Why you should care
Because if you’ve got a right not to get old, then you might be playing tennis or hugging grandkids a lot longer.
Elizabeth Parrish is 44, the tough-gunning, sharp-talking CEO of a life-sciences startup, and seemingly full of life herself. But she says she suffers from a deadly disease. Hoping to stave off the sickness, Parrish recently journeyed to a clinic in Colombia, where she underwent a course of therapy that the FDA hasn’t touched with a 10-foot pole. One treatment would alter her telomeres — the stuff at the end of her DNA. The other would inhibit a protein that stops muscle growth.
Her affliction? Aging — and all the nasty diseases that come with it, from Alzheimer’s and heart trouble to “basic muscle deterioration.” Yes, we all get older, and, yes, the certainty of mortality is a bedrock principle of our poems and policies alike. But Parrish sees things differently. “I felt like it was a human right to do with my body as I saw fit,” she tells me.
Parrish, though perhaps unorthodox, is not alone in her insistence that aging is an evil we have a right to combat. Rather, she’s part of a whole generation of futurists talking eagerly of the right to grow old in a better way. At a time when we’re living longer — the average life expectancy in 2013 was nearly 80 years old, according to the CDC — this cohort wants even more. They want to live not a few years longer, but tens, even hundreds, of years longer, and what’s more, they believe they — and one day all of us — are entitled to do so. Before you write them off as freaks or fringe, know that their ranks include Silicon Valley luminaries who have invested millions in cryonics and in laboratories where scientists can investigate these topics without worrying over profits: billionaire PayPal founder Peter Thiel, founder of the XPrize Peter Diamandis and techno-visionary Ray Kurzweil, who reportedly consumes at least a hundred pills a day, dropping some $1,000 a year on his diet, to help him live longer. There is, today, a kind of “libertarian push,” driven by big money and the private sector, toward the Fountain of Youth, says Chris Scott, faculty and senior research scholar at the Stanford Center for Biomedical Ethics. And these libertarians and their acolytes are, if you’ll forgive, dead serious about extreme longevity.
The burgeoning interest in long life isn’t mere academic fodder: It has implications for public policy, law, and the health care system as we know it. The central question around which this explosive new debate will churn: Is aging itself a disease? Or is it, as the dominant thinking goes today, just the unfortunate condition that gives rise to a bunch of other nasty illnesses? If societies decided that old age was not a sad yet inevitable fact of life and that it — like malaria, like cancer — demanded a bevy of dollars and doctors battling it, then your primary care doctor and insurers, palliative care providers and government agencies would all have to adjust to a brand-new gravity. And if you thought Obamacare was explosive … well, just wait until presidential debates and congressional filibusters involve discussion about living multiple centuries. This is a whole new iteration of the term “pro-life.”
The aging haters have a reasonable spiel down: It’s health, pure and simple. That’s the line Cambridge researcher Aubrey de Grey, one of the most prominent scientists working on anti-aging issues, gives me. We’re not talking about a right to never die, in his view, or even a right to live on and on. It’s the right to have your health taken care of, your diseases ebbed away. It’s just that aging happens to be an “uber-disease” we’ve not yet started to fight, he says. (He once scolded a VICE interviewer that the word “immortality” is “taken” by the religious; stop with that nonsense!) Rather, if we live longer, he says, well, that’ll just be a rather nice side effect of researchers like him solving aging diseases.
This “uber-disease” kills around 100,000 people a day, de Grey says, citing CDC data. And, he adds, it’s “an uncontroversial thing to say” that health care is a basic right. Indeed, preventative health care formed one of the few popular cornerstones of Obamacare, and socialized health care is one of a handful of things (liberal) Americans don’t mock about Canada. Thinkers in the de Grey camp can call upon some fairly strong rhetorical language to make their case: It’s ageist, even morally repugnant, to not treat aging as a disease that needs a cure, they can argue.
An illustrative example comes from Nick Bostrom, the highly fangirled futurist, philosopher and director of the Future of Humanity Institute at Oxford, who tells me in his rather endearing Scandinavian accent that he expects the right to not grow old to someday plug into our basic health care debates. Some years ago, Bostrom wrote a fable suitable for kiddo bedtime reading. A dragon looms over a village and kills people every day. The townspeople should obviously do something about the dragon, but instead they spout the standard stuff of those fighting aging: The dragon (read: mortality) is what gives life meaning! What is it to be human without the dragon?! To wit: People who don’t want to tackle aging head-on? They must be whack.
To watch de Grey pace various stages, rapidly preaching a gospel that he seems to think shouldn’t have to be preached at all, is to be forcibly reminded of nearly-1,000-year-old Methuselah, largely because of his forest of a beard. I’m not the first to make such a comparison, as one audience member at his 2006 TED talk asked: “Since you’ve been talking about aging and trying to defeat it, why is it that you make yourself appear like an old man?” The reply: “Because I am an old man. I am actually 158.” Chuckles ensued. Slightly rude, unquestionably sharp, yet somehow warm in his cheekiness, de Grey had won his audience.
The “it’s just health” argument is all well and good when it’s a friendly checkup with your primary care doc. But that doc might not see, say, our friend Kurzweil’s very expensive morning routine, or Parrish’s Latin America trip, as her territory. (Kurzweil didn’t reply to our request for comment via his think tank, Singularity University.) This is where things get hairy. Parrish says her treatment included two therapies — one set of injections to lengthen the telomeres of her DNA (associated with longevity), and the other set to inhibit myostatins (associated with building muscle) — and was conducted in the care of a doctor and a nurse. But to Scott, it sounds like it included some “pretty scary” medical practices. He adds: “It’s a mystery to me why anyone would put themselves at risk with this technology without the rigor of a clinical trial.” Nir Barzilai, the director of the Institute for Aging Research at the Albert Einstein College of Medicine, calls those injections “just dangerous” and “not responsible.” Barzilai, an M.D., says the research isn’t completely solid: While people with longer telomeres seem to live longer, they’re also likelier to have cancer.
