This article is for my (J.P.’s) sister.
She’s always been the one in my family most vocal about her concerns with the pros and cons of immortality.
Particularly the cons.
And I think the potential problems of increased life expectancy that she identifies are concerns a lot of people share.
Because once you get past the question of if radical human life extension is even possible, the inevitable next question is, “Should we do it?”
In fact, there are a lot of ethical arguments against life extension (as my sister is wont to remind me).
I’m sure you’ve heard, or even thought of, many of them yourself.
“What if only the rich can afford it?”
“What about overpopulation and the environment?”
“Won’t you just get bored?”
“Who would want to live to 150 if you’re just old and decrepit and in a nursing home all that time?”
In this post, we’re going to try and address all these longevity objections, and more (Immortal dictators! Religious concerns! Social Security!), but first we should talk about that last question (being old and decrepit for decades) briefly.
Many people, when they think about life extension, assume the process will simply extend the tail-end of our lives, adding more years on to that period when we are beset with frailty and age-related mental and physical decline.
Stuck in a wheelchair, you’ll have to play bingo for an extra fifty years while you’re forced to stay alive through uncomfortable tubes up your nose or something.
And believe me, no one, myself included, wants that.
But what spanners and other people interested in human longevity want is not just extended lifespans, but extended healthspans.
As we said in our very first article on human life extension here:
Human life extension addresses both chronological and biological aging; it asks not just how can we live longer, but how long can we live well. Healthspan, or the years of our lives when we’re unencumbered by disease or disability, addresses just that. What if you could have the body you had at 25 well into your 80s or 100s or 120s? What more could you do with those extra rich years of life? Who could you become?
The technical term for this is compressing morbidity: shortening the decrepit, morbid years and extending the healthy ones. And, as we also discussed in our first article, there’s plenty of scientific evidence to suggest that anti-aging interventions can do just this in both animals and in humans.
So what we’ll be talking about throughout the rest of this article on the ethics of life extension is not extending the unhealthy years of our lives, but extending our healthy, active, vibrant years and why (quite a few, actually) people think that could still be a bad thing.
Because this is a (really) long post, feel free to jump to the section you’re most interested in, rather than read through everything.
Table of Contents
1. Religious and loss-of-meaning arguments: Won’t you just get bored?
Does death make life meaningless?
Tolstoy and Nietzsche would argue that that’s absolutely the case—and they’ve gotten plenty of attention for it, especially in Western culture, because it runs contrary to an unspoken assumption that death itself is what gives life meaning. Christians look forward to heaven. Jews see death as a terrible but necessary part of God’s plan. Buddhists believe death leads only to rebirth. In so many philosophical traditions, death is essential for life itself to have meaning.
Some even go as far to claim that death is required for life to have meaning. They—the likes of the late Holocaust survivor Viktor Frankl and philosopher Sir Bernard Williams—present three major arguments against life extension:
- The extension of life is against the Universe’s plan
- Mortality is an excellent motivator
- Immortality leads to indefinite boredom
Let’s break them all down.
The indefinite extension of life is against the Universe’s plan
Religious fatalism is the belief that an individual’s health is predetermined by a higher power; the individual can not and should not intervene. Religious fatalism isn’t something relegated only to cults or extremists. It’s significantly correlated with race, people with lower incomes, and people with lower levels of education. Religious fatalism is distinct from fatalism, in that it refers specifically to healthcare decisions. Many who believe in destiny or fate will also argue that they are predetermined to suffer from an illness or disease, and recovery will not hinge on medical intervention—it’s up to the universe.
And, if fate does have a role in medical outcomes, intervening would be foolish. Why waste the money and resources on doing so if you’re just going to die anyway? Using this logic, aging should be embraced as a natural part of life.
Following that line of thinking, the medical field should cease to exist. Forget cancer research—close the children’s hospitals and ER rooms and eliminate the FDA. Life-sustaining drugs like insulin, Albuterol, and Levothyroxine should be banned along with seatbelts and helmets.
Of course, many who believe in religious fatalism don’t necessarily want to be so prescriptive to the rest of society. They might see it as an important personal choice, but not something to put on others. Or—and I find this common among my circles—it’s the elimination of age-related death altogether that’s off-putting. They’re completely comfortable with, say, finding a cure for Alzheimers, cancer, and diabetes, but when age itself is indicated as a major precursor to all these diseases, they shrug it off. Ageing is an essential part of life. It’s not to be tampered with.
Part of the reason is because being old without being healthy is horrific. Think wheelchairs, struggling to open Jell-O cups, and slowly losing your senses—each one a tragic loss for a 15-year-old but an inevitability for someone over 90. But this goes to show that we just don’t consider the elderly as human as those younger than them. Frailty is a tragedy for anyone, not just for those deemed young enough for it to be uncommon.
Thus, the indefinite extension of healthspan, or “the years of our lives when we’re unencumbered by disease or disability,” is really the ultimate goal of life extension. And many find that option far more palatable; if one practices yoga or avoids processed carbohydrates in an effort for a longer healthspan, the prospect of a lengthened lifespan becomes far more palatable.
And in the end, the ethics of life extension require that no one is forcing anyone else to live longer than they would like. Just like anyone can deny medical interventions, so too can they choose not to live longer than they believe they were destined to. That is, in my view, nothing but a personal choice.
Mortality is an excellent motivator
“If we were immortal, we could legitimately postpone every action forever. […] But in the face of death as absolute finis to our future and boundary to our possibilities, we are under the imperative of utilizing our lifetimes to the utmost, not letting the singular opportunities – whose “finite” sum constitutes the whole of life – pass by unused.”— Victor Frankl, The Doctor and the Soul
Frankl, in the quote above, argues that with all the time of eternity, nothing could get done. One could, theoretically, indefinitely put off confessing a love, writing a novel, or starting a company. Of course, discomfort should also be a part of the conversion; while one could choose to never eat because the process takes action, hunger is a tremendous motivator, even if one is nowhere near close to dying from starvation.
