Stem Cells, part 2

December 17, 2004 | 13 comments
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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?

13 Responses to Stem Cells, part 2

  1. Adam Greenwood on December 17, 2004 at 10:23 pm

    Perhaps this would actually diminish class differences. The rich would consume all the own money in endless retirement rather than passing it on to their kids.

    Seriously, though, questions like this are open-ended enough that I think one really needs something like science fiction to handle it. A sensitively done SF story allows one to test a writer’s vision againts one’s instincts.

  2. Jack on December 17, 2004 at 10:58 pm

    Is it way off base to believe that we may have something to do with ushering in the millennium? I like the idea that the Lord is preparing the way right now for millennial conditions by pouring out his spirit in greater measure upon His children (generally speaking) Is it possible that this research might be useful in extending human life to the age of a tree?

  3. Derek on December 17, 2004 at 11:19 pm

    I’ve found that the more gas I put in my car every week, the more often it needs maintenance. So that calorie restriction thing makes sense.

    If the cost of my insurance goes up the older I get, then I will die when I can no longer afford to live. (Of course this is easy for me to say now, while I’m still fairly young.) But something will have to prevent me from going deeper and deeper into debt in the quest to save my own life.

    As for the theological implications, all we need is a Deus ex Machina to save everyone from the nearly endless wait for the rest of the Plan of Salvation to be played out. “Sorry kids, it’s time for bed” sort of thing.

  4. J. Stapley on December 17, 2004 at 11:29 pm

    What a complex set of issues…This is very timely considering the looming Medicare shortfall is something like 5 times that of Social Security (though you rightly state that there are issues outside of making this completely elective – Adam’s was not a jest. This is possibly the ultimate death tax).

    I just finished A Brave New World and there is something very pragmatic about death at 60…insane, but pragmatic. I do, however, know people that have lived full lives and live in intentional remoteness, so that when the time comes, it will be definitive.

    I don’t see anything innately wrong with cloning organs or whatever (though it does weaken the human genome). It is how the society decides to doll out the technology that becomes the difficulty.

    And as for the calorie reduction, that would be an interesting asceticism if one could start an utopist quasi-religion around it. Otherwise, society (I believe) would rather live a shorter life full of Big Macs than a longer one without. Though you state yourself that it is the potential mechanisms that are the interest, not the lifestyle.

    Oh, and Highlander was a great film…There can be only one.

  5. Clark on December 17, 2004 at 11:29 pm

    Given the ages of the early patriarchs it seems difficult to assert that living older is a sin. Although I am very skeptical of many of the claims regarding aging. On the other hand calorie restriction is healthy up to a certain point. (The point where one begins to look like a meth addict)

  6. VeritasLiberat on December 18, 2004 at 3:11 am

    “questions like this are open-ended enough that I think one really needs something like science fiction to handle it.”

    I remember reading a story called “The Martyr” that dealt with this…part of a collection by Alan Nourse called _Psi High and Others._ Anyone here remember it?

  7. danithew on December 18, 2004 at 7:28 am

    Taking the issue of growing new organs and replacing them with surgical procedures, it seems obvious that we are only talking about the heart and guts of a person? Some organs seem a little more problematic … such as the skin and the brain.

    So if there are some people who are wealthy and strong enough to undergo drastic surgical procedures and have their guts replaced, they’d still have extra-wrinkly skin and brains that were aging and degenerating at the normal rate.

    I’m just not sure what the quality of life then would be for such people. The issue of the brain is really the central issue I suppose. There are some people who stay very sharp into their eighties and maybe even nineties. But so many people mentally just aren’t themselves any more at that point.

  8. Glen Henshaw on December 18, 2004 at 12:08 pm

    Danithew writes:
    “So if there are some people who are wealthy and strong enough to undergo drastic surgical procedures and have their guts replaced, they’d still have extra-wrinkly skin and brains that were aging and degenerating at the normal rate.”

    A good point. On-demand organ replacement isn’t the fountain of youth. However, part of the degeneration you mention is due to the reduced functions of “the guts”, i.e. decreased bloodflow and oxygenation because of the heart and lungs becoming less efficient.

    Clark writes:
    “I am very skeptical of many of the claims regarding aging.”

    And rightly so, especially since there are so many quacks in the field. I chose the examples of stem cells and calorie restriction because, aside from the quacks, there is some really good science behind those particular ideas. Nevertheless, clearly the idea of slowing down aging is speculative at this point.

  9. Charles on December 19, 2004 at 6:37 pm

    There are many social impacts to consider with the latest breakthroughs in science and medicine. To a great extent we don’t have to wait for the world of today to catch up with the world of tomorrow envisioned by science fiction.

