Aging

Does a single mechanism of aging exit? Most scientists have their own pet theories about what is aging, but the lack of generally accepted theory is mind-blowing. Here we suggest an explanation: evolution works against unitary mechanism of aging because it equalizes ‘warranty period’ of different resilience systems. Therefore, we need life-extension methods that go beyond fighting specific aging mechanisms: such as using a combination of geroprotectors or repair-fixing bionanorobots controlled by AI.

The effective altruism movement aims to save lives in the most cost-effective ways. In the future, technology will allow radical life extension, and anyone who survives until that time will gain potentially indefinite life extension. Fighting aging now increases the number of people who will survive until radical life extension becomes possible. We suggest a simple model, where radical life extension is achieved in 2100, the human population is 10 billion, and life expectancy is increased by simple geroprotectors like metformin (...) or nicotinamide mononucleotide by three more years on average, so an additional 750 million people survive until “immortality”. The cost of clinical trials to prove that metformin is a real geroprotector is $65 million. In this simplified case, the price of a life saved is around eight cents, 10 000 times cheaper than saving a life from malaria by providing bed nets. However, fighting aging should not be done in place of fighting existential risks, as they are complementary causes. (shrink)

There is disagreement among physicians and medical ethicists on the precise goals of Hospice and Palliative Medicine (HPM). Some think that HPM's goals should differ from those of other branches of medicine and aim primarily at lessening pain, discomfort, and confusion; while others think that HPM's practices should, like all other branches of medicine, aim at promoting health. I take the latter position: using the ars moriendi to set a standard for what it means to die well, I argue that (...) if HPM's practices were to aim at mitigating suffering with little regard to promoting health, some patients would die worse deaths than if HPM's practices were to aim at health. According to the ars moriendi, flourishing at the end of one's life requires that one exercise her agency and pursue the goods most important to her. On this view, HPM's practices should promote patients’ health to enable them to pursue these goods. (shrink)

Philosophers have become newly interested in the ethics of sex. One promising feature of this new discussion is that it has been broadening our moral lens to include individuals whose sexual interests have historically been denied or ignored. One such group is the elderly. Contrary to popular belief, many elderly people want to have sex and see it as a regular part of their lives. If society harbors ignorance about or prejudice against elderly sexuality, it harbors stronger views against the (...) sexual expression of elderly people with dementia. People with dementia are often prohibited by nursing‐home staff, sometimes in extreme ways, from having sex with their partners. This prohibition is at least partly motivated by the goal of protecting the vulnerable. However, cutting people with dementia off from sex has negative health effects and is a needless restriction of their autonomy. In this article, I argue that the expanding moral lens in sexual ethics should include the sexual expression of elderly individuals with dementia and that their sexual expression should be respected. Specifically, I argue that many people with dementia are competent to consent to sexual activity with their long‐term partners. (shrink)

To assess the perception regarding the quality of life, a qualitative study was conducted on 20 old people of balance gender in Dhaka, Bangladesh. Most of the participants of our study were upper poor class and literate. Male participants were a little higher than females. The majority were between 60 and 65years. They were significantly more active, independent, and took part in productive work contributing in the country’s economy, and had significantly greater decision power than other age group. Quality of (...) life of the elderly is related to physical and, economical wellbeing and coping mechanism during old age. The government of Bangladesh has taken varying degrees of initiative to improve the elder condition, but that was not publicized well. Old age Allowance should be increased to BDT 5000/ ($50). Family attachment and emotional support is also related to the self-assurance, self-respect, and self-drive of the elderly. Parent's Care Act 2013 should be implemented for retrospective care of seniors. (shrink)

