Time for one of those rare substantive posts
I like Glenn Reynolds. I read his blog daily. Generally speaking, he exemplifies the common-sense (mileage may vary) agnostic libertarian perspective: not particularly supportive of several of the religious right's (that is, my) pet causes, but supportive of less government intrusion and not getting blown up by terrorists. But every now and again I find something with which to disagree.
I
Yesterday Reynolds posted a TCS column on life extension, which strikes me as toeing the line between optimism and enthusiastic folly at the prospects for "radical life-extension". Reynolds tells us two things: First, very soon (within the next 50 years or so) we will have achieved radical life extension (RLE)--which Reynolds never defines precisely, but he seems to imply that would mean at least doubling our current life expectancy, if not extending it indefinitely. Moreover, the deleterious effects of aging will be halted in one's 50s (or the new equivalent of 50) so this long life will be experienced with relative vigor and grace, as opposed to spending a few extra decades in a nursing home.
It would be foolish to deny that new technology is likely to increase our lifespan by a noticeable margin, but there is a distinct difference between preventing premature death--the cause of rising life expectancy over the past century--and changing the definition of premature death--what is what will have to happen in the next century to achieve the results Reynolds desires. To put it another way, the past century was about stopping lethal illnesses (influenza, etc.) which cut us down in our prime; the next century will need focus on stopping the natural degradation of the human body. So I don't think our success in this endeavor will be quite as strong as past experience would seem to predict.
Second, Reynolds posits that this new growth of technology will solve pressing problems we are now facing, including the one which everyone knows about and no one is really lifting a finger to stop: the West's suicide by demographics. The majority of countries in the First World have fallen well below the birth rate necessary for a stable population; barring a major change in behavior the (non-immigrant) population of Europe and Japan will be very small, very old and utterly incapable of supporting the welfare structures needed to keep the old cared for. Reynolds cites a recent article by Mark Steyn on this subject and claims that RLE will serve to combat this problem. I know he read to at least the fourth paragraph because that's the one he quotes, but it seems to me that Reynolds stopped reading at that point because he misses much of what Steyn is saying. If we are suffering from a crisis of confidence in our civilization, and that is the cause of our declining population, then increasing our life expantacy won't solve the problem by itself; at least, it never has before. The current malaise afflicting the West came with our prosperity, after all. And unless we achieve literal immortality--which I find highly unlikely--we'll need to start meeting a replacement birth rate sooner or later. Technology can save us from many problems, but I don't think it can save us from ourselves.
It might be somewhat unfair to take on Reynolds on this point, since his comments towards Steyn's column don't amount to much more than a throwaway line. But his passion for RLE seems a wee bit excessive; he's devoted several columns now to the possibility that RLE might one day come about and serve as a panacea for several pressing problems. Given that none of the advances he believes will happen has actually happened, it seems rather like claiming in 1950 that traffic problems will be solved by 2000 because of flying cars--which everyone living at the time knew we would have by then.
(Joss Whedon, in his introduction to Fray, notes that his vision of the future is nothing unique: "The rich get richer, the poor get poorer, and there are flying cars." I take this as a lesson that while certain technologies we think will never be developed eventually are, numerous others that we are certain will be developed never come.)
II
But, we should surely view RLE as a good thing? Well, yes and no. Certainly, we can be thankful for the medical advances we have had so far. These are certainly good. But it would be wrong to take from them the false hope that we will somehow liberate ourselves from death. And this belief can have very dangerous consequences.
Eric Cohen and Leon Kass recently authored an article which addresses this point very directly:
In an age of medical triumphs, it is not surprising that our first approach to the dilemmas of old age is to think we can cure our way out of them. ... [T]he twin goals of attacking debility and caring for the debilitated are not intrinsically or necessarily opposed to each other. But it is also foolish to act and speak as if medical progress (whether in prevention or in cure) will liberate us from the realities of decline, debility, and death or from the unavoidable duties of caregiving at the end of life. ... This is the paradox of modern aging: we are vigorous longer and we are incapacitated longer. ... [I]n fueling our love of youthfulness and limitless life, and our hatred of senescence and decline, the campaign for healthy aging also subtly encourages us to devalue the need to give care and comfort to those we cannot cure. When, moreover, aging does not bring the good tidings we were promised, we may seek instead an even more absolute control over death and come to embrace the pseudo-mastery of “death-on-demand” as the cure for our unconquerable miseries. (emphasis original)
And from the conclusion:
As we noted earlier, Americans increasingly regard old age as a bundle of needs and problems demanding solution, or as a time of life whose meaning is defined largely by the struggle to stay healthy and fit. This outlook has generated discontent with the life cycle itself, producing an insatiable desire for more and more medical miracles, and creating the fantasy that we can transcend our limitations-or that death itself may be pushed back indefinitely.