Some contemporary psychological studies support Frankl. For example, a 2007 article published in Personality and Social Psychology Bulletin found that those who encounter death over a long period are more likely to be intrinsically motivated (and actually write that novel they’ve always wanted to). That said, the threat of death isn’t necessarily a requirement for intrinsic motivation in general. Realistically, there is a range of reasons why people do things—for praise, for accomplishment, or to “just do it,”—and very few of them have to do with the inevitability of death.
In fact, philosophers like Heidegger have argued that most people live their lives in denial of their death. One study on mortality salience (awareness of one’s own death) found that research participants actively tried not to engage with their own mortality—a reaction that may be a biological response. It would be tough to argue death is the sole reason for any significant actions people take throughout their lives if they’re actively avoiding considering it.
Immortality leads to indefinite boredom
Let’s say that immortality has no effect on your motivation—in fact, you have the curiosity of a 25-year-old and the body to match. You’ve ticked off your bucket list. You live where you want, work where you want (if you want), and you do what you want. Life is splendid. And boring.
This could be one of the major cons of immortality, but Brooke Alan Trisel points out that not all of life is meaningful. He writes, “most of our lives are neither meaningless nor meaningful, but lie somewhere between these two extremes.”
I would amend his argument further to say that most moments of our individual lives are neither meaningless or meaningful, but lie somewhere in between. For example, celebrating your wedding day might be tremendously meaningful, but the hours spent visiting florists might not be.
It’s true that old people experience boredom, and that that boredom can be detrimental to their health. The boredom that they experience, however, often has to do with perils of aging: loneliness, immobility, and declining faculties.
I doubt anyone would advocate that we euthanize everyone over 80 because they might suffer from boredom. Finding interest in new activities, engaging with curiosity, and experiencing excitement, joy, and contentment are all pillars of mental health. Boredom, itself, is a health issue, and not necessarily a reason to prevent life extension.
2. Inequality and accessibility: What if only the rich can afford it?
We’ve all seen those dystopian sci-fi stories.
While the rich lead lives of unimaginable luxury in their space stations, enjoying near-immortality and all the sexbots they can afford, the poor toil in the spice mines below, dying early from Spice Lung or malfunctioning cheap cybernetic implants.
No one wants to live in that world—and not just because it would entail having to endure more of Matt Damon’s terrible acting.
And with rising concerns about wealth inequality, it’s entirely understandable that many people ask the question:
“What if only the rich can afford life-extension treatments?”
Because while global wealth inequality has actually been declining for the first time in two centuries—due largely to the rapid economic growth afforded by technological innovation and the opening of markets, particularly in Asia—some measures of wealth inequality within countries have shown worrying rises.
So is it ethical to pursue life extension if it’s not accessible to everyone?
Is there an existing lifespan-wealth gap?
A 2016 study found that, “The gap in life expectancy between the richest 1% and poorest 1% of individuals was 14.6 years for men and 10.1 years for women.”
However, it may not be as bad as it seems.
A more recent study that took into account income mobility (instead of assuming people kept the same income their entire lives) found a gap of only 2.4 years for men with different income levels, and just 2.2 years for women.
They did also caution that though the gap is not as large as originally thought, it has been widening slightly over the last 30 years, possibly due to differences in education levels.
In short: yes, there is already a (small) gap in the longevity of the rich versus the poor.
Will expensive life-extension treatments widen that gap so much that the poor will be doomed to die early?
The answer to that question has several components:
- First, will life-extension treatments be prohibitively expensive?
- Second, if they are expensive, will they remain so?
- Third, even if they are expensive and remain so forever, is it moral to ban them?
Will life-extension treatments be prohibitively expensive?
To answer that first component we can look at some real-world examples, both of existing anti-aging treatments already on the market, and of past medical innovations.
For instance, the diabetes drug metformin is a classic candidate for a possible anti-aging pill. According to a recent metformin meta-analysis, “Diabetics taking metformin had significantly lower all-cause mortality than non-diabetics,” and a host of other studies have shown other beneficial effects of the drug, like cancer protection and slower brain aging.
And the cost of this possible wonder drug?
According to GoodRx, retail costs for 60 tablets of 500mg of metformin (a 1-2 month supply) range from $9 to $16, even without insurance.
That’s about 15-25 cents a pill.
Other potential life-extension molecules are similarly cheap.
Glucosamine costs as little as ten cents a pill, has been the subject of several recent studies showing it decreases all-cause mortality by as much as 39%, and may be as effective for longevity as exercise.
Aspirin (shown to extend life in male mice) costs $1 for 100 pills at my local Rite Aid.
And the list goes on.
What about newer, expensive anti-aging medicines?
All the ones listed above have been known about and studied for decades—in some cases over a century—is there evidence that newly discovered and developed drugs would be similarly inexpensive?
It’s likely. Take vaccines.
Vaccines are a good parallel to anti-aging medicines because they are developed to treat a deadly, widespread disease that impacts large swaths of the human population and they thus have a huge demand and a requirement to distribute to the most people possible. Both also represent huge net benefits to society compared to the costs of not treating the diseases they target (some research indicates slowing aging could save the U.S. $7.1 trillion over 50 years).
Developing a vaccine can cost as much as $2.8-$3.7 billion and yet many vaccines, including those for the most widespread diseases, are offered free-of-cost or at very low prices. For example, the flu vaccine is often free and almost always fully-covered by insurance.
