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The Fountain of YouthReview - The Fountain of Youth
Cultural, Scientific, and Ethical Perspectives on a Biomedical Goal
by Stephen G. Post and Robert H. Binstock (Editors)
Oxford University Press, 2004
Review by Bertha Alvarez Manninen
Sep 23rd 2005 (Volume 9, Issue 38)

The purpose of this book is to introduce the reader to the scientific and ethical issues concerning prolongevity, i.e. the process of significantly increasing either the human life span or human life expectancy in a manner that renders human life generally free from ailment or disease. This book is a compellation of articles from scholars in various fields, including history, philosophy, biology, and biomedical ethics, and this myriad of writings aids in offering the reader a cohesive understanding of the different issues that surround science's attempt at realizing De Leon's dream of drinking from The Fountain of Youth.

The introductory chapter by the book's editors is thorough and clear and it is here where the three models of prolongevity are introduced to the reader. There is "compressed morbidity," where life span is not necessarily elongated but the majority of an average human life span is lived free from the diseases associated with aging, with death finally taking its toll in a quick and painless manner. Second, there is "decelerated aging" where life span or life expectancy is increased, thereby resulting in age-related diseases occurring much later in life. Finally, there is "arrested aging", where the process of aging is actually reversed and aids in the restoring of human vivacity. After the introduction, the book is divided into three main sections.

The first section, entitled "The Perennial Quests for Extended and Eternal Life" and consisting of chapters 1 through 5, introduces the issue at hand to the reader, offering historical, ethical, and religious accounts concerning the human desire for immortality and how this desire has fueled the current scientific research. Chapter 1, "The Search for Prolongevity: A Contentious Pursuit" by Robert Binstock offers a wonderful account of the history of prolongevity research, particularly the battle by biogerontologists (scientists that study aging) to be taken seriously by the scientific community and receive adequate funding for their research. The chapter ends by requiring the reader to think through some of the ethical issues surrounding such research, and therefore serves as a springboard for the articles to come where these issues will be dealt with more extensively. It is an excellent chapter for introducing any novice to the issue. Chapter 2, "The Quest for Immortality: Visions and Presentiments in Science and Literature" by Mark Adams offers a rather interesting account of how art reflects life by illustrating how many popular literary works of the late 19th and early 20th century were reactions to the scientific findings of the time. Particularly, Darwin's theory of natural selection set off a tidal wave of concern amongst certain individuals who realized that Darwin's theory entailed that the human species, much like all other species, will inevitably meet its demise. The desire to regain control over human destiny led to many writings touting both positive and negative eugenics and the achievement of prolongevity. Many works of popular fiction that are read today are a direct response to the desire to regain ultimate control over human destiny; books like Aldous Huxley's A Brave New World and J.R.R. Tolkien's Lord of the Rings trilogy are interpreted as direct criticisms of such an endeavor. This chapter is a rich one and serves to educate the reader that this debate has been prevalent for more than a hundred years. Chapter 3, Stephen G. Post's "Decelerated Aging: Should I drink from a Fountain of Youth?," is the first attempt in the book to really grapple with the ethical concerns surrounding the goal of prolongevity. Whereas Adam's article leaves the reader with the impression that the battle over the ethics of prolongevity is a battle between the deeply religious opposing it and the secularists supporting it, Post offers a refreshing account as to how religion can actually fuel the desire for prolongevity. Since death is taken to be a result of Original Sin, and not part of God's original natural order, to be relieved of death is a form of salvation, a psuedo-return to the Garden of Eden. Post is weary about the eugenic desires of most who seek prolongevity, but he also recognizes that the desire to eliminate human disease and ailment is one that is not an affront of human dignity, but rather can serve to advance it. He warns the reader of the possible dangers that may be entailed by the practice of prolongevity, given that the evolution of human morality rarely parallels the evolution of science, but seems open to the idea that the goals of prolongevity can be used to benefit humanity. The final two chapters in this section, Neil Gillman's "A Jewish Theology of Death and Afterlife" and Carol G. Zaleski's "In Defense of Immortality," are wonderful articles in their own right, but primarily focus on the religious view of the afterlife and hence seems out of place in a book about preserving longevity in this "earthly" life. Gillman's article implies that prolongevity study is mandated by the Jewish religion, given that "the aggressive treatment of the sick and the prolongation of life are divine commands" (p. 104) and Zaleski briefly discusses what she terms "alpha immortality," the "physical invulnerability to death" (p. 116) and how such immortality can be viewed as a curse rather than a blessing, but by and large the focus of these articles is more about the afterlife rather than increasing the average human life expectancy or life span.