This chapter summarizes the conceptual foundations and research on emotional creativity. Emotional creativity is defined as a pattern of cognitive abilities and personality traits related to originality and appropriateness in emotional experience. This construct pervades human creative performance and represents an important link between emotional experience and cognitive processes. Empirical research in this field has revealed various links of emotional creativity to personality variables (e.g., openness to experience), positive affect, fantasy proneness, coping strategies, post-traumatic growth, better self-understanding, and one’s engagement (...) in practicing creative leisure activities. In the applied settings, emotional creativity has been found to be positively related to the intrinsic motivation of employees, the innovative performance of employees, teaching efficacy, and an increased awareness of professional roles. Interestingly, the available meta-analysis of past studies revealed that women showed significantly higher emotional creativity than men. Emotional creativity has also been found to be lower in older adulthood compared to younger age. Because the levels of emotional creativity were found to be sensitive to the decline of cognitive functions in older adults, their decrease can be considered as one of the indicators of cognitive aging. Recent research in clinical neuropsychology has also revealed that older adults in the early stages of Parkinson’s disease showed decreased emotional creativity compared to healthy older adults. (shrink)

Podstawowym założeniem artykułu jest uznanie, że złożoność wyzwań związanych ze starzeniem się populacji wymusza rozwój powiązań kooperacyjnych między podmiotami polityki publicznej reprezentującymi różne sektory. Innymi słowy: niezbędna jest bardziej intensywna i lepiej skoordynowana współpraca między organizacjami sektora publicznego, komercyjnego, pozarządowego, nieformalnego oraz sektora obejmującego podmioty gospodarki społecznej (np. spółdzielnie). Zasadnicze znaczenie ma w tym kontekście wdrażanie założeń teorii współzarządzania (governance), koprodukcji oraz mieszanej gospodarki dobrobytu (inaczej: wielosektorowej polityki społecznej). W konsekwencji artykuł wskazuje na wybrane wątki dyskursu dotyczącego relacji procesu starzenia (...) się ludności z przedsiębiorczością społeczną i innowacjami społecznymi. Tekst przytacza także przykłady dobrych praktyk i inicjatyw z obszaru gospodarki społecznej. Podsumowanie zawiera rekomendacje dla podmiotów polityki publicznej oraz proponowane kierunki dalszych badań. (shrink)

[This piece is written for those working in social gerontology and aging studies, with the aim of bringing insights from disability studies and philosophy of disability to bear on enduring debates in those fields.] The guiding question of humanistic age-studies—What does it mean to grow old?—cannot be answered without reflecting on disability. This is not simply because growing old invariably means becoming impaired in various ways, but also because the discriminations and stigmas involved in ageism are often rooted in ableism. (...) We here draw on research in the philosophy of disability as well as the interdisciplinary field of disability studies to explore the relationship between ageism and ableism. (shrink)

Dans notre société de plus en plus digitalisée, avons-nous vraiment le choix d’adopter ou non les technologies? Comment cette digitalisation impacte-t-elle les personnes âgées en particulier et son écosystème? Quels sont les enjeux éthiques soulevés par cette digitalisation? Ce texte vise à amener des éléments de réflexions en lien avec ces enjeux selon le point de vue de divers experts des domaines de la technologie, du vieillissement et de la bioéthique. Ces experts se sont rencontrés lors d’un symposium ayant eu (...) lieu à Angers, France, en octobre 2019. Le texte est un compte-rendu des échanges et points de vue de ces experts, ainsi que des discussions ouvertes qu’ils ont eues avec l’assistance, portant sur les principaux enjeux soulevés par cette digitalisation selon la perspective des personnes âgées, des proches-aidants, des soignants, de la société et de la recherche. (shrink)

Boredom has dominated discussions about longevity thanks to Bernard Williams’s influential “The Makropulos Case.” I reveal the presence in that paper of a neglected, additional problem for the long-lived person, namely alienation in the face of unwanted change. Williams gestures towards this problem but does not pursue it. I flesh it out on his behalf, connecting it to what I call the ‘curmudgeonly attitude to change.’ This attitude manifests itself in the tendency, amongst those getting on in years, to observe (...) that things are getting worse. Curmudgeonliness is typically met with dismissal because it often concerns changes that don’t radically inhibit the curmudgeon’s well-being or autonomy. I believe that taking the curmudgeonly attitude more seriously will provide insight into the longer-lived self and its relation to the future. Using Williams’s approach to longevity as the framework, I contend that—as with boredom—a sense of alienation born of curmudgeonliness can become terminal for the subject, rendering her unable to envision the future as a site of worthwhile activity. However, I also uncover ways in which this agential stasis is significantly distinct from boredom and constitutes a different worry and a different risk for the long-lived individual. (shrink)

