Die wachsende Nachfrage nach Anti-Aging-Medizin wirft die Frage auf, welche medizinischen Leistungen ein solidarisches Gesundheitssystem tragen sollte. Die deutsche Entscheidungspraxis beruft sich auf den Begriff der Krankheit. Im Blick auf Anti-Aging wäre demnach 1) zu klären, was der Krankheitsbegriff bedeutet, 2) zu prüfen, ob das Altern sich unter diesen Begriff subsumieren lässt, um 3) abzuleiten, inwieweit Anti-Aging-Maßnahmen zur Verfügung zu stellen sind. Dieses Prozedere führt jedoch zu keinem brauchbaren Ergebnis. Unter Berufung auf den Krankheitsbegriff allein ist der Umfang solidarischer Gesundheitsversorgung (...) nicht zu bestimmen. Allerdings lässt sich durch Reflexion auftretender Probleme ein gangbarer Entscheidungsweg aufzeigen. Er sieht eine faire Verständigung über die Frage vor, wie wir alt werden wollen. (shrink)

In Humanity’s End: Why We Should Reject Radical Enhancement, Nicholas Agar presents a novel argument against the prospect of radical life-extension. Agar’s argument hinges on the claim that extended lifespans will result in people’s lives being dominated by the fear of death. Here we examine this claim and the surrounding issues in Agar’s discussion. We argue, firstly, that Agar’s view rests on empirically dubious assumptions about human rationality and attitudes to risk, and secondly, that even if those assumptions are granted, (...) the fears that Agar adverts to are unlikely to dominate people’s lives if and when radical life-extension is made possible. Further, we claim that the structure of the decision-making process around life-extension is unlikely to be the way that it would have to be in order for Agar’s claims about fear of death to make sense. Finally, we argue that Agar is implicitly committed to a narrow conception of human value. In response, we suggest that the pursuit of life-extension can itself be seen as an expression of certain important aspects of our distinctively human nature. (shrink)

Debates about the ethical and social implications of research that aims to extend human longevity by intervening in the ageing process have paid little attention to the attitudes of members of the general public. In the absence of empirical evidence, conflicting assumptions have been made about likely public attitudes towards life-extension. In light of recent calls for greater public involvement in such discussions, this target article presents findings from focus groups and individual interviews which investigated whether members of the general (...) public identify ethical issues surrounding life-extension, and if so, what these ethical issues are? In this study, while some participants were concerned primarily with the likely personal consequences of life-extension, for others the question of whether or not to pursue interventions to extend longevity, and how they should be implemented, clearly raised important ethical issues, many of which have been prominent in debates among bioethicists. (shrink)

Much bioethical discussion has been devoted to the subject of human enhancement through various technological means such as genetic modification. Although many of the same technologies could be, indeed in many cases already have been, applied to non-human animals, there has been very little consideration of the concept of “animal enhancement”, at least not in those specific terms. This paper addresses the notion of animal enhancement and the ethical issues surrounding it. A definition of animal enhancement is proposed that provides (...) a framework within which to consider these issues; and it is argued that if human enhancement can be considered to be a moral obligation, so too can animal enhancement. (shrink)

Department of Political Studies, Queen's University, 99 University Avenue, Kingston, Ontario, Canada, K7L 3N6. Email: farrelly{at}queensu.ca ' + u + '@' + d + ' '//--> Abstract Should we invest more public funding in basic aging research that could lead to medical interventions that permit us to safely and effectively retard human aging? In this paper I make the case for answering in the affirmative. I examine, and critique, what I call the Fairness Objection to making aging research a greater (...) priority than it currently is. The Fairness Objection presumes that support for aging research is limited to a simplistic utilitarian justification. That is, a mode of justification that is aggregative and permits imposing high costs on a few so that small benefits could be enjoyed by numerous recipients. I develop two arguments to refute the Fairness Objection. The Fairness Objection mischaracterizes the utilitarian argument for retarding human aging. It does so by invoking the fallacious conceptual distinction between "saving lives" and "extending lives", as well as making a number of mistaken assumptions concerning the likely benefits of retarding human aging. Secondly, I argue that the case for tackling aging can be made on contractualist , in addition to utilitarian, grounds. Because the harms of senescence are "morally relevant" to the harms of disease, contractualists can permit aggregation within lives. And thus no one could reasonably reject, I contend, a principle that makes the aspiration to tackle human aging more of a priority than it currently is. CiteULike Connotea Del.icio.us What's this? (shrink)

