Is aging a disease? the philosophical debate between bioconservatives and transhumanists on life extension

Resum

A profound revolution is afoot in the biomedical sciences. Aging is typically understood as a biological process of growing older with deleterious effects on our cognitive and physical capacities—a natural, normal, and universal phenomenon that everyone must undergo with the passage of time, without exception. In the previous decades, there was no possibility of scientifically intervening in aging, either to control it or decelerate it. Our ancestors simply had to accept it and only looked for the best way of successfully aging, regardless of how much pain or suffering it could cause in for them and those in their lives. Traditionally, medicine has tried to manage and treat many age-related diseases (ARDs), such as Alzheimer’s or various cancer types. In contrast, biogerontology has made huge advances over the past decade hoping to improve people’s health, such as the discovery of the hallmarks of aging—for instance, cellular damage, which leads to an increased risk of the appearance of these ARDs. From this new perspective, aging could be considered a syndrome, as a special type of disease inherent in all humans, and the underlying cause common to all ARDs. Now, the scientific community already has enough knowledge to start developing anti-aging treatments (AATs) in humans, similar to those currently being studied in other model organisms. The research line will focus on the intervention in the aging process itself, regardless of a favorable outcome in its first phases, since what really matters is to intervene now. These AATs are still hypothetical, but they provide a plausible picture of a scientific approach to addressing aging. This profound revolution is based on a substantial change in medicine: the shift away from a restorative approach to ARDs and towards a preventive alternative starting around the first moments in which we age. According to the above, the real goal is not to search for a method of life extension related to longevity—that is, the years of life lived. Exceeding 122 years and 164 days as the longest recorded life span of a human should not be the goal of the scientific community. The end of life is currently characterized by dependency, disability, and weakness, and for many of us it is not desirable to live under those circumstances. The change must be more radical: maintaining a high level of functioning of our cognitive and physical capacities for long as we live, and controlling the decrease in quality of life that has traditionally accompanied old age. This approach does not necessarily imply living much longer, at least in the first instance. The possibility of living a healthier life with a biological condition similar to our 20s may be more desirable than becoming a centenarian. And perhaps most importantly: this would impact most of the population—something similar to the increase in life expectancy in developed countries in the twentieth century. Therefore, I advocate “adding life to the years of life of those persons”. Finally, the treatment of aging should not be related to the alleged dream of immortality. The goals of biogerontology differ from the attempt to live forever. The research lines are so far apart from each other that any supposed connection simply undermines the daily work of the scientific community. The premature success of aging interventions should not generate excessive expectations, since the “death of death” will not be achieved in the coming decades. One of the great philosophical and social challenges is to lower the expectations connected to promises coming from a world of science fiction rather than real science. Furthermore, the fact that many humans may not want to die today does not necessarily imply a desire to live forever. Some people would embrace the unknown, only because of their strong fear of death; for instance, our mind being uploaded into a computer and its possible existence in a digital reality. Immortality is not only technologically unfeasible, but it also compromises our meaning of what it is to be human, its relationship with the world, and with life. To preserve and promote what we value in what it currently means to be human, we should strive to decelerate the onset of cognitive and physical decline rather than attempting to overcome death itself. In an ideal scenario, we may want to live longer without suffering the ravages of aging. The defense of AATs must be based on a real and rigorous science, which can be distinguished from approaches to and conceptualizations of immortality.