Anti-ageing: knowledge, practice and conflict in the control of ageing.

1. Anti-ageing: knowledge, practice and conflict in the control of ageing. • John A. Vincent (University of Exeter) • Anti-ageing rhetorics: "health span", "regenerative medicine", "looking ten years younger" and "anti-ageing pralines". • Jennifer R. Fishman, Robert H. Binstock, and Eric T. Juengst;(Case Western Reserve University ) • Anti-Ageing Scientists and the Politics of Presentation • John Bond, (Newcastle University) and TiagoMoreira, (Durham University) • Preventing brain ageing: anti-ageing medicine or what? • Mone Spindler (Free University of Berlin) • Anti-aging and spirituality - Surrogate religion, spiritual materialism, post-modern Calvinist ethic? • Cassandra Phoenix (University of Exeter) • Anti-ageing bodies?: Considering the dark underside of the sport sub-culture.

2. Anti-ageing rhetorics: “health span”, ”regenerative medicine”, “looking ten years younger” and “anti-ageing pralines”. John Vincent, University of Exeter

3. Anti-ageing, what is it? • In recent year there has been a significant increase in anti-ageing phenomena – activities and practices aimed at slowing, stopping or reversing the ageing process. • The anti-ageing label covers a wide variety of activities and groups which arise out of the deep antipathy to old age embedded in Western culture. They construct old age as a naturalised self-evidently negative biological phenomenon which must be overcome. • These groups have differing claims to knowledge, technical expertise and ability to control natural phenomena. They include people, organisations and activities designed to make people look younger, avoid the diseases of old age, challenge the biological processes of ageing and to greatly extend the human life span, possibly even for ever.

4. What are the issues raised by anti-ageing activities? • There are large scale existential issues, ones that question the fundamental nature of the human condition. • What is old age? • What is the purpose of life, and its different stages? • Is life always preferable to death – is immortality desirable?

5. What are the issues raised by anti-ageing activities? • There are issues related to the particular cultural, social and political status of older people. • Should old age be considered a valued part of the life course or something to be abolished as soon as practicable?

6. What are the issues raised by anti-ageing activities? • There are intermediate level issues, ones which stem from the current advances in biology and bio-gerontology. • What is biological ageing? Is it a single process or a variety of different processes? What is the potential for control of ageing? • These issues are sometimes debated around the question of whether ageing should be considered to be a disease. • What are the consequences of treating as a disease? • What are the priorities for research – fundamental biology or disease control?

7. What are the issues raised by anti-ageing activities? • There are further questions which arise from these science issues. • To what extent is a biological or medical model of old age an appropriate basis for policies for older people? • Are there alternative models perhaps akin to the social model of disability and thus aspire to a more elder friendly society?

8. What are the issues raised by anti-ageing activities? • There are smaller scale more immediate issues, for example about life style choices. • What and how much should we eat? • What exercise should we take? • What should the responsible consumer do in terms of living a satisfactory old age?

9. Can it be done? Should it be done? • There are biologists, bio-engineers, medics, pharmacists etc who debate whether life span extension can be done. • There are philosophers and ethicists who debate whether is should be done • There are social scientists who observe the anti-ageing movement and seek to understand what is being done and why – and implicitly with what consequences • Biologists and ethicists are the object of study

10. Cultural questions • As social scientists we can modify Moody’s second question.– not ‘should it be done’, but ‘how do people seek to justifying doing it’ – what sources of values and moral legitimacy do people appeal to for and against ‘anti-ageing’? • Hence the interest in the study of the cultures within which biologists and ethicist work. • In this paper I will concentrate primarily on the protagonists of anti-ageing. This focus is selected because it can tell us something broader about the cultural and moral status of old age.

11. Methods for the study of cultural meanings. • In this case the meanings of old age in the world of anti-ageing. • Discourse analysis. This approach is frequently characterised as having its origin in the work of Foucault – as his archaeological method • Other traditions –the anthropology of language, and drawing more heavily on structuralist assumptions and techniques • Critical theory - deconstructionists unmasking of dominant ideologies. • The techniques of grounded theory provide a way of handling data in the form of text, speech, performance and observation. • The analytic strategy is to examine the language, speech and text, of those engaged in knowledge exchange in the field of anti-ageing to explore how these participants justify their activities.

12. Interpretive analysis • Often legitimation is implicit. It has to be read into the presentation, abstract or summary. Identifying that which is taken to be a ‘good’, without it having to be stated that it is ‘good’, is a key part of the interpretative process. It is important because such articulation reveals the taken for granted assumptions under which the scientists / knowledge creators are working, assumptions which are almost certainly linked to more fundamental tenets of their culture. • If we examine the stated and implied justifications for the research made in a selection of papers presented at the four conferences we can extract themes and come to general conclusions. We can the see the revealed meaning of old age based on the rhetoric used to justify the research and knowledge making activities. • If we then seek to identify key concepts they can be listed in the following table.

13. The case study conferences • 3rd Annual Anti-Ageing Conference London, September 15th – 17th, Royal College of Medicine, London. (acknowledge funding) • London Regenerative Medicine Network, Meetings October 2005, and December 2006, Kings College London. • 3rd International Conference on Functional Genomics of Ageing March 29- April 1st 2006 Palazzo Normani, Palermo. • Strategies for Engineered Negligible Senescence (SENS2), Second Conference, Queens' College, Cambridge, 7th -11th September 2005 (acknowledge funding)

14. Anti-ageing discourse – emergent themes for characterisation of ageing.

15. Thus we can summerise the underlying discourse of anti-ageing as identifying ageing as something that • is bad, • is associated with the organs of the body, • should be the target of intervention and • should be understood through knowledge of particular biological processes. • Each of these they can be read as a form of legitimation, an appeal to taken for granted moral values assumed to be universal. We cannot be against things that are • ‘good’ (rather than ‘bad’), • part of our bodies (as opposed to ‘foreign bodies’), • intended to ‘cure’ (rather than to kill), and • are based on knowledge (as opposed to ignorance) of ‘natural’ (read ‘biological’ as opposed to ‘unnatural or artificial’) processes.