This last fantasy, of course, is precisely what Reynolds argues is the coming reality. So it seems that this problem is merely a difference in estimating the capacity of our technology to solve our problems. But the problem stretches deeper than that.
III
I did a joint oral presentation of Leo Tolstoy's The Death of Ivan Ilyich with my twin brother in high school. It's a very morbid book, so we spent a good deal of time trying to liven up the presentation just to keep the class interested. But I think sometimes the work should just be taken as it is:
Besides considerations as to the possible transfers and promotions likely to result from Ivan Ilych's death, the mere fact of the death of a near acquaintance aroused, as usual, in all who heard of it the complacent feeling that, "it is he who is dead and not I."
Each one thought or felt, "Well, he's dead but I'm alive!" But the more intimate of Ivan Ilych's acquaintances, his so-called friends, could not help thinking also that they would now have to fulfill the very tiresome demands of propriety by attending the funeral service and paying a visit of condolence to the widow. ...
"He suffered terribly the last few days."
"Did he?" said Peter Ivanovich.
"Oh, terribly! He screamed unceasingly, not for minutes but for hours. For the last three days he screamed incessantly. It was unendurable. I cannot understand how I bore it; you could hear him three rooms off. Oh, what I have suffered!"
"Is it possible that he was conscious all that time?" asked Peter Ivanovich.
"Yes," she whispered. "To the last moment. He took leave of us a quarter of an hour before he died, and asked us to take Volodya away."
The thought of the suffering of this man he had known so intimately, first as a merry little boy, then as a schoolmate, and later as a grown-up colleague, suddenly struck Peter Ivanovich with horror, despite an unpleasant consciousness of his own and this woman's dissimulation. He again saw that brow, and that nose pressing down on the lip, and felt afraid for himself.
"Three days of frightful suffering and the death! Why, that might suddenly, at any time, happen to me," he thought, and for a moment felt terrified. But - he did not himself know how - the customary reflection at once occurred to him that this had happened to Ivan Ilych and not to him, and that it should not and could not happen to him, and that to think that it could would be yielding to depressing which he ought not to do, as Schwartz's expression plainly showed. After which reflection Peter Ivanovich felt reassured, and began to ask with interest about the details of Ivan Ilych's death, as though death was an accident natural to Ivan Ilych but certainly not to himself.
Thus goes the first chapter. The remainder of the book devotes itself to the life and death of Ivan himself, and shows how a man who possessed that same certainty as Peter Ivanovich is disabused of the notion. He slowly comes to realize not just the truth of the old syllogism (all men are mortal), but what denying it does to those around him.
Ivan Ilych told Gerasim to sit down and hold his legs, and began to talk to him. And strange to say it seemed to him that he felt better while Gerasim held his legs up.
After that Ivan Ilych would sometimes call Gerasim and get him to hold his legs on his shoulders, and he liked talking to him. Gerasim did it all easily, willingly, simply, and with a good nature that touched Ivan Ilych. Health, strength, and vitality in other people were offensive to him, but Gerasim's strength and vitality did not mortify but soothed him.
What tormented Ivan Ilych most was the deception, the lie, which for some reason they all accepted, that he was not dying but was simply ill, and the only need keep quiet and undergo a treatment and then something very good would result. He however knew that do what they would nothing would come of it, only still more agonizing suffering and death. This deception tortured him - their not wishing to admit what they all knew and what he knew, but wanting to lie to him concerning his terrible condition, and wishing and forcing him to participate in that lie. ... The awful, terrible act of his dying was, he could see, reduced by those about him to the level of a casual, unpleasant, and almost indecorous incident (as if someone entered a drawing room defusing an unpleasant odour) and this was done by that very decorum which he had served all his life long. He saw that no one felt for him, because no one even wished to grasp his position. Only Gerasim recognized it and pitied him. And so Ivan Ilych felt at ease only with him. ... Gerasim alone did not lie; everything showed that he alone understood the facts of the case and did not consider it necessary to disguise them, but simply felt sorry for his emaciated and enfeebled master. Once when Ivan Ilych was sending him away he even said straight out: "We shall all of us die, so why should I grudge a little trouble?" - expressing the fact that he did not think his work burdensome, because he was doing it for a dying man and hoped someone would do the same for him when his time came. (emphasis added)
When Andrew and I gave the report we were quite certain to hammer home the theme: a culture which cannot admit death will invariably ignore, mistreat, or otherwise refuse its responsibilities to the dead, the dying, and the elderly. To take such responsibilities seriously would require taking death itself seriously, and that is something a materialistic culture, whether Tolstoy's aristocratic Russia or the (post-)modern West cannot do by temperament. That, Tolstoy and Cohen and Kass argue, is the ultimate result of Reynolds's "fantasy": our hubristic attempt to make ourselves immortal removes our ability to treat the dying. To face them requires that we face the ultimate failure of our will to solve every problem.
