Reasons and methods for promoting our duty to extend
healthy life indefinitely
Aubrey D.N.J. de Grey Chairman
and Chief Science Officer, Methuselah Foundation aubrey@sens.org Journal
of Evolution and Technology - Vol. 18 Issue 1 – May 2008
– pgs 50-55 Abstract
A pervasive reaction to the idea of extreme
or indefinite postponement of human aging – one heard from many professional
bioethicists and also from a high proportion of the general public – is that
aging differs morally from other causes of debilitation and death in a manner
that exempts us from the duty to combat it that we perceive as so self-evident
in respect of those other causes. Precisely what characteristic of aging
underpins this alleged distinction? I argue here that it is in fact a false
distinction, perpetuated only by unwarranted psychological forces posing as
philosophical arguments. In particular, I note that even an argument based
ultimately on the currently unpopular meta-ethical concept of non-cognitivism
cannot logically permit one to regard aging as a phenomenon that we can morally
desist from combating to the best of our ability. I conclude that a
cognitivism-agnostic line of reasoning, based on reflective equilibrium, offers
the best chance for influencing hearts and minds on this issue in the near
term. The pro-aging flight
from reason It is hardly necessary in this essay to
enumerate the plethora of almost comically irrational defences of aging that
are commonly encountered when the topic of extreme life extension arises in
casual conversation (de Grey 2003). All that is really worth mentioning here is
that the irrationality of most of these reactions primarily resides not in
their inherent validity as concerns, but rather in the certainty with which
their exponents present them as supposedly obvious proofs that the elimination
of aging would make life not worth living. There is no doubt that a post-aging
world will be radically different from today’s, and indeed that some of the
differences merit extensive forward-planning to minimise their drawbacks
(particular the drawbacks that may accompany the transition to the post-aging state). Thus, if someone who may
hitherto have applied only minimal thought to the topic raises concerns as to
whether issues such as inequality of access, boredom or cognitive ossification
might merit caution, they do not thereby identify themselves as having
abandoned the respect for rationality that constitutes the central prerequisite
for any productive debate. Rather, such people often turn out to be quite
receptive (albeit perhaps not instantly) to the simple and highly compelling
arguments, surely familiar to all readers, that demonstrate the moral
equivalence of combating aging and combating the panoply of other causes of
suffering and death that are rather more rarely defended in modern society. No
– the problem is that, all too often, these conversations never attain the
level of objectivity necessary for such arguments to be rehearsed at all.
Rather, defenders of aging frequently exhibit from the outset a lack of sincere
interest in the question: a determination either to change the subject, or to
restrict the conversation to an exchange of witticisms, or even to cast their
interlocutor as a dangerous dreamer or ignoramus, so fixated by the lure of
scientific and technological progress as to have abandoned all sense of ethical
propriety. When earnest debate is resisted, options
for how to proceed are usually limited. In this case, however, the situation is
in my view not so bleak. The feature that I perceive as providing a
constructive and promising way forward is one that is popularly viewed as being
just the opposite, an obstacle to progress. This is the presence in the debate
of a number of highly articulate and prominent theologians and ethicists who
sincerely propound the pro-aging position and claim to be able to defend it
against the arguments alluded to above (President’s Council 2003). The paradoxical utility
of bioconservatives One
might initially suppose that the ideal spectrum of academic opinion on a topic
that divides society is a consensus in favour of the “correct” opinion. When
the topic really does divide society, that may be true – but this is not such a
case. The problem for those of us who are not in favour of aging is that, sad
to say, there is an overwhelming preponderance of opinion (essentially a
consensus) within society that aging is, if not a good thing, then at least
something opposition to which must be viewed with grave suspicion. In this
situation, I believe that the existence of a wide spectrum of opinion within academia
is actually preferable to the alternative in which opposite consensi exist
within academia and among the general public, because that latter situation
does not encourage anyone in either community to engage in sincere discourse.
When academia is split, by contrast, such discourse will occur – and it will be
public and publicised, so it will inform and eventually affect public opinion. The
above line of reasoning has become particularly apposite during the tenure of
George W. Bush in the White House and the contemporaneous elevation of Leon
Kass to a position of influence arguably not enjoyed by any bioethicist for a
century. Kass has spent his entire academic career at the forefront of the
battle against biomedical progress, starting with in vitro fertilisation in the
1970s (Kass 1971). His installation by Bush as chair of the President’s Council
on Bioethics surely resulted not only from this, however, but also from his
exceptional skill at conveying his point of view in a language that the general
public seems to find attractive. The
rhetorical wisdom of the wisdom of repugnance In 1997, Leon Kass published in The New Republic an essay entitled “The wisdom of repugnance” in
which he presented his reasons for opposing human reproductive cloning (Kass 1997).
