A study published in this week’s Nature magazine reveals that the likelihood that a senior citizen will be so disabled that they require high-cost nursing and medical care is fairly constant up till age 100. In other words, increased longevity will not drive up costs related to disability and dependency. But with progress supporting healthy aging with longevity therapies seniors could live even healthier and more able lives. Silke Fauve considers the demographic and economic arguments against increasing longevity.
Phillip Longman writes in “The Global Baby Bust,” that the human population is aging at an unprecedented rate while the birth rate is falling in most of the world, resulting in an increasing imbalance of producers (working adults) and dependents (most significantly, the elderly). This imbalance threatens government budgets.
But are economic challenges the only ones created by this shift in demographics? Individuals’ most deeply held values inform their actions in times of crisis, and the same can be said of a nation or of the human species. Recent statements made by policy makers expose values that are incompatible with compassion and caring. How will value-laden choices made by policy makers, in response to global graying, affect social and ethical progress?
Demography plays a starring role in charting the future, but as a 1999 report published by the National Academy on an Aging Society concludes, “Demography is not destiny.” The report explains that
population projections change as the assumptions on which they are based change,” stressing the dynamic interaction of demographics with other relevant factors such as “economic growth, changes in people’s expectations and behavior, and changes in public policies.
Co-factors aside, population statistics paint a big picture of many interrelated patterns of behaviors and characteristics, allowing corrective and proactive adjustments to be made on both the individual and policy levels.
That is the good news. Unfortunately, when an unfamiliar picture emerges, its potential to undermine economic and social stability can provoke a reaction, which, if not countered with a creative response grounded in respect for persons, will result in unethical, undemocratic, and inhumane policy decisions that limit human potential. In response to shifting aging demographics, ethical policy makers should take care to make decisions grounded in respect for persons. Choosing the ethically sound course of action will foster, rather than limit, the growth of human capacities.
Loss of respect for persons is frequently a result of allowing abstractions to become more “real” than the human beings they represent. An individual is often defined by the generalizations made about a particular category: the “feeble senior,” an “unproductive retiree.” Instead of manipulating abstractions without considering the needs of the actual human beings affected by program and entitlement changes, policy makers should make decisions that empower aged individuals to participate meaningfully in life to whatever degree their health permits. Of course, that position presupposes a Kantian view of human value: that people’s worth exists independently of what they do or produce for the benefit of others.
Clearly, this is not the view held by Alan Greenspan, who, in 1983 at a meeting of the Health Insurance Association of America, questioned whether the money spent annually on the “5 to 6 percent of Medicare enrollees who die within the year” was justifiable.1 In 1984, Richard Lamm, then governor of Colorado, reportedly echoed Greenspan’s sentiment with a less diplomatic “older persons have a duty to die and get out of the way.”2 Sadly, these remarks and many others subsequently made in the anti-aged campaign reveal a fundamental disrespect—more accurately, a disdain—for elders despite the lip service traditionally paid to them as repositories of wisdom. Continuing in that vein, today’s jealous guardians of the public dollar, at the expense of their own humanity, are making pariahs of the most richly experienced and underrated segment of the population.
Fortunately, the same demographic panorama that has inspired loathing of elders in people of limited vision has revealed life-affirming possibilities to humanistic leaders, scientists, and scholars. Rather than proposing discriminatory policies and entitlement changes that would strip elders of their human rights and abandon them to a steep, unassisted decline to their death, these tireless humanists are seeking solutions that will enable all people to enjoy additional healthy years of productivity.
One prolific writer and visionary, theoretical biologist Aubrey de Grey, argues that a dramatically extended human life span will eliminate age-related frailty and the concept of retirement altogether. In “Escape Velocity: Why the Prospect of Extreme Human Life Extension Matters Now,” he explains that
those who get first generation therapies only just in time will in fact be unlikely to live more than 20-30 years more than their parents, because they will spend many frail years with a short remaining life expectancy…whereas those only a little younger will never get that frail and will spend rather few years even in biological middle age.
His ideas may have sounded like science fiction a decade ago, but de Grey points out that even conservative bioethicist Leon Kass has acknowledged that “modest success [in scientific research] tends to place the bit between our teeth and can often result in advances far exceeding our expectations.”
It would be impossible to imagine anyone preferring a future in which persons over the age of 65 were discarded as easily as a half-eaten ham sandwich to one in which age 65 marked the beginning of an exciting new career or friendship—if those working to eliminate Social Security, ration health care, and redefine the “natural” life span hadn’t already expressed their preferences and demonstrated their own limited capacities. Human caring and longing for actualization will triumph over their pitiful grasping for illusory security. The choice is crystal clear.
Endnotes
1. James H. Schulz and Robert H. Binstock, Aging Nation: The Economics and Politics of Growing Older in America, (Baltimore: The Johns Hopkins University Press, 2006), p. 187.
2. Ibid.
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