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BOOK REVIEW |
Charlton Professor of Philosophy and Associate Dean, Faculty of Arts and Science Queen's University Kingston, Ontario, Canada K7L 3N6
A History of Ideas About the Prolongation of Life, by Gerald J. Gruman. Springer Publishing Company, New York, 2003, 221 pp., $42.95 (paper).
The Prolongation of Life: Optimistic Studies, by Ilya Ilyich Metchnikoff. Springer Publishing Company, New York, 2004, 264 pp., $47.95 (paper).
Is optimism a virtue? What if the optimism is directed toward living a longer life? Is that optimism justified? In other words, are there good reasons for believing that a significant increase in life expectancy, life span, or both is possible and desirable?
Both of the books reviewed in this essay are optimistic, but in different ways. Ilya Ilyich Metchnikoff's The Prolongation of Life: Optimistic Studies presents a series of optimistic arguments, mostly derived from studies of nonhuman animals, as to why a longer life is possible and attainable for human beings. Gerald Gruman's A History of Ideas About the Prolongation of Life presents the written record of optimism about both the desirability and attainability of a longer life. Gruman's book is optimistic in still a third way; he believes our extensive human history of seeking a longer life has had positive effects on the human tendency to speculate and on research leading to "useful discoveries" (p. 2).
Each of these books is a reprint. Metchnikoff's was first published in 1908, Gruman's in 1966. The first is by a scientist; the second is by a historian of ideas. There is a connection between the two—Gruman wrote the introduction to the 1977 edition of Metchnikoff's book. Whereas the latter is a curious mélange of botany, zoology, biography, and ethics, Gruman's is more organized and scholarly. His aim is to trace the origins and evolution of the idea of prolongevity, which he defines as "the significant extension of the length of life by human action" (p. 3).
Orthobiosis and Prolongevity
Both books are of historical interest, but in different ways and for different reasons. One could read Metchnikoff's book as the record of the thoughts of a Nobel Prize winner (in 1908 for Medicine) and the inventor of the term "gerontology" (Metchnikoff, xxvi), who was deeply interested in enabling human beings to attain what he called "orthobiosis," meaning "the most complete cycle of human life, ending in extreme old age" (p. 155). For the most part, his thoughts are mainly of biographical interest, since the science on which he relies is a century out of date. He also provides little in the way of argument to convince the reader of the value and importance of orthobiosis, mostly confining himself to a brief reference to the rights of the individual and a claim that orthobiosis would not harm the society in which it is sought.
Gruman's book is of historical interest, too, but for a different reason and in a different way. Here we find gathered together a record not just of the thoughts of one man but rather the visions of many human beings over the course of centuries, about the various means touted throughout the ages for achieving a longer life. As Harry Moody, the author of the book's introduction, notes, those visions are a "fascinating mixture of science and superstition" (p. xii).
Some of the earliest examples of interest in prolongevity are found in the Hebrew scriptures, and the search for prolongevity also appears in ancient Greek, Indian, and Celtic myths. Gruman points out that people have sought longer life by religious, magical, medical, hygienic, protoscientific, ethical, and social means (p 7). He traces the theme through the Taoist tradition, the literature of the alchemists, the work of Renaissance literary figures (whom Gruman dubs "the Hygienists" for their emphasis on cultivating a healthy and pure body and mind), and the writings of 17th and 18th century philosophers. The hope of extending life is a theme woven through religion, science, and philosophy for literally thousands of years.
Unfortunately, Gruman pursues ideas and arguments about prolongevity only up to 1800. Although he provides a tantalizing two-page summary of trends in prolongevity research since 1800 (Gruman, 159–60), what still does not exist, to my knowledge, is a comparable historical survey of debates about prolongevity that would cover the 19th and 20th centuries.
As a philosopher, I am particularly interested in the normative issues—the metaphysical, ethical, and social policy questions—that are mostly implicit in Metchnikoff's book and are more explicitly presented in Gruman's work. What concerns me is not simply the question, how might life extension be achieved, but rather, is it justified to seek life extension? Is a good life a long life? My own discussion of the arguments, and my qualified support for prolongevity, are to be found in my book, Aging, Death and Human Longevity: A Philosophical Inquiry (Overall, 2003a). In producing that book, I was strongly assisted by the work of Gruman—for Gruman also explores the history of justifications for increasing the length of human life. The latter theme is both important and controversial. At a time when aging people are described more and more as burdens, when human beings are urged to accept and indeed welcome their death, when those who wish to go on living are excoriated for their alleged moral weakness in clinging to life, the development of arguments for prolongevity is of the utmost interest. Although Gruman does not formulate a unified set of philosophical arguments, he provides considerable historical groundwork for assessing the justification of prolongevity.