To what extent do we value future generations? It may seem from our behavior that we don’t value future generations much at all, at least in relation to how much we value present generations. However, in his book _Death and the Afterlife_, Samuel Scheffler argues that we value the future even _more_ than we value the present, even though this is not immediately apparent to us. If Scheffler’s argument is sound, then it has important ramifications: It would give us a (...) strong motivation to put more energy into abating environmental crises like climate change, and it supports at least a limited form of ethical _longtermism_. However, in this paper, I show that Scheffler’s argument is fallacious. Scheffler claims that we do not regard the fact that we in the present generation will all die relatively soon as a catastrophe, but we do regard the non-existence of future generations as a catastrophe. But the particular scenario used by Scheffler to illustrate this point—the plot of the book _The Children of Men_—is one in which _both_ the present generation will perish _and_ there will be no future generations, and it is this _conjunction_ that is catastrophic, thus giving no information about which is worse. I suggest other ways to compare our valuations of present and future generations, and recommend that philosophers who are interested in the moral psychology of how we value future generations ought to engage with social science, as it is an empirical issue. (shrink)

Ageing is often deemed bad for people and something that ought to be eliminated. An important aspect of this normative aspect of ageing is whether ageing, i.e., senescence, is a disease. In this essay, I defend a theory of disease that concludes that ageing is not a disease, based on an account of natural function. I also criticize other arguments that lead to the same conclusion. It is important to be clear about valid reasons in this debate, since the failure (...) of bad analyses is exploited by proponents of the view that ageing is indeed a disease. Finally, I argue that there could be other reasons for attempting to eradicate senescence, which have to do with an evaluative assessment of ageing in relation to the good life. I touch on some reasons why ageing might be good for people and conclude that we cannot justify generalized statements in this regard. (shrink)

Transhumanists and their fellow travelers urge humanity to prioritize the development of biotechnologies that would eliminate aging, delivering ‘an endless summer of literally perpetual youth.’ Aspiring not to age instantiates what philosopher Martha Nussbaum calls the yearning for ‘external transcendence,’ or the fundamental surpassing of human bounds due to confidence that life without them would be better. Based on Immanuel Kant’s account of the parameters of human understanding, I argue that engineering agelessness could not be a rational priority for humanity (...) on the level of public policy. This stance is complemented by an argument focused on individual decision-making in liberal-democratic milieus, where no governing conception of the good is presumed and the first-personal level matters greatly. Here, drawing on philosopher and cognitive scientist Laurie Ann Paul’s concept of ‘transformative experience,’ I maintain that individuals could not ‘rationally,’ meaning, here, ‘prudentially,’ say ‘yes’ to agelessness. Absorbing the irrationality of human zeal to eliminate aging, based on assurance that an ageless existence would be better, should spur a redoubled dedication to human flourishing. (shrink)

Drawing on Ezekiel Emanuel’s controversial piece ‘Why I hope to die at 75,’ I distinguish two types of concern in ethical debates about extending the human lifespan. The first focusses on the value of living longer from prudential and social perspectives. The second type of concern, which has received less attention, focusses on the value of aiming for longer life. This distinction, which is overlooked in the ethical literature on life extension, is significant because there are features of human psychology (...) and the structure of a life that should give pause when considering how long one should aim to live, but which do not neatly coincide with considerations about how valuable additional life is likely to be. I argue that, while Emanuel’s case for hoping to die at 75 is unconvincing, he nonetheless provides weak pro tanto considerations in favour of taking a moderate life span as a prudential aim around which to base at least some significant life plans. (shrink)

