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Sunday, May 23, 2004

Is Aging A Natural Kind?

There is a saying that nothing is inevitable but death and taxes, but it is beginning to look, strangely enough, as if taxes will end up being the more inevitable of the two. In fact, reading the reports of gerontologists these days (for highly readable accounts of what I am talking about here and here are pieces by Aubrey de Grey) sometimes suggests that if we just put our tax dollars to work in the right places we might have the whole death thing licked in no time at all.

Once upon a time, aging meant a shrivelling of features, a creeping infirmity of frame, a diminution of countless capacities, the loss of libido and of memory, a disastrously rising susceptibility to disease. Already, pharmacological interventions are changing much of what it has meant to embark on the profound metabolic processes we customarily associate with aging. It is such a commonplace to cynically observe that face lifts and Viagra have not in fact conferred immortality upon the "foolish" and "superficial" Boomer Generation that I think we sometimes overlook just how profound a transformation these interventions have introduced into our sense of what we can properly hope for and expect from a human life.

With each passing year, indeed with each passing month, medical science offers up to swelling ranks of gerontocrats in the "developed" world genetic, prosthetic, pharmacological interventions into what have been called the “diseases of aging.” Although it is foolish to leap off the deep end and start talking in an alarmist or ecstatic fashion about the immanent arrival of human “immortality,” one has to wonder just how proximate is the date of the arrival of the longevity singularity, the threshold date when average life expectancy begins to increase one year per year in a sustained and sustainable fashion.

As our assumptions and expectations about what it must mean for a human body to age fall one by one in the face of medical intervention, I begin to wonder if there really is such a thing as "aging" in the first place. Is "aging" a word that will soon outlive its usefulness?

Maybe "aging" is a word like "instinct": Just as when we propose to explain a behavior in the natural world by positing an instinct as its source we are admitting our ignorance about its actual causes while following the forms of an explanation of causes, maybe the word "aging" is also one we have used to pretend mastery in the face of deep perplexity.

What remains of "aging" when "its" underlying processes and outward forms explode into a rich tableau of multiple and competing descriptions, each one of which then, in turn, becomes a field for intervention rather than a "natural" limit to contemplate?

Scientists are beginning to speak not just of "diseases of aging," now, but of "aging as a disease." And inspired by this new confidence, some technophiles are beginning to call for a "War on Aging." But is it really right to think of "aging" as a singular enemy we soon hope to be equal to, or is it that we are discovering that "aging" is another artifact of ignorance, a shorthand label for complex realities we never before could get a handle on? Won't it remain true, for example, that the post-senescent healthcare provision of actually living human beings will involve significantly different sorts of treatments and concerns than did their pre-senescent healthcare, just as pre-adolescent and post-adolescent healthcare differ in some significant respects? To render much or even all (surely a dubious hope for quite some time to come) the damage hitherto associated with statistically typical experiences of senescent processes negligible through medicine is not the same thing as eliminating senescence as such through medicine, is it?

Treating "aging" as a natural monolithic thing too easily misleads us into imagining that our interventions into its many forms amount to a comparable intervention into the other mysterious monoliths with which "aging" has been associated historically –- mortality, finitude, and so on. Quite apart from questions about whether or not any kind of narrative coherence for a legible "self" could be prolonged to the timescales celebrated by some enthusiasts of longevity and rejuvination medicine, there is nothing to suggest that increasing healthy post-senescent longevity would confer even bodily "immortality" on beings still prone at all to disease, mischief, or mischance. Nor should we imagine that tweaking our biology will confer on us some kind of godhood.

If anything one hopes the promise of the ongoing therapeutic amelioration of the processes and effects we have historically associated with "aging" will mean that we will cease to freight these pernicious processes with this enormous metaphysical baggage in the first place. Since even modest increases in average life expectancy, however healthy, will introduce unprecedented problems and promises for global stability, social justice, welfare provision, environmental sustainability among other things it seems best not to get too distracted from these urgent inevitabilities by dwelling on what looks to me like little more than confused vestigial theological meditations on eternity.

As we learn that there is not just one way that "aging" threatens to claim our lives, we set out upon the road along which ever more of our lives are our own to claim. Perhaps the point will not be so much to defeat "aging" as to proliferate its forms and so replace it simply with the story of our lives.

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