The Changing Face: Extended Longevity

Some changes happen so gradually it takes human society decades or centuries to notice. Most intellectual revolutions, from the scientific to the industrial, only appear revolutionary in hindsight. At the time, people see only incremental progress, and they give little thought to the world-shaking significance of the few changes they observe directly. Those few who protest this cultural inertia, who speak in wonder or terror of the consequences they see coming, usually find their visions dismissed by society at large as hysterical or irrelevant. Nevertheless, such changes do come to pass, often leaving great upheaval in their wake. The greatest challenge, and the greatest opportunity, that society faces in modern times comes from the drastic increases in life-expectancy that medical technology has brought humanity. Though few if any cultures have changed to adapt to current life-spans, all of them must and inevitably will alter their perspectives on life — and death — in order to cope with the radical social change following in longevity’s wake.

Present day political economics, as well as science and technology, show a very clear trend towards increasing the average human lifespan. This shows up globally, along with a tendency towards a lower birthrate as countries’ economies advance and the standards of living improve. Social patterns have already shifted in response to longer lived, healthier populations, and the arc of a person’s life will change even quicker along with inter-generational relationships as life-expectancy grows. Death will remain prominent, but the human relationship with death will alter considerably. The real possibility and feasibility of increased longevity will impact human society far more than anyone expects.

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The current draft of the social contract overwhelmingly supports the aging and the elderly. Taken together, Social Security and Medicare represent the lion’s share of the federal budget, as the U.S. spends more on retirees even than on defense and the military. Normative judgments, of course, vary. Some believe the country owes a comfortable living to those too old to support themselves. Others argue that each individual must assume responsibility for his or her own retirement, especially considering the nation’s budgetary woes. Regardless of one’s moral stance, the numbers speak for themselves. Social Security and Medicare together make up over a third of the national budget, and with the baby-boom generation reaching retirement age, these programs will grow faster than any other expenditure. America committed itself to supporting the elderly back during FDR’s New Deal and Johnson’s Great Society initiative. The country did not expect, however, that the elderly they committed to supporting would grow so numerous or live so long.

Globally, one cannot miss the general trend. Citizens in advanced economies live longer on average than ever before. Fortunately, the Malthusian scenario has been averted because industrial nations also have lower birth-rates–often below the replacement rate of two children per mother. Developing nations such as India already show a glimmer of these trends, and economists predict the Earth’s population will peak sometime in the middle of the 21st century before starting to fall. How quickly it falls will depend on how long people live. That in turn will depend on how inexpensive and widespread life-extension technologies become. Basic medical care, while necessary, won’t sufficiently improve people’s lives. The aging human presents more and more of an engineering problem as time goes on. Joint replacements and heart-valve replacements have already become the norm, and scientists have recently made progress developing replacement kidneys and tracheas. More advances will follow, until the entire body becomes renewable and possibly upgradeable. If human society desires the extension of actual life, as opposed to a drawn-out decrepitude and slow death, it will need all these technologies and more.

Humans have more than doubled their effective lifespan through a host of different technologies. Indeed, at this point several distinct scientific and medical fields serve the demand for better health and longer life. Vaccines and antibiotics belay disease and infection. Statins lower cholesterol while blood thinners aid the heart. Doctors can replace heart valves themselves along with knees and hips thanks to the nascent field of bioengineering. Scientists have only just begun peering into the human genome, the four-letter book of life, and once they identify genetic factors associated with aging, genetic longevity enhancement will become a reality. Given the ancient human demand for immortality, a myriad of disciplines from bioengineering to neurology will continue receiving interest and financing and keep paying dividends as they advance.

brainPresident Obama recently called for a brain research initiative, ostensibly another moonshot though it bears closer similarities to Nixon’s “War on Cancer.” While intended as a venture of pure science, part of the impetus for this ten-year project lies in gaining a better understanding of how the brain fails. Alzheimers and general dementia ravage the elderly, producing far more pain and suffering for them and family members than any physical ailment. A brand-new body serves no purpose without a functioning mind. The biggest hurdle life-extenders face lies within the most complex system of matter and energy yet discovered by humankind. Understanding the brain, at least enough to halt the progress of degenerative disease, will influence all other sciences and technologies that deal with complexity and information processing. Only with a grasp of such complex systems and how they function will human culture have any chance of coping with vastly increased longevity.

Subtle changes in behavior have already begun to manifest in society. Young-adults spend far more time in the education system, some well into their thirties. This makes perfect sense if one expects to work into one’s nineties, rather than retiring in one’s sixties as many do now. Such decisions may not occur consciously on the individual level, of course, but they reflect a broader change in this culture’s view of aging generally. Many have observed (often critically) that childhood in general lasts longer than it used to. At present, so does true old-age, with all its aches and ills. Adult life gets the squeeze, at the moment, but this will necessarily change for those whose primary desire isn’t dependence. Another common criticism of modern culture cites a general lack of long-term thinking. In fact, while futurism and dreaming serve as a wonderful diversion for many, the majority lack the capability for long-term action. Many boomers caused one particular crisis-of-the-moment by failing to save for retirement, under the assumption that pensions and Social Security would do the trick. Whether the current generation makes the same mistake depends on several factors. Today’s youth may still see the predicament in which their parents and grandparents find themselves and take steps to avoid it, either by saving more or working longer. Or, they may not.

