drugs or hormones to enhance aging therapies in the hands of
cline in population—a happy athletic performance. Enhancement Robert Mugabe, Fidel Castro, or Kim
prospect. Whether or not aging ther- technologies raise all sorts of tricky Jong Il?
apies will ever be effective enough to ethical problems, relating to authen- Historically, a great benefit of
engender overpopulation, this would ticity and identity, for example.17 Life aging has been deliverance from
not provide sufficient grounds to cur- extension bears more than a passing tyranny. It is biology’s analog of the
tail their development and so lose the resemblance to an enhancement tech- most successful feature of parliamen-
benefits in terms of reduced disease. nology, as long as the current average tary democracy: an effective means to
After all, advances in medicine along life span is considered healthy—to ex- dispose of bad leadership. Even under
with improved nutrition and hygiene tend a life beyond the current average tyranny one can at least wait, and
have greatly reduced infant mortality span would be to go beyond what hope to outlive one’s oppressor. For
during the last century. This has led health requires. Similarly, as with this reason alone, anti-aging treat-
to dramatic increases in population, many enhancement technologies, its ments represent a very serious threat
but no one has called reducing infant value is strongly culturally deter- to humanity in the long term. The
mortality undesirable. mined and it could lead to alterations happy events of 1989 should not de-
Another concern is that, in our in identity. Guilt by association with lude us as to the inevitability of ulti-
desperation to avoid death, we end up the disreputable forms of enhance- mate, unending global democracy.
endlessly prolonging the morbid ment is likely to reinforce the desire Consider the possibility of a global
phase of our lives. Recent popular ar- of biogerontologists to distance them- dictatorship with a non-aging presi-
ticles on the subject of the new biolo- selves from life extension. dent. Remember the words of
gy of aging have ruminated over the Another important issue that has O’Brien to Winston Smith in Or-
myth of Tithonus of Troy, whose been considered previously is distrib- well’s 1984: “If you want a picture of
good looks inspired the love of Eos, utive justice: greatly increased the future, imagine a boot stamping
goddess of the dawn. Eos convinced longevity for the rich alone would be on a human face—forever.” This “for-
Zeus to grant Tithonus the gift of hard to stomach for those without ac- ever” is what biogerontological re-
eternal life, but the king of the gods cess to such treatments. More serious- search has the potential to achieve.
slyly did not also give him eternal ly, this might also result in a further Doing away with Stalin is the
youth. With time, Tithonus grew ever concentration of wealth and a widen- most benign example of a more gen-
more decrepit, yet could not die, until ing of inequality. It has also been sug- eral benefit for society of aging: the
there was barely more of him than his gested that access to life extension redistribution of power. Less impor-
croaking voice. This, of course, mor- technology might be considered a tant, but still worrisome, is the possi-
tified Eos, and in the end, as an act of fundamental human right, like that bility of extending the lifespan of
mercy, she transformed him into a of access to education. But as business tycoons. One may easily en-
grasshopper. Most of us would agree biogerontologist Leonard Hayflick visage problems arising from ener-
that it makes little sense to postpone has asked, should such a technology getic, supercentenarian tycoons, in
death once our quality of life has di- be made available to all—even mur- the mould of the media magnate Ru-
minished beyond a certain point. As derers?18 Should we rejuvenate pert Murdoch, relentlessly and rapa-
has been observed, “Most older peo- Charles Manson? Hayflick also ciously expanding their business em-
ple fear disability and the dependency touches on a more worrying issue, pires, and concentrating power in
and loss of dignity it brings more that of preventing the aging of their hands. But perhaps with effec-
than they fear death.” 15 tyrants. tive legislation to prevent such accu-
One may also ask whether life ex- mulations of power and wealth, akin
tension per se constitutes a medical The Political Value of Aging to those that guard against monopo-
treatment in the usual sense, or some- lies, such threats may be disarmed.
thing quite different. A distinction is
often drawn between medical treat-
ments, which restore us from illness
T his is why I fear research into
aging. If treatments had been
available in the twentieth century that
A quite different nest of worries re-
lates to the value of life extension it-
self—that is, its effect on quality of

