Anti-ageing and the scientific avoidance of death.

1. Anti-ageing and the scientific avoidance of death. John A. Vincent Egenis Seminar Presentation 2nd February 2010

2. Outline the problem – how to understand the cultural devaluation of old age. Comparative material from anthropology and history – locate unique features of contemporary construction of age and death. Use Rose’s work to think about the consequences of the biologisation of old age and death. Structure of the presentation

3. Old age defined by end of middle age and the onset of death Cultural construction of life stage is dependent on cultural ideas of time and of death Time and the boundaries of old age

4. Cultural construction of time • Types of time • Western [arrow of time] • Hindu [round of time] • Australian [Dream time]

5. Anthropology of ageing and death • Key analyses in this literature describe the way societies understand and manage the transition from the world of the living to the world of the dead. • One theme is that of social transition and looks at inheritance of property and resources, and the succession of statuses from one generation to the next. • Another theme is that of symbol and ritual, including the way different communities give meaning to this transition through recreating collective or individual identities

6. Selected examples • Dinka, • Mardu, and • Madagascar

7. For Lafontaine the key factors in understanding modern attitudes to death - what she calls the ‘post-mortal’ society – are: individualisation (existential meaning is only to be found in individuals not collectivities) and ‘de-symbolisation’ (the lack of ritual and symbolic meanings for death). Celine Lafontaine ‘La Société Post-Mortelle’

8. The main thesis of this work is that in the contemporary world at the start of the 21st century the way ‘life itself’ has come to be understood has changed. It has been biologised and reconstructed to lie at the sub-cellular and molecular level. The advances in bio-chemistry and the understanding of genetics and cell science have atomised the biology of life into a string of complex genetically induced cascade of complex molecules. Nikolas Rose - The Politics of Life Itself

9. We can take this idea about the changing understanding of life and apply it to death. If life has been biologised, fragmented, reduced to a bio-chemical essence and rendered political by new potentialities for control, then so too has death. This is the realm of anti-ageing science. Politics of death itself

10. Anti-ageing and the avoidance of death • In other work I have classified anti-ageing phenomena into four types. • Firstly there is an approach in which ageing is the appearance of old age, a phenomena of the body’s surface. This anti-ageing is thus cosmetic in intention. • The second approach is to consider ageing to be a disease to be tackled by medical strategies with the intention of cure. Ageing from this perspective is a phenomenon of the body interior. • The third view of ageing is that it is a fundamental biological process particularly located in the intra cellular bio-chemistry. Biological anti-ageing strategies seek to modify these processes by manipulation of cell chemistry. • And fourthly, for some ageing is death. These anti-ageing activities aim to achieve immortality, or at least something close to it.

11. Managing death in the ‘post-mortal’ world • The policing and control of life, implies the same processes for death. Not only in the sense of avoiding death and prolonging life, but dealing with the inevitable fact of death. • For all the culturally enwrapped denial, we all still die, and this fact has to be managed. The extent of the denial makes this a difficult task. As Lafontaine points out, death has been removed from the world of symbol, ritual and meaning and turned into a mundane biological fact. As such, without its sacred quality and apparently subject to technical biological analysis and control, it creates new problems of management.

12. Rose suggests five process through which to understand changes to ‘the politics of life itself’. We can look at these in turn and examine what they mean for death in the post-mortal world. They are: molecularisation, optimization, subjectification, somatic expertise, and the economics of vitality. Key processes

13. According to Rose, the essential vitality which animates life is now seen as a molecular process. Molecularisation, or at least modern cell science, has profoundly influenced contemporary understanding of death. Cell death – apoptosis and senescence. The biology text books and popular science media habitually describe apoptosis as cell suicide. Sometimes they call it murder (when the cell responds to external stimuli but I have only found one case where it is referred to as euthanasia). However, apoptosis is clearly good death. Its death at the right time and the right place is a necessary and desirable outcome. molecularisation The final stage of apoptosis; cleaning up after the death

14. Old age at the cell level • On the other hand senescence is the cell in old age. The metaphor is a powerful one even if the belief that there is a specific direct link to organism ageing is contentious. • Historically in biology the meaning of senescence has shifted from specific form of decline, loss of efficient function in all aspects, including the accumulation of ‘junk’, to being used specifically in the sense of replicative senescence - the cessation of mitosis (cell division). • Even at the cellular level old age is imaged as bad.

