Opponent 1: The views expressed by the presenter are for the purposes of debate and do not necessarily represent his own opinions, nor are they intended to represent in any way the opinions or other views of the AGHE. Comments prepared and presented orally by Jeffrey A. Chesky.

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I am so happy that I am participating in this debate. As a scientist, I have always felt that we need to pay more attention to the effects upon society of scientific advances and maybe take some of the blame for the problems we, by making these advances, cause. When I first entered this field three decades ago, ethics was something only for the ethicists. I didn't see biologists participating in discussions dealing with who controls technology, who decides, what are the impacts upon society. I'm sure there were some, but I don't think we started to get really involved until the early 1970's when recombinant DNA technology was developed. And I note with pride that biologists have taken the lead in organizing some of the sessions dealing with the extension of life that Gerontological Society of America has sponsored, and now here today at the Association for Gerontology in Higher Education.

When we first proposed this panel discussion for this [Pittsburgh] meeting, I believe our thinking was a debate on can we extend life? Discuss the pros and cons B dealing with ability to develop technology. We did something wrong B the others here might not agree B the debate should not be couched in the terms ..can we develop new technologies? We can! And even old technologies have shown efficacy in reducing the rate of aging. It's been almost seventy years since Clive McCay did that with caloric restriction (we could have another debate as to whether caloric restriction extends life, or sitting in a cage, eating all you want, retards longevity B that's a different panel).

But I am on the NEGATIVE side of this debate which is good because I am not as optimistic as others about the ability to increase longevity for everyone and by how much. Most people go off on their own pet theories and try to divine an interventionB the best example being that since free radicals cause cellular injury, slowing down cellular injury by antioxidants will extend life -- and I think that is somewhat foolish, at least simplistic, because of my belief that aging is multi-factorial. So when people tell me that injecting telomerase into people to increase numbers of cell divisions will "cure" aging , I am not persuaded.  In fact, I find this concept "curing aging" incredulous because aging is a natural process and thus it makes no semantic sense to try to cure it -- you may as well try to cure the weather. We can talk about modifying it, perhaps retard it, deal with it B this makes more semantic sense. However, realistically I see no reason why someday, all these factors and how they relate won't be known.

In fact, I believe that aging is to a large part genetically based, -- this is not an original phrase with me, but I like it, "it is not age that determines aging, but genetic expression." Whether-or-not you believe in aging genes or programmed aging, or longevity assurance genes, genetic technology will be developed. I think there are going to be more technical problems than people realize, I believe that it is going to be later than sooner, but remember, we had all the theory worked out centuries ago to send people to the moon, we just needed to be able to build the rockets. So I believe we shall extend longevity but it is not going to be quick or as easy as others on this panel think and it is going to be fraught with problems.

So maybe you think the next logical question would be, and that we should frame the debate, "Should we"? Should we try to control aging? That makes sense to me and I would like to debate it...we are going to discuss it a little, but I also think that is irrelevant... because "We shall." If we can, we shall. That is human nature. We will develop new technologies and once they are developed, they cannot be stopped. So, at least in my mind, the real discussion is "How do we control? Who decides? Let's plan for the impact@ because it is going to happen. I am not sure today how or by what method longevity will be increased, but I am convinced it will be; but because this session is in the form of a debate and I am taking the negative B let me say I don't think the development of technology to extend life is all that viable, certainly not all that easy, and is not necessarily a good idea. And one reason I don't think it is a good idea is that it, I believe, eventually it will involve genetic technology, to redesign us. I an not opposed to genetic technology to eliminate diseases...but the use of genetic technology to redesign us raises a whole specter of eugenics, playing God, and who decides what we should be?

I want to get to what I believe are the two real basic question. Why should we try to extend life AND if we do try, what are the consequences? One is a philosophical question, the second is applied.  In preparing this talk, I kept fiddling with the order I wanted to present those two different issues and then I decided, risky as it might be, to talk about them together B because maybe they are not two separate issues, but so intertwined it is better to address them together.

Why should we extend life and what are the consequences?                  

Sometimes old ideas are the best. I'm not sure you will think the 1970's are that old (I have a colleague who is teaching a history course on the 1970's ! !) and in the early 1970's, NIH published a document that has been seminal in my thinking ever since. It asks "why should we try to extend life" and presents three simple explanations which bear review. [note B if anyone reads this and knows the original citation, I would be very appreciative if you could send it to me B chesky.jeffrey@uis.edu  B our library has purged a lot of pre-1980 material.)

1) We have a right to life B that would be another issue to debate, but if you believe in the right to life, then doesn't it follow that we have the right to as long a life as possible? Do we have rights to have our life extended? I am going to talk in a moment that I fear we don't really know the consequences of extended longevity, but I am sure of this one. If we do as individuals have the right to live longer and the technology develops and we have more older people, then I believe that society is going to have a right to the intentional termination of life.  That is going to be a consequence of extended longevity. If you think debates upon whether-or- not we should extend life are contentious, see what happens when society is forced to debate how and when to end it because of too many older people. So "Let's hold back development of technologies to extend life" until this issue is addressed.