34 H A S T I N G S C E N T E R R E P O R T July-August 2003
life in the one who experiences it. Man sets himself goals, and while many are highly repeatable—though
Would life inevitably become bor- he is heading towards them he is the capacity of desires to be revived
ing—even to the point that it would buoyed up by hope, indeed, but and rekindled varies with the type of
not be worth living? This is the meat gnawed at the same time by the experience concerned. Some take a
of this discussion. There are two fac- pain of unsatisfied desire. Once long time before their repetition does
tors that will affect how much we the goal is reached, however, after not involve a diminution of quality.
ought to want life extension and that the first flush of triumph has And some can never be repeated–—
have not previously been considered. passed away, there follows in- particularly where the experience in-
One is the progressive psychological evitably a mood of desolation. A volves a discovery; to be rediscovered,
changes that occur during normal void remains, which can seeming- a thing must first be forgotten, and
aging, the other the character of the ly find an end only through the some things are hard to forget.
life plan or life narrative in whose painful emergence of new long- Nicholas Saunders has spoken of
context much of what we do has ings, the setting of new goals. So parachute jumping as an example of
meaning. the game begins anew, and exis- an unrepeatable experience: no jump
tence seems doomed to be a rest- can ever be quite as vivid as the first.21
Pessimism and the less swinging to and fro between Some people seem especially able
Repeatability of to enjoy endless repetition
Experience of the same experience, a

W hat is immortality to Sisyphus

quality that one may value

O ne problem with liv-

ing a lot longer is
that one might end up but the cruelest element of his
or despise. Leon Kass,
imagining a possible 25
percent increase in lifes-
having experienced all pan, has asked: “Would
there is to experience and punishment? Yet really this is an the Don Juans of our
arrive at a state of terminal world feel better for having
boredom. An example of unrealistically gloomy seduced 1,250 women
an unhappy Methuselah is rather than 1,000?”22 I can
Elena, the 337-year-old accept that on his
opera singer in Karel
assessment of the character of goals deathbed, the extra 250
Capek’s play The Makrop- women might not seem
ulos Secret.19 She describes and desires and their place among that important to Don
her condition as “not so Juan. But if he was only at
much boredom as frozen, the things that make life engaging. number 1,000 and was of-
soulless emptiness, such fered an extra 250, one can
that the short-lived people only imagine his joy.
around her seem little more than
shadows.” The play ends with all the pain and boredom, which ends at Aging and Rigidity of Identity
dramatis personae gloomily rejecting last in the nothingness of death. 20
life extension and burning a paper
bearing the recipe for Elena’s anti-
aging elixir.
What is immortality to Sisyphus C onsider the fact that, on the
whole, people become more set
but the cruelest element of his pun- in their ways as they get older. One
Why does Capek think life exten- ishment? Yet really this is an unrealis- cannot, it is said, teach an old dog
sion is so terrible? In part, it reflects a tically gloomy assessment of the char- new tricks. One informal study has
pessimism that was fashionable acter of goals and desires and their suggested that as we grow older, win-
among intellectuals during the early place among the things that make life dows of receptivity for the acquisition
twentieth century (the play was pub- engaging. I often think, in this con- of new tastes close progressively—for
lished in 1922). Modern audiences text, of my parents. I am pretty cer- one particular fashion (tongue-pierc-
might not be so sympathetic with the tain that however much their lives ing) by age twenty-three, for popular
play’s ending. were extended (with reasonable music by thirty-five, and for an alien
Central to such pessimism is the health), my father would continue to food type (sushi for Kansans, say) by
notion of the absurdity of human en- enjoy going sailing, and my mother thirty-nine.24 Admittedly, these find-
deavour. Here is Moritz Schlick, de- writing plays and gardening. While it ings were not published in a peer-re-
scribing Arthur Schopenhauer’s certainly is true that some desires viewed scientific journal—in fact, in
views: have the Schopenhauerean quality of general, studies of age-related changes
disappearing upon their attainment, in personality are notoriously diffi-
many do not. More importantly, cult to reproduce.25 Yet for primary

