Technologies to extend life are closer than you might imagine. So are the ethical and theological questions they raise.
By KEVIN SPURGAITIS
“I’m simply not afraid to die,” says a peevish Edra Ferguson, shifting in her wheelchair inside her studio apartment at Belmont House, a Toronto home for seniors. Having lived for a whole century leads to all sorts of biting exclamations. So does cataloguing the scores of people she has outlasted. A former Ontario court judge and recipient of the Queen’s Jubilee Medal, Ferguson can no longer conceal her 99 years. She is leathery skinned with thick, silver hair, and wears a threadbare housecoat, heavy sports socks and velcroed shoes. Her movements are also noticeably slower now and her speech meticulous. But she kept things upbeat for her 100th birthday, celebrated last August: just a few friends, her two children and niece — and pink, bubbly champagne. “Because champagne just isn’t champagne unless it’s pink,” Ferguson says with a throaty laugh that quickly gives way to a guffaw.
Eight years ago, Ellen Vincent also moved into Belmont House after giving up her home in Toronto following her husband’s death. Vincent is now surrounded by other Rosedale matrons and the usual geriatric trappings: fitness classes, yoga sessions, Sunday morning tea, early-evening bridge, shuffleboard and a nine-hole putting green. Once employed at a high-profile research firm, Vincent remains “busy as a bee,” participating in the retirement community’s many ‘activation’ programs.
“I’m in my ninety-third year of earthly life, and in that span of time, life hands you a tremendous number of difficulties,” says Vincent, who survived three heart attacks since September 2006. The second one put her out of her one-bedroom apartment and into Belmont’s long-term care facility. But even with her arteries hardened like peach stones, she remains in astoundingly high spirits. “Well, it was another hard move to make, let me tell ya. But you simply have to deal with what is put before you … Oh, I don’t know, it’s all part of life, I suppose.”
For centuries, scientists have puzzled over human aging. In recent years, their puzzlement has turned to excitement thanks to tantalizing developments in biotechnology that could make people like Edra Ferguson and Ellen Vincent more the rule rather than the exception. But the developments come laden with heavy ethical baggage. If the technology exists to prolong life, do we have an obligation to use it? Who gets to use it? Should it be used at all in an overpopulated, underfed world? For people of faith, the issues are as basic as whether humans even have the right to toy with the God-given order of things. Or does the God-given order of things include the capacity of humans to develop life-extending technologies?
Generally speaking, life spans can slightly increase with a good diet, exercise and avoidance of smoking. Physicians also prescribe nutritional supplements that contain antioxidant agents as anti-aging medicine. It’s a multibillion-dollar business that also includes hormone replacement therapy, which restores youthful levels of growth hormone, testosterone and estrogen. Though the widely recognized method of extending maximum life span is caloric restriction, known simply as CR. It has been shown to extend the life of almost every species on which it has been tested: rats, yeast and fruit flies. Then there’s the senior population of Okinawa, Japan. According to Okinawa Prefectural University College of Nursing, the city is home to some of the longest-living people on the planet. It boasts the highest ratio of centenarians in Japan — close to 50 people of every 100,000 in 2004. It’s said that Okinawa’s centenarians have managed to stay lean — and alive — by consuming about 1,800 calories per day (compared with about 2,500 calories in western societies). That means a steady diet of pork, tofu, purple sweet potato and jasmine tea.
However, the real causes of aging, according to other researchers, are the loss, deterioration and mutation of cells, as well as the overall decline of the immune system. Theoretically, the extension of life can also be achieved by reducing the rate of this aging damage, by the periodic repair or replacement of cells. A recent development in the field of life extension has been the work of biogerontologist Dr. Aubrey de Grey of Cambridge University. De Grey proposes that damage cells, tissues and organs be rejuvenated through advanced biotechnology.
“The first person to live to 1,000 might be 60 already,” claims de Grey. Born and educated in London, the self-described prolongevist leads the Senescence (SENS) project at the University of Cambridge. He is also the chairperson and chief science officer of the Virginia-based Methuselah Foundation, which promotes evidence-based interventions in the aging process. To this end, the foundation offers the multi-million dollar Methuselah Mouse Prize — or Mprize — to scientists able to dramatically extend the life spans of lab mice.
When he entered biogerontology, De Grey saw nothing wrong — nothing undignified — about death. What he hated was aging. Until very recently, anti-aging science was a real backwater within biology, he admits. But it is now considered the “granddaddy” of all sciences. “It’s the most important thing anyone will have ever achieved . . . When we get these (rejuvenation) therapies, we will no longer all get frail and decrepit and dependent as we get older, and eventually succumb to the innumerable, ghastly, progressive diseases of old age.”
He continues: “The various aspects of the biology of aging are now at a point where we are within range of putting them all together and actually implementing comprehensive, coherent interventions for the molecular changes that eventually kill us. This is something we should all be excited about because aging doesn’t just kill people, it kills them really horribly.”