There is a certain metaphor that has enjoyed tremendous longevity in the evolution of ageing literature. According to this metaphor, nature has a certain goal or purpose, the perpetuation of the species, or, alternatively, the reproductive success of the individual. In relation to this goal, the individual organism has a function, job, or task, namely, to breed and, in some species, to raise its brood to maturity. On this picture, those who cannot, or can no longer, reproduce are somehow invisible (...) to, or even dispensable to, the evolutionary process. Here, I argue that the metaphor should be discarded, not on the grounds that it is a metaphor, but on the grounds that this particular metaphor distorts our understanding of the evolution of ageing. One reason the metaphor is problematic is that it frames senescence and death as nature’s verdict on the value of older individuals. Instead, we should explore a different metaphor: the lengthy post-reproductive period in humans and some other animals is not an accident of culture, but designed by nature for the purpose of supporting and guiding younger generations. On this alternate picture, different stages of life have their own evolutionary rationales, their distinctive design features, their special mandates. (shrink)

Ageing is one of the main risk factors for Covid-19. In this paper, we delineate four alternative conceptualisations of ageing, each of which determines different understandings of its causal role to the susceptibility to Covid-19 as well as to the severity of its symptoms and adverse health outcomes.

Coronavirus disease 2019 can lead to respiratory failure. Some patients require extracorporeal membrane oxygenation support. During the current pandemic, health care resources in some cities have been overwhelmed, and doctors have faced complex decisions about resource allocation. We present a case in which a pediatric hospital caring for both children and adults seeks to establish guidelines for the use of extracorporeal membrane oxygenation if there are not enough resources to treat every patient. Experts in critical care, end-of-life care, bioethics, and (...) health policy discuss if age should guide rationing decisions. (shrink)

Pandemic-related restrictions can be especially tragic for people whose lives are ending; it seems that the needs and desires of people who are dying should be given extra consideration. Given an additivist view of well-being, however, the last weeks of a person's life can only matter so much relative to the rest of the life they had. This article reflects on the end of my mother's life during the Covid-19 pandemic in order to make the case that the additive view (...) of well-being is part of a broader trend of dehumanizing emergency ethics. (shrink)

Tamamlayıcı ve alternatif tıp (TAT) uygulamaları temel tıbbi tedaviye ek ya da temel tıbbi tedavinin yerine kullanılan, uygulamaları genelde konvansiyonel tıp tarafından tedavi olarak kabul edilmeyen çeşitli tıbbi ve sağlık bakım sistemi, pratikleri ve ürünleri olarak tanımlanmaktadır (Hossein et al., 2014, Amira ve Okubadejo, 2007; National Institutes of Health [NIH], 2018). TAT konusunda yapılan araştırmalar Afrika, Asya ve Latin Amerika gibi gelişmemiş ya da gelişmekte olan ülkelerde hastaların bazı tedavi ihtiyaçlarını karşılamak amacıyla geleneksel uygulamalara başvurmaları doğrultusunda geleneksel tıp teriminin tamamlayıcı (...) ve alternatif tıpa karşılık gelecek şekilde kullanıldığını da göstermektedir. (shrink)

Lippert-Rasmussen and Petersen discuss my ‘Moral case for legal age change’ in their article ‘Age change, official age and fairness in health’. They argue that in important healthcare settings (such as distributing vital organs for dying patients), the state should treat people on the basis of their chronological age because chronological age is a better proxy for what matters from the point of view of justice than adjusted official age. While adjusted legal age should not be used in deciding who (...) gets scarce vital organs, I remind the readers that using chronological age as a proxy is problematic as well. Using age as a proxy could give wrong results and it is better, if possible, for states to use the vital information directly than use age as a proxy. (shrink)