15. optimization http://stemcells.nih.gov/info/scireport/2006report.htm • life is no longer simply constrained within the parameters of health and illness, but that it can be manipulated in order to optimise such features as intelligence or longevity. He links these developments to a stress on ‘functionality’ - enhancing the body’s ability to perform what the individual desires from it. • Death is seen as the ultimate loss of functionality. Optimization requires the body to overcome time and function for ever thus avoiding old age and death. • Stem cell research holds out the possibility of replacing worn out or failed bits of the body by growing genetically matched replacements to be transplanted as the need arises. Cloning technology not only offers the prospect of cloning your favourite pet so it is replaced by a genetically identical substitute, it offers the possibility of reproducing yourself. • Post-human aspirations

16. subjectificaton • Rose’s third theme is that of ‘subjectificaton’ and the individual’s responsibility for body management. ‘the politics of life itself’ in his title refers to the development of a biocitizenship with rights and duties for life, body and risk. He suggests this creates ‘somatic ethics’ – not ethics as moral precepts but as values about the conduct of a life placing the body and its management at the centre. • Death becomes someone’s fault, perhaps the individual who did not look after themselves properly, perhaps the expert who failed to prevent death from a specific disease. The prologeviste movement, those striving for immortality take this position to the logical conclusion, death is the ultimate failure, the final sin/ dereliction of an individual. • From this perspective ageing becomes the fault of the individual. It is slackers, morally culpable people who do not follow the best practices of healthy living that will lose out on immortality and die.

17. somatic expertise • the rights and responsibilities of others for biological control over our bodies. • He identifies a professionalisation of expertise concerning the body. There is a proliferation of sub-branches of biology and bio-chemistry and specialisms which control the technical expertise of these sciences. • There is also professionalization of the pastoral response to life and death, experts who offer counselling and advice on how individuals should manage grief. • Rose notes ‘bioethics’ as a new discipline in which people claim expertise with which to legitimate research and ‘medical’ activities. • Rose analysis thus directs us to look at death managers and death avoidance experts and the role they play in policing death. • We can divide policing death into two kinds, policing the dead and policing the survivors.

18. Policing the dead • Historically policing the dead was the apparatus of church and religion, the proper processing of souls to pass from this world to the next. In the modern secular world is becomes a health issue, hygienic disposal of corpses through properly sanctioned crematoria and prohibition of bodily disposal in any but authorised sites. • The ‘post-mortal’ society creates new dilemmas and institutions in the policing of the dead. There are those who seek immortality through revival of the corpse when science has progressed to perform such miracles, in other words entrusting their body to future life and death experts.

19. The most well developed of these is the cyronics industry with active facilities in both USA and Russia. Despite the absence of current to technology for thawing out and resuscitating those that have chosen this method of bodily disposal, faith in the progress in science is felt to justify such procedures. An essential feature of cryonics is the location of the individual, the persona, personality, in the body, indeed in the brain, and that the preservation of the chemical constituents will preserve the essence of the person. Such a radical approach challenges a number of our key institutions, the legal system recognises the frozen as dead, inheritance laws apply and there is no way of ensuring the revived are not destitute. The freezers are run by commercial firms who are liable to economic failure and bankruptcy as any other economic institution thus potentially leaving immortality in the hands of administrators. cyronics industry Photo courtesy Alcor Life Extension FoundationIn an operating room at Alcor Life Extension Foundation, a cryonics patient is cooled in a vat of dry ice as part of the "freezing" procedure.

20. Policing the living • At a death we have institutions for policing the living. For example, we have institutions to manage the laws on succession and inheritance of property and status. We have judicial and law enforcement institutions to hold to account those who commit homicide. Older people are vulnerable to mass murder c.f. Harold Shipman. • In modern world psychological well being of survivors – post traumatic stress, grief counselling – has become an additional realm of professional expertise. However, individuals are expected to engage in personal self policing. In terms of ‘somantic ethics’ they have a responsibility for coming to terms with bereavement. The living are required to manage ‘the morning process’ - the psychological process of consigning the dead to quiescent memory and there are psychological experts to help people through this process. To fail to do so in due time is to open up moral/medical accusations of being morbid, of insufficient self-control.

21. Euthansasia • Policing, and self policing of the living, also leads us to the realm of euthanasia and choice of ones death. The Western culture with its values of individualism and choice, produces a profound ambivalence to suicide. It is the ultimate act of individual control and choice. It is also in terms of somantic ethics the ultimate sin destroying the material basis of existence. • Euthansasia therefore might be seen as the converse of attempts at immortality such as cryonics. It involves both a rejection of the power of science and reason to solve the problem of disease and pain satisfactorily and involves the abdication of self. Yet it involves the expression of individuality through choice - the ultimate choice to live or die.