16. Contested legitimacy • This list can then be taken to characterise the common ground in anti-ageing rhetorics. • Those engaged in anti-ageing practices also disagree about a number of the key concepts. • What is bad about ageing? • What organs should be targeted? • What constitutes effective intervention, and, • What counts as biological knowledge?

17. What is bad about ageing: ill-health or death? • An appeal to ethics and the authority of the sage, prophet, and codes of values. • Different anti-ageing approaches identify different characteristics of ageing as problematic. • There are those people for whom the prime problem is that of illness and the accompanying pain and suffering. • There are others for who the prime issue is that of life its self, which should not be cut short when it could be made longer. • Can you have healthy ageing, health span followed by death, or is death intrinsically bad because any further life is always valuable.

18. Arking, R. (2006) The Biology of Aging: Observations and Principles. OUP, 3rd ed.

19. What organs should be targeted: holistic approaches or not? • An appeal to identity and the individual as sole source of authority over oneself. • The anti-ageing scientists in the conference overwhealmingly, with some notable exceptions, concentrated on very specific cell processes, organs and therapies. • However, very evident at the Anti-ageing conference and present but more implicit at the others is a division between those who emphasise a ‘holistic’ approach to ageing; paying attention to the ageing of the whole body as opposed to elements of it. • Cosmetic strategies can also be differentiated between those which tackle specific parts of the body – the skin via a face lift, or holistic approaches emphasising change in life-style to rejuvenate the approach to life.

20. Not a science / anti-science distinction • This is importantly not to be understood as a simplistic distinction between woolly ‘new age’ pseudo science and the real hard nosed biologists. There are alternative therapists appealing to holistic concepts such “bio-resonance” or “mind-body” therapies. However, there are also important biologists arguing for a more comprehensive and integrated view of ageing. • The are biologists such as Rose who make a case against the reductionist tendencies of modern biology which see biological processes as essentially cell chemistry and miss out the organism and species levels of analysis. There are also biologists such a Tom Kirkwood who are seeking theories and methods to integrate the vast amount of information on genetic and cellular processes into a coherent understanding of the process as whole – a new branch of biology known as “systems biology”.

21. Health span?

22. What constitutes effective intervention: medical models or life-style • An appeal to the authority of medicine and the therapist • The knowledge of anti-ageing experts in terms of action and therapeutic strategies differ radically from each other. • The dilemmas of holistic versus reductionist approaches are also visible in the clash between practices informed by the social model disease, disability and ageing and clinical therapists. • The clinical model follows from reductionist science. Its atomistic approach to the body sees the ideal therapy as universalistic – something that applies to all bodies equally, all being subject to the same bio-chemical routines. All social identities removed from this image of the body, all bodies seen as fundamentally the same. • These legitimation activities have important material consequences, not only in terms of commercial marketing, but also is researchers access to funds. The debate about whether ageing is a disease is also a clash about funding priorities between biologists and medics.

23. Appropriate therapies? • Should the strategy be to cure one disease or all? Should ageing itself be thought of as a disease? • On display at the conferences were, on the one hand there were cutting edge medical therapeutic practices, for example the use of stem cells to promote cardiac regeneration, and on the other accounts of drugs such “resveratrol” which were credited with arresting the whole process of ageing. • Alternative therapies, some of which will be lifestyle recommendation designed to beef up the whole body while others will be dietary supplements, some of which will be directed to particular organs e.g. “brain food”. • There were presentations on transforming the resilience of the whole body in the face of ageing through exercise and those who sought to transform and beautify particular parts of the body by having them restyled through the skills of cosmetic surgeons.

25. What counts as biological knowledge: science or not • An appeal to the authority of science and the producers of knowledge. • There are a variety of anti-ageing discourses which limit real knowledge – the facts - to hard science. • Yet there are other discourses which make the appeal to the validity of their knowledge through different or ‘alternative’ sources. These others include, for example, practitioners who entertain a variety of alternative knowledge systems including Ayurvedic, homeopathic, and other esoteric forms of medicine. • The language used tend to make an appeal to natural or traditional wisdom – secrets from the past and from other cultures. Here the legitimising authority is presented as knowledge, revelation, or experience denied to those blinded by western / scientific / establishment preconceptions. • Court cases and competitions – indeterminate results

26. “anti-ageing pralines”.

27. Conclusions • What can we learn from the way that anti-ageing activities are legitimated by their practitioners. One thing we can learn is how deeply embedded ageist approaches to old age are embedded in our culture. • The identified rhetorical elements in anti-ageing discourse are homologous, fit hand in glove, with the dominant discourses of modern western culture. • These include extreme individualism, reflected in a focus on the body and the rejection of collective identities, and the authority of science which undermine the value of old age and older people. • But they also reveal the fluidity and contested nature of authority in the contemporary world which gives hope that it can change.

28. A role for social science • What is the role for the social scientist in the anti-ageing debates? The role for social sciences is clearly not to participate in the debate in the sense of demarcating science from non- science, or assay the claims of one anti-wrinkle cream as opposed to another. • The task is rather to reveal the cultural processes which some practices seem so natural as to require no justification and the power that goes with such ideological domination. • The detailed examination of the culture of those engaged in anti-ageing knowledge creation is an essential component that will help reveal how ageist assumptions are built into these endeavours and in turn shape a cultural response to the ageing construct.