July-August 2003 HASTINGS CENTER REPORT 35

 language acquisition, for example, a Biologists refer to this phenome- Vanian, slid his microphone over the
tight window of receptivity certainly non of serial adult identities as social low ceiling to create a head-splitting
exists. development, or age polyethism, and feedback. But what is significant is
If a prerequisite for enjoying a it is a marked feature of eusocial ani- that I thought it all perfectly wonder-
greatly extended life is the capacity to mals—those that live in colonies ful. Now, at age forty-two, I am often
change and develop oneself, find new where there is a single reproductive tormented by pop music (often not
interests, and develop new ambitions queen.26 These include bees, ants, and even especially loud) in public places.
and desires, then the loss of flexibility termites, and one mammal: the naked I suspect that this change reflects pro-
with age limits the value of life exten- mole rat, colonies of which live in big found age-related psychological
sion. In this sense Elena Makropulos’s underground nests in parts of East changes affecting not only my musi-
condition could really be horrific: ex- Africa. An interesting possibility is cal tastes (this morning I listened to
tended life accompanied by progres- that something akin to age poly- Mozart’s Waisenhaus Mass), but also
sive straitjacketing of the mind and ethism occurs in human beings. In my aesthetic and moral sensibilities.
ossification of the self, resulting in the fact, humans’ high degree of social In my teens I once tried to add syn-
condition of a mental Tithonus. structure and interdependence is rem- thetic estrogens to the water supply
This raises an important empirical iniscent of eusocial species.27 We even of a caravan where an old, one-eyed
question about the rela- school warden lived, in
tionship between biologi- attempt to get him to
cal and cognitive aging.
Why do people so often
T he extension of lifespan might not grow breasts. I would not
dream of doing such a
become more conservative simply be more of the same, thing now.
as they get older? Is it a The possibility of
property of mind—of the something like age poly-
same sort as the acquisi-
but rather, it could create a larger ethism in human beings
tion of knowledge? Or is it raises interesting ques-
the consequence of age foundation upon which a life of tions relating to the value
changes in brain neuro- of life extension. For ex-
physiology? greater scope, possibility, ample, it suggests that
I suggest a hypothesis one might distinguish
about the character of and achievement forms of adult maturation
aging itself. Consider the or character development
honeybee. Among worker may be constructed. that are biologically pro-
bees are many castes per- grammed from those that
forming different roles in are simply the result of ac-
the maintenance of the hive. At the have non-reproductive adult females: cumulated experience. Imagine three
end of pupation, the newly emerged post-menopausal women. Are we soul individuals who had undergone life
worker bee takes on the role of nurse brothers of the naked mole rat? extension, but in whom the progres-
bee, feeding the growing larvae and Admittedly, such parallels are a lit- sion of age polyethism was arrested at
tending to the queen. After a while, tle far-fetched, but let us stay with different stages, equivalent, say, to the
she transfers to hive-cleaning duties. this idea for a while. The presence of ages of seventeen, forty and sixty-five
Then, typically at the age of around age polyethism in humans would years. In an important respect, each
three weeks, she undergoes a major imply a concerted program of biolog- of them would continue to mature,
physiological change—her hormone ical changes in our brains, occurring acquire experience, develop new abil-
levels alter and there are transforma- during the course of adulthood.28 ities, interests, and perhaps new vices.
tions in the structure of her brain— From my own experience, I am Yet somehow each would retain char-
and she leaves the nest to start work amazed by how much my character acteristics of the stage of arrest. For
as a forager, seeking out flowers, col- has changed over the years. Once in example, the “seventeen year old”
lecting nectar and pollen, bringing it 1978, at the age of seventeen, I went might grow wiser yet retain a stage-
back to the hive, and communicating to a small club in Torquay to see a typical plasticity of identity—and
its whereabouts to other foragers. punk band called The Damned. The perhaps continue to enjoy having his
From the time that she becomes a for- venue was chock-a-block with sweat- ear-drums rattled in a mosh pit at the
ager, her life expectancy is around sodden, drunken teenagers, and the age of 150.
three weeks. Toward the end of her music was so loud that my ears rang Perhaps the most desirable out-
life, she may take on a fourth role, for weeks afterwards. I believe that I come would be this: if one under-
that of soldier and defender of the suffered slight but permanent damage stood the neurobiological basis of age
hive. to my hearing when the singer, Dave polyethism, one could develop the

