lifespan

What we still have to be thankful for

PNRJ core principles, current events, ethics, futurism, inequality, politics, public policy , , , , , , , , ,

Nov 30 JDN 2461010

This post has been written before, but will go live after, Thanksgiving.

Thanksgiving is honestly a very ambivalent holiday.

The particular event it celebrates don’t seem quite so charming in their historical context: Rather than finding peace and harmony with all Native Americans, the Pilgrims in fact allied with the Wampanoag against the Narragansett, though they did later join forces with the Narragansett in order to conquer the Pequot. And of course we all know how things went for most Native American nations in the long run.

Moreover, even the gathering of family comes with some major downsides, especially in a time of extreme political polarization such as this one. I won’t be joining any of my Trump-supporting relatives for dinner this year (and they probably wouldn’t have invited me anyway), but the fact that this means becoming that much more detached from a substantial part of my extended family is itself a tragedy.

This year in particular, US policy has gotten so utterly horrific that it often feels like we have nothing to be thankful for at all, that all we thought was good and just in the world could simply be torn away at a moment’s notice by raving madmen. It isn’t really quite that bad—but it feels that way sometimes.

It also felt a bit uncanny celebrating Thanksgiving a few years ago when we were living in Scotland, for the UK does not celebrate Thanksgiving, but absolutely does celebrate Black Friday: Holidays may be local, but capitalism is global.

But fall feasts of giving thanks are far more ancient than that particular event in 1621 that we have mythologized to oblivion. They appear in numerous cultures across the globe—indeed their very ubiquity may be why the Wampanoag were so willing to share one with the Pilgrims despite their cultures having diverged something like 40,000 years prior.

And I think that it is by seeing ourselves in that context—as part of the whole of humanity—that we can best appreciate what we truly do have to be thankful for, and what we truly do have to look forward to in the future.

Above all, medicine.

We have actual treatments for some diseases, even actual cures for some. By no means all, of course—and it often feels like we are fighting an endless battle even against what we can treat.

But it is worth reflecting on the fact that aside from the last few centuries, this has simply not been the case. There were no actual treatments. There was no real medicine.

Oh, sure, there were attempts at medicine; and there was certainly what we would think of as more like “first aid”: bandaging wounds, setting broken bones. Even amputation and surgery were done sometimes. But most medical treatment was useless or even outright harmful—not least because for most of history, most of it was done without anesthetic or even antiseptic!

There were various herbal remedies for various ailments, some of which even have happened to work: Willow bark genuinely helps with pain, St. John’s wort is a real antidepressant, and some traditional burn creams are surprisingly effective.

But there was no system in place for testing medicine, no way of evaluating what remedies worked and what didn’t. And thus, for every remedy that worked as advertised, there were a hundred more that did absolutely nothing, or even made things worse.

Today, it can feel like we are all chronically ill, because so many of us take so many different pills and supplements. But this is not a sign that we are ill—it is a sign that we can be treated. The pills are new, yes—but the illnesses they treat were here all along.

I don’t see any particular reason to think that Roman plebs or Medieval peasants were any less likely to get migraines than we are; but they certainly didn’t have access to sumatriptan or rimegepant. Maybe they were less likely to get diabetes, but mainly because they were much more likely to be malnourished. (Well, okay, also because they got more exercise, which we surely could stand to.) And they only reason they didn’t get Alzheimer’s was that they usually didn’t live long enough.

Looking further back, before civilization, human health actually does seem to have been better: Foragers were rarely malnourished, weren’t exposed to as many infectious pathogens, and certainly got plenty of exercise. But should a pathogen like smallpox or influenza make it to a forager tribe, the results were often utterly catastrophic.

Today, we don’t really have the sort of plague that human beings used to deal with. We have pandemics, which are also horrible, but far less so. We were horrified by losing 0.3% of our population to COVID; a society that had only suffered 0.3%—or even ten times that, 3%—losses from the Black Death would have been hailed as a miracle, for a more typical rate was 30%.

At 0.3%, most of us knew somebody, or knew somebody who knew somebody, who died from COVID. At 3%, nearly everyone would know somebody, and most would know several. At 30%, nearly everyone would have close family and friends who died.

Then there is infant mortality.

As recently as 1950—this is living memory—the global infant mortality rate was 14.6%. This is about half what it had been historically; for most of human history, roughly a third of all children died between birth and the age of 5.

Today, it is 2.5%.

