The war on ageing: what's wrong with fighting the ravages of time? John A. Vincent

1. The war on ageing: what's wrong with fighting the ravages of time? John A. Vincent

2. When is banana ripe?

3. Winning The War Against Aging Americans are frantically spending millions to look and feel younger. Meanwhile, new scientific discoveries are promising us The Fountain of Youth. How can this war against aging finally be won? http://www.buzzle.com/editorials/8-10-2006-105105.asp Stay Fit To Fight The Ageing Process Are you prepared to go to the gym for one hour, three times a week, for 20 weeks all in the name of science? If so researchers at The University of Nottingham want to hear from you.As part of their on-going research into the ageing process, scientists in the School of Biomedical Sciences need a team of volunteers .. http://www.medicalnewstoday.com/articles/90387.php The war on ageing

4. Ageism and knowledge of old age • Why is ageism so prevalent? • Why do we fear old age? • What particular forms does it take in early 21st century • How can we understand it? Understanding is the necessary first step to challenge and change it.

5. Cultural context - medicalisation of death and old age. • Western scientific medicine has transformed old age from a natural event to a disease. Successful old age is not seen as it was in the 18th and 19th century as the outcome come of a moral life but as the absence of disease. Old Age has become an object of scientific and rational knowledge controlled by experts. • You are not “only old as you feel” – when there is a scientifically trained expert waiting to tell you the basis of your feelings, your probabilities of survival, and which drug will make it all bearable.

6. Cultural context - old age and biological science • Ageing in the contemporary West is considered to be a biological process [as opposed to a social, psychological, spiritual or other process] • Biological understanding of ageing is advancing rapidly particularly in cell science, bio-chemistry and genomics • Scientists can now modify the life span of model species – yeasts, fruit flies, nematode worms and mice. • Should we fight the ravages of time and seek to extend the human life span?

7. Cultural context - rejection of the ageing body • The development of the modern concept of self – rise of individualism • Relationship of self to body • Modern view of body as project • Body as moral signifier – ‘letting yourself go’ • Problems of the ageing body

8. Social context – the boundaries of old age • The markers and social processes by which old age is distinguished from middle age have been examined. • Excellent historical work has identified the establishment of retirement as a key marker of old age at 60 or 65. • Much less researched is the transition out of old age. There is only one way to leave old age (at the moment) and that is through death.

9. Social context – the boundaries of old age • Science is the principle method through which old age transitions are defined and understood • Modern death means: • Death of the body • Caused by biological failure • Unredeemed by medical intervention • Certified by a medical practitioner

10. My research - kinds of anti-ageing science My research is based on an examination of the language and cultural concepts used in anti-ageing science and medicine. Four types of anti-ageing based on biological and medical science can be identified. • ‘symptom alleviation’ • ‘life expectancy extension’ • ‘life span extension’ and • ‘abolition’

11. 1. Anti-ageing as symptom alleviation Scientific attempts to hide, postpone or relieve the symptoms of biological ageing (i) cosmetic – powder and paint, anti-wrinkle cream to disguise the signs of ageing (ii) prophylactic – exercise and diet or vitamin pills to stave off the onset of physical ageing and its signs (iii) compensatory – viagra, HRT designed to re-invigorate failing functions to a youthful standard.

12. “looking ten years younger”

13. 1. Anti –ageing as a cosmetic strategy • These symptom alleviation strategies have to be understood in the context of a society which has come to understand body image as the key component of personal identity. • Thus the implicit definition of old age in this form of anti-ageing is that of appearance. To look old is to be old. • The boundary between youth and old age is marked in this way of looking at the world by physical appearance. • Death is the social death of being unable to present a socially acceptable body.

14. 2. Anti-ageing as life expectancy extension • There are powerful claims of an imminent increase in life expectancy of approximately three to six years are based on new attempts to treat or eliminate the diseases which commonly cause death in old age. • Would the elimination of disease mean people reach their full life span or produce ever increasing longevity? Hence debates as to • whether there is a ‘natural’ limit to human life span? • whether the life span was determined by evolution? and • whether ageing should be considered to be a disease?

15. http://stemcells.nih.gov/info/scireport/2006report.htm

16. 2. Old age as disease • The dominant view of old age from this discourse sees it as a stage in life medically defined. The critical distinctions being where people are in the first instance ‘at risk’ from a set of specific diseases and thereafter afflicted by them. • Old age from this perspective in not fundamentally about appearance of the body per se but about the diseased condition of the human body. • What marks old age from youth is its disease status. • Death is the inability of the body to survive the disease.