36 H A S T I N G S C E N T E R R E P O R T July-August 2003
means to select at will the stage at ance of being somewhere between minent death. According to Grof
which one wanted to live. Such a ca- twenty and forty years old through- and Halifax, this has less to do with
pacity would also affect the length of out their adult life. They would then fear of imminent nonexistence, or
life that, given the choice, one die suddenly, typically in their even the horror of dying, than with
would select. For surely the process eighth or ninth decade. Further- the difficulty of accepting that plans
of becoming progressively set in more, death would be painless, not for the future will not be fulfilled. A
one’s ways with increasing age helps involving illness or disease—a sud- focus of Grof’s psychotherapy
to make more bearable the diminu- den loss of consciousness, preceded (which included the use of the psy-
tion of one’s life expectancy with in- optionally for a few days or weeks by chedelic drug LSD) was to help the
creasing age, since it makes it less some form of painless, unambigu- patients to radically alter and curtail
likely that one’s identity will alter ous indicator of impending death to their conceptions and expectations
and give rise to new ambitions and allow time for goodbyes. Such non- of their future lives. A measure of
desires. It has often been argued that aging mortals might fear death, but the efficacy of such treatments was,
a blessing of the aging process is that they would have no cause to fear the according to Grof and Halifax, that
it encourages us to weary of life, process of dying, any more than patients often required less pain
thereby drawing the sting from they should fear falling asleep. Such medication.
death. Yet if it were possible, when a life would represent the perfect Arguably, the most transforma-
experiencing the ennui of a very fulfilment of the current stated aims tive element of effective anti-aging
long life, to revert to the biological of biogerontological research pro- treatments would be to bring about
mental age of a seventeen-year-old, grams such as BBSRC ERA. an expansion of one’s future. Expec-
with the relative plasticity of identi- Such evergreen mortals might tation of a future of a given, approx-
ty that would result, one could then elect to undergo a life-extending imate length provides the founda-
undergo a renewed adult ontogeny, treatment either because they want a tion for our future plans and expec-
bringing with it new desires, tastes longer life, or because they are afraid tation of the trajectory of our lives.
and ambitions, and a renewed desire of death. Arguably, considered apart This sense of future is one of the
to live. In such a future, young and from the questions of one’s reasons mainstays of the framework of
old minds would live side by side— for wanting to live, for the evergreen meaning in which many of our ac-
as now—yet either could be chrono- mortals the actual process of dying is tions make sense. To use the current
logically ancient. This would be something of a non-event. As for argot, “Human actions are embed-
akin to replacing the cycle of life and death itself . . . as the Epicurian ded within the narrative of a human
death of a perennial flower with the adage rightly has it: when death is life, and human lives are embedded
cycle of renewal of a deciduous tree. there, we are not, and when we are in larger social narratives.”31 From
But to return to biologists’ cagi- there, death is not—really, we this it follows that the value of an
ness about life extension: the occur- should not fear it.29 extension of future will be influ-
rence of patterned psychological So our evergreen individual has enced by the sort of life narrative or
changes with increasing age raises se- rationalized away his fear of death. It life plan a person has.
rious questions about the quality of would not surprise us to learn that Where do life narratives come
extended lives. Clearly, at least, we he still chose to extend his life. Sev- from, and do they exhibit general
may not assume that life extension eral factors might influence how features or fall into distinguishable
of the magnitude of that achieved in much such an evergreen individual types? Presumably, like other facets
nematodes and rodents would be, would want such a treatment, and of human culture, individual life
like good health, simply more of the how much of such a treatment he plans draw on a common cultural
same. would want. stock of life narrative elements that
In The Human Encounter with have evolved over the millennia of
Life Plans and Expectation of Death, Stanislav Grof and Joan Hal- human cultural history. This being
Future ifax describe the difficulties that ter- so, one would expect that many
minally ill cancer patients experi- such components will have evolved