Where our distant ancestors expected two out of three of their children to survive and our own great-grandparents expected five out of six can now safely expect thirty-nine out of forty to live. This is the difference between “nearly every family has lost a child” and “most families have not lost a child”.

And this is worldwide; in highly-developed countries it’s even better. The US has a relatively high infant mortality rate by the standards of highly-developed countries (indeed, are we even highly-developed, or are we becoming like Saudi Arabia, extremely rich but so unequal that it doesn’t really mean anything to most of our people?). Yet even for us, the infant mortality rate is 0.5%—so we can expect one-hundred-ninety-nine out of two-hundred to survive. This is at the level of “most families don’t even know someone who has lost a child.”

Poverty is a bit harder to measure.

I am increasingly dubious of conventional measures of poverty; ever since compiling my Index of Necessary Expenditure, I am convinced that economists in general, and perhaps US economists in particular, are systematically underestimating the cost of living and thereby underestimating the prevalence of poverty. (I don’t think this is intentional, mind you; I just think it’s a result of using convenient but simplistic measures and not looking too closely into the details.) I think not being able to sustainably afford a roof over your head constitutes being poor—and that applies to a lot of people.

Yet even with that caveat in mind, it’s quite clear that global poverty has greatly declined in the long run.

At the “extreme poverty” level, currently defined as consuming $1.90 at purchasing power parity per day—that’s just under $700 per year, less than 2% of the median personal income in the United States—the number of people has fallen from 1.9 billion in 1990 to about 700 million today. That’s from 36% of the world’s population to under 9% today.

Now, there are good reasons to doubt that “purchasing power parity” really can be estimated as accurately as we would like, and thus it’s not entirely clear that people living on “$2 per day PPP” are really living at less than 2% the standard of living of a typical American (honestly to me that just sounds like… dead); but they are definitely living at a much worse standard of living, and there are a lot fewer people living at such low standard of living today than there used to be not all that long ago. These are people who don’t have reliable food, clean water, or even basic medicine—and that used to include over a third of humanity and does no longer. (And I would like to note that actually finding such a person and giving them a few hundred dollars absolutely would change their life, and this is the sort of thing GiveDirectly does. We may not know exactly how to evaluate their standard of living, but we do know that the actual amount of money they have access to is very, very small.)

There are many ways in which the world could be better than it is.

Indeed, part of the deep, overwhelming outrage I feel pretty much all the time lies in the fact that it would be so easy to make things so much better for so many people, if there weren’t so many psychopaths in charge of everything.


Increased foreign aid is one avenue by which that could be achieved—so, naturally, Trump cut it tremendously. More progressive taxation is another—so, of course, we get tax cuts for the rich.

Just think about the fact that there are families with starving children for whom a $500 check could change their lives; but nobody is writing that check, because Elon Musk needs to become a literal trillionaire.

There are so many water lines and railroad tracks and bridges and hospitals and schools not being built because the money that would have paid for them is tied up in making already unfathomably-rich people even richer.

But even despite all that, things are getting better. Not every day, not every month, not even every year—this past year was genuinely, on net, a bad one. But nearly every decade, every generation, and certainly every century (for at least the last few), humanity has fared better than we did the last.

As long as we can keep that up, we still have much to hope for—and much to be thankful for.

For my mother, on her 79th birthday

PNRJ core principles, current events, personal, politics , , , , , , , , , , , , ,

Sep 21 JDN 2460940

When this post goes live, it will be mother’s 79th birthday. I think birthdays are not a very happy time for her anymore.

I suppose nobody really likes getting older; children are excited to grow up, but once you hit about 25 or 26 (the age at which you can rent a car at the normal rate and the age at which you have to get your own health insurance, respectively) and it becomes “getting older” instead of “growing up”, the excitement rapidly wears off. Even by 30, I don’t think most people are very enthusiastic about their birthdays. Indeed, for some people, I think it might be downhill past 21—you wanted to become an adult, but you had no interest in aging beyond that point.

But I think it gets worse as you get older. As you get into your seventies and eighties, you begin to wonder which birthday will finally be your last; actually I think my mother has been wondering about this even earlier than that, because her brothers died in their fifties, her sister died in her sixties, and my father died at 63. At this point she has outlived a lot of people she loved. I think there is a survivor’s guilt that sets in: “Why do I get to keep going, when they didn’t?”

These are also very hard times in general; Trump and the people who enable him have done tremendous damage to our government, our society, and the world at large in a shockingly short amount of time. It feels like all the safeguards we were supposed to have suddenly collapsed and we gave free rein to a madman.

