Hard to believe but some people are worried that when rejuvenation biotechnology is available they may be forced to use it.
Might rejuvenation become an imposition?
Suppose that, on a nice day not too far into the future, while everything is going reasonably well in your life and you are enjoying yourself, you walk into the doctor’s office for a regular checkup. The doctor finds nothing wrong with you, but in order to minimize your risk of developing diseases that are likely to strike people in your age range, she recommends that you undergo senolytic treatment. The treatment is safe, with no serious adverse effects, it is administered simply through injections, and it is either state-subsidized or otherwise affordable. In your opinion, what are the odds that you would refuse the doctor’s prescription and say that you’d rather take the risk of getting sick?
Assuming that you are in your right mind, your answer is likely something along the lines of “not a chance.” If there are medicines that will spare you the trouble of getting sick, even seriously so, you will probably want to take them.
The example above outlines perfectly well why it is highly unlikely that rejuvenation treatments might ever become an imposition—you cannot impose something on people who actually want it. Yet, if you discuss the topic of rejuvenation long enough with a sufficient number of people, you are likely to eventually bump into someone who will raise the rather bizarre concern that these treatments might eventually be directly or indirectly imposed on people who do not want them. However improbable this may be, for the sake of completeness, let’s discuss the possibility.
Two important remarks
Before we delve into the ramifications of this concern, we should take notice of two facts. The first is that the concern of rejuvenation becoming a legally required direct imposition is absolutely incompatible with the concern that it might be just a privilege for the rich. It’s clear that if rejuvenation is a luxury good that only very few can afford and get, then it’s not being imposed on the populace; conversely, if rejuvenation is imposed on the populace, then it’s clearly not just for a few lucky ones.
The second fact is that, even if the concern of rejuvenation becoming an imposition were justified, this would not constitute a valid reason to halt the development of rejuvenation therapies, as that would cause a worse imposition on a different group of people, namely those who do not want to experience age-related decay and death. Even assuming that everyone on the planet were legally obligated to take rejuvenation treatments, it would be easier to evade this obligation than it would be to escape age-related diseases and death in a world without rejuvenation, where staying alive and in good health indefinitely would be utterly impossible. In simpler terms, would you say that we should ban blood transfusions altogether to make sure that the relatively few people who refuse them on religious grounds can never be forced to have any? Once again, your answer is probably negative.
Direct imposition
In the context of this discussion, “direct imposition” of rejuvenation means that laws are in force saying that everyone must undergo rejuvenation treatments whether they want them or not.
The right to refuse treatment is often a thorny matter, as people tend to basically bicker about which moral system deserves the most respect: the idea that life is sacred and under no circumstances should anyone be allowed to dispose of his or her own life, or the idea that patients should be free to decide for themselves. However, this issue only becomes relevant in end-of-life situations, when religious beliefs are involved, or when a patient is sick with an incurable, incapacitating, but non-lethal disease that makes his or her life unbearable.
It’s important to notice how these cases differ from those of patients having to choose whether they want rejuvenation for themselves. Rejuvenation is most definitely not about postponing the inevitable at the cost of prolonging suffering, and it’s not about extending misery in the name of the sanctity of life; it’s about maintaining health for as long as possible, preventing diseases that may cause misery and suffering altogether. The right to refuse rejuvenation should therefore not be compared to the right to refuse aggressive end-of-life care; rather, it should be compared to the right to refuse vaccines, as they both are examples of preventive medicine. It should be noted that people who refuse vaccines almost always do so due to scientific misconceptions or religious conviction, not the desire to suffer from infectious diseases.
Unlike infectious diseases, age-related diseases are noncommunicable and so do not endanger people other than those who contract them, but they do place a heavy burden on both the patient’s loved ones and society at large. Elderly people who are no longer able to take care of themselves, or require constant and expensive medical assistance, cause emotional distress to their families as well as financial problems either for their families or society; someone, whoever that may be, has to pay for elderly care expenses, and given that the number of people over the age of eighty is expected to triple by 2050, this will soon become unsustainable.