    One of the greatest social complicaitons will be cost. Even if proceedures as radical as these become more commonly affordable, the question remains. Does everyone have the ‘right’ to these treatments or are they a luxury. If everyone has a right to life, one could make the argument that everyone has a right to this science. But these treatments are no doubt the result of a very costly research done by private companies with obligations to their stockholders. How does this impact the taxpayers. Should a relatively healthy taxpayer encur the cost of someone who has mistreated their body? Before any social constructs begin solid boundaries must be considered.

    Another serious problem is that of retirement. When would the person retire? At the rate that social security and even private retirement accounts are going today, Doubling or tripling the lifespan would exaust those resources. People would have to continue working well into their later years. And with the ability to regenerate aging parts that may be plausible.

    Overpopulation would be another issue. Countries like China already demonstrate how an overpopulated country is challenged by rising birth rate and a declining death rate. Even expanding the average life by 20 years would add another generation to the world.

    How old should we live. Certainly the patriarchs of the old testament lived much longer than we do now. But how old should we live. What is our responsibility to society and natural law to live beyond when we should.

    My understanding is that the cutoff date could easily be placed at 100. I’ve come to this thought from two sources. My understanding of the millenium is that people will still be alive when it begins and that children can still be born during it. These people would then live to 100 years old and then be transformed to their perfected bodies, never tasting death. This is a theological view and may not be valid for a global scale but my second thought, if accurate might be.

    I heard a news clip that seemed to suggest that scientists have discovered that the human body does not continue to age after age 90. Once a person reaches 90 they will typically not die of old age but rather complications due to old age. The aging process itself has ended. If this is true than giving a person up to a decade after thier body stops aging on its own just sounds like a good arbitrary point to let them live to.

    Just some thoughts as I’ve seen them.

  10. Clark on December 19, 2004 at 6:59 pm

    I think that already the mandatory retirement age is too low. 40 is the new 30. 50 the the 40. And there are many, many people being very productive into their 70′s. Of course many people retire simply because they want to. And if they can afford it, more power to them. I’d love to retire at 45 and go back to school. However is maintaining a visage of old age that is largely a product of the WWII generation wise?

  11. Glen Henshaw on December 19, 2004 at 9:09 pm

    Clark:
    “I think that already the mandatory retirement age is too low.”

    I concur with that. I’ve read that the retirement age was originally set by Napoleon, who didn’t want to pay pensions for his soldiers and figured they would all be dead by 65. Does anyone know if that’s true?

    In any case, I don’t think there is any rational basis for choosing age 65, and even if there ever was that basis is certainly out of date.

    Charles:
    “Overpopulation would be another issue.”

    Yes, a huge one, and again an issue that we’ll have to tackle whether anti-aging technologies pan out or not. In an interesting way this is tied to the issue of the stewardship of the earth being discussed on the secular knowledge thread.

    I’m interested in the social problems that might be caused if we decide not to publicly finance this kind of health care and end up restricting it to the very rich. Does anybody have any thoughts on that?

  12. Charles on December 19, 2004 at 9:15 pm

    Clark has a good point and one I was inferring to. As people live longer, and more to the point have a better quality of life as they age, their retirement will certainly have them spending more money than generations before them. Not only in medicine but travel and other luxuries they would not have been able to enjoy with a lower quality of life.

    But that quality comes at a cost, and unless they are prepared to retire early and live longer they will likely need to continue working past the normal retirement age. But I would caution not to have any set mandatory retirement. I would hate to encur roadblocks as I tried retiring early just because I was better prepared.

    But more to the point, isn’t this really the afluence of America showing its head. After all, if your cars are paid off and your house is paid off and all you really need for your daily life is food, heat, electricity, etc. can’t a person make a very reasonable living at part time wages? Throughout most of the country the answer is yes. The choices we make in how we live determines how much money we will need to sustain us through retirement.

    Most of what has been discussed is more wants than needs.

  13. Charles on December 19, 2004 at 11:55 pm

    Glen,

    I think that restricting this to the rich will have at least two effects. One is short term. If there is anything that history has shown us, its that technology begins as a luxury for the rich and eventually becomes economically available to all. In the future it may be a luxury like a 50″ big screen TV. But there are those who are in poverty that still find ways to spend 10 grand on a TV or 50 grand on a SUV.

    The second set of problems comes into play when you are dealing with credit companies. Imagine credit being extended to a person to allow them to aford this medicine. That person may not make a lot of money but now they will live twice as long, work twice as long and may fool themselves into being able to afford the longer life. Unfortunately, as history has shown us most will pay the minimum monthly payment and again the credit companies will make out like bandits.

    Its easy to see the individual benefits some of this technology presents but the more it is examined the more I find reasons to reject this, and I don’t even think I’ve begun to consider how this will impact the plan of salvation or any theological consequences.

    If anyone is interested in population control you should check out the Georgia Guidstones if you haven’t already. Thinking about this now makes me think I’ll post on it later today or tomorrow.