But while there are many loved ones we have lost, there are many we still have; and nor need our set of loved ones be fixed, only to dwindle with each new funeral. We can meet new people, and they can become part of our lives. New children can be born into our family, and they can make our family grow. It is my sincere hope that my mother still has grandchildren yet to meet; in my case they would probably need to be adopted, as the usual biological route is pretty much out of the question, and surrogacy seems beyond our budget for the foreseeable future. But we would still love them, and she could still love them, and it is worth sticking around in this world in order to be a part of their lives.

I also believe that this is not the end for American liberal democracy. This is a terrible time, no doubt. Much that we thought would never happen already has, and more still will. It must be so unsettling, so uncanny, for someone who grew up in the triumphant years after America helped defeat fascism in Europe, to grow older and then see homegrown American fascism rise ascendant here. Even those of us who knew history all too well still seem doomed to repeat it.

At this point it is clear that victory over corruption, racism, and authoritarianism will not be easy, will not be swift, may never be permanent—and is not even guaranteed. But it is still possible. There is still enough hope left that we can and must keep fighting for an America worth saving. I do not know when we will win; I do not even know for certain that we will, in fact, win. But I believe we will.

I believe that while it seems powerful—and does everything it can to both promote that image and abuse what power it does have—fascism is a fundamentally weak system, a fundamentally fragile system, which simply cannot sustain itself once a handful of critical leaders are dead, deposed, or discredited. Liberal democracy is kinder, gentler—and also slower, at times even clumsier—than authoritarianism, and so it may seem weak to those whose view of strength is that of the savanna ape or the playground bully; but this is an illusion. Liberal democracy is fundamentally strong, fundamentally resilient. There is power in kindness, inclusion, and cooperation that the greedy and cruel cannot see. Fascism in Germany arrived and disappeared within a generation; democracy in America has stood for nearly 250 years.

We don’t know how much more time we have, Mom; none of us do. I have heard it said that you should live your life as though you will live both a short life and a long one; but honestly, you should probably live your life as though you will live a randomly-decided amount of time that is statistically predicted by actuarial tables—because you will. Yes, the older you get, the less time you have left (almost tautologically); but especially in this age of rapid technological change, none of us really know whether we’ll die tomorrow or live another hundred years.

I think right now, you feel like there isn’t much left to look forward to. But I promise you there is. Maybe it’s hard to see right now; indeed, maybe you—or I, or anyone—won’t even ever get to see it. But a brighter future is possible, and it’s worth it to keep going, especially if there’s any way that we might be able to make that brighter future happen sooner.

Grief, a rationalist perspective

PNRJ core principles, ethics, personal , , , , , , , , , , , , ,

Aug 31 JDN 2460919

This post goes live on the 8th anniversary of my father’s death. Thus it seems an appropriate time to write about grief—indeed, it’s somewhat difficult for me to think about much else.

Far too often, the only perspectives on grief we hear are religious ones. Often, these take the form of consolation: “He’s in a better place now.” “You’ll see him again someday.”

Rationalism doesn’t offer such consolations. Technically one can be an atheist and still believe in an afterlife; but rationalism is stronger than mere atheism. It requires that we believe in scientific facts, and the permanent end of consciousness at death is a scientific fact. We know from direct experiments and observations in neuroscience that a destroyed brain cannot think, feel, see, hear, or remember—when your brain shuts down, whatever you are now will be gone.

It is the Basic Fact of Cognitive Science: There is no soul but the brain.

Moreover, I think, deep down, we all know that death is the end. Even religious people grieve. Their words may say that their loved one is in a better place, but their tears tell a different story.

Maybe it’s an evolutionary instinct, programmed deep into our minds like an ancestral memory, a voice that screams in our minds, insistent on being heard:

“Death is bad!”

If there is one crucial instinct a lifeform needs in order to survive, surely it is something like that one: The preference for life over death. In order to live in a hostile world, you have to want to live.

There are some people who don’t want to live, people who become suicidal. Sometimes even the person we are grieving was someone who chose to take their own life. Generally this is because they believe that their life from then on would be defined only by suffering. Usually, I would say they are wrong about that; but in some cases, maybe they are right, and choosing death is rational. Most of the time, life is worth living, even when we can’t see that.

But aside from such extreme circumstances, most of us feel most of the time that death is one of the worst things that could happen to us or our loved ones. And it makes sense that we feel that way. It is right to feel that way. It is rational to feel that way.