According to De Grey, researchers have a 50-50 chance of developing the first round of comprehensive rejuvenation therapies within 25 years. Those therapies will be applied to those who are in their middle ages. It’ll buy them 30 years of time at first, but then those therapies will rapidly improved. But he concedes that scientists will never be able to render people’s bodies completely ageless. Like HIV/AIDS treatment, anti-aging methods are merely repair and maintenance work that will need to be applied periodically. “We will still die, of course — from crossing the road carelessly, being bitten by snakes and catching a new flu variant — but not in the drawn-out way in which most of us die at present.”
Prior to the 19th century, more than a quarter of those born expired before their first birthday, and many women succumbed to childbirth. French doctor Louis Pasteur, who highlighted the importance of hygiene and antibiotics, is credited as the person who has extended more lives by more years than anyone in history. Last century, average life expectancy skyrocketed by 57 percent, from about 49 years of age in 1901 to 77 years by century’s end. Canada, like most western nations, has experienced a dramatic shift in its population. Those over the age of 85 now comprise the fastest growing segment of the population, according to Statistics Canada.
De Grey compares anti-aging research to Pasteur’s. “From a theologically point of view, God put us here with the ability and desire to improve our world and give ourselves the best quality and quantity of life . . . I see absolutely no difference in developing a vaccine for people still in infancy and developing technology to save the lives of those who already lived a while. Old people deserve the very vest medical care like anybody else.”
A decline in mortality rates from various diseases is celebrated as the greatest of medical victories. So it’s not too far-fetched to say that the most important war conducted by modern medicine is that against death, according to Daniel Callahan, a leading bioethicist with The Hastings Center, in Garrison, NY. The not-for-profit research institute has explored emerging questions in medicine and biotechnology since 1969.
In his 2003 book, What Price Better Health, Callahan writes: “Unless we are over-burdened with pain and suffering, there is not much good that can be said about death for individual human beings, and most people are actually willing to put up with much suffering rather than give up life altogether. That seems a perfectly sensible response.”
But he questions why death is still denied, evaded, and in the case of many clinicians, fought to the bitter end for patients. Callahan’s own conclusion is this: “While it makes sense for medicine to combat some causes and forms of death, it makes no sense to consider death as the enemy. It distorts the goals of medicine to give it a permanent priority, taking some money from research that could improve the people’s quality of life.” At the Edmonton Aging Symposium last winter, Callahan further attacked the view that science will find ways to keep elderly populations healthy. It may not even be a wonderful life for them after all, rather a Malthusian nightmare. “If we all live to be 150, the hospitals would all be full and everyone would still say (life) certainly went by fast,” he says, adding that some seniors may elect or be forced to work much longer, eventually flooding the labour force. “So the only case for extending life spans is that some people want it and that doesn’t seem to be good enough.”
Regarding death as a disease, Callahan told The Observer it isn’t like any other physical pathology, rather a “natural, biological inevitability.” We may, or may not, get cancer or heart disease or diabetes, but we will surely get old and die. Slowing of the aging process to a snail’s pace then is not exactly a clean cure but an “indefinite forestalling” of the worst consequences and its final outcome: death.
Like Callahan, Canadian ethicist Margaret Somerville has long been active in the worldwide development of bioethics. Somerville urges society to be humble in the face of life extension. It must be cautious enough to “move beyond intense individualism and retrieve some ancient First Nations wisdom of looking back and forward seven generations.” She says there’s a fine line between sustaining the life of a human being and altering the very nature of that being. “We have these extraordinary powers to alter life itself — powers no other humans before us have ever had,” explains the founder and director of McGill University’s Centre for Medicine, Ethics and Law. “We, humans, are the result of four billion years of evolution. We’re the wondrous outcome of a combination of stardust and time. And we can now alter that combination in just fractions of a second.”
According to Sommerville, scientists also promise ‘extreme life extension’ in a variety of fields: nanotechnology, microbiology and biological engineering. Some combination of human cloning and cryonics (the deep-freezing of the body) could play an essential role in immortality, short of severe trauma. Robert Freitas, a nanorobotics theorist, suggests we may be able to create tiny medical nanorobots that could go through our bloodstream, find dangerous things like cancer cells and bacteria, and then destroy them. Others say we will continually create biological or synthetic replacements for dead or dying organs.
As well, transhumanists, who support new sciences to enhance humans, contend it will someday be possible to create cybernetic humans or at least upload human consciousness onto a computer system. At this point, the human body would become a mere accessory. People would live virtually and indefinitely. These same transhumanists see a radical future in which technology is the higher power. Perhaps an inconsequential fringe group, but their critics fear that their feverish “pro-technology doctrine” could worsen class divisions, pitting biologically superior humans against their lower-grade counterparts.