17. 3. Anti-ageing as life span extension • Recent scientific interventions have achieved dramatic increases in life span amongst yeast, nematode worms, fruit-flies and mice. It is suggested that these experiments open the possibility of greatly extended human longevity of perhaps twenty to sixty years. • Bio-gerontologists have developed new techniques and understanding of intra-cellular bio-chemistry and how it relates to ageing. Their prime anti-ageing strategies take the form of stem cell therapies, gene therapy and bio-chemical methods for upgrading cell maintenance capabilities.

18. The final stage of apoptosis; cleaning up after the death

19. From the perspective of the bio-gerontologists ageing is a fundamental biological process applicable to all life dependent on sexual reproduction not just humans. Hence old age is the end stage of a sequence of biological developmental processes. • ‘Old age’ can be identified from cellular processes, hence cellular senescence. • It is distinguishable from youth by biological markers such as shortened telomeres or the cessation of mitosis. • Death is cell death - apoptosis or necrosis. • This view detaches old age from the level of humanity and even level of the organism.

20. 4. Anti-ageing as immortality • Some bio-gerontologists make the explicit claim it will be possible to reverse ageing and to create a form of immortality (they don’t exclude death by accident merely death by ageing). • The best publicised of these is the SENS programme (Strategies for Engineered Negligible Senescence) promoted by Aubrey De Grey. • Other scientists warn of over optimism. They are concerned to avoid undeliverable claims that shift the debate back into the realm of fantastical prophecies and out of the realm of ‘science’. • Significant life extension is not currently a possibility for humans although many assume it to be a readily achievable goal. There is considerable dispute about the time-scale for scientific ‘progress’ and about the priority such science should be given.

22. 4. Immortality and old age • Old age from this perspective is an unnecessary burden; it is a result of failure to technically control a biological process. • The boundary between old age and death is removed leaving the boundary between youth and old age problematic. • Science plays a key cultural role in modern society in authenticating knowledge and is presumed in modern cultures to be an omniscient problem solver. Hence reports of dramatic new discoveries on ageing reinforce the view of old age and death as technically soluble problems. • However this set of understandings inevitably condemns old age and older people to the status of failure and to meaningless social roles.

23. Two questions: can it be done? should it be done? • As social scientists we can alert people to the consequences of the belief that it can be done. • And we can comment on the link between culturally dominant values and the arguments produced by philosophers and ethicists. • Christine Overall (2003) Aging, Death, and Human Longevity: A Philosophical Inquiry contrasts prolongivist v. apologist points of view

24. ‘Apologist’ argumentsagainst the prolongation of human life 1) Why death should not be dreaded 2) Why death is a natural part of the ‘rhythm of life’. 3) Why the human life span is long enough 4) Why the social cost of prolonging human life is too high.

25. ‘Prolongivist’ arguments in favour of extended life. 1) The intrinsic value of longevity – gain experience, knowledge, wisdom (?) with increased life. 2) The intrinsic value of life – all life is good so the more the better. [this is the one that convinces Overall most.] 3) The right to life – ones share of life doesn’t get used up or run out. Inequalities of life expectancy are unfair. 4) Advances in health care and other contributions to human well-being – life can only get better [cannot stop science, gain from increased knowledge and experience of those who have already acquired knowledge]

26. Other key issues • Resource limits of the planet • Loss of all one knows • The problem of boredom - “millions long for immortality who don’t know what to do with themselves on a rainy Sunday afternoon.” • Preserving personal identity [the key role of extreme individualism of modern culture is always underplayed in the philosophical debates and sustaining collective identities undervalued] • Chronological age and its physical limitations [what age do you want to be immortal at?] shades into human enhancement and post-humanism.

27. What are the consequences of life without limits? • “If prolonging life is, ceteris paribus, desirable, are there any reasonable limits to the length of a good life? How much more life is it desirable to have? Is there an upper limit to the human life span that is incompatible with being human? The last is not a question primarily about biology but is rather about what it means to be human in moral and existential terms rather than physical terms.” Overall 2003:122

28. Conclusions • Can we extend the life span? – not now, unlikely in the foreseeable future, not by definition but because of shear complexity • Should we ? – more important and immediate question, at root of ageism, so we need to clarify our priorities.

29. Conclusions The great investment of time, resources, and cultural ingenuity to find ways to live longer and if possible for ever, have consequences for old age. Fantasies of immortality are bad for older people. These attitudes: • Identify old age as a problem waiting for a solution • Postpone action on current problems of old age • Seek technical solutions to cultural problems • Waste resources in pursuit of undesirable goals • Inhibit research into death as a natural event and the final stage of the life course as a positive meaningful coda.

30. This presentation, and various papers can be viewed at:http://www.people.exeter.ac.uk/JVincent/