T he added value to human exis-

tence of increased longevity
may be further explored by means of
ence in coming to terms with
death.30 It is generally held that
death is more tragic when it occurs
within the constraint of the twenty
to fifty years of active adult life typi-
cally available to our ancestors.
a thought experiment. Suppose that in the young, since it is premature, If the value of life extension de-
it were possible to eliminate entirely coming before its victims have had pends upon the sorts of life plans
the outward symptoms of senes- the opportunity fully to live out people possess, then to evaluate life
cence without increasing life span. their lives. This is borne out by the extension one needs to ask what sort
One may imagine the resulting peo- particular difficulty experienced by of different life plans there are, and
ple, who would retain the appear- younger cancer patients facing im- how they affect the value of life ex-

July-August 2003 HASTINGS CENTER REPORT 37

 tension. There certainly are differ- Big Man pattern is characteristic of ethical problems associated with life
ences in the sort of life plans that youth and early adulthood. Between extension (and convincing review
people possess. Some are relatively adolescence and the age of perhaps panels)—especially since the poten-
static, such that the desired future is thirty, many people pass through tial medical benefits are so great.
essentially a continuation of things as multiple cycles of transformation of Life extension poses some intrigu-
they are: carrying on in the same or life plan and identity, as they “discov- ing problems.32 For me, the most
similar relationships, doing a similar er who they are” or “find themselves.” chilling of these is the prospect of
job, or pursuing similar past-times. In To some extent, one may distinguish power concentrated relentlessly into
others, the focus is on the achieve- varying degrees of maturity in life the hands of a few undying individu-
ment of specific goals—getting mar- plans, particularly as there develops a als—and particularly into the hands
ried, having children and seeing them better sense of one’s own capabilities of tyrants. Concerns about the effect
through university, reaching the top (or arête, as the ancient Greeks would of more life on the quality of life,
of a promotion ladder, or paddling have it). Similarly, static life plans however, are less compelling. De-
across the Pacific in a canoe. A key may become increasingly common pending partly on whether one re-
feature of this sort of life plan is that among older people, for example tained the mental plasticity of youth
a given goal can be reached (however among those who have fulfilled or as one aged and on whether one
unlikely its achievement may be). abandoned their aspirations. opted for an open-ended life plan, ex-
The life has discrete milestones and The type of life plan that one has, tending a life has the potential to im-
an end point—at least theoretically. or is likely to conceive, may affect the prove it. Thus, extension of lifespan
In still other life plans, however, goals value of a possible extension of fu- might not simply be more of the
may be more open-ended. Consider a ture. In the case of static plans, where same, but rather, it could create a
medical researcher who wishes to re- the possibility exists of wearying of larger foundation upon which a life