Die individuellen und gesellschaftlichen Folgen des demographischen Wandels rücken moralische Fragen, die den angemessenen Umgang mit älteren Menschen und die sinnvolle Gestaltung des Lebens im Alter betreffen, verstärkt in den Mittelpunkt öffentlicher Aufmerksamkeit sowie medizin- bzw. pflegeethischer und gesundheitspolitischer Auseinandersetzungen. Allerdings wird das Altern als Prozess und das höhere Alter als Lebensphase in vielen dieser medizin- bzw. pflegeethischen und gesundheitspolitischen Debatten zumeist lediglich unter dem spezifischen Gesichtspunkt der jeweils erörterten Praktiken, Fragestellungen und Problemlagen thematisiert. Eine Betrachtung, die diese verschiedenen konkreten (...) Praxis- und Diskussionskontexte übergreift, das in ihnen jeweils vorausgesetzte Verständnis des Alter(n)s als solches thematisiert und in seiner Bedeutung für die ethische Fachdiskussion grundsätzlich reflektiert, findet dagegen kaum statt. Die Arbeitsgruppe „Altern und Ethik“ in der Akademie für Ethik in der Medizin soll zur Entwicklung einer solchen grundlegenderen und umfassenderen Betrachtungsweise beitragen. Der vorliegende Beitrag gibt einen ersten orientierenden Überblick über die zentralen Themenschwerpunkte, Problemstellungen und Kontroversen in den aktuellen medizin- bzw. pflegeethischen und gesundheitspolitischen Diskursen um das Alter(n) und markiert offene Fragen und Forschungsdesiderate. Wie sich dabei zeigt, kann eine eingehendere Auseinandersetzung mit dem Alter(n) nicht nur den einschlägigen alter(n)sbezogenen Fachdebatten zu fundierteren Perspektiven verhelfen, sondern auch der ethischen Diskussion insgesamt wichtige Impulse im Hinblick auf ihre anthropologischen Grundlagen und ihren normativen Bezugsrahmen vermitteln. (shrink)

edited by Tuija Takala and Matti Häyry, welcomes contributions on the conceptual and theoretical dimensions of bioethics.

Social Justice, Health Inequities, and Access to New Age-Related Interventions Content Type Journal Article Category Original Paper Pages 281-295 DOI 10.1007/s12376-009-0027-3 Authors Hans-Jörg Ehni, University of Tuebingen, Tuebingen, Baden-Württemberg Germany Georg Marckmann, University of Tuebingen, Tuebingen, Baden-Württemberg Germany Journal Medicine Studies Online ISSN 1876-4541 Print ISSN 1876-4533 Journal Volume Volume 1 Journal Issue Volume 1, Number 3.

Various debates on the desirability and rationality of life-extending enhancements have been pursued under the presupposition that a generic psychological theory of personal identity is correct. I here discuss how the narrative approach to personal identity can contribute to these debates. In particular, I argue that two versions of the narrative approach offer good reasons to reject an argument against the rationality of life-extending enhancements.

Applied ethics is home to numerous productive subfields such as procreative ethics, intergenerational ethics and environmental ethics. By contrast, there is far less ethical work on ageing, and there is no boundary work that attempts to set the scope for ‘ageing ethics’ or the ‘ethics of ageing’. Yet ageing is a fundamental aspect of life; arguably even more fundamental and ubiquitous than procreation. To remedy this situation, I examine conceptions of what the ethics of ageing might mean and argue that (...) these conceptions fail to capture the requirements of the desired subfield. The key reasons for this are, first, that they view ageing as something that happens only when one is old, thereby ignoring the fact that ageing is a process to which we are all subject, and second that the ageing person is treated as an object in ethical discourse rather than as its subject. In response to these shortcomings I put forward a better conception, one which places the ageing person at the centre of ethical analysis, has relevance not just for the elderly and provides a rich yet workable scope. While clarifying and justifying the conceptual boundaries of the subfield, the proposed scope pleasingly broadens the ethics of ageing beyond common negative associations with ageing. (shrink)