It's said that when a Roman general returned to the capital victorious, and a Triumph was held in his honor, as he rode his chariot down the streets with the adoration of the citizenry bombarding him from every side, would have next to him a slave, whose task was to whisper in his ear, "But you, too, are mortal." Can you imagine anyone saying those words today, in any context? When was the last time--save for suicide, the ultimate act of self-will--any of us thought of death?
IV
The European heat wave of 2003 is arguably the worst natural disaster the so-called First World faced in the past half-century; it certain wins out if we calculate sheer loss of life. But for me the most disturbing part of the whole incident was the behavior of the French. It wasn't just that French workers on their yearly vacation didn't stay in sufficient contact with their elderly relatives to prevent their deaths, or that most medical practitioners were also on holiday, so effective treatment was unavailable. The French death toll was exceeded by Italy's, so it's likely that France was not alone in its neglect. The shocking part is that, even after their parents died, those same vacationing sons and daughters went ahead and finished their vacation, delaying the funeral until it wouldn't inconvenience them. They were too busy enjoying their personal pursuit of their lives to be bothered by another's death (because death is something which always happens to the other).
This sort of culture is not, of course, what Reynolds wants to encourage. But if Cohen and Kass are right--and I'm inclined to believe them--then Reynolds's almost obsessive focus on RLE over the past several months is contributing to the problem. Perhaps the "medical miracles" he hopes for will eventually come to pass; I'm not holding my breath. Meanwhile he's supporting, admittedly in a very sophisticated way, the same self-focus and self-indulgence pervading our society right now. That current selfishness, and not the possibility of its future rehabilitation, should be our concern.
I
Yesterday Reynolds posted a TCS column on life extension, which strikes me as toeing the line between optimism and enthusiastic folly at the prospects for "radical life-extension". Reynolds tells us two things: First, very soon (within the next 50 years or so) we will have achieved radical life extension (RLE)--which Reynolds never defines precisely, but he seems to imply that would mean at least doubling our current life expectancy, if not extending it indefinitely. Moreover, the deleterious effects of aging will be halted in one's 50s (or the new equivalent of 50) so this long life will be experienced with relative vigor and grace, as opposed to spending a few extra decades in a nursing home.
It would be foolish to deny that new technology is likely to increase our lifespan by a noticeable margin, but there is a distinct difference between preventing premature death--the cause of rising life expectancy over the past century--and changing the definition of premature death--what is what will have to happen in the next century to achieve the results Reynolds desires. To put it another way, the past century was about stopping lethal illnesses (influenza, etc.) which cut us down in our prime; the next century will need focus on stopping the natural degradation of the human body. So I don't think our success in this endeavor will be quite as strong as past experience would seem to predict.
Second, Reynolds posits that this new growth of technology will solve pressing problems we are now facing, including the one which everyone knows about and no one is really lifting a finger to stop: the West's suicide by demographics. The majority of countries in the First World have fallen well below the birth rate necessary for a stable population; barring a major change in behavior the (non-immigrant) population of Europe and Japan will be very small, very old and utterly incapable of supporting the welfare structures needed to keep the old cared for. Reynolds cites a recent article by Mark Steyn on this subject and claims that RLE will serve to combat this problem. I know he read to at least the fourth paragraph because that's the one he quotes, but it seems to me that Reynolds stopped reading at that point because he misses much of what Steyn is saying. If we are suffering from a crisis of confidence in our civilization, and that is the cause of our declining population, then increasing our life expantacy won't solve the problem by itself; at least, it never has before. The current malaise afflicting the West came with our prosperity, after all. And unless we achieve literal immortality--which I find highly unlikely--we'll need to start meeting a replacement birth rate sooner or later. Technology can save us from many problems, but I don't think it can save us from ourselves.