Apologism Versus Prolongevitism
Gruman uses the term apologism in a general sense to describe the acceptance of reality and existence as they are, as inevitable and not to be changed. Apologism, he says, "condemns any attempt by human action basically to alter earthly conditions" (p. 9). Apologism is highly suspicious of the idea and the value of progress. More specifically, Gruman uses the term apologism to describe the views of those who regard a significant extension of the length of human life as both impossible and undesirable to achieve (p. 2).
Gruman notes, with a puzzlement that may be just a little disingenuous, that proponents of apologism attach "strong emotion" to their theory. He points out that those who have decided that prolongevity cannot be attained also tend to jump to the conclusion that it is not desirable: "A statement of fact is made the core of a mesh of ethical and esthetic judgments which obscure the original decision" (p. 28). Why do apologists so readily move from what (they think) is to what ought to be, blithely jumping the fact/value gap with no apologies to those who believe it requires a bridge built of arguments? Gruman wisely observes that a human being who both loves life, as most of us do, yet recognizes the inevitability and finality of death, may experience considerable cognitive dissonance. And one sure way of resolving that dissonance is to conclude, with vehemence, and contrary to one's immediate feelings, that death is desirable and that it is simply illegitimate to prolong life.
Whatever the psychological origins of apologism, how might one try to show that death is valuable and prolonged life undesirable, given the apparent a priori value of continuing to live? Gruman identifies six main historical arguments for apologism. Most of them rely upon alleged limits set by God, nature, or both. Thus, some apologists believe prolongevity violates either the divine order or the natural order; others, that it is ruled out by original sin or by "inherent defects in human nature" (p. 26). Apologists also tend to see old age and death as desirable in themselves and prolongevity as inherently undesirable. To this list I would add two other arguments frequently advanced in favor of apologism: the claim that human existence is already long enough for everything one might legitimately want to do during one's life and the claim that prolonging people's lives simply multiplies the "burden" of elderly, sick, and disabled people on the rest of society and deprives future generations of resources that would and should otherwise be theirs.
Gruman writes that the opposite of apologism in its general sense is meliorism, by which he means the idea that "human effort can and should be applied to improving the world" (p. 1). Meliorism, then, represents a belief in progress, a commitment to positive change and the gradual improvement of human individual existence and human society. The specific form of meliorism that interests Gruman is given the awkward name "prolongevitism," meaning the belief that a significant extension of life is both possible and desirable.
Though the term had not yet been invented, Metchnikoff, too, was certainly a prolongevist. He wisely observes that human nature alone cannot form the basis of "rational morality" (p. 238). He writes, "...old age begins too soon, ... it is not what it ought to be under normal conditions, and ... human life itself does not last nearly so long as it ought to do in ideal conditions. We may predict that when science occupies the preponderating place in human society that it ought to have, and when knowledge of hygiene is more advanced, human life will become much longer and the part of old people will become much more important than it is today" (p. 165).
In assessing the debates between apologism and prolongevitism it is, of course, important to distinguish between increasing life expectancy and increasing life span. Life expectancy is the average number of years lived, or anticipated to be lived, by the members of a particular cohort of individuals—for example, White men born in the United States during the 1950s. Life expectancy varies by sex, race, and socioeconomic class. Women's life expectancy is almost everywhere greater than that of men, and membership in privileged racial and socioeconomic groups increases life expectancy, independent of the sex of individuals. Life span, by contrast, refers to the maximum possible length of human life. Despite apocryphal stories of individuals who have lived to be hundreds of years old, it is widely believed that approximately 120 years is the longest attainable human life.
One might be an apologist or a prolongevist about both life expectancy and life span, or about neither. Or one might conceivably be an apologist with respect to life span, regarding something around 120 as the outermost limit of achievable human age, while still being a prolongevist about life expectancy, which has increased enormously, at least for affluent people in the West in the last two centuries, and arguably could also be increased significantly for those in the developing world who are much less privileged.
One way of seeing the debate between apologism and prolongevitism, as Metchnikoff's book explicitly suggests, is to cast it as a contrast between pessimistic and optimistic worldviews. According to the Oxford English Dictionary, pessimism means "the tendency or disposition to look at the worst aspect of things; the habit of taking the gloomiest view of circumstances." Optimism means "hopefulness and confidence about the future or the successful outcome of something; a tendency to take a favorable or hopeful view."
Apologism is pessimistic to the extent that it recommends submission to nature, acceptance of the way things are, modesty with respect to our capacity to initiate change, and acquiescence in the lot that one has been dealt. Apologism's advocates regard it as an unassuming and humble outlook upon the hand life has dealt. The apologist is pessimistic about two separate issues, which he nonetheless conjoins: The first is whether a significantly prolonged life span is possible and achievable. We could call this empirical pessimism. And the second deals with whether a prolonged life span is good and whether seeking it is morally and socially justified. We could call this ethical pessimism. Apologism is, largely, a negative moral assessment of the value of a long life.
