So it’s finally afoot then. Biomedicine is drawing blood from that familiar incubus, age-related disease. The changes in the flesh which cause old people’s bodies to fail, are now within the sights of regenerative medicine.
It is not yet certain to what extent rejuvenation biotechnologies will be able to reverse the crippling conditions of late life. But given that everybody has always dreaded the prospect of age-related disease, why were rejuvenation biotechnologies not widely demanded and anticipated before, by entire populations, even when they were beyond our grasp? Why were they not conceived of as objectives years earlier, along with cures for every other infectious disease plus cancer? Why wait for regenerative medicine to reach its present state before even considering a strike of this sort at the diseases of aging? The answer is that it had never been seen as a logical step until recently. Among both scientists and the general public, there was never anybody with the vantage point necessary to conceive of an initial problem connected to aging upon which to act, or demand action.
Repairing damaged tissue
The central science of aging is the field of biogerontology, which essentially means the study of aging as a metabolic process. Biogerontology research is animated partly by the prospect of some day intervening in that metabolism in a manner which slows the aging process, or makes it less destructive. Knowledge gained from biogerontology is applied to intervening in metabolic processes, but as the metabolic processes which sustain us are also those that age us, there are universally acknowledged limits on the wonders that can be achieved. Biogerontology is also the science which identifies the damage that metabolism inflicts on body tissue by aging it. But tissue damage, being a mere reality of old age and not a root cause, was never an obvious angle of intervention in the eyes of biogerontology. As such, there was little motivation to examine the potential for tissue repair that could be found in other emerging technologies.
Where regenerative medicine meets biogerontology
The ‘emerging technology’ in question was the entirely disparate field of regenerative medicine, which specializes in restoring damaged tissue using such tools as stem cell therapy and tissue engineering. But biogerontology, which is not involved with regenerating tissue, had never compiled a comprehensive damage report for aging around which regenerative medicine could fashion an agenda for combating age-related disease. And so regenerative medicine lacked the targeting capabilities of biogerontology, and biogerontology lacked the firepower of regenerative medicine. That is until the last few years, when, from a series of consultations between the two fields, the ‘SENS’ strategy for applying regenerative medicine to the diseases of aging, began to take shape.
Myth of inevitable aging
The public’s general lack of demand for rejuvenation biotechnology, or anything of the sort, is much harder to pin down. It seems to revolve around a popular misconception of ‘aging itself’ as distinct from disease. The public are aware of the medical realities of classifiable diseases and sicknesses, and they demand cures, knowing that they are by their nature curable, but still see ‘aging itself’ as a great abstraction, existing in addition to disease and infirmity, a mysterious but almost harmless condition under which distinct diseases might occasionally arise, and occasionally get shot down again by medical technology.
Aging is seen as the thing we should like to have left over after we’ve cured all disease, just as we would like to keep puberty even after we’ve cured teenage acne
As such, the thought of ‘aging itself’ does not evoke the same moral outrage as disease does. Therefore, the study of aging does not attract the same public support for funding. Aging, stripped of all its associated diseases, is something of a facetious topic, fascinating and a little bit scary, not a priority for medicine. Aging is seen as the thing we should like to have left over after we’ve cured all disease, just as we would like to keep puberty even after we’ve cured teenage acne. Furthermore, although aging is widely acknowledged to be a physical process, the diverse symptoms – from grey hair to lethargy to Alzheimer’s – are not united by anything externally visible, nor even plainly imaginable like a tumor. It is only observed through the passage of time, making the specific physical nature of aging seem unavoidable to most people. For all the above reasons, no science, no industry, no charity, no political party, no demographic, ever had any moral or practical understanding of aging on which to base a coherent vision for anything resembling rejuvenation biotechnology.
Turn ‘30’ back into ‘20’
Yet rejuvenation biotechnology makes consummate sense. Old age is a multi-faceted injury. There will never come a point when we can cure Alzheimer’s, macular degeneration, senile dementia, weak knees, weak hearts, osteoporosis, and so on, and still have a recognizably old person left over, for the early stages of these conditions are the very basics of old age in this era. They are malfunctions that arise from tissue damages which accumulate early, even between the ages of 20 and 30, and thereafter to pathogenic levels. The ability to repair all types of damage comprehensively would amount to powers of rejuvenation over all tissues – the power to turn ‘30’ back into ‘20’.
To whine about aging is currently seen as the mark of a weak or vain person, a person unable to face the facts of life.
Yet even if it succeeds, how should we to come to terms with the prospect of rejuvenation biotech? What now for society’s view of aging? To whine about aging is currently seen as the mark of a weak or vain person, a person unable to face the facts of life. That is why it has always been the perceived epitome of wholesomeness to poke fun at the midlife crisis. There is an entrenched view that aging is a just process, like paying a debt. So now that rejuvenation biotechnology is advancing and can’t be un-invented, should we expect progress in this area to be hampered by moral controversy, or protests reciting the alleged virtues of aging, such as that it controls population, or is sacrosanct in some other way?
Old age as unseemly
How about the fact that, although nobody likes aging, few people look upon it as unseemly?
Consider the concept of ‘aging gracefully’. ‘Aging dis-gracefully’ could be defined as any social activity which highlights the injustice of aging by reminding onlookers that aging is an arbitrary injury. We say a person is aging disgracefully when that person chooses a lifestyle which makes their own aging appear unseemly. Aging gracefully, by contrast, is the attempt to avoid giving this impression. For example, when an eighty year-old man goes to university, dates young women, and takes up skateboarding, he is undertaking projects which would be easier if he had the healthy tissues of youth. And so his frail state could logically be seen as an injustice, for his situation is practically equivalent to that of a terminally ill young man who finds it hard to concentrate, copulate or skateboard.
The conventional attitude, however, is to divert the blame away from the unfortunate natural disaster that is his physical condition, and toward the victim himself, and his choice of behavior. So, we see his behavior, his attitude, his lifestyle, as the problem. Why? Because his inner passions have remained undiminished over the years, and yet advancing decrepitude makes doing these things less and less possible. He is therefore being crushed while fully alive, and this spectacle is too much for society to confront. But as society cannot very well implore him to halt his aging, the next best thing they can do is label as ‘disgraceful’ the kind of activity with which aging interferes: skateboarding, university, age-gap relationships and so on. ‘If he would only limit his behavior’ – they reason – ‘that would camouflage the disgrace of aging, because he would stop running up against the limitations of old age. Then we could get on with our lives without this appalling spectacle going on around us’. I make this point about aging in society because these are the tinted spectacles which will either drop off once rejuvenation biotechnologies are sufficiently advanced, or which we will someday have to remove, if we are to see clearly to demand that they are fully pursued.
Aging is clearly bad. It lands on young people and then cripples them to death
Open antagonism toward aging will always be commensurate with the extent to which it has been proven reversible. When an impairment is universally inevitable, we will refuse to vilify it outright. Yet when that impairment is proved reversible, we will see it as insufferable wherever it still occurs. When rejuvenation biotechnologies advance, and some aspects of aging are undone, we will see that aging is clearly bad. It lands on young people and then cripples them to death, at a rate arbitrary in relation to their aspirations. Could there be anything worse? Perceptible progress in rejuvenation biotechnology would result in a growing recognition that the diseases and sicknesses of aging are not some special case, but merely a more stubborn variety. And a growing recognition of that would result in the demand for further success in rejuvenation biotechnology.
Iain Inkster is a Research Professor of International History at Nottingham Trent University. The main work of Ian Inkster lies in the history of industrialisation and technological change and in global history since circa 1492.