It might be somewhat unfair to take on Reynolds on this point, since his comments towards Steyn's column don't amount to much more than a throwaway line. But his passion for RLE seems a wee bit excessive; he's devoted several columns now to the possibility that RLE might one day come about and serve as a panacea for several pressing problems. Given that none of the advances he believes will happen has actually happened, it seems rather like claiming in 1950 that traffic problems will be solved by 2000 because of flying cars--which everyone living at the time knew we would have by then.
(Joss Whedon, in his introduction to Fray, notes that his vision of the future is nothing unique: "The rich get richer, the poor get poorer, and there are flying cars." I take this as a lesson that while certain technologies we think will never be developed eventually are, numerous others that we are certain will be developed never come.)
II
But, we should surely view RLE as a good thing? Well, yes and no. Certainly, we can be thankful for the medical advances we have had so far. These are certainly good. But it would be wrong to take from them the false hope that we will somehow liberate ourselves from death. And this belief can have very dangerous consequences.
Eric Cohen and Leon Kass recently authored an article which addresses this point very directly:
In an age of medical triumphs, it is not surprising that our first approach to the dilemmas of old age is to think we can cure our way out of them. ... [T]he twin goals of attacking debility and caring for the debilitated are not intrinsically or necessarily opposed to each other. But it is also foolish to act and speak as if medical progress (whether in prevention or in cure) will liberate us from the realities of decline, debility, and death or from the unavoidable duties of caregiving at the end of life. ... This is the paradox of modern aging: we are vigorous longer and we are incapacitated longer. ... [I]n fueling our love of youthfulness and limitless life, and our hatred of senescence and decline, the campaign for healthy aging also subtly encourages us to devalue the need to give care and comfort to those we cannot cure. When, moreover, aging does not bring the good tidings we were promised, we may seek instead an even more absolute control over death and come to embrace the pseudo-mastery of “death-on-demand” as the cure for our unconquerable miseries. (emphasis original)
And from the conclusion:
As we noted earlier, Americans increasingly regard old age as a bundle of needs and problems demanding solution, or as a time of life whose meaning is defined largely by the struggle to stay healthy and fit. This outlook has generated discontent with the life cycle itself, producing an insatiable desire for more and more medical miracles, and creating the fantasy that we can transcend our limitations-or that death itself may be pushed back indefinitely.
This last fantasy, of course, is precisely what Reynolds argues is the coming reality. So it seems that this problem is merely a difference in estimating the capacity of our technology to solve our problems. But the problem stretches deeper than that.
III
I did a joint oral presentation of Leo Tolstoy's The Death of Ivan Ilyich with my twin brother in high school. It's a very morbid book, so we spent a good deal of time trying to liven up the presentation just to keep the class interested. But I think sometimes the work should just be taken as it is:
Besides considerations as to the possible transfers and promotions likely to result from Ivan Ilych's death, the mere fact of the death of a near acquaintance aroused, as usual, in all who heard of it the complacent feeling that, "it is he who is dead and not I."
Each one thought or felt, "Well, he's dead but I'm alive!" But the more intimate of Ivan Ilych's acquaintances, his so-called friends, could not help thinking also that they would now have to fulfill the very tiresome demands of propriety by attending the funeral service and paying a visit of condolence to the widow. ...
"He suffered terribly the last few days."
"Did he?" said Peter Ivanovich.
"Oh, terribly! He screamed unceasingly, not for minutes but for hours. For the last three days he screamed incessantly. It was unendurable. I cannot understand how I bore it; you could hear him three rooms off. Oh, what I have suffered!"
"Is it possible that he was conscious all that time?" asked Peter Ivanovich.
"Yes," she whispered. "To the last moment. He took leave of us a quarter of an hour before he died, and asked us to take Volodya away."
The thought of the suffering of this man he had known so intimately, first as a merry little boy, then as a schoolmate, and later as a grown-up colleague, suddenly struck Peter Ivanovich with horror, despite an unpleasant consciousness of his own and this woman's dissimulation. He again saw that brow, and that nose pressing down on the lip, and felt afraid for himself.
"Three days of frightful suffering and the death! Why, that might suddenly, at any time, happen to me," he thought, and for a moment felt terrified. But - he did not himself know how - the customary reflection at once occurred to him that this had happened to Ivan Ilych and not to him, and that it should not and could not happen to him, and that to think that it could would be yielding to depressing which he ought not to do, as Schwartz's expression plainly showed. After which reflection Peter Ivanovich felt reassured, and began to ask with interest about the details of Ivan Ilych's death, as though death was an accident natural to Ivan Ilych but certainly not to himself.