Die wachsende Nachfrage nach Anti-Aging-Medizin wirft die Frage auf, welche medizinischen Leistungen ein solidarisches Gesundheitssystem tragen sollte. Die deutsche Entscheidungspraxis beruft sich auf den Begriff der Krankheit. Im Blick auf Anti-Aging wäre demnach 1) zu klären, was der Krankheitsbegriff bedeutet, 2) zu prüfen, ob das Altern sich unter diesen Begriff subsumieren lässt, um 3) abzuleiten, inwieweit Anti-Aging-Maßnahmen zur Verfügung zu stellen sind. Dieses Prozedere führt jedoch zu keinem brauchbaren Ergebnis. Unter Berufung auf den Krankheitsbegriff allein ist der Umfang solidarischer Gesundheitsversorgung (...) nicht zu bestimmen. Allerdings lässt sich durch Reflexion auftretender Probleme ein gangbarer Entscheidungsweg aufzeigen. Er sieht eine faire Verständigung über die Frage vor, wie wir alt werden wollen. (shrink)

The technical possibilities of biomedicine open up the opportunity to intervene in ageing itself with the aim of mitigating, reducing or eliminating it. However, before undertaking these changes or rejecting them outright, it is necessary to ask ourselves if what would be lost by doing so really has much value. This article will analyse the desirability of ageing from an individual point of view, without circumscribing this question to the desirability or undesirability of death. First, we will present the three (...) most widely used arguments to reject biomedical interventions against ageing. We will argue that only the last of these arguments provides a consistent answer to the question of the desirability of ageing. Second, we will show that the third argument falls prey to a conceptual confusion that we will call the paradox of ageing: although ageing entails negative health effects, it leads to a life stage with valuable goods. Both valuations, one positive and the other negative, refer to two different dimensions of ageing: the chronological and the biological. We will defend that, by not adequately distinguishing these two types of ageing, it does not become apparent that all the valuable goods exclusive to ageing derive only from its chronological dimension. Third, we will argue that, if we just conceive ageing biologically, it is undesirable. We will elaborate on the two kinds of undesirable effects biological ageing has: direct and indirect. Finally, we will respond to potential objections by adducing that these are insufficient to weaken our argument. (shrink)

Recent developments in biogerontology—the study of the biology of ageing—suggest that it may eventually be possible to intervene in the human ageing process. This, in turn, offers the prospect of significantly postponing the onset of age-related diseases. The biogerontological project, however, has met with strong resistance, especially by deontologists. They consider the act of intervening in the ageing process impermissible on the grounds that it would (most probably) bring about an extended maximum lifespan—a state of affairs that they deem intrinsically (...) bad. In a bid to convince their deontological opponents of the permissibility of this act, proponents of biogerontology invoke an argument which is grounded in the doctrine of double effect. Surprisingly, their argument, which we refer to as the ‘double effect argument’, has gone unnoticed. This article exposes and critically evaluates this ‘double effect argument’. To this end, we first review a series of excerpts from the ethical debate on biogerontology in order to substantiate the presence of double effect reasoning. Next, we attempt to determine the role that the ‘double effect argument’ is meant to fulfil within this debate. Finally, we assess whether the act of intervening in ageing actually can be justified using double effect reasoning. (shrink)

In this essay, we argue against radical ethical views about human enhancement that either dismiss or endorse it tout court. Instead, we advocate the moderate stance that issues of enhancement should be examined with an open mind and on a case-by-case basis. To make this view plausible, we offer three reasons. The first lies in the fact that it is difficult to delineate enhancement conceptually, which makes it hard to argue for general ethical conclusions about it. The second is that (...) an appropriate view of the edifice of moral theory suggests that tenable moral judgements about human enhancement are the result of a careful consideration of the pros and cons that attach to the use of a specific enhancement technology. Lastly, we show that important normative factors in the enhancement debate can be used both in arguments for and in arguments against enhancement. The bottom line of our discussion is that we should treat issues of human enhancement like we do any other ethical issue, viz. by weighing up the reasons pro and con. (shrink)