Other vaccines can be had, even without insurance, for as low as $6.
Most of these vaccines have been developed only in the last few decades, and yet their cost is low enough that almost everyone can afford them. The combination of widespread demand and subsidies means that usually the obstacle to getting a vaccine is a lack of education or of desire, not of financial means.
And there’s good reason to think new anti-aging treatments may be treated like vaccines. If the FDA labels aging a treatable disease (which may well happen), and since fully 100% of the population is afflicted by this disease, demand for effective longevity treatments will be so high that medical and pharmaceutical companies can afford to set prices low, since they will be selling their products to so many people.
But of course, there may be many different types of therapies and interventions that are developed to reverse and slow aging, and not all of them will be as simple or cheap as a pill or a shot.
What if more complex interventions are needed to reverse aging?
Things like gene therapy can cost millions of dollars. In fact, there’s already an (unproven) gene therapy for aging on the market, similar to the procedure longevity influencer Liz Parrish of Bioviva performed on herself in 2015, and its price tag is $1 million.
Not exactly pocket change.
So let’s look at how likely expensive longevity treatments are to stay expensive, such that only the wealthy can afford them.
If life-extension treatments are expensive, will they remain so?
And most technological innovation follows this same pattern.
First an experimental, expensive innovation is developed. Wealthy early-adopters buy it (think investment bankers and car phones back in the 80s), and their purchases fund the research and development needed to improve the innovation, better distribute it, and make it less expensive. Soon, every person who wants one can afford it, and at a much higher level of quality than the original that was available only to the rich.
High initial prices of a new product are thus almost an extended form of R&D funding (and clinical testing with data provided by early adopters). The rich are essentially paying the money necessary to further develop the product and get it to the masses. What the rich pay for with money, the poor pay for with time.
It’s the reason the smartphone in your pocket only costs a couple hundred dollars, and you don’t need to lug a car around to use it.
It’s also the reason your Apple Watch isn’t the size of a room, and yet can do way more health monitoring than the early electrocardiogram machines could (and at a significantly lower price).
In fact, Elon Musk’s business model for Tesla was explicitly written around this principle. He designed and built an impractical, expensive electric sports car (the Roadster) and sold it at exorbitant prices to the rich, in order to fund the research and development of his more affordable mass market car, the Model 3.
And the medical market is little different from the car market (or other technology markets) in this respect. Despite lots of hand-wringing about rising medical costs, especially in the United States, most of the increase in cost is due to increased consumption, not an increase in the cost of individual medical procedures, devices, or medicines themselves (obviously there are exceptions that get lots of media coverage, but in general this is the case). As we get wealthier, it turns out, we want to buy more medical care.
Intuitively, anti-aging medicine should even help lower the total cost of medical care for people, as individuals will have to spend less on treating the very expensive chronic diseases of old-age like Alzheimer’s or cancer. These health-cost savings from longevity medicine are often referred to as the “Longevity Dividend.”
Contrary to popular belief, the real money in almost any market is not in selling boutique treatments to a few billionaires, but selling commercialized interventions to the millions (and, globally, billions) in the middle and lower classes.
Globally, the middle class accounted for $35 trillion in consumer spending, and the lower class another $8 trillion, for a combined spending power of $43 trillion. The rich (those spending over $110 a day) accounted for only $11 trillion in total consumer spending.
All else equal, which market would you rather develop an anti-aging product for?
But of course, despite all this there is still a slim chance that life-extension therapies could buck every historical, technological, and market trend ever observed and somehow remain insanely expensive forever.
So if anti-aging medicines and treatments turn out to be one of those rare types of goods that will only ever be available to the super wealthy, is it moral to ban them or prevent their development?
If life-extension treatments are expensive and remain so forever, is it moral to ban them?
This philosophical question can be addressed from any number of different frameworks. It’s an age-old ethical question: should some people (like the rich) be afforded more opportunities than others (like the poor)?
Bioethicist John Harris offers a utilitarian perspective: “If immortality or increased life expectancy is a good, it is doubtful ethics to deny palpable goods to some people because we cannot provide them for all.”
Harris further analogizes, “We cannot and should not seek to prevent the development of [longevity treatments], any more than we should deny kidney transplants because there are not enough kidneys to go around—in other words, we should develop life-extension even if we cannot provide it to everyone.”
Philosophy professor John Davis, in The American Journal of Bioethics, argues that,
We accept the general principle that taking from the Haves is justified only if doing so makes the Have-nots more than marginally better off. If life-extension is possible, then one must weigh the life-years at stake for those who receive the treatment against whatever burdens making such treatments available might impose on the Have-nots, who cannot afford the treatment.
The greatest burden…is that one’s death is worse the earlier one dies relative to how long it is possible to live. For example, a death at 17 is much worse than a death at 97. Because life extension changes how long it is possible to live, life-extension will make death at 97 tragic in a way it has never been before…However…when this burden is compared to the number of additional life-years the Haves will lose if life-extension is prevented from becoming available, the burden to the Have-nots is marginal compared to what is at stake for the Haves. Therefore, Inhibiting the development of life-extension is unjustified, even though it will probably not be available to everyone for a long time.
In other words, if life-extension research alleviates aggregate suffering even a little, even if only for the wealthy, anti-aging treatments are a moral good.
From a Kantian perspective, we may actually have a moral duty to pursue life extension research.
When a 10-year-old girl falls into a swollen stream and we rescue her, or when she is diagnosed with leukaemia and we cure her, it is customary to say that we saved her life. When we do this for a 50-year-old woman, we still say that. When we develop a vaccine for a new strain of influenza that is claiming thousands of lives per day and it is distributed and brings the pandemic under control, we again say that we have saved some (estimated) number of lives…What, then, have we done when we develop and distribute a cure for ageing?