lieve as many people as possible from such a life, the value of an extended of greater scope, possibility, and
suffering, or an entrepreneur who future may be relatively low. In the achievement may be constructed.
wants to make as much money and case of fixed goal life plans, the value
acquire as much power as possible. of life extension will depend on Acknowledgements
An interesting type of life plan is whether the plan is realizable. Some- Many of the ideas in this essay
that which can lead to changes of one might choose to extend his fu- emerged from discussions with partici-
personal identity, and consequently, ture indefinitely in the hope of wit- pants of the bioethics project Enhance-
to an altered life plan. This in turn nessing the Second Coming of Jesus. ment Technologies and Human Identi-
can further alter identity, producing In the case of open-ended plans, the ty, funded by the Social Sciences and
another alteration in life plan, and so value of extension may be higher, Humanities Research Council of Cana-
on. Such cycles of change could end since the conception of new plans is da. Carl Elliott and Françoise Baylis
with the appearance of other types of likely to bring with them the desire were especially helpful. I have also ben-
plan. The Western Little Big Man de- for more time to fulfil them. efited from discussions with members
picts this life plan; the hero, played If life plans involve a framework of the aging research community, in-
by Dustin Hoffman, is by turns a within which our actions have mean- cluding Richard A. Miller, John
Wilmoth, and Aubrey de Grey. I have
Cheyenne brave, a Christian evange- ing and are of a traditional length, received funding through a Royal Soci-
list, a quack medicine salesman, a then life extension might appear su- ety University Research Fellowship,
gunfighter rubbing shoulders with perfluous. But this, of course, is no and through grants from the BBSRC,
Wyatt Earp, a drunken hobo, and a argument against life extension. The the European Union, and the Well-
scout working for General Custer’s possibility of conceiving life plans on come Trust.
7th Cavalry, which he sees cut down a grand scale represents an exciting
at the battle of Little Big Horn. challenge. References
Other life plans may be directed, 1. A. Bartke et al., “Extending the Lifes-
with self-development as a goal. They A Life of Greater Scope pan of Long-lived Mice,” Nature 414
are therefore less open-ended, insofar (2001): 412.
as they aim to remain open-ended.
An example here is the life plan of
someone whose ambition is to be-
I t is impossible to say whether life-
extending treatments will ever ac-
tually be developed. But simply to
2. L. Partridge and D. Gems, “Mecha-
nisms of Ageing: Public or private?” Nature
Reviews Genetics 3 (2002): 165-75.
come ever wiser, or creative in new state that human life extension is not 3. D.E. Martínez, “Mortality Patterns
Suggest Lack of Senescence in Hydra,” Ex-
ways. Perhaps Leo Tolstoy lived this an aim of biogerontological research perimental Gerontology 33 (1998): 217-25.
way. ducks the issues. Yet, biologists are 4. L.W. Buss, The Evolution of Individu-
To some degree, the different bound to be more concerned with ality (Princeton: Princeton University Press,
types of life plan are typical of differ- obtaining funds to continue their re- 1987).
ent ages, or stages of life. The Little search than with resolving the tricky