Though the outcome remains far from certain, extended life-spans will likely have a greater effect on human behavior than any other product of technology. New age classes may develop, in time. Currently, society acknowledges children, adolescents, young-adults, adults, middle-aged, retirees, seniors, and the ancient. These divisions may grow more fluid, or more calcified. How an individual cares for his or her parents or grandparents while they still care for the great-grandparents will make for an interesting social dance. Increased longevity will heighten economic competition, as well, with decades of experience pitted against cutting-edge education in the workforce. In the political arena, those over 65 already vote at a far higher rate than those 18-24. Our national policies and priorities reflect this trend, but it may not last. When many more generations insist on representation, each with their own social and cultural era of ethics, voting blocs and their issues will take on a much more interesting character. Arguably, culture evolves with each new generation. The older generations do not simply go away, however, leading to sharper divides and more heated disagreement over a host of social issues. Aside from the economic issue of supporting the elderly as well as all other citizens, social competition may become the greatest challenge facing a longer-lived human race.

young and oldHow humans adapt to this new environment will determine their success in maintaining social cohesion. Part of this will have to do with the nature of the aging mind. Assuming dementia and other brain problems no longer affect an elderly individual, and assuming that individual still possesses a working physical body, nobody knows how the consciousness will adapt to other radical changes technology will surely bring. As one lives longer, one may continue to get “set in one’s ways,” leading to dramatic tension as the world grows more and more alien. On the other hand, with the memory and experience of many decades, one will have a greater knowledge base to draw on in dealing with issues of the moment. Coming from the other side of the spectrum, youths may develop a closer relationship with their parents, grandparents, and great-grandparents, returning to the classic model of the extended family. Or, youths may resent the economic and political dominance of obsolete generations even more than they do now. Society as a whole may stagnate due to an aged population, or it may stabilize and advance even more quickly as a result of a larger workforce and more collective wisdom all around. All these questions and more remain outstanding, as society lacks any past experience or comparable models to draw upon.

The issue of death will force another radical change in cultural consciousness. Fear of death drives the longevity movement and its attendant government expenditures. Over a third of medical expense occurs in the final weeks and months of life, and do little more than draw out a semi-conscious hospital stay. Medicare covers a host of procedures designed to keep a person alive at all costs (financial and personal) while Social Security subsidizes their continued existence. Irrespective of opinions as to the value of these practices, aversion to death undoubtedly drives such enormous expenditure. To date, only three states have “Right to Die” legislation on the books. In all others, doctors, hospitals, and the government have no choice but to keep individuals alive, regardless of their quality of life, until they reach a state where a Do Not Resuscitate order can take effect. The movement for death with dignity cannot yet stand up to the edifice of moral and religious biases that call for life at all costs, no matter the pain or the expense involved.

dancing_tophat_skeletonThis will change. When an individual can live for an arbitrarily long period of time, many people will undoubtedly reach a point where life no longer interests them. Whether because of physical pain, the loss of friends and loved ones, or sheer boredom, the desire to voluntarily and peacefully end one’s life will become more and more common. Dr. Kevorkian became a household name for his efforts to aid these people. Without medical assistance, suicide becomes messy, painful, and unreliable. Nevertheless, many still feel that a life of crippling arthritis, dementia, or a machine-aided bedridden existence beats an “unnatural” death. This issue already shows signs of coming to a head, but the larger cultural view of suicide will change more slowly. More societies may honor the choice to end one’s life under reasonable circumstances. Conversely, this culture may cling even more closely to life the older it gets, and increased longevity may only drive the search for true immortality further. Whether a human’s natural rights grow to include the right to die remains to be seen.

The resource issue becomes trivial when compared to the larger social issues extended life will bring. As stated previously, people tend to reduce their birth-rate with increased economic comfort, and demographers expect population to start falling by 2050. Moreover, advanced economies tend to use resources more efficiently, and technology continually reduces energy demands and expands energy supplies. Of course, stupendous challenges face global society as it attempts to bring everyone up to a modern quality of life. In the absence of longevity, however, these issues would remain. Populations would still grow to their carrying capacity or beyond, and the young would demand as many comforts and benefits as the old. Thus, puerile notions such as arbitrary age limits would change little. That said, technology shows a tendency to get cheaper and more widely available over relatively short periods of time. The wealthy elite will not monopolize longevity for very long. Basement biohackers already do more than the most advanced genetic labs of twenty years ago, and they alone will ensure people’s access to a substantial portion of the technology coming down the pipe.

At this point, scientific research and everyday human desire make extended lifespans a given. Unless development reaches a plateau, an absolute limit on longevity, society will have no choice but to deal with the consequences. These include the economics of supporting the elderly, the issue of fairness and entitlement to such technologies, and the new social tensions and changing relationships between varying degrees of young and old. Of course, longevity will produce many positive benefits as well. Aside from the obvious fact of more life, culture will benefit from expanded perspective and eyewitness accounts covering centuries of history. Increased productivity among the middle-aged will offer great economic potential. Extended youth, too, will allow for deeper education and more opportunities for exploration and risky innovation. Humanity has given itself a marvelous opportunity. Everything has its costs, however, and how society copes with the new frontier depends in large part on how well it anticipates the unintended consequences.