Christopher Wareham

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It makes sense that new tools that have potentially life-extending properties–CRISPR, for instance–will become affordable enough in rapidly so that their gifts can reach the masses. That should hold true for whatever next-level treatments that follow. In a time of radical abundance, there will be enough for all, we’re promised. 

Of course, we already live in a time of relative radical abundance, with adequate wealth to feed, clothe, house, inoculate and educate every last person. Distribution, however, often depends on geography, race, gender, politics, etc. Even when the stars align, a regression into myths and conspiracies can do damage (e.g., unfounded fears about immunizations). What I’m saying is humans are awfully good at mucking up something great, and that may be a permanent part of who we are.

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In an Aeon essay, ethicist Christopher Wareham wonders how we can prevent a new type of wealth inequality centered on life expectancy without banning breathtaking technologies, which would be a foolhardy step. An excerpt:

Even if life-extending drugs were relatively cheap, it is reasonable to assume that the poor, with less disposable income, are likely to spend money on more immediate and pressing needs. An intervention whose benefits, though substantial, are long-term and preventive is more likely to be marketable to wealthier groups who already have longer, healthier lifespans. The ‘healthspan rich’ would get richer, and the ‘healthspan poor’ would remain poor. This could entrench a two-tier society in which poorer groups suffer not only from poverty, but also from comparatively shorter youth and greater susceptibility to age-related disease.

The bioethicist John Harris at the University of Manchester claims that this unjust outcome is ‘the major ethical problem with life-extending technologies’.

Some bioethicists argue that this justifies a ban on life-prolonging technologies, or at the very least deprioritising research and treatments aimed at substantially extending human healthspans. But this move is too harsh. Besides the practical problems with policing bans and preventing the emergence of unregulated products, banning has some obvious ethical drawbacks.

First, banning longevity medications would be an instance of ethically questionable ‘levelling down’. While other bans, such as the prohibition of drugs, arguably ‘level up’ by reducing the harms of banned substances, a ban on extending healthy lifespans explicitly aims at preventing some people from getting too well-off. As Harris points out, this is like refusing to cure one person’s cancer because it would be unfair on those who are incurable.

A second ethical problem with banning is that life-extending interventions could be used as treatments for a range of health effects. Humans and other primates that show signs of slowed ageing tend to have lower incidences of cardiovascular disease, diabetes and cancer. This complicates a ban even further: denying the opportunity to receive treatments because they might result in too much healthspan increase appears deeply objectionable.

Banning is a bad option, but if avoiding radically unequal healthspans is a priority, what type of policies would best achieve it? Is there a way to increase welfare without creating drastic imbalances in healthspan?•