2) Society would benefit if people lived longer.  I don't know how NIH stated that as an axiom. How would we benefit? Well certainly, if all these people had jobs and produced to the economy...or maybe if Beethoven hadn't died at 56. Personally, I think society is at a disadvantage B overpopulation, old people move to warmer areas, but use more fossil fuel in cooling themselves in the summer. I don't know why society benefits ... but I want you to think about it.

I don't think there is time in my presentation to address the legal, familial, marital, economic issues associated with life extension, except perhaps one obvious one B it will be expensive and therefore the rich will have greater access to it. There is no sense debating whether this is good or bad B it's a reality. Rich people have always had better health care than poor ones.

Genetic technologies are being developed to treat age-changes in the myocardium. I suppose that's good...loss of adrenergic receptors play a role in loss of cardiac performance. But won't that exacerbate already existing differences between rich and poor?.

Predicting the future is, of course speculative, and when it comes to predicting what is going to happen with aging, it is even more risky and try to put the two together...we simply cannot accurately predict the economic and social implications of extended longevity.  Stating with accuracy what is going happen to society because more people might live longer is moronic, because we don't know by what method longevity extension will be achieved.

Let me elaborate --We cannot really answer the question about what are the consequences without knowing the methodology by which life is being extended? The method of longevity extension has an impact upon demographics.

Simply put, methods that involve increases in longevity due to better lifestyle, targeting elimination of disease, physical fitness, perhaps bolstering immune system, or assuming that aging is due to random accumulation of injurious assaults upon the body and decrease the rate of injury, those methods result in the elimination of premature deaths. They increase life expectancy, but do not necessarily increase ultimate life span, and they result in a GREATER PERCENTAGE OF OLDER PEOPLE relative to the young.  But caloric restriction, perhaps genetic engineering, that is like taking a rubber band and stretching it. You have the same relative distribution of young, middle-aged, and old. So we really cannot talk about the effects upon society without knowing the method that will result in this extension.

I'm not sure of this relevance, but how many of you have been saying in your classrooms [note -- most attendees at this presentation are professors] forever, that the percentage of the older population is increasing? And what happened in the 2000 census - for the first time in the history of the census, the population over 65 did not grow faster than the total population. I know that's misleading -- we certainly had an increase in the number of older people, but as a percentage of the population it decreased!! (More young people, more immigrants) I don't want to gloss over that because lots of predictions about the consequences of extended longevity have been based upon that axiom in gerontology that the percentage of the older population is increasing

3) Everybody wants to live as long as possible.  I suppose that makes some sense. The aging process is the major predictor of illness, disability, and death. Well, everyone wants to live as long as they are healthy...maybe I can accept that idea, but I don't accept the idea that individuals want to live as long as possible.

I want to interject something here that I don't think is thought about enough, at least by biologists. I suspect our colleagues in psychology and sociology have done more thinking about this B the disassociation of chronological age from physiological age. There are some things that happen as a passage of time, there are other things that occur as part of the organism's aging. They are not necessarily the same. It's easier to understand if I give examples. In most mammals, we reach reproductive age at about 10-20% of the life span. For simplicity, let's say people live to be 100 and that most people become capable of reproduction 15% of the way through. So we can reproduce at age 15 (I think that's too young in America, but it is certainly a biological reality). Let's say we found a way to extend longevity to 200 by "slowing aging." Would we still be able to reproduce at age 15, or would it now be 30? And by the same argument, let's say that Alzheimer's disease is not related to the aging process B that's another debate, but that brain cells and synapses (this is not a session on Alzheimer's but I want to make a point) start to fail late in life. . Say at age 90, mental acuity really begins to decline. Well that's bad...but if we expect to be able to live to be only 100, you are on your way out. But what if we live to 200 B and mental acuity still begins to decline at age 90?

There is a saying...and my students laugh when I say it but I don't see anything funny (again, not original with me) "The way research is progressing, we may someday live to be 150  B 70 years of virility and 80 years of senility." Tell me (to other panelists) what is it about telomerase, or genetic engineering, or antioxidants, that predicts that cholinergic neurotransmission doesn't decline? In simple English, what is in those technologies that stop the brain's self-disintegration. I'll flip it around ... I don't think physiological aging and mental acuity are necessarily linked, or at least our models are bad B why do people with progeria have normal intellectual functioning while everything else is haywire?

So since we don't know enough yet about the basic biology of aging and since we cannot predict the consequences within any moderate degree of accuracy, to me that is enough to say "Let's hold back development of technologies to extend life."

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Prepared and presented by Jeffrey A. Chesky.

Copyright 2002: Jeffrey A. Chesky, Professor of Gerontology and Biology, University of Illinois at Springfield, chesky.jeffrey@uis.edu