In a nutshell, his core argument was that the objective reasons why this
procedure is morally unacceptable are of secondary importance in the process of
determining that it indeed is unacceptable. Rather, what matters most is that
human reproductive cloning is “repugnant” and that this gut reaction can safely
be relied upon to cast human reproductive cloning as morally unacceptable. In
Kass’s words, “repugnance is the emotional expression of deep wisdom, beyond
reason's power fully to articulate it.” What are we to make of this position? It bears analysis for two
sharply contrasting reasons. The first is its meta-ethical status. A dominant view within
ethics nowadays, cognitivism, is that propositions concerning the moral
acceptability or imperative of particular actions have objective truth values,
independent of the existence of minds that agree or disagree with those
propositions. The opposing view, non-cognitivism, is that no such objective
morality exists: a certain action may be morally unacceptable to one agent,
acceptable to another and morally imperative to a third, without any of them
being objectively incorrect. Now: either a cognitivist or a non-cognitivist
could, in principle, either agree or
disagree with Kass’s position that repugnance is reliable, because that
position concerns the methods by which we discover what is right and what is
wrong, which is formally independent of whether such rightness or wrongness is
objective. However, I would suggest that in practice a cognitivist cannot agree
with Kass on this point. The idea that an objective truth can reliably be
discovered by examining one’s emotions is surely far-fetched. Thus, I claim
that Kass is implicitly espousing a clear non-cognitivist meta-ethical position
here – a position which, as just mentioned, currently enjoys little support
within his field. The second reason for examining Kass’s reliance on repugnance is
its rhetorical status. This particular essay remains among Kass’s most
high-profile publications; as such it may well have played a major part in his
elevation to his current stature within the US political establishment. It may
also, by the same token, have contributed substantially to President Bush’s
ability to strike a rapport on ethical matters with a sufficient proportion of
the US electorate to facilitate his re-election in 2004, a result that many
attributed largely to his ethical stance. It is a fact – perhaps a circular
fact, but a fact nonetheless – that most people’s gut feeling is that they
should generally trust their gut feeling. To be told by an eminent professor
that that’s OK is probably rather comforting to most people, whether or not it
actually should be. Factoring out the cognitivism question: motivation and means The alert reader may have noticed that I devoted the last section
to highlighting an example of a situation that exhibits precisely the problem I
described in the previous section: a disconnect between the consensus of the
relevant academic discipline and that of the general public. Specifically,
professional ethicists are generally cognitivists whereas, whether they know it
or not, the public are generally non-cognitivists. Kass has done himself big
favours by abandoning the consensus of his field, but this disconnect means
that from the point of view of engendering constructive debate he has done no
one else any favours at all. Naturally I do not restrict my conclusion on this
matter to the topic of human reproductive cloning: it extends to all issues on
which the public exhibit a consensus deriving more from psychological pressures
than from dispassionate logic, and in particular it extends to the desirability
of defeating aging. It
is worth spelling out explicitly what this sort of situation means in practice.
