An examination of the ethical issues raised by the possibility of human life extension, including its desirability, unequal access, and the threat of overpopulation.

Life extension—slowing or halting human aging—is now being taken seriously by many scientists. Although no techniques to slow human aging yet exist, researchers have successfully slowed aging in yeast, mice, and fruit flies, and have determined that humans share aging-related genes with these species. In New Methuselahs, John Davis offers a philosophical discussion of the ethical issues raised by the possibility of human life extension. Why consider these issues now, before human life extension is a reality? Davis points out that, even today, we are making policy and funding decisions about human life extension research that have ethical implications. With New Methuselahs, he provides a comprehensive guide to these issues, offering policy recommendations and a qualified defense of life extension.

New Methuselahs Book Review

New Methuselahs goes deep into the ethics of life extension, examining the impact on society and individuals, and takes a look at the moral implications of life extending therapies become available to society. The author assumes, probably fairly, that initially (period of time uncertain) life extension treatments won’t be available to everyone, but over time they will become cheaper (and society richer) so that anyone who wants it can elect to stop ageing.

John Davis isn’t trying to persuade the reader to out and out support life extension, more he lays out his thinking, and how he got there. Where he feels there are downsides to people living radically longer lives, he says so. But, on balance, comes out for developing life extension therapies – and goes on to say that if we’re going to do so then we should do as quickly as possible.

I was particularly pleased to see his analysis of rapid population growth if fertility rates increase with long lives (which it seems likely they would) and puts forward a first draft plan on how to prevent it. 

There are some reflections on the classic objections, for example, even if life did become boring after a few hundred years, then taking a pill to help you feel engaged in worthwhile pursuits would not be wrong. It’s also a good introduction to general ethics principles as he explains the main arguments of different ethical theories and how they apply to life extension arguments. Though the last few chapters get a bit harder to follow when balancing benefits and harms of promoting or inhibiting life extension against individual rights.

Throughout New Methuselahs the assessment of whether banning rejuvenation treatments would be a good decision is looked at by running the scenario backwards – would we decide to shorten people’s lives now to make it better? For example, some people argue that we will become less productive with longer lives, but no one is suggesting shortening our current evolution-derived life expectancies in order to be more productive now.

The book is well structured with really useful summaries at end of each chapter to consolidate the in-depth thinking and examples previously lad out. Whether new to wondering about the ethics of life extension, or an old hand, I think this book is suitable for everyone.

Quick aside: although primarily covering ethics, the book starts with a description of some “promising” methods being developed for life extension. Only 6 years ago but doesn’t mention cellular reprogramming nor senolytics – things are moving fast!

Highlights

Here are 95 key points from New Methuselahs,:

• We are effectively making policy decisions about life extension right now... by making decisions about how much to fund the relevant research.
• Research in the United States is inhibited by the fact that the Food and Drug Administration does not currently have a regulatory pathway for interventions meant to slow or halt aging.
• The average life expectancy at birth would be about 1000 years if people died only from causes that are completely unrelated to aging.
• We’ll see components of life extension coming over the horizon long before it all arrives in a complete form.
• If your life is good, it’s good to have more of it.
• Aging and death have always been unavoidable, and perhaps we adapt to that fact by convincing ourselves that this is a good thing.
• Religious affiliation made little difference to one’s views on whether life extension was “fundamentally unnatural.”
• To acquire a new set of interests to replace the ones that bore you after a few centuries, you need to make some changes to your personality and values.
• People differ psychologically, so extended life may bore some people and not others.
• Scholars of boredom — there’s a lively literature on this — have identified three kinds of boredom.
• People who live extended lives might, however, be likely to suffer from what psychologists call situational boredom, which results from repetition or inadequate stimulation.
• We still enjoy warm sunshine at 96; we’ll probably enjoy it at 796.
• If you knew your life really was boring, would you take a pill that made you feel it was not?
• Even a drastic amount of change may be compatible with being the same person over time.
• Your later self is continuous with your earlier self (and vice versa) if, at every stage in between, you retain a lot of memories and personality traits from the preceding stage.
• I would rather fade away by slowly evolving into someone else in a body that lives than fade away into senility in a body that dies.
• It seems needlessly cautious to turn down extended life just because it becomes boring a long time in the future.
• Extended life could become very boring, but it probably doesn’t have to be.
• Even if extended life is unavoidably boring, that’s not a good reason to refuse extended life.
• Extended life is not just a longer version of life as we know it.
• It’s easier to make interesting arguments that extended life is bad than it is to make interesting arguments that extended life is desirable.
• Extended life gives you more time to accomplish your life goals and contribute to the world.
• Extended life can go as well or as badly as any other life, and over enough time, it may well do both.
• Arguments about immortal life don’t transfer well to extended life.
• Suppose there’s an afterlife where we exist as immortals (a possibility I accept). Do we lose our virtue once we get there? Do we suffer boredom, procrastinate, become more selfish, fail to appreciate life, or find the afterlife meaningless?
• If we naturally had 45-year life spans, would we have better lives and be better people? Probably not.
• If we die only from causes that are not age-related, and if death deprives us of centuries of life, then we might become far more anxious about this than we are now.
• Shortening life works even better as don't have to envisage a post-mortal world first.
• To say that a life has meaning is to say that it is worth living — that it has value for the person who is living it.
• Extended life might come to lack subjective meaning. But this is the boredom issue in another guise.
• Most of the situations where you develop virtue by facing or risking death involve potential causes of death that are not age-related.
• Science fiction gives us starships that travel faster than light and machines that travel back in time but rarely gives us humans who do not age.
• Even if you decline life extension and age normally, aging is no longer inevitable — it is elective.
• If extending your life were an irreversible decision, you might want to play it safe and not take a chance on it, but because it’s reversible, you can give it a try and find out for yourself.
• In radically extended life, the odds of death are the same at any time, and they never go up.
• Life extension does not make your death worse, even though you lose centuries when you die.
• In the new human condition, we might try a series of careers or different ways of life with no intention of assembling it into a coherent story.
• If you can get life extension when you want it, then you might procrastinate and use your time poorly even if you never extend your life.
• Refusing or discontinuing life extension is a kind of suicide, but not an immoral suicide.
• Imagine trying to maintain anything like a traditional relationship with your children when you and they enjoy the health and appearance of a young adult and the generations pile up, with no one obviously qualified for role of an elderly counselor.
• It’s one thing to vow to stay together until death when you expect death in 50 years or so. It’s quite another to make that commitment when death may be centuries away.
• Extended life is just another massive change in the human condition, on a par with what we navigated as we moved from being hunter-gatherers to living on farms or from farms to the industrial and technological world of the city.
• Most people get about as good as they ever will [in a profession] in the first 20 years.
• Most of us form our worldview by our mid-40s or sooner, and it doesn’t seem to change much after that.
• We learn a lot along the way, and we might learn a lot more along a longer way.
• There is reason to be optimistic that a world full of people living extended lives will be in many ways a much better world: more mature, more interesting, more stable, wiser, more concerned about the future and the environment, and more at peace.
• Life extension should be made available only on the condition that those who extend their lives restrict their reproduction enough to avoid a Malthusian crisis.
• According to an estimate from the Global Footprint Network, the world is now consuming the equivalent of one and a half earths.
• If people live an average of 150 years and women have an average of 2 children the population will triple and then stabilize!
• If people have an average life expectancy of 150 years and women have an average of three children per woman the population grows to nearly seven times its original size in 200 years and grows indefinitely thereafter.