That’s pure science fiction to Very Rev. Bruce McLeod, the former moderator of the United Church of Canada and president of the Canadian Council of Churches. An “Old Boy” of Upper Canada College, a charismatic McLeod was the youngest moderator in the history of the denomination. Now 78, he insists that old age is a benediction.
“We’re simply not intended to be here forever,” McLeod says. “ . . . The sudden rush to make everybody live longer is really sad, inappropriate and even offensive; there’s a certain beauty about the aging process. There is a wisdom in the wrinkles.”
Of anti-aging impulses, he also says the bargaining for and stretching of life beyond all limits is an “evasion of this blessing of mortality.” He compares life cycles to those of waves. New people come into the world and open the way for change and development; others die to assist this replenishing of the species. To ask for more time is to interrupt the rhythm of birth and dying. For eventually, our own ocean must break on the shore, he muses.
“Perhaps all your natural functions deteriorate, you lose your eyesight, hearing or ability to walk. And arthritis becomes very painful. It seems almost like a signal from your body that you are gradually subsiding. To try to deny that is almost blasphemous.”
According to McLeod, the paradox is that the healthier people get, the more they want to spend on their bodies, not less. He says: “Only in an affluent society is the luxury of being able to stop aging possible. It’s terrible and unreasonable to pull scientists away from looking at hunger and poverty in Haiti and the Sudan, in order extend life spans (in the Western World).”
The life extension movement dates back to 1970, when the American Aging Association was formed. Denham Harman, originator of the free radical theory of aging, wanted an organization of biogerontologists that was devoted to extending human life span. Then Saul Kent wrote The Life Extension Revolution in 1980 and made a controversial appearance on the Merv Griffin Show. Responding to a deluge of supportive letters, he created the nutraceutical firm called the Life Extension Foundation. The non-profit organization has grown to produce a widely circulated magazine that promotes the benefits of many health supplements, such as S-adenosyl methionine and melatonin. Money raised by the Life Extension Foundation allowed Kent to finance the largest cryonics organization.
Nonetheless, the U.S. Food and Drug Administration (FDA) hasn’t viewed life extension as a valid treatment category. For years, the FDA plagued the Life Extension Foundation by seizing their merchandise and court action. In 1991, Kent and the foundation’s other principal, Bill Faloon, fought the federal agency and filed countercharges concerning their alleged mistreatment. And by 1996, the FDA dropped their case altogether. In response to the legal to-and-fro over the years, the American Academy of Anti-Aging Medicine (A4M) has grown considerably to create an anti-aging medical specialty distinct from geriatrics, and to hold conferences for physicians interested in this field.
With the pace and potential of their research accelerating, biogerontologists simply have an obligation to publicly discuss the timescale for slowing, halting or reversing human aging — what may be possible and when, according to Colin Farrelly, associate professor of political science and philosophy at the University of Waterloo. Farrelly is also a former research fellow at Oxford University’s Centre for the Study of Social Justice and a visitor in Oxford’s Program on Ethics and the New Biosciences. His research interests include the moral imperative to combat aging.
He insists that the ethics just has to keep up with the science. “We can’t be overly optimistic in assuming that genetic technologies will not pose any risk to us. Of course, they can. We must responsibly regulate the technologies to harness the benefits and minimize the risks.”
In his 2007 paper, Sufficiency, Justice and the Pursuit of Health-Extension, published in the science journal Rejuvenation Research, he argues that society should still heavily invest in research projects that seek to retard — even eliminate —the aging process: “The moral imperative to combat aging is important. . . . Our societies currently place a big premium, coping with the debilitating effects of aging: bone mineral loss, reduced muscle mass and decreased lung function. Aging not only affects the wellbeing of individuals, it puts pressure on healthcare resources. The stakes are very high.”
Besides, Farrelly maintains it’s widely considered a great thing when somebody makes it to 100. “My own grandmother lived to almost 100. If she was a centenarian living in the U.K., she would have received a letter from the Queen of England,” he says. “And typically, if you are living a flouring life and are in a loving relationship, you want those things to persist as long as they can. If we’re to be honest with ourselves, we want to wake up tomorrow and the day after that.”
American author Henry David Thoreau once wrote, “Time is but the stream I go fishing in.” Everyone enters that waterway at birth and floats along through life’s joys and sorrows. But inevitably, the water dries up and the journey grows harder. Edra Ferguson compares surviving a century to winning a million dollars. But with that kind of milestone comes the toil of self-preservation. Plagued with Bell’s palsy, as well as failing legs, stiff limbs and hearing loss, she confesses she doesn’t like to be a burden to anyone but herself now. “We are just trustees of our own bodies. That’s our only business later in life — our challenge,” Ferguson says. Her eyes are both stern and prophetic now. Her heart is seemingly stirred. “You know all that said, I’m still not afraid to die.”
Originally published in the United Church Observer, July 2007
