Pratt Museum: Kachemak Bay's Museum of Arts, Sciences, & Humanities

Community Conversations

Bio Ethics

A position paper by Dr. Deland S. Anderson based on a Community Conversation held at the Pratt Museum on 19 November 2004.

More than a dozen people assembled at the museum to discuss the topic of bio ethics. They represented all different walks of life and ranged in age from 18 to 78. As might be expected with such a diverse group discussing a topic as broad as this one, the conversation covered a lot of ground. It also occasionally cut pretty close to the bone as participants began to reflect upon life choices involving medicines, diet, surgical procedures, longevity and human populations, and immortality.

The facilitator started the ball rolling by bringing up one of the most recent major developments within the field of medicine, and potentially one of the most divisive to society, namely gene enhancement therapy. Researchers affiliated with various universities in the U.S., including Harvard and Berkeley, have striven in the past decade to develop techniques to lengthen the lives of various subjects through altering their genes. Though techniques vary to a large degree, the more dramatic procedures focus on preserving or “rejuvenating” mitochondrial DNA in the cells. Varying degrees of results have been achieved in the laboratory. Fruit flies, worms, and rats have all been given longer lives, sometimes as much as 20% longer. Of course little can be known about the quality of the life enjoyed by these subjects. But this has not stopped a consortium associated with the Berkeley team of geneticists from marketing a dietary supplement designed to make one’s mitochondria younger, thereby halting or even reversing the normal effects of aging. These gene therapists promise improved memory, vitality, and more.

But this raises a host of questions. Henry I. Miller of the Hoover Institute at Stanford University maintains that gene-enhancement therapy is scientifically, legally, and ethically no different from a nose job, for example. But, he adds, it promises far more benefits to society. Any number of debilitating diseases, like diabetes or Alzheimer’s, might be successfully treated through gene therapy, not to mention such socially stigmatizing conditions such as baldness, shortness, or obesity. And it’s the latter items that have some leaders in gene therapy research concerned. They simply don’t want their knowledge turned toward the aim of making average people a bit better. The fear is that people will treat gene therapy like hair coloring. Imagine home mitochondria jobs going wrong! But they have another concern as well. Even if gene therapy is restricted to treating debilitating diseases, how will it be regulated? What is to determine who can benefit from it, need or the ability to pay?

This and a host of other questions swarm around the topic of increased longevity through gene enhancement therapy. But other techniques of prolonging life also came under scrutiny during this conversation. For, whatever technique is employed, significantly extending the average life span will significantly impact society. What if the quality of life of the person who is to live longer is poor? As one participant put it, why should someone be responsible for someone else’s vegetation costs? What about the cost to Social Security or to society in general, wondered another. But what if we don’t prolong a person’s advanced old age, like we would if we made an 80-year old able to live to 180? What if instead, the person began to slow the process of aging at 40, say, and hold there until he or she expired a hundred or more years later? What if, one participant posed, our techniques allow us to spread a “normal” life span over a much greater period of time? In that case, people might not go through puberty until 40. As this last thought illustrates, even if the quality of life is high for the longer-lived person, questions still arise. As one participant remarked, there is need to make room for the younger generation, to step aside. And this is not merely limited to resources. The increased use of resources by an extremely long-lived population in a voracious society like the U.S. is a daunting thought on its own. But other things are involved as well. What would the younger generations do if the elders refused to retire? What if the elders plundered the ranks of the younger generations for breeding partners, leaving the youngsters with few choices within their own age set? What if the elders consolidated political power to reform laws to favor the advanced aged? What if…?

What if …? There is no what if, as someone pointed out, it’s already happening. A greater and greater share of available resources is being used up by the older members of today’s society. Indeed, it might be argued that, as the average age of the populace in the U.S. increases, the country itself is being made over to suit the aged. We already employ pervasive techniques for prolonging life, so why stop now? We eat colorful organic vegetables, limit the intake of toxins, exercise, learn languages, avoid risks of injury and exposure to disease, take vitamins, undergo complex surgical procedures, implant machines and devices in order to restore bodily functions, and employ a pharmacopoeia of drugs. What, do you want to kill yourself just to get out of the way, one person probed? Or perhaps we should do as the Japanese proposed—establish a law that when you reach 70 you have to leave the island. At this point, someone suggested lowering the average life span to 40 years.

A rift began to open in the group. Some argued for extending one’s life through whatever means available, including head transplantation/body donation (what you call it depends on how you look at it). Others argued that you need to live within the limits of your body—accept the risks of life and let it take you as far as it can. A story was shared about a Hindu holy man who throughout his long life refused any kind of medical care, arguing that the body itself is a disease. This led someone to quip that life is a sexually transmitted fatal disease. Nevertheless, it was pointed out, it is wrong to exploit other people to prolong your own life, and that’s what’s going on around the world with economic exploitation so we can live cheaper, better, longer. Someone else remarked that a recent trip to the Mayo Clinic underscored the disparity of health care and availability to health care in this country. A whole underclass of workers is being exploited to make quality health care available to the wealthy or the well insured. Education is key to setting limits on life, one participant argued. Educate people in the duty to die, suggested another. But, someone remarked, a recent nationwide study indicates clearly that college educated people are more likely to opt for life-prolonging techniques than their less educated peers are. It depends on the culture and the education, someone remarked. For the Hindu or the Buddhist, to prolong life is just to put off samsara, the cycle of birth, death and rebirth that leads to ultimate spiritual release. So life must be considered in relation to spirituality. Someone added, for various religions, putting off death is also putting off immortality: to live an indefinitely long period of time is not to achieve immortality.

If one may attempt to summarize views on this volatile topic, it might be ventured that some clearly favor using whatever resources available to prolong life, while others view life as an allotment to be accepted. Those in the former group are pushing the limits of what society will accept in the name of longer lives, to wit stem cell research. Those in the latter group are either interested in maintaining a healthy planet with a sensible population size or testing the tolerance of a medical culture that says you have to live as long as you can, such as Dr. Kervorkian has done. In developed and developing countries throughout the world today, the former group is making huge advances at the expense of the latter group. In this country, for example, you do not have a choice whether you want to fund the genetic enhancement of worms—it’s already being funded by taxpayer dollars through the National Institutes of Health. Those dedicated to prolonging their own life or to increasing the average life span employ all of the usual techniques. In addition they are increasingly likely to employ as well such exotic techniques as gene enhancement therapy, organ/whole body donation, mechanical, robotic or cybernetic technologies including “uploading” or feeding one’s mind into a computer and leaving the whole mind/body problem behind, etc. On the other hand, some still take a minimalist approach. The ancient Chinese Taoists said the wise ones attained immortality by using fewer and fewer resources until they subsisted wholly on air. Someone suggested instead that we could lunch on the life-enhancing algae of Kachemak Bay and wash it down with the longevity granting rock flour waters of Grewingk Lake.