De Grey’s answer is, of course, that we are saving lives (by extending them) and that it is immoral, through inaction, not to attempt to save those lives (even if the people being saved are wealthy). Following this line of thinking, life-extension research is a categorical imperative. By banning the development or use of longevity treatments, you would be shutting off even the possibility that they might become cheaper and more available to everyone in the future, excluding both rich and poor alike from a potentially better, more healthy life.
Finally, the enforcement of such a ban on certain types of medical research could have tons of negative consequences that might outweigh whatever benefit is gained by its mandated equality.
For instance, with the precedent set that any new technology or medical advancement be made available to everyone as soon as it is developed, many fewer such innovations would ever come to market (for the reasons we discussed above about how most technology starts out expensive, but gets cheaper and more accessible over time as wealthy early-adopters pay for the research and distribution systems needed to improve the product).
Not to mention, how would such a ban even define “life-extension treatments?”
Hypothetically any medical intervention, drug, or treatment is done to extend life in some manner.
Is a cure for cancer a life-extension treatment?
Conversely, is a life-extension treatment that has the side-effect of curing cancer included in the ban or not?
By trying to ban longevity research or anti-aging medicines, you might inadvertently ban whole swaths of other medical research and technology that currently benefits rich and poor alike.
Probably not something we want to mess with.
Ok, cool, so maybe anti-aging interventions could be available to both the rich and the poor, but doesn’t that also mean they could be available to bad people?
Like what about murderous dictators, or just incompetent people that currently hold power due to their age and experience, like scientific or business elites? Couldn’t that lead to societal stagnation or, worse, permanent tyranny?
Let’s find out!
3. Stagnation and tyranny: What about immortal dictators and incompetent elites?
“A new scientific truth does not triumph by convincing its opponents and making them see the light, but rather because its opponents eventually die, and a new generation grows up that is familiar with it.”—Max Planck, Scientific Autobiography and Other Papers
Physicist Max Planck’s famous assertion, quoted above and sometimes misquoted and shortened to, “Science advances one funeral at a time,” is a fair concern.
If dogmatic older scientists, stuck in their ways and unwilling to learn new things don’t eventually die and clear the way for new, younger thinkers with new ideas, won’t science just stagnate? If the people that condemned Copernicus and Galileo were still alive today, would we still think the sun revolved around the earth, and not the other way around?
This life-extension con can be expanded to almost every realm of civic and political life. For example, how would attitudes on race, gender, and technology adoption be now if everyone from 1850 was still alive and running companies, governments, and social institutions? Would women have the right to vote? Would the Civil Rights act have been passed? Would we have the internet?
Although, the opposite argument could also be made: If people who actually survived the horrors of things like slavery were still alive today and they were healthy, young, and active in our political and social spheres, might we be even farther along the road to moral progress than we are already?
We try to base our discussion here at Longevity Advice, as much as possible, on peer-reviewed science and well-established evidence, so, given that, what do the nerds have to tell us about the answers to these questions?
Well, to cover the realm of science first, there are a lot of studies into how age affects the ability of scientists to accept new ideas or contribute their own breakthrough research to the scientific corpus.
With few exceptions, the conclusions from those studies are that age either has an extremely minor effect, or that it doesn’t make scientists any less willing to accept new theories, or to put forward new, groundbreaking theories themselves. Let’s dig into a few of them.
A 1995 study that looked at acceptance of the theory of evolution by age cohort found that, “regardless of the amount of time elapsed since Darwin’s theory of evolution was introduced, we find no systematic empirical evidence that older scientists were any slower than younger scientists to embrace this revolutionary theory.”
In fact, they (and other researchers) suggest the opposite could happen: that older scientists, being more established with job tenure and so able to take risks, could be more likely to adopt radical new theories than younger scientists who are anxious to fit in and build a reputation and so may “play it safe” with more conventional research.
A more comprehensive review of the literature on aging and scientific progress found that as we learn more in any given scientific field, younger scientists have to take more time learning what we already know before they can contribute to the bleeding edge of the field. This process is called “the burden of knowledge” and could explain why eminent scientists now are older than they used to be.
The review concludes, “from an efficiency point of view it is unclear that the aging of the scientific workforce by itself leads to a reduced number of ‘paradigm shifts,’ ‘breakthroughs,’ ‘Nobel-worthy research’ or anything in that class of outputs.”
And while many studies do show a slowing down of productivity and a loss of neuroplasticity as we age, these are quite likely as a result of the accumulated damage and decay brought on by the physical process of aging itself.
But if an anti-aging treatment can make an 80-year-old’s body as healthy as when they were 20, why not their brain as well?
We already have evidence certain drugs can induce a youthful-like neuroplasticity in the brain, and there’s no reason to think life-extension and rejuvenation treatments won’t be able to do the same.
If that’s true, and there becomes no physical difference between the brain of an old scientist and a young one, the result of life-extension interventions may not be a scientific stagnation, but a scientific renaissance.
Going off the idea of the burden of knowledge mentioned above, how much more effective do you think a scientist with a deep knowledge of their field attained by years of study and experience, plus the neuroplasticity and creativity of a 20 year old, would be?
Imagine if Nikola Tesla or Albert Einstein were still alive and youthful today and able to use technology like machine learning and the internet to further contribute to our understanding of science?
Now multiply that by every great scientist in history.
Of course, scientific productivity is one thing, attitudes towards race, gender, slavery, and sexuality are totally different, right?
Well, maybe not.
While some research shows people’s attitudes tend to become more conservative with age (at the rate of about 0.38% per year) those attitudes are not necessarily the ones of the society and time they were born into.
