Why We Should Embrace Death: An Argument Against Life Extension (Francis Fukuyama)

Living as I do in Silicon Valley, I am surrounded by tech billionaires who are investing huge sums of money in longevity research. Jeff Bezos, Larry Page, Larry Ellison, and Peter Thiel have all sunk money into research that will ultimately help them and (presumably) the rest of us live longer. While I think the impulse driving them is understandable, I strongly believe that life extension is a bad idea.

Life extension is already one of the most remarkable positive consequences of advances in human biomedicine over the past century. One hundred years ago, life expectancy at birth in the United States and other rich countries was in the range of 55-60 years; today, it is 75-80 years. It is higher for women than for men, and somewhat lower in the United States than in Japan, Sweden, or the United Kingdom because of higher U.S. rates of poverty and drug use.

It is hard to overstate how great an improvement in the quality of human life this represents. In the 19^th century, life expectancies at birth were held down primarily because of childhood deaths and diseases. Some 30-50% of children in Western Europe died before their fifth birthdays, with higher numbers in more rural and poorer parts of the continent. It was thus a common experience for parents to lose a child, and not uncommon for the mother to die in childbirth.

These advances in longevity were the collective result of huge improvements in a number of interrelated systems—municipal water plants, public health, the development of antibiotics and other drugs, a better understanding of preventive care, and the like. In more recent decades, with childhood mortality mostly under control in rich countries, the largest gains in life expectancies have come in keeping older people alive with new treatments for diseases such as cancer and cardio-vascular disease.

Today’s cutting edge life extension dollars are now being spent on keeping older people alive and healthy. There are two broad approaches: one is the traditional one of seeking treatment for individual diseases that affect this population like cancer, Alzheimer’s, or Parkinson’s. The other, however, seeks to address aging at a molecular level, for example by affecting the telomeres that act like biological clocks determining the timing of cell death. The rate of improvement in life expectancies has flattened over the decades as biomedicine dealt with low-hanging fruit; new research into specific diseases may help improve this rate of change. But dramatic improvements in this realm are unlikely. A breakthrough in the second line of research—the molecular one—might potentially yield much more spectacular improvements, allowing people to live routinely into their 100s or beyond.

I am not looking forward to living in such a world, and indeed I think that such a world might constitute an immense disaster for humankind. There are two basic reasons for this.

The first has to do with simple probabilities. Our human minds and bodies are built around a series of faculties and abilities that interact with one another, like sight, hearing, muscular strength, health of the immune system, cognitive abilities, sexual potency, and more. Each one of these systems has its own life cycle and begins to deteriorate over time. In an ideal world, all of these systems would run in parallel and then shut down at the same time, allowing each individual to live a life free of debility. But what is the chance of present-day or future biomedicine achieving such an across-the-board goal? Its advances are likely to be episodic and narrowly focused, leaving people with increasing debilities even as their life spans increase.

We are already entering such a world. Nearly half of all seniors in their mid- to late-80s suffer from some form of degenerative neurological disease like Alzheimer’s or Parkinson’s, in the later stages of which they are completely unable to care for themselves. An optimist may hope that there will be cures for these diseases over time, but survival is not the same thing as having treatments that restore a functioning and flourishing life.

This brings us to the second issue that is not widely discussed, but which is at the core of the problem of life extension. Among the cognitive debilities that occur over time is rigidity in one’s fundamental outlook and assumptions about life. One’s outlook is usually set relatively early in life; usually by early adulthood you are either a liberal or a conservative; a nationalist or an internationalist; a risk-taker or someone habitually fearful and cautious. There is a lot of happy talk among gerontologists about how people can remain open to new ideas and able to reinvent their lives late in life, and that certainly happens with some individuals. But the truth of the matter is that fundamental change in mental outlooks becomes much less likely with age.

The slowing of generational turnover is thus very likely to slow the rate of social evolution and adaptation, in line with the old joke that the field of economics advances one funeral at a time.

Social change tends to happen in generational cycles. I recently reviewed two books that discuss this phenomenon, The Fourth Turning Is Here by Neil Howe, and End Times by Peter Turchin. They both present theories of history that are built around generational change. According to Howe, American history can be fitted into century-long cycles that each consist of four generational cycles; Turchin notes a similar cycle based on what he calls “elite overproduction.” There is obviously something to generational social change: my father’s generation that experienced the Great Depression and World War II had a lot of faith in big government’s ability to do big things; the generation that experienced Watergate and the Vietnam War lost that confidence, and gave way to a libertarian generation that thought the government was the problem.

I once had a debate with the science editor of a libertarian publication who enthused about the prospects for life extension. My response was, “I am not looking forward to a world in which you will be spouting your same dumb libertarian ideas 100 years from now.”

Howe assumes that generations last around 25 years, and his four-generation theory therefore divides American history into saecula of 100 years. But what will happen if people routinely live into their 100s? You will have an overlapping of generations and increasing social conflict as younger people begin to think differently and demand change, while older ones resist. The problem will not be conflict per se, but a gradual slowing of the rate of social change. Meanwhile, technological change will continue to happen at ever faster rates, requiring ever-faster rates of adaptation.

If you combine these two likely future scenarios, life extension will leave us with a world that is more economically and socially stagnant, and in which large proportions of older populations are suffering from some form of debility. There will be grave economic consequences to this, already being felt in East Asia where fast-dropping birth rates in countries like Japan and Korea are shifting age distributions from squat pyramids to wine glass-shaped figures. Japan, which has one of the world’s longest life expectancies, faces a huge sustainability crisis.

In the world that is emerging, a major source of pressure for social change will have to come from immigration. As birth rates drop first in rich countries, the major sources of younger people will be coming from poor developing ones. I don’t need to explain that immigration is already a huge source of social conflict, and will get even bigger as time goes on. But those immigrants will be necessary to care for the native-born in their nursing homes, as is already the case in countries like Japan.

There are good evolutionary reasons, related to adaptation, why individuals of virtually every species do not live forever. Life extension is something that is individually desirable by everyone, but disastrous on a social level. This is what will make it very hard to stop research in this area.

As for me, I’ve already benefited from existing biomedical technologies. No male on my father’s side of my family has lived to the age I am now. But I honestly do not look forward to the prospect of living another 20 years, and having people say behind my back (as they likely do already) “he’s still spouting the same nonsense he was in the late 20^th century.” There is a time to move on.