This is why grief hurts so much.

This is why you are not okay.

If the afterlife were real—or even plausible—then grief would not hurt so much. A loved one dying would be like a loved one traveling away to somewhere nice; bittersweet perhaps, maybe even sad—but not devastating the way that grief is. You don’t hold a funeral for someone who just booked a one-way trip to Hawaii, even if you know they aren’t ever coming back.

Religion tries to be consoling, but it typically fails. Because that voice in our heads is still there, repeating endlessly: “Death is bad!” “Death is bad!” “Death is bad!”

But what if religion does give people some comfort in such a difficult time? What if supposing something as nonsensical as Heaven numbs the pain for a little while?

In my view, you’d be better off using drugs. Drugs have side effects and can be addictive, but at least they don’t require you to fundamentally abandon your ontology. Mainstream religion isn’t simply false; it’s absurd. It’s one of the falsest things anyone has ever believed about anything. It’s obviously false. It’s ridiculous. It has never deserved any of the respect and reverence it so often receives.

And in a great many cases, religion is evil. Religion teaches people to be obedient to authoritarians, and to oppress those who are different. Some of the greatest atrocities in history were committed in the name of religion, and some of the worst oppression going on today is done in the name of religion.

Rationalists should give religion no quarter. It is better for someone to find solace in alcohol or cannabis than for them to find solace in religion.

And maybe, in the end, it’s better if they don’t find solace at all.

Grief is good. Grief is healthy. Grief is what we should feel when something as terrible as death happens. That voice screaming “Death is bad!” is right, and we should listen to it.

No, what we need is to not be paralyzed by grief, destroyed by grief. We need to withstand our grief, get through it. We must learn to be strong enough to bear what seems unbearable, not console ourselves with lies.

If you are a responsible adult, then when something terrible happens to you, you don’t pretend it isn’t real. You don’t conjure up a fantasy world in which everything is fine. You face your terrors. You learn to survive them. You make yourself strong enough to carry on. The death of a loved one is a terrible thing; you shouldn’t pretend otherwise. But it doesn’t have to destroy you. You can grow, and heal, and move on.

Moreover, grief has a noble purpose. From our grief we must find motivation to challenge death, to fight death wherever we find it. Those we have already lost are gone; it’s too late for them. But it’s not too late for the rest of us. We can keep fighting.

And through economic development and medical science, we do keep fighting.

In fact, little by little, we are winning the war on death.

Death has already lost its hold upon our children. For most of human history, nearly a third of children died before the age of 5. Now less than 1% do, in rich countries, and even in the poorest countries, it’s typically under 10%. With a little more development—development that is already happening in many places—we can soon bring everyone in the world to the high standard of the First World. We have basically won the war on infant and child mortality.

And death is losing its hold on the rest of us, too. Life expectancy at adulthood is also increasing, and more and more people are living into their nineties and even their hundreds.

It’s true, there still aren’t many people living to be 120 (and some researchers believe it will be a long time before this changes). But living to be 85 instead of 65 is already an extra 20 years of life—and these can be happy, healthy years too, not years of pain and suffering. They say that 60 is the new 50; physiologically, we are so much healthier than our ancestors that it’s as if we were ten years younger.

My sincere hope is that our grief for those we have lost and fear of losing those we still have will drive us forward to even greater progress in combating death. I believe that one day we will finally be able to slow, halt, perhaps even reverse aging itself, rendering us effectively immortal.

Religion promises us immortality, but it isn’t real.

Science offers us the possibility of immortality that’s real.

It won’t be easy to get there. It won’t happen any time soon. In all likelihood, we won’t live to see it ourselves. But one day, our descendants may achieve the grandest goal of all: Finally conquering death.

And even long before that glorious day, our lives are already being made longer and healthier by science. We are pushing death back, step by step, day by day. We are fighting, and we are winning.

Moreover, we as individuals are not powerless in this fight: you can fight death a little harder yourself, by becoming an organ donor, or by donating to organizations that fight global poverty or advance medical science. Let your grief drive you to help others, so that they don’t have to grieve as you do.

And if you need consolation from your grief, let it come from this truth: Death is rarer now today than it was yesterday, and will be rarer still tomorrow. We can’t bring back who we have lost, but we can keep ourselves from losing more so soon.

The upsides of life extension

PNRJ development economics, ethics, futurism, Uncategorized , , , , , , , , , , , , , , , ,

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.