For instance, people’s beliefs change much more over a ten year period than even they themselves realize.
And older people, while not as fast to adopt new attitudes on changing social norms, nonetheless are still quite capable of doing so, and in significant numbers.
The changing views on gay marriage in the United States, for example, show a fairly consistent increase across all age cohorts over time.
There is evidence also that beliefs about race and gender are very changeable indeed, and in fact are based much more on political affiliation than age.
Political statistics website FiveThirtyEight found that, “it turns out that rather than voters supporting the party that best represents their views about race and gender, the effect may more often work the other way—the parties may be shaping voters’ personal beliefs.”
This is further shown in the case of beliefs about global warming where, for instance, within the Democratic party, there is almost no difference between old and young people when it comes to the belief that global warming is happening (in fact, older Democrats were slightly more likely to think it is than younger Democrats).
What all this suggests is that—even without the neuroplasticity-rejuvenating effects of an effective anti-aging treatment—in a world composed only of 120-year-olds, significant social progress (while possibly a little slower than now) will almost certainly still occur.
Is it possible that an 80-year-old, with a brain that has been rejuvenated to a more youthful, flexible, creative state, would be more likely to accept new social ideas and mores (or even initiate them) than they are now?
I think it is, though we’ll have to wait on the actual rejuvenation treatments themselves to find out for sure.
What about immortal dictators?
In just the 20th century alone, horrible, brutal tyrants like Stalin (who killed 20 million people), Mao (who killed 70 million), and Kim Il-sung (who killed 1.6 million) were able to live out their entire natural lifespans. How much more damage and suffering could they have inflicted if longevity research had allowed them to live even longer?
Of course, the ironic side of this question is that medical advances have already likely benefited some dictators and allowed them to live longer. Early in 2020, speculation about North Korean dictator Kim Jong-Un’s disappearance led to reports that he had undergone major cardiovascular surgery to save his life. In essence, a life-extension procedure has already extended the life of a dictator in recent history. If true, it raises the additional question: Should we stop pursuing advances in heart surgery and treatments for cardiovascular disease because some dictators may benefit from them and live longer?
The answer here seems obvious and applies equally, I think, to life-extension treatments: The benefit to be gained by everyone else in the world suffering from these diseases (cardiovascular disease and aging, respectively) far outweighs the possible negative effect of allowing dictators access to new healthcare treatments.
There are roughly 7.8 billion people on the planet, all of whom suffer from aging. Denying all of them access to life-saving health and longevity treatments just to possibly have a chance at lessening the suffering of the ~2.6 billion people currently living under dictatorships is, from a utilitarian perspective, bad math.
Plus, it’s not like natural death is a good solution to the problem of dictators holding on to power anyway.
In Venezuela, socialist dictator Nicolás Maduro took over as heir after socialist dictator Hugo Chavez died of natural causes, and he has killed over 7,000 people and made the country even more tyrannical under his rule. And no one could look at North Korea and say the death of Kim Jong-il and the ascension of his son and heir Kim Jong-Un has done the people there any good or lessened their burden of tyrannical rule.
Extensive research has suggested that the main factors moving a country from authoritarian to democratic rule are not the natural deaths of dictators, but broader changes like economic failures, a better-educated populace, and external financial or military pressure.
According to the research:
Transitions from personalist dictatorship are seldom initiated by regime insiders; instead, popular opposition, strikes, and demonstrations often force dictators to consider allowing multiparty elections (Bratton and van de Walle 1997). Personalistic dictators are more likely to be overthrown in revolutions, civil wars, popular uprisings, or invasions (Skocpol and Goodwin 1994; Geddes 2003)…Several observers have suggested that transitions from personalist rule are more affected by international factors, such as pressures from international financial institutions and invasion by neighboring or ex-colonial countries, than are other kinds of authoritarianism. International financial institutions pressured a number of African dictators to agree to multiparty elections (Bratton and van de Walle 1997).
And the good news is this problem is lessening over time.
In the past four decades the number of democracies has substantially increased, and the number of authoritarian countries has declined, according to Pew research.
Ok, great, so maybe life-extension treatments will be accessible to both rich and poor, and our society won’t suffer terrible stagnation or tyranny if everyone lives to 150, but surely all those extra old people are going to put huge strains on our social welfare systems and government budgets right?
4. Social (in)security: What about poor old people without jobs and government insolvency?
In 1964, President Lyndon Johnson began the “War on Poverty” with a rousing declaration: “For the first time in our history, it is possible to conquer poverty.” So began programs like the Food Stamp Act, Job Corps and, most notably, the Social Security Act. And though scholars (both on the left and on the right) have largely agreed that the War on Poverty has been a tremendous failure, there is one glaring success relevant to this article: nearly ending poverty for the elderly.
Between 1960 and 2020, poverty rates for people older than 65 dropped from 35.2% to 9.4%. I don’t think anyone would advocate for a return to a world where retirement also meant destitution. (While it’s worth noting that Social Security covers people of all ages in extenuating circumstances, the bulk of beneficiaries are people over 66 years of age).
Even without massive life-extension interventions, Social Security isn’t futureproofed. A report from the Center on Budget and Policy Priorities states, “The elderly share of the population will climb steeply over the next 20 years, from just under 1 in 6 Americans to 1 in 5, and then inch up thereafter… if policymakers take no further action, Social Security’s combined Old-Age and Survivors Insurance (OASI) and Disability Insurance (DI) trust fund reserves will be depleted in 2035.” While that doesn’t mean the program will be insolvent, it does mean that Social Security will need more income for it to continue operating as it has been… and that’s without people living into their 150s.