By contrast, prolongevitism is optimistic. It recommends both resistance and progress. The prolongevist is committed to rejecting the material and social conditions of the human race as mere givens and to reshaping nature to enable human beings to thrive. The prolongevist is both an empirical optimist—that is, he believes that human life can in fact be made significantly longer—and a moral optimist too—that is, he believes that a longer life is worth striving for.
Thus, the debate between apologists and prolongevists is at least as much about values as it is about what science can or cannot do or prevent. It is about what we ought to do, individually and collectively. It is about what kind of persons we should be and the kind of life we want. What constitutes a good life? What constitutes a full life, a complete life? It's also about what kind of life we want for other people and other societies, and what we—meaning those of us in the wealthy Western nations—might be willing to do to enable others to share our high quality of life.
Optimism as a Moral Virtue
An apologist might say that his so-called pessimism about human prolongevity prospects is in fact realism. He might stress that he pragmatically accepts the life we do have, rather than wasting time imagining a life we might have. However, I wonder whether the apologist's acquiescence in his fate is in fact a weakness and whether optimism, in the context of prolongevity, might be a moral virtue.
For not only does the history of advances in life expectancy give empirical grounds for optimism, in addition, there are potential moral justifications for this optimism. Natural and medical science is replete with examples where human beings have refused to acquiesce to nature's way—a way that seems to decree high rates of infant and maternal mortality, the spread of diseases, the risk of famine, the inevitability of poverty, and early death. Instead, the hope for a better future has fueled scientific research that improves health, diet, medical care, and living conditions. It may therefore be incumbent upon us to be optimistic.
Metchnikoff and Gruman both believe that the quest for greater longevity brings about general scientific progress. Indeed, in unfolding the history of prolongevity theories, one of Gruman's aims is to show that "[b]elief in the possibility and desirability of prolongevity [has] furthered the progress of science and medicine" (Gruman, 159). Such a view might be regarded as hubristic. And indeed, any prolongevists who regard science as likely to offer the complete prevention of aging and the "cure" for death are obviously expecting far too much. The optimism of prolongevitism is misguided if it takes immortality as its goal.
Moreover, increasing prolongevity only for affluent citizens of already privileged Western nations is clearly unjust. It is not outré science—gene manipulation, cloning, or the creation of synthetic organs and limbs—that is needed to achieve the best prolongevitism has to offer. Rather, important increases in life expectancy have been achieved and can continue to be achieved, especially for disadvantaged peoples, via such common-sense improvements as safe contraception and abortion, good maternal and infant care, the reduction of childhood illnesses, good nutrition, improved access to education, universal—and free—health care, clean and safe working conditions, safe and secure housing and transportation, and the improvement of air and water quality.
In making their case against prolongevity, apologists tend to focus upon individuals, particularly individuals who are forthright prolongevists, chastising them for any tendency to want to prolong their lives, as if to have the desire to postpone death is a sign of moral weakness. In so doing, apologists fail to recognize the liabilities of apologism as a social doctrine, liabilities especially for poor people, who are expected to accept an early death on top of the other deprivations of their lives, and elderly and disabled people, who are consistently and inaccurately regarded as burdens who ought to recognize their responsibility to die on time and without protest. Apologists also apparently fail to recognize the potential benefits of a prolongevist social policy not just for specific individuals but for entire groups of people, whose better quality of life with respect to hygiene, health, diet, working conditions, and education also contributes to extending their lives.
Prolongevity, the Life Course, and Social Progress
Metchnikoff suggests, "[T]he wish to live according to the ideal of orthobiosis and to make others live a normal life would be a powerful agency in improving social life, in preventing mutual damage, and promoting mutual help. Such a motive, within the reach of persons whose altruistic feelings are not specially [sic] strong, must largely extend moral conduct amongst human beings..." (p. 242). Metchnikoff is saying that systematic attention to increasing human longevity will not only pay off in scientific knowledge; it will also promote a more supportive, safe, and cohesive society, one in which people will have a greater propensity to treat each other well.