A comprehensive rejuvenation platform could prevent this problem from ever manifesting altogether, as chronologically old people would be just as healthy as chronologically young people generally are; they would thus retain their independence, both physical and financial, and would not burden the economy with extra health expenditures any more than a young person typically does. So, in a way, one might argue that rejuvenation biotechnology may help prevent certain global issues in the same way that vaccines may prevent pandemics, and it would therefore not be a bad idea to make rejuvenation treatments compulsory. However, this will hardly ever be necessary; people rarely desire disease and sickness for themselves, and if therapies are available to prevent them, odds are that they will undergo said therapies voluntarily.
It is important to keep in mind, however, that refusing rejuvenation treatments ultimately means voluntarily exposing oneself to a higher risk of chronic, debilitating conditions that are often difficult and expensive to manage. Therefore, if rejuvenation were available, and a person refused to take it on whatever grounds, that person should also be ready to accept the consequences that may derive from this choice. If I chose to refuse rejuvenation treatments and ended up needing hospitalization or other forms of continuous care as a direct consequence of my own choice, it would be unfair of me to ask third parties to pay for the resulting expenses or my relatives to look after me. It does not make sense to expect other people to pay for the medical expenses of somebody who has actively decided not to take available preventative measures against the risk of age-related diseases. This would be especially true if rejuvenation therapies were subsidized, wholly or partially, by the government.
Indirect imposition
Rejuvenation would be indirectly imposed if, although free to refuse it, you were seriously discriminated against if you did so. One example that was once presented to me as a serious potential problem is that of discrimination in the workplace. What if employers refuse to hire people who do not take rejuvenation? This concern is nowhere near as justified as it might appear at first glance.
If you are a chronologically young person, no older than about forty, then you don’t need rejuvenation treatments, and there’s no reason that you should take them. Assuming that your potential employer likes asking candidates their opinions on rejuvenation in order to decide if he should hire them—and you could easily lie about that and get away with it—he really wouldn’t be interested in whether you would undergo a certain treatment or not in twenty years or so, especially since you’re likely to have a different job in a few years’ time anyway.
If you are chronologically old, and you refuse to take rejuvenation, then your potential employer would have all the right to worry about that and take it into account when making his decision, because there is a significant chance that in relatively little time, you would no longer be able to perform the job for which you are applying—which, by the way, is the very reason that retirement exists.
More generally, we should remind ourselves that rejuvenation is a set of medical treatments that will be prescribed to people by doctors at the right time; it’s not like cosmetic surgery, or fancy make-up, or the latest smartphone model. It’s not something that you would buy at will to show off your social status or to better fit in your group; rather, it’s like antibiotics or cancer drugs. People who refuse to take the medicines they need today may come across as weird, ignorant, or irresponsible, but they are hardly a group that experiences widespread discrimination. That being said, is it possible that people will frown upon you if you decide that you do not want to be rejuvenated and want to grow old and die the old-fashioned way? Certainly, but it is not sensible to oppose rejuvenation for this reason, just as it is not sensible to oppose the existence of cell phones because of any social stigma associated with not using one.
One last observation worth making is that it is theoretically plausible for rejuvenation to become an instrument of indirect discrimination while still being a privilege for the rich. One could imagine a world in which rejuvenation treatments are still rather expensive and where older people who cannot afford them are discriminated against. Luckily, due to widespread demand and the fact that governments would have a strong economic motive to subsidize rejuvenation treatments rather than extremely expensive end-of-life care, this scenario appears unlikely.
Conclusion
Everyone wants to be healthy. If given the choice between being healthy for as long as you lived and becoming seriously sick at some point, you would probably choose the former. Rejuvenation is all about staying healthy for as long as possible. This is why we will hardly ever have to worry about rejuvenation becoming an imposition—you don’t need to impose what people want.