In principle, I don’t think that most people would disagree with the goal of a program like Social Security—or Medicare or Medicaid. Who wants to live in a country where you get old and frail, lose all your money paying for healthcare costs, and then have no means of earning more when the tinder runs dry?
If we’re all living infinitely, how can we avoid this problem? Is it ethical to burden younger people with the costs of the elderly indefinitely?
“Old” in longevity terms
The first thing to keep in mind is that, if anti-aging treatments work as anticipated, tomorrow’s 65-year-old will have the body of someone much younger—think in the range of 25-35. A majority of age-related diseases, like most cancers, diabetes, and heart disease, will be a thing pushed off indefinitely instead of an inevitability. Trillions in annual healthcare costs would significantly subside over time.
Let’s say we’re unable to stave off aging indefinitely, but we’re able to slow it down significantly—what if we’re able to live to 250 instead of 80? Would that mean that we’d have a longer, more painful decline? As David Sinclair points out in his top anti-aging book Lifespan, “Most people aren’t afraid of losing their lives; they are afraid of losing their humanity.”
Sinclair also points out that long, slow, painful deaths are likely not in store for humans based on studies done in rodents. He writes, “The science of longevity shows that the longer we make rodents live, the faster they tend to die. They still die of the same diseases [cancer, Alzheimer’s, etc], but, perhaps because they are very old, and the animals are on the brink anyway, they tend to suffer for days rather than months, then keel over.”
Of course, the promise of quick relief may be troubling for families and loved ones, but I would personally, in translating rodent years to human years, rather have a few really bad months to resolve things as I die than a few really bad decades to live in suffering. That “compressed morbidity” also, again, alleviates many of life-sustaining medical costs that we have to pay for now.
What about money?
Even if we’re spending less on healthcare, will old people have to work forever?
Let’s consider, for a moment, current statistics on aging and wealth.
- Older Americans are 47 times richer than the young. This statistic is, in part, due to the economic fluctuations in the housing market and cultural trends—like accumulating college debt. But it’s also due to more time participating in the workforce and being able to invest over a longer period.
- Seniors don’t really enjoy not working. According to one analysis from Kiplinger, “Many Americans simply don’t have a great life in retirement. This chapter of life could be the best and most meaningful, yet far too many experience isolation and a lack of purpose.”
- Social Security remains an essential part of retirement. Almost half (45%) of Americans do not have any retirement savings.
- Older people in the workforce tend to significantly out-earn younger people in the workforce.
Based on these current statistics, there are a couple important conclusions that we can make.
Americans need to redefine their ideas about “retirement.” Retirement is often viewed as an end to work, period. “After 45 years in the workforce, older people should sit back and do nothing. Even though that level of disengagement is bad for their physical and mental health, what would be worse is being forced to continue working.”
Now, the key operator here is choice. After a half-century, of course most people would want an extended break. The trouble comes for those who retire indefinitely.
It’s far outside the scope of this article to explain all the benefits of financial independence and retiring early, but we have to critically evaluate why we work: is it because we find meaning in it or because we have to?
Divorcing income from labor is the purpose of programs like Social Security, and time helps those who start saving and investing earlier. So that means more robust social and educational programs to make saving tools like IRAs and 401Ks more accessible to those who need them is essential. Instead of relying wholly on Social Security—which about a quarter of retired Americans do—we should better emphasize personal savings for indefinite lives.
Social Security, of course, can’t go away as our society is constructed now. After all, if people can’t save, they can’t save for retirement. As Sinclair points out, “There is simply no economic model in the world in which people live forty years or more past the time of traditional retirement.” If we’re able to age in healthy bodies, it’s not unreasonable to expect people to work for longer, maybe take mini-retirements, and then continue working.
What’s unreasonable is not working to cure cancer, Alzheimer’s, and diabetes because doing so might possibly strain a well-supported, fluid social program.
But even if financial resources like Social Security may not be as big an issue as people think, what about all the better things we could be doing with the money and effort being spent on life extension research? Aren’t there more urgent, pressing problems to solve first?
5. Resources best spent elsewhere: What about all the people suffering from other diseases and problems right now?
Malaria kills over 400,000 people a year globally (about 1,120 a day), most of them babies and young children.
Meanwhile, possible existential risks for all of humanity like global warming, AI, and nuclear proliferation continue to concern experts.
With all these current and possible issues to worry about and fix, why should we devote any time or resources to extending already pretty lengthy (by historical standards) human lifespans?
Lengthening already-lengthy lives
First, in terms of urgency, while things like malaria and poverty kill tens of thousands of people a day, aging kills over 100,000 people a day.
Deaths from age-related causes are far-and-away the largest proportion of world-wide deaths, representing over 60% globally and up to 90% within developed countries.
Old people are people too, and worthy of our compassion. I think it’s hard to argue that those suffering with cancer, or Parkinson’s, or other painful, debilitating, age-related chronic diseases are suffering any less than those suffering from poverty, or malaria, or other health concerns, simply because they happen to be older.
Anyone who has cared for a bedridden older relative, seen the despair in their eyes, and heard them say they wished they were dead rather than having to continue to deal with the pain, loss of function, and loss of independence caused by age-related illness, cannot doubt that aging extracts a horrific toll on older people.
And this suffering is not limited to wealthy countries.For example, 80% of chronic disease deaths are from people in low- and middle-income countries.
And while you can argue the death of a child from malaria is more important to prevent than the death of an 80-year-old from cancer, because the 80-year-old has already been able to enjoy a full, long life, how much more important is it?
Is it two times? Five? Is the life of a child worth seven times the life of an elderly person? Because that’s right around the current ratio of global deaths by age cohort.
But maybe this is the wrong way to think about it.