Thus goes the first chapter. The remainder of the book devotes itself to the life and death of Ivan himself, and shows how a man who possessed that same certainty as Peter Ivanovich is disabused of the notion. He slowly comes to realize not just the truth of the old syllogism (all men are mortal), but what denying it does to those around him.
Ivan Ilych told Gerasim to sit down and hold his legs, and began to talk to him. And strange to say it seemed to him that he felt better while Gerasim held his legs up.
After that Ivan Ilych would sometimes call Gerasim and get him to hold his legs on his shoulders, and he liked talking to him. Gerasim did it all easily, willingly, simply, and with a good nature that touched Ivan Ilych. Health, strength, and vitality in other people were offensive to him, but Gerasim's strength and vitality did not mortify but soothed him.
What tormented Ivan Ilych most was the deception, the lie, which for some reason they all accepted, that he was not dying but was simply ill, and the only need keep quiet and undergo a treatment and then something very good would result. He however knew that do what they would nothing would come of it, only still more agonizing suffering and death. This deception tortured him - their not wishing to admit what they all knew and what he knew, but wanting to lie to him concerning his terrible condition, and wishing and forcing him to participate in that lie. ... The awful, terrible act of his dying was, he could see, reduced by those about him to the level of a casual, unpleasant, and almost indecorous incident (as if someone entered a drawing room defusing an unpleasant odour) and this was done by that very decorum which he had served all his life long. He saw that no one felt for him, because no one even wished to grasp his position. Only Gerasim recognized it and pitied him. And so Ivan Ilych felt at ease only with him. ... Gerasim alone did not lie; everything showed that he alone understood the facts of the case and did not consider it necessary to disguise them, but simply felt sorry for his emaciated and enfeebled master. Once when Ivan Ilych was sending him away he even said straight out: "We shall all of us die, so why should I grudge a little trouble?" - expressing the fact that he did not think his work burdensome, because he was doing it for a dying man and hoped someone would do the same for him when his time came. (emphasis added)
When Andrew and I gave the report we were quite certain to hammer home the theme: a culture which cannot admit death will invariably ignore, mistreat, or otherwise refuse its responsibilities to the dead, the dying, and the elderly. To take such responsibilities seriously would require taking death itself seriously, and that is something a materialistic culture, whether Tolstoy's aristocratic Russia or the (post-)modern West cannot do by temperament. That, Tolstoy and Cohen and Kass argue, is the ultimate result of Reynolds's "fantasy": our hubristic attempt to make ourselves immortal removes our ability to treat the dying. To face them requires that we face the ultimate failure of our will to solve every problem.
It's said that when a Roman general returned to the capital victorious, and a Triumph was held in his honor, as he rode his chariot down the streets with the adoration of the citizenry bombarding him from every side, would have next to him a slave, whose task was to whisper in his ear, "But you, too, are mortal." Can you imagine anyone saying those words today, in any context? When was the last time--save for suicide, the ultimate act of self-will--any of us thought of death?
IV
The European heat wave of 2003 is arguably the worst natural disaster the so-called First World faced in the past half-century; it certain wins out if we calculate sheer loss of life. But for me the most disturbing part of the whole incident was the behavior of the French. It wasn't just that French workers on their yearly vacation didn't stay in sufficient contact with their elderly relatives to prevent their deaths, or that most medical practitioners were also on holiday, so effective treatment was unavailable. The French death toll was exceeded by Italy's, so it's likely that France was not alone in its neglect. The shocking part is that, even after their parents died, those same vacationing sons and daughters went ahead and finished their vacation, delaying the funeral until it wouldn't inconvenience them. They were too busy enjoying their personal pursuit of their lives to be bothered by another's death (because death is something which always happens to the other).
This sort of culture is not, of course, what Reynolds wants to encourage. But if Cohen and Kass are right--and I'm inclined to believe them--then Reynolds's almost obsessive focus on RLE over the past several months is contributing to the problem. Perhaps the "medical miracles" he hopes for will eventually come to pass; I'm not holding my breath. Meanwhile he's supporting, admittedly in a very sophisticated way, the same self-focus and self-indulgence pervading our society right now. That current selfishness, and not the possibility of its future rehabilitation, should be our concern.