Dec 16 JDN 2458469

If living is good, then living longer is better.

This may seem rather obvious, but it’s something we often lose sight of when discussing the consequences of medical technology for extending life. It’s almost like it seems too obvious that living longer must be better, and so we go out of our way to find ways that it is actually worse.

Even from a quick search I was able to find half a dozen popular media articles about life extension, and not one of them focused primarily on the benefits. The empirical literature is better, asking specific, empirically testable questions like “How does life expectancy relate to retirement age?” and “How is lifespan related to population and income growth?” and “What effect will longer lifespans have on pension systems?” Though even there I found essays in medical journals complaining that we have extended “quantity” of life without “quality” (yet by definition, if you are using QALY to assess the cost-effectiveness of a medical intervention, that’s already taken into account).

But still I think somewhere along the way we have forgotten just how good this is. We may not even be able to imagine the benefits of extending people’s lives to 200 or 500 or 1000 years.

To really get some perspective on this, I want you to imagine what a similar conversation must have looked like in roughly the year 1800, the Industrial Revolution, when industrial capitalism came along and made babies finally stop dying.

There was no mass media back then (not enough literacy), but imagine what it would have been like if there had been, or imagine what conversations about the future between elites must have been like.

And we do actually have at least one example of an elite author lamenting the increase in lifespan: His name was Thomas Malthus.

The Malthusian argument was seductive then, and it remains seductive today: If you improve medicine and food production, you will increase population. But if you increase population, you will eventually outstrip those gains in medicine and food and return once more to disease and starvation, only now with more mouths to feed.

Basically any modern discussion of “overpopulation” has this same flavor (by the way, serious environmentalists don’t use that concept; they’re focused on reducing pollution and carbon emissions, not people). Why bother helping poor countries, when they’re just going to double their population and need twice the help?

Well, as a matter of fact, Malthus was wrong. In fact, he was not just wrong: He was backwards. Increased population has come with increased standard of living around the world, as it allowed for more trade, greater specialization, and the application of economies of scale. You can’t build a retail market with a hunter-gatherer tribe. You can’t built an auto industry with a single city-state. You can’t build a space program with a population of 1 million. Having more people has allowed each person to do and have more than they could before.

Current population projections suggest world population will stabilize between 11 and 12 billion. Crucially, this does not factor in any kind of radical life extension technology. The projections allow for moderate increases in lifespan, but not people living much past 100.

Would increased lifespan lead to increased population? Probably, yes. I can’t be certain, because I can very easily imagine people deciding to put off having kids if they can reasonably expect to live 200 years and never become infertile.

I’m actually more worried about the unequal distribution of offspring: People who don’t believe in contraception will be able to have an awful lot of kids during that time, which could be bad for both the kids and society as a whole. We may need to impose regulations on reproduction similar to (but hopefully less draconian than) the One-Child policy imposed in China.

I think the most sensible way to impose the right incentives while still preserving civil liberties is to make it a tax: The first kid gets a subsidy, to help care for them. The second kid is revenue-neutral; we tax you but you get it back as benefits for the child. (Why not just let them keep the money? One of the few places where I think government paternalism is justifiable is protection against abusive or neglectful parents.) The third and later kids result in progressively higher taxes. We always feed the kids on government money, but their parents are going to end up quite poor if they don’t learn how to use contraceptives. (And of course, contraceptives will be made available for free without a prescription.)

But suppose that, yes, population does greatly increase as a result of longer lifespans. This is not a doomsday scenario. In fact, in itself, this is a good thing. If life is worth living, more lives are better.

The question becomes how we ensure that all these people live good lives; but technology will make that easier too. There seems to be an underlying assumption that increased lifespan won’t come with improved health and vitality; but this is already not true. 60 is the new 50: People who are 60 years old today live as well as people who were 50 years old just a generation ago.

And in fact, radical life extension will be an entirely different mechanism. We’re not talking about replacing a hip here, a kidney there; we’re talking about replenishing your chromosomal telomeres, repairing your cells at the molecular level, and revitalizing the content of your blood. The goal of life extension technology isn’t to make you technically alive but hooked up to machines for 200 years; it’s to make you young again for 200 years. The goal is a world where centenarians are playing tennis with young adults fresh out of college and you have trouble telling which is which.

There is another inequality concern here as well, which is cost. Especially in the US—actually almost only in the US, since most of the world has socialized medicine—where medicine is privatized and depends on your personal budget, I can easily imagine a world where the rich live to 200 and the poor die at 60. (The forgettable Justin Timberlake film In Time started with this excellent premise and then went precisely nowhere with it. Oddly, the Deus Ex games seem to have considered every consequence of mixing capitalism with human augmentation except this one.) We should be proactively taking steps to prevent this nightmare scenario by focusing on making healthcare provision equitable and universal. Even if this slows down the development of the technology a little bit, it’ll be worth it to make sure that when it does arrive, it will arrive for everyone.

We really don’t know what the world will look like when people can live 200 years or more. Yes, there will be challenges that come from the transition; honestly I’m most worried about keeping alive ideas that people grew up with two centuries prior. Imagine talking politics with Abraham Lincoln: He was viewed as extremely progressive for his time, even radical—but he was still a big-time racist.

The good news there is that people are not actually as set in their ways as many believe: While the huge surge in pro-LGBT attitudes did come from younger generations, support for LGBT rights has been gradually creeping up among older generations too. Perhaps if Abraham Lincoln had lived through the Great Depression, the World Wars, and the Civil Rights Movement he’d be a very different person than he was in 1865. Longer lifespans will mean people live through more social change; that’s something we’re going to need to cope with.

And of course violent death becomes even more terrifying when aging is out of the picture: It’s tragic enough when a 20-year-old dies in a car accident today and we imagine the 60 years they lost—but what if it was 180 years or 480 years instead? But violent death in basically all its forms is declining around the world.

But again, I really want to emphasize this: Think about how good this is. Imagine meeting your great-grandmother—and not just meeting her, not just having some fleeting contact you half-remember from when you were four years old or something, but getting to know her, talking with her as an adult, going to the same movies, reading the same books. Imagine the converse: Knowing your great-grandchildren, watching them grow up and have kids of their own, your great-great-grandchildren. Imagine the world that we could build if people stopped dying all the time.

And if that doesn’t convince you, I highly recommend Nick Bostrom’s “Fable of the Dragon-Tyrant”.

Stop making excuses for the dragon.