Maybe we can avoid all this macabre accounting and comparing the value of one life to another.
Maybe we don’t have to choose between saving the lives of those afflicted by malaria, or poverty, or other terrible conditions, and those afflicted by aging.
Two facts suggest this may be the case.
The first fact is that we have already made astounding, historical, almost unimaginable progress against the worst (non-aging related) killers and afflictions of humanity in just the last few decades.
Malaria infections and deaths, for example, have fallen by 50% since just 2000, saving as many as 3 million lives in the process. And those numbers continue to go down every year—malaria deaths decreased by 11,000 just between 2017 and 2018.
By the time anti-aging treatments start being allocated a large proportion of research and charity funding, malaria may have already joined other deadly afflictions like polio, smallpox, and measles on the ash heap of history. Dangerous only to a vanishingly small number of people, if at all, and most won’t even remember it.
Global poverty, likewise, has seen an astonishing reduction in the last forty years.
From 1980 to today, the percent of human beings living in extreme poverty has declined from 42% to 9%; a mind-boggling 78% decrease never before seen in human history.
And, like malaria deaths, the global poverty rate continues to decrease (with a possible temporary bump in 2020 due to COVID-19).
The second fact is that aging itself may not actually be that expensive to solve.
And he may be right.
The NIH spends less than 10% of its annual budget on aging research, and most of that (almost 90%) is not for discovering life-extension treatments, but for treating specific age-related diseases like Alzheimer’s, or for behavioral or social research.
That means less than 1% of the total NIH budget currently goes towards what might be termed “anti-aging research.”
And this disparity in funding holds true in the private sector as well.
While some big name life-extension companies like Unity Biotech, Juvenescence, and Calico make headlines for funding rounds in the hundreds of millions of dollars, this is dwarfed by the tens of billions of dollars invested by pharmaceutical companies in cancer research alone.
And yet even with such small relative funding levels, longevity researchers have made enormous strides in the last few years.
From extending worm lifespans by 500%, to finding a drug that made already aged mice live 14% longer, to—for the first time ever—showing an actual reversal of aging in human beings by 2.5 years (as measured by an epigenetic biological clock) in 2019, anti-aging scientists have already done tremendous work with the limited resources they have.
As for finishing the job?
Some estimates hold that aging could be cured for just 1% of the Medicare budget, or around $3 billion per year, for a few years.
And that funding for longevity research will more than pay for itself.
The World Economic Forum projected global costs for treating just five of the leading chronic diseases of old age could top $47 trillion over 20 years (or $2.35 trillion a year). Imagine cutting that cost down to almost zero, just by investing a tiny fraction of that number into life-extension research.
Some researchers have calculated that simply increasing healthy life expectancy by a modest 2.2 years could save $7.1 trillion in the United States alone over the next 50 years.
And these savings may not even fully account for the “longevity dividend” of the additional productive work older people could provide if rejuvenated by anti-aging treatments.
A report by the International Longevity Center in the UK found that, “Increasing preventative health spend by just 0.1% can unlock a 9% increase in annual spending by people aged 60+ and an additional 10 hours of volunteering.”
By unlocking all the money we currently spend on treating the chronic diseases of the elderly, and by keeping older people healthy and productive for longer, the additional resources available to solve all our other problems would also increase by a staggering amount.
Additionally, other healthcare priorities, like curing cancer, preventing pandemics, and treating cardiovascular disease, are actually all helped by funding anti-aging research.
Dire susceptibility to infectious diseases like COVID-19 or to chronic diseases like cancer or cardiovascular disease is dependent on the frailty brought about by aging. Treating the root cause—aging itself—will better treat and prevent all other diseases and chronic conditions correlated with aging.
Now, however, one possible problem with all this is that by curing all these diseases and saving all these lives, we will start to have too many people on the planet.
Or will we?
6. Environmental risk and resource consumption: What about overpopulation?
In 2019, U.S. Congressional Representative Alexandria Ocasio-Cortez (D-NY) said, “There’s scientific consensus that the lives of children are going to be very difficult. And it does lead young people to have a legitimate question: Is it OK to still have children?”
She, like many, is concerned about the earth’s limited resources and climate change.
Fears of overpopulation and human impact on the environment are nothing new. Thomas Malthus’s 1798 Essay on the Principle of Population indicates many of the in-vogue fears his contemporaries were discussing; specifically widespread famine as a result of overpopulation.
His recommendations ranged from offensive (forced delayed marriage—something we’re already consensually doing now) to obscene (“court the return of the plague”). Of course, Malthus didn’t anticipate industrial food production, sanitation measures, or vaccines—at the time of his writing, the average life expectancy in the UK was just 40 years.
But just because we were able to overcome the catastrophic possibilities associated with overpopulation 200 years ago doesn’t mean that we will be able to do so again. It’s true that the earth itself is a finite resource, so this is a discussion worth having.
If people live indefinitely longer, wouldn’t the population explode? After all, between 1800 and 2019, the world’s population boomed from 1 billion to 7.8 billion people. How long can that possibly be sustainable, especially if indefinitely delayed menopause (and thus longer fertility windows) and undying great-great-great grandparents are a possibility?
In 1960, the United States birth rate was 3.65 kids per female between 15 and 44 years of age. By 2017, that figure fell to 1.77 (below replacement rate). Comparatively, India’s birth rate in 1960 was at 5.91 children per female—and that figure also dropped, to 2.24. Why are women in both countries having so many fewer babies?
It turns out that the more educated and more opportunities women have, the less likely women are to have children. There’s a greater opportunity cost to motherhood for women who are able to participate in the workforce. As prosperity rises, women have better access to birth control and healthcare to prevent infant fatality. In fact, the UN estimates that by the end of the 21st century, there will be zero global population growth. Ultimately, underpopulation may be a cause for greater concern, but that’s out of scope for this article.