22. Moral responsibility for death • The medical technicians at the scene of death have to work within the moral framework which gives them power and responsibility. They have to strive to avoid being blamed. • The moral apparatus of the ‘post-mortal’ society seeks cause, and therefore blame, in the material facts of a material world scientifically understood, a world of cause and effect. Either the individual deceased is responsible for the cause, not engaging in the necessary risk management, or those responsible for not alerting the individual to making the correct ‘safe’ choices are at fault. In these circumstances a good death is not possible. • Even, euthanasia becomes a problematic answer to the construction of a moral death. Somatic expertise implies there must be a discernable cause behind the desire to die – whose failure is behind that desire? Candidates for culpability might include weakness in the moral standing of the individual, or weakness in the psychological make up of the individual due to parental upbringing, or clinical failure on the part of medical technicians to control pain, to control the course of the illness, or failure of public authorities who have not yet devoted the resources which will (inevitably, eventually) find a cure.

23. economics of vitality • the vital elements of life can be: • “decomposed into a series of distinct and discrete objects – that can be isolated, delimited, stored, accumulated, mobilized, and exchanged, accorded a discrete value, traded across time, space, species, context enterprises – in the service of many distinct objectives.” (Rose 2008:7) • This trend is clearly identifiable in the world of anti-ageing science and medicine. Bio-capital is being sought by a wide range of anti-ageing entrepreneurs. The market serves as both source of capital and as outlet for consumer products.

24. A good case example is that of the history of the search for a method of using teleomere science to create an anti-ageing therapy. Bio-value is the realm of the anti-ageing foundations – institutions which forge links between the scientist in the lab and the market. On one level the search for bio-value and ways to exploit it are based in the straight forward entrepreneurial profit motive. A patent on a once a day pill which enables you to live for ever is the ultimate cash machine. However, there is a more profound and subtle critique of capitalism in which bio-capital can be seen as part of the objectification of people, undermining their humanity and dissolving human relationships and collective solidarity through the market. To the market, as with science, death is impersonal, mundane and essentially trivial. Biovalue

25. Biological ageing requires a sense of biological time – at what rate does the body age, how can we measure it? Biological time has to be independent from chronological time. In order to establish biological time we need biomarkers, points which indicate its forward march. Anti-ageing science and time • Measuring functionality - ‘Looking good for our age’, ‘looking ten years younger’, being ‘fit for your age’ requires appeal to such bio-markers. Culturally we a very familiar with the visible symbols we identify as signs of old age, grey hair, wrinkles, changes in posture, loss of hearing, eyesight and mental acuity. The problem, over and above the key issue of defining someone’s humanity by their visual appearance, is that these phenomena do not standardise into predictable chronological age with a high degree of accuracy.

26. Science outside time • Optimisation can mean more that looking good, or being ‘functional’ for ones age. It contains an implicit view of the perfect body, the fully optimised body is one that never fails but is immortal. The construction is embedded in the concept of time inherent in modern science. In one sense the view of time as inevitably progressive underlies the optimisation drive. Science is seen as making inevitable progress - the future is more knowledgeable than the past – history of science the history of elimination of error. • However, in an important sense, science is understood as outside of time. It is about the universal laws of nature, true for all time. The laws of nature at not seen as subject to time, to history and to change. Once they are known it is assumed they always were and always will be the same. Thus in the Petri dish or under the election microscope, in an important sense there is no time. • ‘Failed’ experiments are false, imperfect while the truth will live on for ever. Perfection steps outside time. This is the world of the bio-gerontologists who see immortality as a practical project. It is a world without time; a world which exists in the laboratory at the level of the cell and bio-chemical processes which animate it. It is not a world with human relationships and history. The logic then becomes - when we discover the laws of life we will be able to prevent death for ever because those laws never change. • Perfect understanding, creates immortal functionality and avoids death.

27. Conclusion • As life becomes something to be biologised, essentialised, manipulated and the subject of struggle and contest, so too does death. In the modern world, embedded in the belief in progressive science is the implication that it will provide the solution for death. • Scientists claim to have the techniques for increasing human life span, if not exactly now, at least the potential for the future. Scientific medicine acts as if it should have, and eventually will, find the cure for death. For the medical technician every death represents a failure. • The modern world and its dominant scientific modes of accounting and legitimising knowledge have their share of the fountain of youth myths. Immortality, and the defeat of disease and injury are a common place of science fiction. These cultural manifestations come from the same mind set as that which sees the goal of science as the elimination of death. • The timeless individual has no age, the functionally perfect body does not die. In such a world we struggle to find rituals and to demarcate the sacred or anything meaningful in death.

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