Enhancement, Anti-Aging Medicine & Life-Extending Biotechnologies

Description

Marissa, a young mother, provides substantial support to her aging parents. When her parents begin exploring novel anti-aging treatments, Marissa wonders about the potential social outcomes of such technology.

Body

Marissa frequently visits her elderly parents who live a few hours away from her to make sure they are healthy and comfortable in their retirement community. During her most recent trip last weekend, her father was excited to tell her about a special news report he watched on biomedical research on anti-aging interventions and rejuvenation biotechnologies, and that these new scientific breakthroughs could soon extend natural lifespans by decades. He became so enthusiastic about this new science that he looked into the prospects of undergoing gene therapy as an anti-aging measure for both himself and his wife, Marissa’s mother. [1]  But then, he explained to Marissa how furious he was to find out that his expensive health insurance plan would not cover this intervention because it considers it to be a case of enhancement rather than a case of medical treatment.

Marissa’s father is really upset because he envisioned a retirement filled with travel and other activities with his wife, but lately, several small ailments have interrupted their plans. He thinks the people at the insurance company just don’t understand what it’s like to experience aging and they are just being stubborn and unsympathetic.

Meanwhile, Marissa’s mother heard from the neighbors that the local university’s medical center is conducting a research study on a new “anti-aging therapy.” The study, she explained to Marissa, is to test a new drug that inhibits something called telomerase, which is linked with age-related cancers. [2] Her neighbor then suggested that they might be able to access that anti-aging intervention without any financial cost as research subjects. But, her father says he doesn’t want to be a guinea pig. Marissa’s mother told Marissa that she thinks she can bring him around by reminding him of all the things they still want to do, places they want to visit, etc., and how tired she is of managing the pain in her joints and how she fears her memory is getting worse everyday.

Marissa told her mother to not do anything before she gets a chance to look into this new biomedical research and that she’d also review her parents’ insurance plan. Marissa feels conflicted after their conversation. Of course, she wants her parents to be healthy and happy, and to enjoy their retirement for as long as possible. But, she’s not convinced that the anti-aging procedures are necessary or that they are even safe or effective. And, what if her retired parents live for another forty years? Marissa thinks it would be wonderful for her young children to have their grandparents around for that long, but she also worries about whether her parents would be able to maintain their living standards with the rising cost of living. To Marissa, these prospective changes seem all too sudden.

Discussion Questions

  1. If Marissa founds out that these particular therapies happen to be low risk, would she still have reasons to be concerned with these interventions? If so, why?
  2. If the non-experimental therapy is deemed low-risk and has the potential to prevent age-related illnesses, should private health insurance cover the cost? Or, should the intervention be considered an enhancement rather than healthcare or therapy? What are some implications of defining these interventions one way or the other?
  3. Consider the case in which Marissa’s parents live in a country with universal health care. Should these types of interventions be considered as preventative health measures? What implications might this have on our conception of aging and the way we organize and prioritize certain life plans?

Bibliography

Binstock, Robert H. "Anti-aging medicine: The History - Anti-aging medicine and research: A realm of conflict and profound societal implications." The Journals of Gerontology Series A: Biological Sciences and Medical Sciences 59, no. 6 (2004): B523-B533.

Bostrom, Nick, and Rebecca Roache. "Ethical issues in human enhancement." New waves in applied ethics (2008): 120-152.

de Grey, Aubrey DNJ. "Life extension, human rights, and the rational refinement of repugnance." Journal of Medical Ethics 31, no. 11 (2005): 659-663.

*Derkx, Peter. "Engineering substantially prolonged human life spans: Biotechnological enhancement and ethics." Valuing older people: A humanist approach to ageing (2009): 177-198.

*Fukuyama, Francis. Our posthuman future: Consequences of the biotechnology revolution. Macmillan, 2003. (Chapter 4)

Gems, David. "Is More Life Always Better?: The New Biology of Aging and the Meaning of Life." Hastings Center Report 33, no. 4 (2003): 31-39.

Harris, John. "Immortal ethics." Annals of the New York Academy of Sciences 1019, no. 1 (2004): 527-534.

Juengst, Eric T. "Growing pains: bioethical perspectives on growth hormone replacement research." Journal of Anti-Aging Medicine 5, no. 1 (2002): 73-79.

Juengst, Eric T., Robert H. Binstock, Maxwell Mehlman, Stephen G. Post, and Peter Whitehouse. "Biogerontology, ‘anti‐aging medicine,’ and the challenges of human enhancement." Hastings Center Report 33, no. 4 (2003): 21-30.

Kampf, Antje, and Lynn A. Botelho. "Anti-aging and biomedicine: Critical studies on the pursuit of maintaining, revitalizing and enhancing aging bodies." Medicine Studies 1, no. 3 (2009): 187-195.

