Life expectancy

The front page of yesterday's "I" newspaper carried the story that some researchers believe medical science is close to the point where eliminating almost all deaths from cancer among those under 80 years of age becomes a realistic possibility.

I hope they are right, and this would be a good thing, but we must recognise that it will have consequences.

Regardless of the cartoon rhetoric of the opposition about "Tory cuts" the problems which both the NHS and social care systems are currently experiencing are not primarily due to the policies of either the present government, or the previous Labour government, or indeed the Tory government before that.

The main reason for the massive upsurge in demand for medical services is that the NHS is the victim of its' own success. We have an aging society which is partly due to social factors but mostly because over a whole range of areas, premature mortality is calling.

Far too many people are still killed on the roads, but through a combination of safer vehicles and changes to human behaviour, the number of people killed in traffic accidents has reduced almost every year for decades as drink-driving, speeding, using a hand-held mobile while driving etc, etc become less and less socially acceptable. More people still smoke and overeat than is good for us, but people are becoming more and more aware of the issue and more of us are starting to do something about it - and I'm sure today's headlines about the considerable improvement in life expectancy if you take regular exercise will be one more drop in the steady drip-drip of information which gradually gets this into people's heads.

These social changes combined with better medical care means that literally millions of older people who, had they been born twenty years earlier would not have survived to their present ages, are still alive - and let nobody misunderstand me, this is a very good thing - but with enormous resource implications for the NHS and for social services.

That is why successive governments of all colours which have increased spending on the NHS in real terms year after year are regularly accused of starving it of resources.

We have that problem and will have huge challenges in the future with moderate changes to behaviour and the present improvements to medical science which have essentially enabled a much larger proportion of humans to reach the natural lifespan of an unmodified Homo Sapiens Sapiens without shifting that basic lifespan.

A cure for cancer, welcome as it would be, will further advance that shift and give us the same resource challenge on steroids.

But that is nothing to what will happen if and when - and I would not bet my shirt against it happening in the lifetime of people reading this - we work out how to switch off the aging process.

There is a natural "self destruct" procedure built into our genes, and sooner or later some scientist will work out how to confirm the "cancel self-destruct" command.

The end of death from old age will not mean immortality - because people will still die from accidents, from things which will still occasionally go wrong with the human body, and so on - but it will mean a massively extended lifespan. That in turn will mean massive social and economic change. It is not too early to start the proper debate - beyond what has been appearing for the past few decades in novels like "Trouble With Lichen," and "The End Specialist" - on how to deal with this.

I have four suggestions

1) The first point to make is that when the cure for aging is invented, trying to completely ban it would make Prohibition or the present "War on Drugs" look easy. King Canute knew when he ordered the tide not to come in that the command was a waste of time: he was making a point, Trying to ban a cure for aging would have even less effect than Canute's order to the tide.

2) It may, however, be possible to manage the rollout of the cure so that it reaches people in a controlled and fair way, and in the process buy enough time to start dealing with the social and resource implications

3) Part of this would have to be some form of compact which means that you cannot both have the cure and produce lots of children. An extreme policy would be to say that you can only have the cure for aging if you agree to be sterilised: in practice we would probably not need quite such a hardline position to keep our population from exploding. But allowing people to both take the cure for aging and still produce a kid every other year for decade after decade would just not be sustainable. There would have to be some kind of trade-off between enhanced life expectancy and reproduction.

4) We would also need some sort of career limit: after a maximum of, say forty years in one profession or activity you have to resign from any senior positions and start again at the bottom rung, probably of a different profession.

It is easy enough now for political, social and economic organisations to stagnate if the same people stay at the top for too long. Remove death and retirement as the means to ensure that vacancies open up at the top creating opportunities for new blood and promotion, and this problem would become endemic and intolerable. Humans are not built for stasis and it would not be a healthy thing for society even if we were, so if people are not going to die or retire we must encourage them to move on after a while. Fortunately, though some of those who have to surrender positions of great power will resist, the natural human desire for a change and dread of boredom will mean that for the vast majority such a policy will fit with the grain of human nature.

There are many other things which will have to be done and this is just the start. I hope that by the time a cure for aging really does become reality, other people will have thought them through and society will be ready.

Comments

Jim said…
Im not sure if it could ever be acceptable. Who is to say that those alive at the time of the end of the aging process have the right to it. as you point out there can not be both the cure and no curbs on reproduction, but that leads to a moral implication of do we have the right to make that decision, and deny future generations the right to existence?

on careers, well i could imaging there may be a massive problem for undertakers :)
Jim said…
the Star Trek episode the Mark of Gideon looked at this issue. it shows the problem we may well face
Chris Whiteside said…
There are not going to be easy answers. Which is why I think society should have the debate now about how we will deal with this advance in medical science when it is made - very possibly in the lifetimes of some of the people reading this blog.

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