The natural, and strong, and indeed quite logical, tendency when arguing a
particular ethical position is to start from precepts that one regards as so
self-evident that one’s interlocutor is sure to agree on them, and to work
forwards in sufficiently deliberate steps that one can be optimistic that one’s
argument will be persuasive. Cognitivists generally view cognitivism as just
such a precept – and therein lies the problem. An argument patently founded on
the idea that the moral status of particular actions is objective, and thus on
the (so I claim) inescapable corollary that one’s gut feeling (e.g.,
repugnance) is not reliable at all, will inevitably wash over an unabashed
non-cognitivist like water off a duck’s back: the precept is rejected, so the
entirety of what follows it is ignored. Critically, this is so whether or not
the recipient of the cognitivist’s argument has ever heard the word
“cognitivism,” because no training in philosophy is needed in order to
understand that trust in one’s own repugnance is a personal choice that conflicts
with trust in dry ethical logic. This is, in my view, a fatal flaw in the
rhetorical strategies employed by many pro-technology ethicists when discussing
many issues, including extreme life extension. Is
there an alternative? I believe there is. It derives from a concept which has
become associated with the noted ethicist John Rawls under the moniker
“reflective equilibrium” (Rawls 1971). Rawls observed that a reasonable
approach to determining whether something is morally unacceptable, acceptable
or imperative is to develop principles
– generalisations summarising what types
of things are unacceptable, acceptable or imperative – and to see whether those
principles cover the case under consideration. In order to work optimally,
however, one must revisit these principles in the light of any case of a
situation in which other putatively trustworthy routes to an opinion on what is
right and wrong (such as examination of one’s repugnance) lead to conflicting
conclusions. If only isolated situations exist in which one’s intuition and
one’s stated principles conflict, the indicated way forward is to reject one’s
intuition in favour of the principles. If there are many such situations, on
the other hand, one should seek a modified set of principles that better match
one’s intuition. (From a scientific standpoint one can regard this as very
similar to the principle of Occam’s Razor in prioritising scientific
hypotheses.) Reflective equilibrium is, therefore, simply a method for
discovering the moral status of actions, and in this regard it is one of many
alternatives, reliance on repugnance being another. What distinguishes it from
other such methods – critically distinguishes it, I would contend – is its
possession of two key characteristics: -
it is agnostic on the
cognitivism/non-cognitivism issue; -
it seems to be the algorithm that modern
societies, even if not necessarily most of their constituent individuals,
actually execute in shifting their ethical positions over time. I
will not elaborate much further on the first of the above assertions. I merely
note that the convergence of a set of moral precepts towards what one might
call its “centre of moral gravity” is something that can happen whether or not
the location of that centre is preordained by objective truth. Unlike the case
of individual gut feelings about individual situations, it seems just as
reasonable to suppose that the centre of gravity of an entire society’s views
on the entire universe of ethical issues is reliably in accordance with
objective morality (which exists) as it is to suppose that that centre is
arbitrarily located (and objective morality does not exist). Simply put, we
would probably not be as happy as we are if most
of us weren’t already “right” about most
moral issues. In other words, one can, I claim, be either a cognitivist or a
non-cognitivist and still have no qualms about society’s tendency to find its
moral way using reflective equilibrium. Reflective
equilibrium in recent history It
may be valuable, on the other hand, to elaborate a little on my second
assertion above – that modern societies actually use the reflective equilibrium
algorithm as their main mechanism of moral exploration and progress. There
are many conspicuous issues regarding which contemporary Western society generally
takes a different moral view than it did a century or two ago. Slavery,
universal suffrage and homosexuality constitute a representative selection. In
all these cases, the view that originally prevailed was overturned because the
arguments for the status quo were eventually seen to come down to no more than
a fear of the unknown, a faith in the “natural order” and other similarly
unrooted emotions, whereas the arguments for change consisted of appeals to the
incompatibility of the traditional position with agreed moral stances on
matters that were claimed, and eventually agreed, to be inescapably equivalent
(in moral terms) to the disputed one. There
may be a temptation to regard the success of reasoned arguments in these cases
as supporting cognitivism, or at least as supporting the view that arguments
that ethicists find appealing are likely also to be influential in the wider
world. I dispute these conclusions. My interpretation is that these episodes
are merely examples of reflective equilibrium in action, and thus, for reasons
outlined above, say little about either the cognitivism/non-cognitivism
question or the interest of the general public in what professional
bioethicists think. The key point, I feel, is that the inescapability of an
alleged equivalence between an issue on which the moral position is agreed and
one on which it is initially disputed is not something that can be determined
deductively: rather, it is a consequence of the acceptance of one or more
principles (ethical generalisations, as described above) that encompass both
issues. These principles, I claim, are not shown to be objectively true merely
by their use in a successful reflective equilibrium process. Cognitivism-agnostic