In this paper, I answer the following question: suppose that two individuals, C and D, have been in a long-term committed relationship, and D now has dementia, while C is competent; if D agrees to have sex with C, is it permissible for C to have sex with D? Ultimately, I defend the view that, under certain conditions, D can give valid consent to sex with C, rendering sex between them permissible. Specifically, I argue there is compelling reason to endorse (...) the following thesis: -/- Prior Consent Thesis: D, when competent, can give valid prior consent to sex with her competent partner (C) that will take place after she has dementia, assuming that D is the same person as she was when she gave prior consent, meaning that, if D, when competent, gave prior consent to sex with C, then C may permissibly have sex with D. In section I, I explain both the background and the existing literature on this issue. In section II, I outline relevant stipulations about the kinds of cases I will be examining. In section III, I defend the Prior Consent Thesis. And, in section IV, I address objections to the Prior Consent Thesis. (shrink)

My ambition in this paper is to provide an account of an unacknowledged example of blameless guilt that, I argue, merits further examination. The example is what I call carer guilt: guilt felt by nurses and family members caring for patients with palliative-care needs. Nurses and carers involved in palliative care often feel guilty about what they perceive as their failure to provide sufficient care for a patient. However, in some cases the guilty carer does not think that he has (...) the capacity to provide sufficient care; he has, in his view, done all he can. These carers cannot legitimately be blamed for failing to meet their own expectations. Yet despite acknowledging their blamelessness, they nonetheless feel guilty. My aims are threefold: first, to explicate the puzzling nature of the carer guilt phenomenon; second, to motivate the need to solve that puzzle; third, to give my own account of blameless guilt that can explain why carers feel guilty despite their blamelessness. In doing so I argue that the guilt experienced by carers is a legitimate case of guilt, and that with the right caveats it can be considered an appropriate response to the progressive deterioration of someone for whom we care. (shrink)

Insofar as many older adults fit some definition of disability, disability studies and gerontology would seem to have common interests and goals. However, there has been little discussion between these fields. The aim of this paper is to open up the insights of disability studies as well as philosophy of disability to discussions in gerontology. In doing so, I hope to contribute to thinking about the good life in late life by more critically reflecting upon the meaning of the body, (...) ability, and the variability of each. My central argument is that we should conceptualize age‐associated bodily variations and abilities not in terms of individual capacity, but in terms of what I call “the extended body.” It is in light of the meaning of embodiment and ability in general that we must think differently and more capaciously about the meaning of late life in particular. (shrink)

Ronald Dworkin argued that Advance Directives informed by a principle of autonomy ought to guide decisions in relation to the treatment of those in care for dementia. The principle of autonomy in play presupposes a form of competence that is tied to the individual person making the Directive. This paper challenges this individualist assumption. It does so by pointing out that the competence of a patient is inherently relational, and the key illustrative case to make this point is the case (...) of music therapy. In music therapy, a relatively recent treatment modality in aged care, patients previously thought to be permanently unresponsive are shown on the contrary to be capable of significant levels of social agency. The conclusion to draw is that Advance Directives that fail to acknowledge the real possibility of such relational competence are misapplied. (shrink)

Loss of self is widely regarded to be a consequence of dementia, and this perceived loss presents a variety of problems - not least because a clear understanding of the concept of self is elusive. This paper suggests a way to cut through problems that arise because we rely on conceptions of self in our understanding of the effects of dementia. It is proposed that we can avoid reliance on the concept of self through an approach based in in bio-phenomenology. (...) Such an approach would help us better understand the inner life of those with dementia and assist us to recognize that even in late stage dementia they are semiotic subjects with unique value. (shrink)

Old age in the Indian context and facing it through Ayurveda.