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Inez de Beaufort

professor of Health Care Ethics at the Erasmus Medical Center of Rotterdam

professor of Health Care Ethics at the Erasmus Medical Center of Rotterdam. Speaker at the lecture series Culture and Life. Dialogues on the Impact of Biotechnology organized by the International Center for Scientific Debate (ICSD) and the Centre de Cultura Contemporània de Barcelona (CCCB)


As you grow old, you lose your interest in sex, your friends drift away, your children often ignore you… Age also affects our appearance: baldness, wrinkles, drooping eyelids… We’ll all suffer some of these effects, even if we deny it.

In our society, with a huge emphasis on beauty and the attraction of youth, ageing is not easy. Living younger, rejuvenating or even striving for immortality are familiar themes for humanity. We fear ageing and death. In fictional stories, you can get immortality but you have to sell your soul to the devil, the results of which usually leave much to be desired, as we know from Oscar Wilde’s Dorian Gray!

Antiage is an attractive perspective: we want a longer and healthier life. Behind it lies a huge industry that offers many therapies and devotes huge amounts of money to this purpose. Some say 120 is about the maximum and others believe we might become a lot older. It’s important to emphasize that there are two layers in the debate: life extension (adding years to life) and slowing down the ageing process (adding life to years), which concern different purposes.

Suppose I have developed a pill without side effects with a very strong rejuvenating effect. Would you take the pill if it were offered to you? What arguments would you consider? Do you really want it or are you influenced by society’s expectations? We have our designated areas for the elderly, medical disciplines, hospitals, residences... We consider it decent to take care of them, but often they are lonely and find themselves in the margins of society. The elderly feel ugly, superfluous and very expensive. Every newspaper every day now tells you about the cost of ageing societies. To take the pill, according to that argument, isn’t a personal option but a social one caused by western culture with its merciless idealization of youth. Were we to live in a society that respected the elderly, we would carry our mature ripeness with pride and feel good in our ageing bodies. 

It is important that we think about how we look at old age and old people. There is certainly some force in this argument. I would welcome the opportunities of a longer life because at my age you become painfully aware of all the possible lives and experiences you cannot have anymore. But what would it mean for younger people? The President’s Commission of the United States in its report is very pessimistic: “Many of our greatest accomplishments are forced along by the spur of our finitude and the sense of having only limited time. A far more distant horizon, a sense of essentially limitless time, might leave us less inclined to act with urgency.”

Would a longer life lead to a continuous postponing of things? Would we lose the capacity to have a carpe diem attitude towards life? I think the President’s Commission is too gloomy. Even if, on average, we would live longer, we would still always have the threat of death. I’m not sure that the perspective of living longer would take away the incentive to accomplish things and to act with urgency. On the contrary, one might want to do more things and have more experiences. Curiosity for life and eagerness to live, those are the motives we have.

Another question is: Would we be bored? Would somebody still love me? British philosopher John Harris, in his book Enhancing Evolution, has argued that those who think that they will be bored should not strive for longevity because they are not good candidates. Those of us who do not have terminal failure of imagination should be left to create new ways of enjoying life. I’m not as convinced as John Harris that people can so easily be divided in the terminally boring and the rest of us. Even those of us who would not be bored if we lived 150 years must consider: how many next generations do we want to know? Again, the US President’s Commission emphasizes the cycle of life argument, “Each stage in our life is defined relative to the others and to the whole of life. Age retardation would therefore affect not only our later years, but all of our years.” Does changing the seasons in the cycle mean that the cycle itself loses its meaning? I do not think so.  Making some stages in the cycle last longer seems to be quite possible without losing the whole notion of the cycle. I am not convinced by the argument of the President’s Commission.

This brings us to another question: Am I going against nature? Is it natural to age and to die at a certain age? What is normal now was not normal a century ago when life expectancy was a lot shorter. Does the fact that something is normal make it morally good? Prostate cancer or Alzheimer’s are normal in elderly men, surely this is not an argument against developing treatment. Sometimes it is argued that only natural means (good hygiene, exercise, etc.) are allowed, otherwise it’s not okay. If one uses operations or genetic treatments, then it’s morally doubtful. But, why not use unnatural means if they work?

Societies, families, communities are built in a specific way and life extension would endanger or even destroy the balance of this system of coming and going of individuals and generations. The first argument is that there are already too many people but it has also been argued that people might have fewer children if they lived longer and, hence, it would be a solvable problem in the long run. I have wondered if people would have more successive families because they would have more time. I’m not sure this argument is decisive against ageing. The point of longevity is that you live longer and that you have the experiences and the memories, and the continuity, that it is your story from beginning to end and not multiple people living different lives in the same body.

Another problem would be that there would not only be too many people in general, but too many old people. There are already lots of debates on the ageing society. It is often argued that old people are a burden as they need care and block the way for younger people. If the old are a lot younger physically and mentally, they can take care of themselves. This, again, has to do with the notion of the cycle of life and renewal. Answers may lie in the fact that younger people would start up new companies and find new, innovative activities. But maybe that holds only for the extremely talented. Will we reach a point where we are at the end of our creativity? I’m relatively optimistic and hope that if I am out of ideas in a certain role, say as an Ethics professor, I may be creative in a different role, say a jewelry designer. I hope that there is this stock of mental plasticity that will help us find new ways of living. If not, then, I think it would be necessary to have obligatory expiration dates. Harris speaks of generational cleansing and of the old as a barrier for the young. This would involve deciding collectively how long it is reasonable for persons to live in each generation and trying to ensure that as many as possible live healthy lives of that length. 

And my final question, who has access to this pill? This is a big debate. Should we distinguish between luxury and non-luxury treatment, through a system of merit… It isn’t very realistic that everyone would have access. This would be one of the big problems we would have to face.

Summary of the conference The New Ages of Life given by Inez de Beaufort on 24 October 2011 in Barcelona as part of the series Culture and Life. Dialogues on the Impact of Biotechnology organized by the ICSD and the CCCB.

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