Immortality Quest Raises Ethical Concerns

Scientists, ethicists and theologians debate both the plausibility and the desirability of "curing" aging.

By Vida Foubister, AMNews staff. April 3, 2000.

Philadelphia - As advances in medicine lead us ever closer to the proverbial fountain of youth, scientists, ethicists and theologians are debating whether this is water that we truly want to drink.

The promise of living better and more fulfilled lives has implications for humanity that cannot be ignored. Not the least of which is who will be able to benefit and at whose expense.

"Those who want medicine to try and eliminate death have an obligation to show us what the human and social benefits will be," said Daniel Callahan, PhD, a bioethicist and cofounder of The Hastings Center in Garrison, N.Y. "The burden of proof is on those who want it."

But current research on cloning, stem cells and gene expression is already leading us in that direction.

"What we're seeing is the first steps of the conceptual evolution, where we say, 'Isn't there a better way to get at the genetic and cellular mechanisms that will prevent [chronic diseases]?' " said Michael Fossel, MD, PhD, a clinical professor of medicine at Michigan State University, East Lansing, who is writing a book on human aging and disease.

Recent experiments on Drosophila and lab mice have shown that the life span is malleable.

Fruit flies, for example, can live a longer and more robust life under certain laboratory conditions.

Whether such research ultimately leads to human immortality, a conference put on by the John Templeton Foundation and the University of Pennsylvania's Center for Bioethics last month set out to explore its plausibility and desirability.

"Genetic engineering, computer-brain interaction, new reproductive technologies - all of these things that biomedical science is making possible are going to impinge very powerfully on the way medicine is practiced in the future, because they're going to challenge the accepted norms of healthy functioning that are implicit in everything that medicine does," said Leon R. Kass, MD, PhD, a professor on the Committee on Social Thought and the College at the University of Chicago.

"If you have techniques for enhancing and not just restoring function, and physicians are going to be the ones who can apply these techniques to human beings, how are they going to know what's a proper limit?"

Those who participated in the "Extended Life, Eternal Life" debate,however, didn't even agree on the progress of science so far.

Some argued that the human life span already has doubled because of developments in medicine, while others said the discovery of antibiotics has merely enabled people to live to their full potential.

Needless to say, there was also no consensus on the prospects for an extended life.

Diogenes Allen, PhD, a philosophy professor at Princeton Theological Seminary, Princeton, N.J., views eternal life as a relationship with God through which one can "consume movement toward perfect love." Extended life on earth cannot "satisfy our aspirations," he said.

"This life as it is now, were it to continue indefinitely, would become a dreary business."

Indeed, even today's life-prolonging options aren't always wanted.

"Some people, when you tell them that they have advanced cancer and there's something that you can do to prolong life, they say, 'Well, don't do it,' " said the Rev. Calvin O. Butts III, DMin, pastor of the Abyssinian Baptist Church in New York City. "A lot of people say, 'I don't want the surgery, the chemotherapy. Just leave me alone and I'll die.' "

Preserving life, however, holds inherent value to Rabbi Neil Gillman, PhD, of the Jewish Theological Seminary in New York City.

"There is nothing redemptive about death," he said.

In fact, Dr. Gillman's belief that life is inherently good led him to choose a family physician because of his creed that "Death is my enemy and I will wage war against him until the end."

"Everything that can be done to preserve life, to extend life, must be done," he said.

According to Pittsburgh theologian Ronald Cole-Turner, PhD, MDiv, extended life might lead to growth in our collective spiritual and religious understanding.

"It would offer an opportunity for a kind of blossoming of our humanity that has not yet been obtained."

To which Dr. Callahan retorted: "That seems to be pure moonshine. ... We should already be seeing some evidence of it."

Even if there were consensus to stop immortality research, that's not an easy task.

"It will be impossible to write rules that clearly distinguish what you want to allow from what you do not want to allow," Dr. Cole-Turner said. "Research in this field is intimately related to research on more effective treatments for a wide range of diseases."

Dr. Callahan, however, thought moral repugnance could prevail where restrictions fail. "I don't believe we can ban this research, but we can make it socially despicable."

Robert Lanza, MD, vice president of business and scientific development at Advanced Cell Technology Inc. in Worcestor, Mass., hardly can contain his enthusiasm when he discusses science's tremendous progress in this area.

Cloning genetically modified cells will lead to the creation of animals whose organs can be transplanted into humans without rejection by the end of the year, he insisted. And human therapeutic cloning holds the potential in five to 10 years of using people's own cells to produce stem cells that can then become replacement cells, tissues or even organs.

"We're obligated as physicians to heal the ill," Dr. Lanza said. "This technology allows us to do that."

But other physicians are more skeptical that medicine, even with the ability to replace our aging body parts, will rapidly prevail over death.

"If aging can be in any way construed as a disease, it is the most complex chronic disorder that we have, and we're very unsuccessful at treating chronic diseases," pointed out William B. Hurlbut, MD, a physician and lecturer in the program in human biology at Stanford University, Stanford, Calif.

But even our current capacity to treat disease has begun to change the face of doctors' offices.

"Just about every physician is seeing older patients and beginning to recognize that the older people that we're seeing nowadays aren't necessarily the same stereotype as people who were older years ago," said Harvey Jay Cohen, MD, director of the Center for the Study of Aging and Human Development at Duke University, Durham, N.C.

"On the one hand you have fairly healthy older people who want to be treated, in a sense, like the younger person. They want things done for them. But then there may be the frail and disabled older person who can't really tolerate some of those things and may not even want some of those things done."

Medicine is already under tremendous pressure to meet the expectations of those who want aggressive treatment. As science's potential grows, so, too, will the onus on physicians to attain a "perfect result."

"The more there is this promise of indefinitely extended life, the more death is going to be regarded as medicine's failure," Dr. Kass said.

More effective, more technological health care, however, might further erode the traditional role that physicians now have.

"It used to be that all they could do years ago as a physician would be to hold hands. We got good at this," Dr. Fossel said. "As we get more and more effective at medical care, we may lose some of our core if we're not careful."

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