38 H A S T I N G S C E N T E R R E P O R T July-August 2003
 5. There are a number of good, popular don: Royal College of Physicians of Lon- 26. G.E. Robinson, “Regulation of Divi-
accounts of the biology of aging, for exam- don, 1998), 113-38. sion of Labor in Insect Societies,” Annual
ple Why We Age, by S.N. Austad (New York: 16. P.D. Kramer, Listening to Prozac Review of Entomology 37 (1992): 637-65.
John Wiley and Sons, 1997), The Time of (London: Penguin Books, 1993). 27. This similarity has been discussed by
Our Lives, by T. Kirkwood (London: Wei- 17. E. Parens, “Is Better Always Good? Matt Ridley in The Origins of Virtue (Lon-
denfeld and Nicholson, 1999), and Aging: The Enhancement Project,” in Enhancing don: Penguin Books, 1996), Chapter 1.
A Natural History, by R.E. Ricklefs and Human Traits: Ethical and Social Implica- 28. The psychologist H.J. Eysenck has
C.E. Finch (New York: Scientific American tions, ed. E. Parens (Washington D.C.: suggested that age changes in behavior re-
Library, 1995). Georgetown University Press, 1998), 1-28. flect altered levels of excitation within the
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19. K. Capek, “The Makropoulos Se-
7. For an entertaining account of early cret” (1922), in Toward the Radical Center: (1987): 11-21.
theories of aging, see Roger Gosden’s Cheat- A Karel Capek Reader (Highland Park, N.J.: 29. The question of whether death is an
ing Time, Science, Sex and Aging (New York: Catbird Press, 1990), 110-77. For further evil is discussed thoroughly in Williams,
W.H. Freeman and Company, 1996.) discussion of this play, see Bernard Problems of the Self, and Thomas Nagel’s
8. G.C. Williams, “Pleiotropy, Natural Williams’ essay “The Makropoulos Case: essay “Death,” in Mortal Questions (Cam-
Selection and the Revolution of Senes- Reflections on the Tedium of Immortality,” bridge: Cambridge University Press, 1979),
cence,” Evolution 11 (1957): 398-411. in Problems of the Self (Cambridge: Cam- 1-10.
9. D.B. Friedman and T.E. Johnson, “A bridge University Press, 1973), 82-100. For 30. S. Grof and J. Halifax, The Human
Mutation in the Age-1 Aene in Caenorhab- a review of the many other fictional ac- Encounter with Death (London: Souvenir
ditis elegans Lengthens Life and Reduces counts of immortality, see G. Slusser, G. Press, 1977).
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(1988): 75-86. Engines: Life Extension and Immortality in (New York: Routledge, 1999), Chapter 7.
10. Y.-J. Lin, L. Seroude, and S. Benzer, Science Fiction and Fantasy (Athens Geor- The role of narrative in making sense of our
“Extended Life-Span and Stress Resistance gia: University of Georgia Press, 1996). lives is discussed extensively in A. MacIn-
in the Drosophila Mutant methuselah,” Sci- 20. M. Schlick, “On the Meaning of tyre, After Virtue (Notre Dame, Ind.: Uni-
ence 282 (1998): 943-46. Life,” in Life and Meaning, ed. O. Hanfling versity of Notre Dame Press, 1981); and M.
11. H.M. Brown-Borg et al., “Dwarf (Oxford: Blackwell, 1987), 60-73. Schechtman, The Constitution of Selves
Mice and the Ageing Process,” Nature 384 21. N. Saunders, Ecstasy Reconsidered (N. (Ithaca: Cornell University Press, 1996).
(1996): 33. Saunders, 1997). 32. A number of other important issues
12. R.A. DePinho, “The Age of Cancer,” 22. L. Kass, “L’Chaim and Its Limits: relating to the ethics of life extension have
Nature 408 (2000): 248-54. Why Not Immortality?” First Things 113 been discussed elsewhere. See Kass,
13. R. Holliday, “The Urgency of Re- (2001): 17-24. “L’Chaim and Its Limits,” Hayflick, “The
search on Ageing,” BioEssays 18 (1996): 89- 23. G.P. Baker, Tiberius Caesar (New Future of Ageing,” J. Harris, “Intimations
90. York: Cooper Square Press, 1929). of Immortality,” Science 288 (2000): 59; M.
Gladwell, “The New Age of Man,” The
14. “Why Italians Don’t Make Babies,” 24. R.M. Sapolsky, “Open Season: Why New Yorker, 30 September 1996, 56-67;
The Economist 9 May 1998, 56. Do We Lose Our Taste for the New?” The T.F. Murphy, “A Cure for Aging?” Journal of
15. J.G. Evans, “A Correct Compassion: New Yorker 30 March 1998, 57-72. Medicine and Philosophy 11 (1986): 237-55;
The Medical Response to an Ageing Soci- 25. This subject is reviewed in I. Stuart- R.M. Veatch, ed., Life Span: Values and Life-
ety,” in Increasing Longevity: Medical, Social Hamilton, The Psychology of Ageing (Lon- extending Technologies (New York: Harper
and Political Implications, ed. R. Tallis (Lon- don: Kingsley, 1994), Chapter 5, “Ageing, and Row, 1979).
Personality and Lifestyle,” 110-31.

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