Life Extension Ethics: An Introduction


Five Ethical Questions for Longevity and Life Extension

Longevity and life-extension ethics include the ‘elephant in the room’ of environmental sustainability.

There are also ethical dilemmas of rich vs poor people’s access to longevity treatments, the eternal dictator problem and whether we should ‘mess with nature.’

An individual’s position is influenced by their beliefs covering personal liberty, morality, fairness of outcomes – and fears of a lonely and painful old age.

Another dimension to longevity ethics is the length of life-extension being discussed. Depending on whether you are debating extended lifespans of 120 years, 150, or longer – the answers change.

One thing is for sure: lifespans are increasing, and an era of healthy, active people at 100 years old is imminent. Big social and political discussions about how this can work are needed right away.

This page is the result of my personal deep dive into the fascinating ethics of life extension.

My biggest take away is a question: Longer lives are coming, and rapidly, so why is public policy not discussing the many ethical and political ramifications?

Ethics of Longevity

The 5 Key Areas of Longevity Ethics

Five themes cover 95% of longevity ethics debates:

  • Ageing and death are natural, and we should not mess with nature.
  • Life extension will lead to overpopulation, destroying natural resources
  • Longevity treatments will disproportionally benefit the rich.
  • Longer life will lead to stagnant political institutions (the immortal dictator hypothesis)
  • Extending life means extending suffering and pain.

#1 Death and Ageing are Natural: Is it Unethical to Mess with them?

Nature gives us three-score-years-and-ten, and anything that tries to intervene is going against nature.

This argument is frequently linked to religious beliefs, though it does not have to be. The same types of argument are used for innovative medical treatments. CRISPR, Stem Cells and Cloning for example.

The counter argument is constant progress in the life sciences.

We already have drugs and treatments which allow people to live longer and safer lives than just a century ago. Yet, nobody would argue that we stop treating people with them because it is ‘not natural.’

Antibiotics, medicines, and vaccines are artificially created. Without them decades would be wiped from the average human lifespan. What about mechanical devices used in medicine?

For me there is an element of fear in this type of debate. You should not ‘mess with nature’ because of what exactly?

Flip the Question: If a synthetic drug compound that was safe and added 10 years of active, healthy life was discovered, would it be fair to deny its use, while using other synthetic compounds to treat non-fatal diseases?

Longevity Research not natural#2: Life Extension Will Lead to Catastrophic Overpopulation

Models predicting the size of the population have been drastically scaled back.

At one point, the arrow simply went up and to the right – leading to ecological meltdown. These days, much of the world has lower than replacement birth rates. There are 8 billion people today, and that number is growing.

Boosting average lifespans by 10 years without a reduction in environmental impact is a problem. Should a solution that added 25 active years to average lifespan appear tomorrow, it is easy to see how a population boom would be catastrophic.

A slower increase, a decade per generation, would give us time to adjust. Birth rates would fall. We would need to learn to live in an environmentally conscious way. Longevity benefits from a primarily plant-based diet – a big plus for the impact of each person on the environment.

A sustainable world is already possible. Clean electricity, vertical farming and zero plastic waste would be a wonderful starting point. Living longer would help, as each person would have a bigger personal stake in the future of the planet.

Flip the Question: Should we let people suffer chronic diseases and die 15+ years before their potential healthy active lifespan to save the environment?

Longevity and Overpopulation

#3: The Rich Will Get Outsized Benefits of Life Extension

There are two main threads of the ‘for the rich,’ ethical dilemma.

The first is that longevity benefits will only be for the rich. If only the top few percent of wealthy individuals can access life extension treatments, then should they be banned as unfair.

Another variation is that the rich will have disproportionate benefits.

My favourite thought experiment goes like this:

If Jeff Bezos can access life extending treatments that allow him to live to 250, and everyone else gets to live until 135 – should all research be banned on the grounds of it being unfair?

The interesting part comes when you change the numbers. If you give the billionaires and extra 100 years, and you and I get only 5, that is a big enough change to the ratio to raise some eyebrows. If the gap was smaller, say 30 years for the super-rich and 20 for everyone else, then the ethical questions around fairness all but disappear.

We don’t know how different these outcomes will be. Personally, I’m confident that low-cost medicines combined with lifestyle changes will have an outsized effect. Only time will tell if that assumption is the right one.

Flip the Question: How many years of potential active life would you sacrifice to make sure the super-rich don’t get to live longer than average?

Longevity only for the rich?

#4 The Immortal Dictator Hypothesis

Imagine a terrible dictator, one that makes Pol Pot or Stalin look like Mother Teresa. Now give them the ability to live until they are 500.

Pretty bad outcome from the crazy health span geeks!

This is a common argument against research into life extension.

It is also the easiest to counter.

For a start, we are assuming the same political systems exist ad Infinium – whereas history shows that change is inevitable. Will the post-war international institutions and current nation state setup always be the status-quo? That is another story for another day.

The ethical counter argument is that by keeping the life of a dictator short, you would need to cut longer, healthier life from everyone else too. That could mean leaving 7 billion people to die early, just so the bad ruler also dies soon. That is as an ethically outrageous a proposal as I have ever heard.

Flip the Question: How many healthy years would you sacrifice to ensure that no longer lived dictator could take over? 20? 50? 100?

#5 Increasing Life Span Means Stretching Out Suffering and Pain

Spending decades in a frail state, battling multiple chronic illnesses while life-extending drugs keep you breathing is a common fear.

It has its own name – Tithonus Error.

Convincing someone that imagines that this new paradigm will simply stretch out their suffering is all but impossible. It is seen as deeply unethical to extend pain, a dystopian horror story of people desperate to die and finally have peace.

This is a communication error, rather than a true ethical dilemma.

I’m not blaming the fearful people – or the terrible corporate press. The ball here is in the court of the longevity community. While we know that rejuvenation will lead to bodies potentially decades younger in biology than chronology, the public do not.

An interesting example is the ‘Emotional Death’ of Peter Attia’s ‘Four Types of Death.’ This involves trauma, loneliness and lack of purpose becoming so overwhelming that life is more pain than pleasure. The right of an individual not to go on needs to be addressed, as do the treatments, social acceptance and support for people suffering emotional pain.

Boredom also comes into these arguments. I’ll cover that in a future post.

Older people longer suffering

Wrapping Up: Longevity Ethics Flipped Around

Each of the counter arguments for extending lifespan can be flipped around.

For example, the everlasting dictator scenario can be viewed as ‘would you let billions of people die early deaths, so that nature also killed off the bad person early?’ The rich people’s benefits as ‘would you deny health span improvements to billions to prevent Bill Gates (or whoever!) living to 200 years old?’.

Whatever your own position, the need for a public debate is approaching. As discoveries multiply and treatments get approved, we will be living longer, heathier lives before you know it.

I enjoyed diving into this topic.

This page introduces the main discussions. I look forward to covering each in more detail, and to debating ethics with people inside and outside the longevity / biotech community.

Do let me know what you think.


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