Plenty of environmentalists would scoff at this argument. “We already use too many of the earth’s resources,” they’d say. “We need to worry about reducing consumption yesterday!”
The earth’s population will probably cap at around 11 billion in 80 years. Of course, that number may be low if, say, just 10% of the world’s population didn’t die as projected due to life extension strategies. Maybe, bucking all the trends we discussed above, women will continue to have kids well into their 100s. Maybe the first person to live past 200 is already alive today. Regardless, we do have to address that each new person will consume resources, possibly contributing to how out-of-control we already are with our trash.
Our contemporary world already struggles with this problem. For example:
- 2.7 billion people struggle with water scarcity.
- 2.4 billion people have inadequate sanitation.
- Internationally, we have a waste problem. Slightly less than a third of all trash is dealt in a sanitary, safe, environmentally-friendly manner.
- 821 million people in the world suffer from food insecurity.
- At least half of the world’s population does not have access to essential medical care.
These statistics are troubling now. What will we do when people start to live longer and the world’s population increases 40%?
The disturbing truth is that people in low-income, high-risk areas tend to have more children. While these population areas tend to produce far less waste, they’re more likely to be susceptible to poor sanitation and access to food and water. But they are also unlikely to live as long as a spanner—or even the average American. For example, the Central African Republic, Burundi, and the Democratic Republic of the Congo—the poorest countries in the world—all have average life expectancies at or below 60 years old. Yet their fertility rate is 4.8 births per female, 5.5, and 6.02, respectively. It’s within these developing countries where resources are fraught.
No one questions that residents of those countries deserve a longer, better quality of life. Unfortunately, capitalism, free trade, and time are the only known effective antidotes to ending extreme poverty. Extremely destitute people are going to have resource scarcity problems and population mitigation issues regardless of life-extending interventions. Life-extension in these parts of the world looks like basic health care to Americans. We must start there, and the good news is, as discussed above in section four, we already have and continue to make massive strides towards eliminating global poverty.
Plus, there’s no zero-sum game for life extension—everyone benefits when we’re able to create communities that net live longer, healthier, more prosperous lives.
Environmentalism and life extension
The trouble with climate change is that there are so many solutions that it’s unclear which a country like the United States will choose. For example, there are popular mitigation efforts such as:
- Reducing sources of greenhouse gasses through legislation
- Enhancing greenhouse gas “sinks” (like forests, vegetation, and soils)
- Using renewable energy sources and energy-efficient building improvements
- Eating less meat
There are so many solutions to climate change that there really are only two questions we should be asking: will we actually use these solutions, and are they viable?
We don’t have a way to peek into the earth’s future, but we do know that very few people want a world with undrinkable water, crop failure, massive species extinctions, and maxed-out landfills. Climate change is a real threat.
And here’s the thing: spanners actually need to address it because we will have to continue living through the consequences of climate change if we don’t. (I’m looking at you, Boomers.)
The problems with overpopulation, consumption, and climate change are problems that we’re facing already, and won’t necessarily be significantly impacted by longer lives. If anything, environmentalists should be in favor of people living longer—they’ll care more about the world they actually live in instead of the one they’re “meant” to age out of.
Additional reading on the ethics of radical life extension
While we’ve tried to be comprehensive in covering all the pros and cons of immortality in this post (sorry for the length), if you want to dive deeper into the arguments for and against anti-aging research and other considerations of the ethics of life extension, here is a collection of some other resources we’ve found especially helpful.
- H+Pedia’s “Arguments against life extension” (with cool chart!)
- Cause Prioritization.Org’s “Arguments against life extension” (with counterarguments)
- Rejuvenaction’s “Answers to concerns and objections”
- Future Is Great’s “Top Answers to Societal Arguments Against Radical Life Extension”
- “The search for Methuselah. Should we endeavour to increase the maximum human lifespan?” from report to the European Molecular Biology Organization
- “Who wants to live forever? Three arguments against extending the human lifespan” from the Journal of Medical Ethics
- “Does Death Give Meaning to Life?” from the Journal of Philosophy of Life
- “The Tricky Ethics Of Living Longer” from Popular Science
The pros and cons of immortality: the ethics of life extension
Were we to summarize everything we’ve written up until this point, it’d be this: aging kills.
Aging kills the ability to enjoy life, by crippling us and making us vulnerable to age-related diseases. Aging kills the mind’s plasticity, making us more resistant to new ideas and advances in science. Aging unnecessarily weighs down all affiliated social programs. Aging keeps people in poverty. Aging incentivizes individuals to care less about their consumption habits and personal impact on the earth. Aging, from a healthcare perspective, is at the root of so many ills that it’s incredible that so few have sought out a cure until the past two decades.
While looking closely at each of the arguments against extending life, we couldn’t find a single reason not to treat diseases of aging like cancer, diabetes, or Alzheimers, let alone aging itself. In fact, we found far more reasons to further support ending the aging process altogether. If it can be done, it should be pursued.
We’re open to being wrong though.
If, after reading this article, you’re still convinced that indefinite human life extension shouldn’t be pursued, we want to hear from you. Or if you agree and want to add to this article, let us know why. Tell us your thoughts in the comments.
I’m the co-founder of Longevity Advice and have been passionate about radical life extension ever since I was a teenager. Formerly I was a content marketing director in the B2B software space. I’m also a sci-fi novelist, wargame rules writer, and enthusiast for cooking things in bacon fat. My sister once called me “King of the Nerds” and it’s a title I’ve been trying to live up to ever since.