The second section of the book, entitled "The Science of Prolongevity" and consisting of chapters 6 through 11, may prove more difficult for the average reader or for a student just being introduced to the topic of prolongevity. This section focuses on scientific evidence that either support the possibility of prolongevity or serve to caste doubt as to whether gerontologists can succeed in their goal of forestalling aging-related diseases and death. Chapters 6 and 7 of this section, "In Search of the Holy Grail of Senescence," by S. Jay Olshansky and Bruce A. Carnes, and "The Metabiology of Life Extension," by Michael R. Rose, may be too technical to further the understanding of the layreader, but may succeed in doing so for individuals more familiar with scientific study. Olshany and Carnes' article, in particular, offers an interesting history of past attempts to grapple with the phenomenon of aging, and emphasizes the relationship between reproduction and aging that is made more explicit in later articles in this section. Chapter 8, Robert Arking's "Extending Human Longevity: A Biological Probability" is rather notable for its clarity and thoroughness. Arking takes great pains to detail that the goal that is sought in gerontology (the study of aging) is not physical immortality, which he deems impossible, but rather an increase in the human health span (as opposed to just life span) from its current run of approximately 35 years (between the ages of 20 and 55) to approximately 70 years. He illuminates the connection between reproduction and aging, illustrating why the body only has enough energy for either procreation or bodily reparation, the lack of the latter contributing to why we age. His detailing of experiments on insects and lower mammals concerning the effectiveness of caloric restriction and antioxidants on aging is very informative and again serves to give the average reader a clearer picture of how we age, why we age, and what science is doing to advance the goal of prolongevity. Chapter 9, "Eat Less, Eat Better, and Live Longer: Does It Work and Is It Worth It," by Gemma Casadesus et al., furthers Arking's explanation of the role caloric restrictions and antioxidants can have on repressed aging, detailing the experiments performed on animals that results in a clearer understanding of why a diet that is low on calories and rich in fruits and vegetables leads to a longer and healthier life. These findings, however, are challenged by Aubrey D.N.J de Grey's article (chapter 11) "An Engineer's Approach to Developing Real Anti-Aging Medicine," and instead, he recommends gene therapy as the only feasible way to repress aging given that it combats cellular loss and destruction, which he cites as the main culprit responsible for aging. Chapter 10 of this section, Richard A. Miller's "Extending Life: Scientific Prospects and Political Obstacles" is most notable for the detailing of the major impediments facing applied gerontology, among them the obstacle of gaining credibility as a serious field in science and medicine and the phenomenon of what he calls "gerontologiphobia... an irrational public predisposition to... regard research on aging... as a public menace " (p. 243). That is, the concern that such study is unethical because it will lead to a prevalence of geriatrics rather than younger individuals. Miller does a great job at pointing out how arguments of this form also precludes any effort to cure heart disease, cancer, and diabetes, given that this also allows people to live healthier, and longer, lives, and also how such an argument would have precluded the advent of penicillin, plumbing, and even anesthesia, since all of these lead to an increase in the average human life expectancy. Miller's article, thus, serves as a good segue for section three of the book, which deals with several ethical issues surrounding the study of and desire for prolongevity.