Marshall, Jennifer. "Life extension research: an analysis of contemporary biological theories and ethical issues." Medicine, Health Care and Philosophy 9, no. 1 (2006): 87-96.

Partridge, Brad, and Wayne Hall. "The search for Methuselah." EMBO reports 8, no. 10 (2007): 888-891.

Partridge, Brad, Mair Underwood, Jayne Lucke, Helen Bartlett, and Wayne Hall. "Ethical concerns in the community about technologies to extend human life span." The American Journal of Bioethics 9, no. 12 (2009): 68-76.

Turner, Leigh. "Biotechnology, bioethics and anti-aging interventions." TRENDS in Biotechnology 22, no. 5 (2004): 219-221.

Links:

The President’s Council on Bioethics, Washington, D.C. Beyond Therapy: Biotechnology and the Pursuit of Happiness. October 2003. (Chapter Four): https://bioethicsarchive.georgetown.edu/pcbe/reports/beyondtherapy

SENS Research Foundation: http://www.sens.org

  • [1]For example, scientists are discussing the possibility of using gene therapy to enable cells to produce additional enzymes to help clear accumulated waste from aging cells with dysfunctional lysosomes. 
  • [2]Telomerase is an enzyme that works to lengthen the tips of chromosomes called telomeres. Changes in the length of telomeres over time is associated with the deterioration of human cells and cancer.
Notes

This material is based upon work supported by the National Science Foundation under Award No. 1355547, Karin Ellison and Joseph Herkert, Arizona State University sub-award Co-PIs. Any opinions, findings, and conclusions or recommendations expressed in this material are those of the author(s) and do not necessarily reflect the views of the National Science Foundation.

The author wishes to acknowledge the contributions of Karin Ellison, OEC - Life and Environmental Sciences Editor, and Joseph Herkert, OEC Engineering co-Editor. They provided valuable input in selecting topics and crafting the resources.

Life-extending technologies and anti-aging medicine are emerging areas of focus among bio-gerontologists and molecular biologists. This research is sometimes divided between “weak” life-extension research and “strong” forms. The former label describes biomedical research aimed at preventing and treating common diseases, which occur in older individuals, such as certain forms of cancer, whereas the latter refers to slowing down or stopping the aging process and increasing the average human lifespan in a relatively quick and significant way (Partridge & Hall 2007; Partridge et al. 2009). Not surprisingly, it is the latter, “strong” sense of life-extension or anti-aging research that has provoked most ethical concerns and discussions. Some of these ethical concerns have to do with the prospects of sustaining increasing populations and shifting demographics, which could lead to drastic alterations of social and economic structures, such as the feasibility and implementation of social security policies or the provision of healthcare, the disruption of social arrangements and human relationships (e.g. family structures, rates of marriage and divorce, reproductive and child-rearing practices), and the persistence of tyrannical governments or the slower rate of social change and social progress (Fukuyama 2003; Binstock 2004).

Many of these concerns have to do with justice and fairness (i.e. the fair distribution of benefits and burdens in society), and will have consequences for individuals, society, and the environment. Additional ethical and epistemological questions have been raised about the appropriate goal of biomedical research and healthcare (e.g. whether extending life is or ought to be a goal of biomedicine), and the meaning and value of aging and its implications for our notions of human dignity and identity, and our claims to human rights (Partridge & Hall 2007; Gems 2003). Critics of anti-aging interventions, such as Leon Kass, former chairman of the President’s Council on Bioethics under President George W. Bush, Daniel Callahan, a bioethicist, and Francis Fukuyama, a political scientist, oppose the measures, albeit for different reasons. Kass and Fukuyama take issue with interfering with the natural life cycle, or the traditional human life expectancy. They think these interventions will disrupt the natural order and compromise the value of the different stages of human lives. Callahan is more concerned with consequences of social unrest or social strife that could result from increasing human lifespans, such as the radical changes to our social institutions, notions of personal identity, and economic structures (Turner 2004).

Advocates, such as Aubrey de Grey, scientist and founder of the “Strategies for Engineered Negligible Senescence” (SENS) Research Foundation, claims that the right to live is a fundamental human right, which translates into a moral duty for the medical community to pursue research into life-extension technologies and anti-aging interventions (de Grey 2005). In other words, he argues that the moral obligation to save life in medicine is the same as the duty to extend it (Partridge & Hall 2007). Meanwhile, research into these technologies and interventions are being pursued and, while scientists claim that we are still far from immortality, or even expanding lifespans to 150 or 200 years, political scientist Robert Binstock, as well as others, have argued that anticipatory deliberation concerning the social impact of these measures should be actively pursued (Binstock 2004; Juengst et al. 2003). For example, Binstock argues that we should think about how these interventions will be fairly allocated, if and when they come about. And furthermore, he claims that the scientists involved in this research, along with social scientists and ethicists, should be proactive in shaping and constraining some of the social and environmental ramifications that may result from these interventions (Binstock 2004).