promotion of indefinite life extension This
brings me to the crux of this essay. I take the view that the inexorable loss
of vitality and rise in risk of death that we call “aging” is among – indeed,
possibly foremost among – the sub-optimal features of life as we currently know
it. Thus, I am necessarily keen to combat aging as much as possible as soon as
possible. Since society in general does not share my fervour on this matter,
and since the required technological advances will undoubtedly require very
considerable investment of time and money, my efforts to hasten the defeat of
aging must perforce incorporate not only direct, scientific, contributions to
the development of that technology but also contributions to the effort to
bring society around to my way of thinking, thereby causing these resources to
be brought to bear (de Grey 2005a, 2005b). The considerations discussed above
seem to me to give rise to a clear recommendation for the way forward on this
matter, and it is one that does not always dominate the contemporary approaches
of those commentators who already agree with me that aging is undesirable. It
goes like this. Since
reflective equilibrium (a) often succeeds in changing people’s minds and (b) is
cognitivism-agnostic, we will benefit from constructing arguments that
accelerate the reflective equilibrium process. We will benefit less, I feel,
from arguments that purport to start from the objectivity of morality and thus
from the unreliability of gut feelings, because such arguments fail at the
outset with the many people who accept the wisdom of repugnance. The
difference between a cognitivism-agnostic argument and one starting from
assertions of objective morality is subtle, which is doubtless why it seems to
be easily overlooked. Essentially it comes down to the style of wording of
introductory precepts. A line of reasoning that begins “As a starting-point,
can we agree that X?” is
cognitivism-agnostic, whereas one that begins “As a starting point, there is no
doubt that X” is cognitivist. X is typically a moral position on a
specific issue; the reflective equilibrium process then suggests a principle
that “explains why” the agreed moral position is correct, and then that that
principle also applies to the disputed issue. Typically either the principle,
its applicability to the original agreed issue or its applicability to the
disputed one are then challenged; third and subsequent issues then come into
play. But the critical point is that at no stage in this process is the
interlocutor’s often deep-seated respect for his or her own gut feelings
confronted head-on: rather, it is gradually and systematically undermined piece
by piece. By this avoidance of a defensive reaction, success becomes, if not
necessarily likely, at least possible. Moral
acceptability versus moral imperatives In
respect of combating aging, possibly the most important feature of a
cognitivism-agnostic approach is that it lends itself quite readily to the
conclusion that aging is not merely something we should let people combat if
they wish but actually something that we all have a moral duty to help combat.
The principles that one naturally brings to bear on this question when applying
reflective equilibrium to it are ones supporting the moral equivalence of aging
with phenomena that society has firmly decided that we do all have a duty to
combat – most obviously, age-related diseases. It would be electorally unwise
for a political party to campaign on a manifesto that committed it to
abolishing public funding for research on cancer, diabetes and Alzheimer’s
disease and making commensurate tax cuts; this is because society
overwhelmingly considers that expenditure on such research is a collective
responsibility, not one that should be funded only by voluntary charitable
donations. Arguments based on objective morality often lack this useful
characteristic, because they tend to place more emphasis on speculations
concerning what a post-aging world will be like, which are only as persuasive
as the listener’s inability to postulate contrary speculations permits. This
is not to say that “merely” persuading society that combating aging is morally
acceptable is a failure, and that only the complete victory of persuading
society that it is a moral imperative will do. Not only is the latter goal
implausible in the short term, it is also unnecessary: in the first instance
the support of only a small (though preferably wealthy) minority of society is
required to allow the relevant science to proceed as rapidly as it can. As
regards the rest of society, a muting of their opposition to such a goal is all
that is needed. But this is a classic case of the “suitable outrageous extreme”
– in any debate, one tends to have a much better chance of shifting one’s
interlocutor part-way towards one’s own declared position than the whole way,
irrespective of how far apart the two initial positions are. If, by arguing
cogently that combating aging is a duty, we can convince quite a few active
opponents (not least the theologians and bioethicists highlighted at the start
of this essay) that it is at least an acceptable activity, we will have
achieved much. References de Grey, A. D. N. J. 2003. The
foreseeability of real anti-aging medicine: focusing the debate. Experimental
Gerontology 38(9): 927-934. de Grey, A. D. N. J. 2005a. Life
extension, human rights, and the rational refinement of repugnance. Journal of Medical Ethics 31: 659-663. de Grey, A. D. N. J. 2005b. Resistance
to debate on how to postpone ageing is delaying progress and costing lives. EMBO Reports 6(S1): S49-S53. Kass, L. R.
1971. Babies by means of in vitro fertilization: unethical experiments on the
unborn? New England Journal of Medicine
285(21): 1174-1179. Kass,
L. R. 1997. The wisdom of repugnance. The
New Republic 216(22): 17-26. President's
Council on Bioethics. 2003. Beyond
Therapy: Biotechnology and the Pursuit of Happiness. http://www.bioethics.gov/reports/beyondtherapy/ Rawls, JB. 1971. A Theory of Justice.
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