• If women have an average of only one child each at an average age of 25, the population roughly doubles in a little over a century, before rapidly dropping.
• A policy of “Forced Choice,” forces people to choose between extended life and having more children than the target birthrate.
• Life-extending treatments are likely to require periodic or ongoing interventions of some kind.
• Forced Choice assumes that people choose between extended life and having more children, but what about those who don’t reproduce voluntarily?
• If there is something biologically unnatural about living without aging (and by “unnatural” I don’t mean “therefore bad”), then we should accept that such a life might be bound by biologically unnatural limits on reproductive behaviour.
• There is good reason to believe that making life extension widely available will pose a serious risk of a Malthusian crisis of overpopulation, pollution, and resource shortages.
• A policy of Forced Choice, which requires people to choose between extending their lives and having as many children as they wish, is feasible and just.
• Introducing life extension without making it available to everyone seems to harm billions of people by making them seriously distressed.
• Prohibiting anything that makes some people better off than other people would amount to an extremely radical kind of egalitarianism.
• As the time when life extension is a practical possibility comes closer, the tragedy of missing out on life extension will become greater.
• The distress suffered by Have-nots over the fact that others can get life extension and they can’t is a harm, even if they have nothing to be distressed about.
• People with extended lives have a lot more time and therefore a lot more opportunity than others, and this is wrong.
• We do not deny heart transplants to everyone on the grounds that there aren’t enough hearts for everyone who needs one.
• The Haves must contribute more. One way to do this is to impose a use tax or user fee on life extension treatments or dramatically increase the income tax for anyone above an age that no one can reach without life extension.
• If we cannot provide life extension to all the Have-nots, then justice requires compensating them with something other than life extension.
• Once life extension has been available to Haves for long enough, it may become reasonable for people to think that a normal life span is no longer sufficient.
• Even if we can be sure that many Haves will evade their duty to subsidize or otherwise compensate Have-nots, Prohibition and Inhibition are not justified.
• Ethical theory (in the sense I have in mind) is the project of identifying the common element or elements in our correct moral judgments at the highest level of abstraction.
• In a world where life extension research will be aggressively funded only if we decide to do so, not having a policy is tantamount to having a policy of not funding this research aggressively.
• A world with life extension has less net welfare than a world without life extension only if the gain to each Have is rather small and the harm to each Have-not is stunningly large.
• The percentage of Haves will increase over time, partly because the cost of new technologies falls over time and partly because average living standards are rising around the world.
• It’s very likely that a world with life extension will have a larger population than a world without it and have greater welfare than the world without it.
• There are other good reasons for developing something like life extension, but doing this in order to create a new opportunity for equal distribution is not one of them.
• The Haves are not worse off under Inhibition than they were before; they just don’t get better off.
• Under comparative and noncomparative theories of harm, Inhibition does not harm the Haves.
• Promotion will harm the Have-nots and Will-nots, but Inhibition will not harm the Haves.
• A gain in welfare is big enough to outweigh rights violations when we would be willing to risk that harm on a chance of getting that benefit if we were making that choice for ourselves and we didn’t know our identity or position in society.
• Inhibition through neglect is the funding policy we have right now.
• If the future of the human race is not infinitely long, then starting life extension sooner provides life extension to Haves that much sooner and thereby provides it to that many more Haves.
• People who say they don’t want extended life may be expressing adaptive preferences.
• In time, turning down life extension will become as eccentric a choice as choosing lifelong celibacy.
• If we take all future generations into account, the welfare gained by Haves outweighs the rights violations of Have-nots. 
• Bioconservatives tend to favour conserving the physiological basis of human nature — our genome and all that rests upon it — largely as it is.
• Showing that enhancement isn’t always bad doesn’t show that it’s never bad.
• Life extension is an enhancement in a very particular way. It enhances us by giving humans a life span no human has ever had before.
• The precautionary principle recommends taking action to prevent harm even when the evidence that harm will occur is less than conclusive.
• The maximin rule is meant for choice under uncertainty, not for all choices under risk.
• The ideal of authenticity tells us that we should be true to ourselves.
• The fact that nature gave us a particular life span is not a reason to avoid seeking to extend it.
• Aging is a disease, and life extension is a kind of medicine.
• Life extension is, on balance, a good thing, and we are better off getting it sooner rather than later.
• No one should be denied access to life extension, nor should the development of life extension be inhibited.
• Life extension should be subsidized for those Have-nots who want it.
• Life extension is an enhancement. There is nothing wrong with enhancement per se, and no one thinks there is.
• A century ago, those who made it to 60 lived roughly as long as we do, but the odds of making it to 60 were much worse.

If you’ve got the book but not got round to reading it yet, as well as the highlights above you could just jump to chapter 13 that list all the conclusions, presented at the end of each chapter, all in one place.