Has the time come to take on time itself?
BMJ 2008; 337 doi: https://doi.org/10.1136/bmj.a414 (Published 08 July 2008) Cite this as: BMJ 2008;337:a414
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1. Life is aging.
2. Aging is acquiring emotional and physical wounds.
3. Wound-healing depends on metabolism.
4. Metabolism depends on air, water, and food.
5. Metabolism is undermined by toxins and addictions.
6. Toxins and addictions interfere with wound-healing.
7. Toxins and addictions accelerate aging.
8. Avoiding toxins and addictions slows down aging.
9. Aging does not necessarily lead to infirmity.
10. Aging without infirmity is the purpose of life.
Competing interests:
None declared
Competing interests: No competing interests
Dear Dougal J. Jeffries
Thanks for your rapid response asking “Why slow aging?”.
Below are a few comments pertaining to your concerns about extending the
healthy lives of, as you put it, “wealthy consumers”.
(1) As you are a GP, I hope you do not see expanding the health
prospects of your patients as something that comes "at the expense of the
poor" and thus something contributing nothing to overall welfare. By this
logic doctors in the developed world ought to deny *all* medical treatment
to their patients so that their patients die as soon as possible, thus
minimizing their carbon imprint! And I find it hard to think of a more
perverse opinion for a GP to hold. People in the developed world are
human beings (not just "consumers"), and thus they do not deserve disease
or death.
(2) why assume slowing aging would only benefit those in the
wealthiest countries? Many developing countries are aging the fastest.
And the aged in poorer countries will be even more vulnerable to the
disadvantages of senescence. And so slowing aging would also expand (not
harm) the health opportunities for those in developing countries.
(3) Jeffries claims that retarding aging would simply postpone "all
the problems that beset old age". There are two things to say about this.
Firstly, there is good reason to believe that slowing aging would
also compress morbidity and mortality. Longevity scientist David Sinclear
nicely summarised the aspirations of this research in a recent interview
in the journal Rejuvenation Research. Sinclear claims:
"My stated goal is to keep people out of nursing homes for as long as
possible. It is known that the longer a person lives, the shorter the
period of his or her chronic disability or illness. People who live a
very long time die relatively quickly. Thus, the goal would be to reach 90
years of age, feel well, still be a productive member of society, be able
to play tennis, and see your grandchildren graduate from college. Then,
in a matter of weeks, go through the final stages of life and die. In that
way we would suffer less and be less of a burden on our families and
society."
Secondly, even if slowing aging merely delayed the problems of old
age, it would still be a significant and laudable accomplishment. This is
so because it would increase the number of healthy years we can expect to
live. All else being equal, it is better to suffer disease and death
later in life than earlier. We wouldn’t abandon medical research for
early onset diseases like CF just because, eventually, these patients
would suffer age-related diseases like cancer or heart disease.
No existing medical intervention can achieve more than a delay of
death and disease. A cure for cancer would not stop the people who would
have died of cancer from dying or suffering from heart disease,
Alzheimer’s, diabetes, etc. And so the value of slowing aging should be
measured by its likely impact on our health prospects.
Contrary to Jeffries, I believe slowing aging has the potential to
result in a significant improvement to overall welfare.
Competing interests:
None declared
Competing interests: No competing interests
I don't understand the claim made that we cannot afford NOT to tackle
ageing. The logical outcome of the 'advances' trumpeted by Colin Farrelly
would surely be extension of active life and corresponding high
consumption by wealthy populations with their high carbon footprint - at
the expense of the poor - with a postponement of all the problems that
beset old age at whatever time it occurs. There would be just the same
burden of dementia, degenerative disease etc., just a few years later.
What would be the net contribution of this change to overall welfare?
Competing interests:
None declared
Competing interests: No competing interests
Reply to Colin Farrelly
Dear Colin,
I hope you are right! Of course, the scenario you describe - of fit
90 year-olds playing tennis till their last few weeks of rapid decline -
is attractive, but I wonder if the reality will ever come near to this
dream. I suppose I feel a bit jaded - like most GPs - by the way in which
my practice has changed over the past 15 years or so. I used to believe
that preventive medicine was hugely more important than curative, or
'reactive' medicine. Now I'm not quite so sure. We seem to be
overwhelmed by patients coming in for regular blood tests and huge volumes
of medication (often with risks of dangerous interactions and side-effects
but all mandated by current guidelines), worrying about their state of
health and in fear of everything they eat, drink and do. I wonder whether
a more accepting and fatalistic philosophy of treating life as a bit of a
lottery, with the odds modifiable to a small extent perhaps, might not
lead to less overall anxiety and greater happiness. But then, at 57 and so
far at least, I'm reasonably healthy, play tennis and see my
grandchildren. My views may change as I get older.
As for my comments about consumerism and the rest, it just seems
faintly distasteful that we should be striving to extend life at the upper
limit when so many millions have it snuffed out long before any 'natural'
lifespan, and not because of the ageing process but because of infectious
disease, malnutrition, inadequate hygeine, absence of basic midwifery care
etc. etc.
Kind regards,
Dougal Jeffries
Competing interests:
None declared
Competing interests: No competing interests