Section three of the book, entitled "Ethical and Social Perspectives on Radical Life Extension" and consisting of chapters 12 through17, introduces the reader to the moral issues surrounding the goal of prolongevity. In chapter 12, entitled "An Unnatural Process: Why It Is Not Inherently Wrong to Seek a Cure for Aging," Arthur Caplan proffers an argument as to why aging more closely resembles a disease rather than a natural process. Thus, according to Caplan, gerontology is best viewed as an area of therapeutic study and the process of aging as something that needs to be cured. Christine Overall's "Longevity, Identity, and Moral Character: A Feminist Approach (chapter 13), does a nice job in arguing how virtue ethics is the best theoretical system of morality to deal with the ethical issues that surround the prospect of longer human life spans and life expectancies. Overall takes special care in her article to explain the crux of virtue ethics concisely and clearly, and thus her article may serve as beneficial secondary literature to beginning students of ethics who want to see how virtue ethics can be applied to practical moral issues. Leon Kass' "L'Chaim and Its Limits: Why Not Immortality?" (chapter 14) offers very little surprises when he argues that prolonging the human life expectancy is morally suspect, since most that are familiar with his work know that he is traditionally very conservative when it comes to medical advancements (e.g. he was one of the most staunch opponents of IVF when the technology first emerged, and now uses very similar arguments to oppose human cloning). Kass' article is actually very well, and even beautifully, written, as he spends much of the time musing over the blessings that mortality has to offer. The problem is that he seems to do only that -- musing -- and he does not present very good evidence in favor of his claims that, for example, an immortal person cannot really love another or that an immortal person cannot practice virtue or moral excellence (apparently since, according to him, mortality is a necessary condition for practicing both). The whole article seems to be a straw man for the general purpose of the book -- since very few of the authors claim that they desire immortality for human beings (and Arking explicitly denies that this is possible), but rather an increase in the number of years that human beings live healthy lives. The study of prolongevity does not aim at making human beings live forever (although perhaps some overzealous scientists seem to think it may), but rather to help them live longer and healthier lives. Thus, most of Kass' points are moot, since they target the undesirability of physical or earthly immortality. Chapter 15, Eric Juengst "Anti-Aging Research and the Limits of Medicine," does a good job of introducing the reader to imperative moral questions that surround anti-aging technologies, but is keen to point out that many of these worries are too preliminary to warrant a restriction on such research. The last two chapters of the section, Audrey Chapman's "The Social and Justice Implication of Extending the Human Life Span" and Robert Binstock's "The Prolonged Old, the Long Lived Society, and the Politics of Age," is less a study of philosophical ethics and rather concentrates on the social and political concerns of having a population explosion of the elderly. Chapman's article is more concerned with issues of distributive justice and how a sharp increase in population can have devastating effects on global sustainability. I would have preferred to have read much more of this latter concern, since this strikes me as being perhaps the primary social reason to restrict anti-aging technology. Binstock's article focuses on the political consequences that an increase in the population of the elderly would have on current voting trends. While not really discussing a major moral or ethical issue, the article may be of interest with those interested in the demographics of voting and how it maybe effected by an increase in the geriatric population. The epilogue, entitled "Extended Life, Eternal Life: A Christian Perspective" by Diogenes Allen, was a pleasure to read and infuses some spirituality into the science and philosophy that permeates most of the book. Allen argues against the claim that the Christian belief in the afterlife is nothing more than a response to the fear of death -- a fear that prolongevity study may one day eradicate. Allen makes it clear that this is not so - that the Christian belief in the afterlife is not a response to a fear of death, but rather a response to the inadequacy of earthly life; an inadequacy that cannot be rectified by living a longer life.

The book's most admirable attribute is also its weakest: in its attempt to be inclusive of a wide variety of issues when it comes to the study of prolongevity, it covers too many topics and so offers little depth into any one of them. For example, as abovementioned, I would have liked to have read more concerning the topic of global sustainability in the face of such a sharp population explosion or more concerning how having so many generations of human beings concurrently alive may affect family dynamics, either for the better or worse. The topics were touched upon, but not dealt with in any significant depth. Moreover, it would have been beneficial to see some of the articles as responses to others in the book in order to be exposed to opposing arguments for any given position, which leaves the reader in a better place to make up her own mind about some of these issues. Indeed, there are some opposing views in the book, no doubt, but it would have been more beneficial to see authors directly responding to each other's arguments. The book may also not serve as a good teaching tool for a beginning applied ethics course, since the range of readings in the book span from rather clear and concise articles, to more difficult scientific ones. It may, however, be a good tool for an advanced undergraduate class or a graduate course in medical ethics.

As a general introduction to the topic, the book offers the reader a wide sample of the various issues that surround this controversial new technology, and as such allows one to commence the track to further study. The annotated bibliography at the back of the book is impressive; it is clearly organized and offers a short synopsis of the articles referred to by the contributing authors. It is a wonderful source to go to if one is interested in reading more on any one of the topics presented in the book.

 

2005 Bertha Alvarez Manninen

 

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Bertha Alvarez Manninen is working on her dissertation entitled: "When does a human being gain a moral right to life: An ethical and metaphysical study of abortion and stem cell research" at Purdue University, and will receive her Ph.D. in philosophy in 2006. She is also currently a philosophy adjunct professor at Kirkwood Community College in Iowa City, IA. Her areas of research include several areas in applied ethics and philosophy of religion.


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