Despite controversy over certain methods, some spine-tingling peer-reviewed research has lately appeared from hospitals, universities and privately funded groups like de Grey’s Mountain View-based SENS Research Foundation — which just had its first paper in Science this year — or Google’s biotech company Calico (which is still stealthy as hell and said they couldn’t speak to us yet). Take the mad science-y notion of parabiosis, or sewing two animals together: Researchers 10 years ago tried attaching an old mouse to a young mouse, and found the young mouse’s blood helped its elderly buddy live longer. No one’s about to go all human centipede to try that on us, but scientists, including a private company in the Bay Area, are working on clinical trials to figure out how to make young blood work for older Homo sapiens. What else? There’s talk of diets, studies of centenarians (Barzilai led a famous one) and the drug rapamycin, which has helped some animals live longer, and has been touted as the anti-aging pill of the future.
It’s not just the science that requires sorting out; it’s crucial legal semantics and some fundamental philosophy, too. So says Glenn Cohen, professor at Harvard Law School, an expert in bioethics issues who sees some interesting, slightly messy troubles of language ahead. What counts as “health” or “treatment”? Kurzweil’s diet or Parrish’s injections might be seen as enhancement, which isn’t the same thing as treatment, Cohen suggests. This question of semantics is already appearing in conversations about, for instance, whether the state has an obligation to help LGBT folks reproduce — and is sure to appear in future policy and legal battles, Cohen says.
And then there’s the issue that, in the U.S., life is pretty much thought of as a yes-or-no right: You have the right to live, or not — and you’re not guaranteed the right to a particular “kind” of right, says Sheila Jasanoff, professor of science and technology studies at Harvard’s Kennedy School of Government. Americans don’t have a great history of defining the rights that come with life, like whether you’re guaranteed a right to, say, universal health care or paternity leave. (Europeans, she points out, are not in that camp.) Most policy of the last three decades has been moving in the opposite direction from longevity research, toward “dignified death,” says Jasanoff. Talk of this research will resemble debates over stem cell research more than debates over a right to life, Stanford’s Scott predicts. Which sounds like a surprisingly old conversation.
Progress so far has come at a pace far slower than the private sector likes, and is laden with all the annoyances of bureaucracy and peer review. The National Institutes of Health organizes itself around diseases, Scott explains, but aging is a “constellation of diseases,” like cancer, muscle wasting and dementia. The NIH doesn’t really tackle constellations, he says. Perhaps, he muses, we should have an organization called the “National Institutes of Inflammation?” De Grey spares no words: The National Institute on Aging (NIA) doesn’t have much money, and the way it gets distributed is “inherently biased against revolutionary work,” he huffs. A spokeswoman for the NIA pointed us to some examples of NIA-supported research in aging biology and in the “burgeoning field” of geroscience (which doesn’t treat aging as a disease, but offers a kind of interdisciplinary approach).
Yes, Barzilai says, the FDA moves slowly. Yes, he says, his studies, which target aging-related diseases rather than treating aging itself as a disease, require millions to pull off — one, involving 3,000 people over six years, will run $65 million. And, yes, it’s a pain. “But we’re doing things the way we do them because we don’t want anyone to die,” he says. He gives me a passionate speech: “We” — meaning academics — “are busting our butts here to get enough money to do a study that will change the landscape for them” — meaning the private-sector folks. Without bowing and scraping to the FDA regulations, he says, the technology will never go mainstream, and insurers will never cover it: “If the FDA’s not on board, all they’re going to help is rich people.”
And so, as with so many of our grand inventions of the future, the Parrishes and the Thiels and the Googles of the world will enter the fray first, potentially paying exorbitant amounts to be patient zero over and over again. Does that mean the right to a long life won’t trickle down to the masses? No, de Grey insists, obviously tired of this question of access. “Once people get over the psychological stranglehold that humanity has” when they talk about death, “there’s not going to be any problem at all.” People will see the tech and demand it; doctors, insurers and the government will have to cave. It’ll get cheaper, as technology does. Anti-aging therapies, de Grey predicts, are “going to be as available as water.”
Six years ago, Thiel wrote an essay for a think tank, the Cato Institute, called “The Education of a Libertarian.” The oracle of the Valley has long identified as a libertarian, but, he wrote, he’d recently updated his understanding of what exactly it would take to reach the libertarian dream. He defined this dream as a rejection of “confiscatory taxes, totalitarian collectives and” — wait for it — “the ideology of the inevitability of the death of every individual.” One of those is not like the others. To reach the dream, he wrote, we need to escape to, as Thiel poetically put it, “some undiscovered country.”
Maybe that undiscovered country is just … Colombia. Or Mexico, where Parrish’s Seattle-based company, BioViva, plans to do its clinical trials starting late this year. (“The FDA is slow,” she says, so she’d like to do it at “a fraction of the cost.”) Over the next year, Parrish will become a bit of a lab rat; she’ll have checkups every few months and will squeeze herself into MRI machines over and over again. She is offering to ship off her blood to any “legitimate” research team at a university that would like to study it; BioViva itself will investigate her bodily fluids as well. She’s already gotten “a couple of calls from curious researchers,” she says. She thinks she won’t need new injections, but you never know; much still needs answering, like whether the injections affect reproductive organs. (Parrish says, for now, she suggests therapies only for those “out of child-bearing years.”) She’ll be heads-down the whole time on the company.
This doesn’t trouble her. “It’s part of the job,” she says. I hear a little sniff through the phone line. She has a cold.