We’ve already discussed our moral obligations to the very very young. Now I’d like to talk about our obligations to the very very old.
Fetal stem cells come from a fertilized human egg, and therefore are morally problematic to many people. But stem cells (of any kind) may lead to an second, even more difficult moral problem. One of the possible uses for stem cells is to custom grow organs for transplant. On the surface this seems like an unambiguously good thing; not only would it provide replacement organs for anyone who needed one, but those organs would presumably be in perfect shape, and if grown using an adult stem cell from the patient’s own body would be a perfect genetic match and would therefore not be susceptible to rejection. But there’s a deep problem lurking here, because it is possible that the technology would allow an aging person to replace his or her organs as they grew old, prolonging life far longer that was previously possible. Given the rapidly increasing expense of medical care, this kind of procedure would almost certainly be extremely costly.
There are several other medical technologies on the horizon with a similar promise. For example, a dietary treatment called calorie restriction has extended both average and maximal lifespan in every species in which is has been tried. Calorie restriction entails a diet which is completely nutritionally adequate but has around 30% fewer calories than normal. The fact that it extends maximal lifespan is quite remarkable, because it implies that calorie restriction does more than just improve health. Modern medicine has dramatically increased average lifespan, from 40 a few hundred years ago to near 80 today. But a few hundred years ago the very oldest people lived to be around 110-120, and improved medicine has not increased that. Increasing maximal lifespan implies that the aging process has actually been slowed down. The oldest known calorie restricted rhesus monkey, for example, lived to be 40 years old; this would be roughly equivalent to a 150 year old human. Furthermore, calorie restriction reduces age related diseases. As a consequence, not only do these animals live longer than normal but they remain healthier. They aren’t invalids; they maintain younger characteristics for longer than their control counterparts.
This is important because we don’t really understand why people age. Well, of course they age because time passes. But we don’t know the biological cause of aging, why at some point after adulthood cells lose their youthful vigor. Is it due to accumulated cell damage caused by free radicals? Is it due to telomeres (parts of your DNA that in part prevent uncontrolled cell growth) getting shorter? Is it due to apoptosis? Or some other reason, or all of the above? Nobody really knows.
No one expects humans to voluntarily restrict their diets, of course. However, the fact that biologists now know of a treatment that slows aging gives them a foot in the door — a way to design experiments that allow them to figure out what causes aging. The hope is that once the mechanism is understood, drugs could be designed that mimic the effects of calorie restriction without requiring the dietary changes. Again, this is likely to be very expensive.
So the questions I want to ask are these. First, what are the social implications of creating a very long lived class of people? How do we choose where to expend our resources, and do we owe it to people to help them live as long as medical science allows, even if that entails great expense? Even if you assume that we do away with public or insurance-based financing of these treatments, there would still be a problem in that we would be allowing the creation of enormous class disparities, only this time it would be in health and lifespan in addition to wealth. These are problems we’re already starting to have; seniors have much higher medical expenses than average, and we haven’t really figured out how to deal with that. We have to deal with this basic question whether any of these technologies pan out or not, and if any of them do the problem will get much much worse. In fact, it sounds like a bad science fiction dystopia.
Second, are there any theological problems here? Is it a problem if peoples’ average lifespan is 150? 200? 300? It’s very unlikely, but it’s at least conceivable that someday aging could be prevented entirely, which would mean that people would die only due to disease or accident. A very careful, very lucky person could be nearly immortal. What would that mean for the plan of salvation?