Of course we can't be sure whether Metchnikoff is right about this. It could be argued that a longer life simply provides more occasions for immoral behavior and more possibilities for the exercise of greed and antagonism. But it is at least true that when a prolongevist social policy is followed, the very structure of people's lives changes, and with that change come changes in values. A longer life does not just mean the addition of more years at the end of life. In developed nations where improvements in sanitation, health care, education, and disease prevention have already raised life expectancy into the 70s and 80s, all of the human life span is affected. The idea of what constitutes a full and complete life is evolving and along with it people's notions of what the appropriate stages of human life are. A life that was once devoted to a brief childhood, the premature assumption of often-dangerous labor both inside and outside the home, and an early marriage and the rearing of many children, has gradually been replaced by a life in which the norm is to devote the first two decades of life to maturation and education, to begin full-time paid work only thereafter, to postpone marriage (if it occurs at all) to the late 20s, to have two or fewer children, to engage in life-long learning, to retire from paid work in one's 60s, and to live one or two or more decades of life in retirement. Women now survive well beyond menopause, and, like men, they live to know their grandchildren and even their great-grandchildren.
And people who live longer tend also to live better. They receive more education, they attain higher levels of literacy, they have fewer children with less cost to the health of both babies and mothers, and they are able to earn more resources. People have more opportunities for self-development and for artistic, athletic, and intellectual expression. Hence, not only is the expected length of life growing; in addition, what it means to be a child, an adolescent, a young adult, a working man or woman, a middle-aged person, a retiree, and an elderly person is also changing (Overall, 2003b).
Apologists, however, rely upon inaccurate or outmoded concepts of the life course. For example, in his book, False Hopes: Why America's Quest for Perfect Health is a Failure, apologist Daniel Callahan (1998) argues that the average life expectancy in developed nations that is now provided by "nature" is "perfectly adequate for human life, both collectively and individually" (p. 134). According to Callahan, "The average person in good health in the developed countries of the world (and living in a reasonably safe environment), already lives long enough to accomplish most reasonable human ends. ... Neither the human species as a whole, nor most individuals, need more than the present average life expectancy in the developed countries (the mid-seventies to low eighties) for a perfectly satisfactory life" (p. 82).
It may be that in earlier times, people—at least, those who were reasonably privileged with respect to their race, sex, and socioeconomic class—could do all that one might reasonably expect to do by the time they were in their mid-70s. But even if they live that long, those who are socially disadvantaged on racial or economic grounds don't live "a perfectly satisfactory life" by age 75 and should not have to accept death at that age. Moreover, the gradual lengthening of life brings about changes in what people expect and hope for; it changes the trajectory of their lives. The apologists' concept of a complete life has been rendered obsolete because it does not take into account the social changes in earlier life stages, and because it fails to recognize that those changes have occurred because of increased longevity. As a result, the very meanings of the life stages that precede age 70 have changed, and the meanings of life stages after 70 have also changed. Longer education, later marriage, later onset of paid work, and improved health mean that the collective concept of the good life excludes being old by 60 and dead by 75.
As Metchnikoff puts it, "The sense of life is very different at different ages, and a man who lives beyond the age of 45 experiences many sensations which he did not know before. There is a great evolution of the mind during the advance of age. ... [W]e cannot deny that youth is only a preparatory stage and that the mind does not acquire its final development until later on" (p. 233). Although Metchnikoff may be overly optimistic if he believes that the mind necessarily "evolves" during a person's lifetime, he seems to grasp the implications of increasing longevity for our understanding of human life stages. He recognizes that our concepts of old age and youth, and the very meanings of different decades within human life, are altered once human beings have good prospects of longer life. So, for example, he remarks that with the attainment of orthobiosis, "Old age will be postponed so much that men of from 60 to 70 years of age will retain their vigor and will not require to ask [sic] assistance in the fashion now necessary. On the other hand, young men of 21 years of age will no longer be thought mature or ready to fulfill functions so difficult as taking a share in public affairs" (p. 240). Indeed, the changes that he foresaw are, arguably, already occurring, so that men who would formerly have been considered old now govern major nations and men (and women) in their 20s are thought to be still in a process of prolonged youthfulness and personal development.
We could say, then, that people in Western nations have become more optimistic about their life prospects—and for good reasons. The optimism about prolongevity advocated by Metchnikoff and Gruman is both empirically and morally justified. A social policy of prolongevitism supports people's hopes for a longer, better, and more fulfilled life than their ancestors experienced. As Gruman puts it, "in the crisis of our time, the best course would be a conscious furthering of the meliorist tradition, and, in regard to the problem of death, the forwarding of efforts for prolongevity. ... The ‘worth’ of the individual is, one might suggest, not so much a fact as a goal" (Gruman, 160). And it is a goal worth seeking, especially for citizens of developing nations and for members of disadvantaged groups in the West.
References
This article has been cited by other articles:
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  R. Arking BIOLOGY, FRUIT FLIES, AND HUMANS: CAN EXTENDED LONGEVITY STRETCH FROM ONE TO THE OTHER? Gerontologist, June 1, 2005; 45(3): 418 - 425. [Full Text] [PDF]
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