This paper argues that we can see our lives as a snapshot happening now or as a moving picture extending across time. These dual ways of seeing our lives inform how we conceive of the problem of age group justice. A snapshot view sees age group justice as an interpersonal problem between distinct age groups. A moving picture view sees age group justice as a first-person problem of prudential choice. This paper explores these different ways of thinking about age group (...) justice and illustrates them using a principle of respect for human dignity, understood in terms of reasonable support for floor level central human capabilities at each stage of life. I argue that different frames are suitable for different kinds of decisions, and each provides a true, but partial, picture of aging and age group justice. (shrink)

In this paper, I present an emerging explanatory framework about ageing and care. In particular, I focus on how, in contrast to most classical accounts of ageing, biomedicine today construes the ageing process as a modifiable trajectory. This framing turns ageing from a stage of inexorable decline into the focus of preventive strategies, harnessing the functional plasticity of the ageing organism. I illustrate this shift by focusing on studies of the demographic dynamics in human population, observations of ageing as an (...) intraspecifically heterogenous phenotype, and the experimental manipulation of longevity, in both model organisms and humans. I suggest that such an explanatory framework about ageing creates the epistemological conditions for the rise of a peculiar form of prevention that does not aim to address a specific condition. Rather it seeks to stall the age-related accumulation of molecular damage and functional deficits, boosting individual resilience against age-related decline. I call this preventive paradigm “ground-state prevention.” While new, ground-state prevention bears conceptual resemblance to forms of medical wisdom prominent in classic Galenic medicine, as well as in the Renaissance period. (shrink)

This paper addresses a philosophical problem concerning the ontological status of age classification. For various purposes, people are commonly classified into categories such as “young adulthood”, “middle adulthood”, and “older adulthood”, which are defined chronologically. These age categories prima facie seem to qualify as natural kinds under a homeostatic property cluster account of natural kindhood, insofar as they capture certain biological, psychological, and social properties of people that tend to cluster together due to causal processes. However, this is challenged by (...) the observation that age categories are historically unstable. The properties that age categories are supposed to capture are affected by healthcare and cultural developments, such that people are staying biologically, psychologically, and socially young for longer. Furthermore, the act of classifying people into age categories can bring about changes in their behaviors, which in turn alter the biological, psychological, and social properties that the categories are supposed to capture. Accordingly, I propose that age categories are best understood as interactive kinds that are influenced in dynamic ways by looping effects. I consider some implications of these looping effects for our classificatory practices concerning age, including how different disciplines may need to review the ways they define and use age categories in their inductive inferences. (shrink)

During his celebrated 1922 debate with Bergson, Einstein famously proclaimed: “the time of the philosopher does not exist, there remains only a psychological time that differs from the physicist’s.” Einstein’s dictum, I maintain, has been metabolized by the natural sciences, which typically presuppose, more or less explicitly, the existence of a single, univocal, temporal substratum, ultimately determined by physics. This reductionistic assumption pervades much biological and biomedical practice. The chronological age allotted to individuals is conceived as an objective quantity, allowing (...) one to straightforwardly assign and compare the biological age of organisms. This essay argues that the standard practice of assessing the age and aging of organisms against the backdrop of a physical conception of time is problematic. This becomes especially evident in light of recent discoveries of various levels of senescence underlying the development of individual organisms—a phenomenon known as ‘age mosaicism.’ The bottom line is that the study of age and aging requires a biological conception of time, as opposed to a physical one. Einstein clearly wasn’t wrong about his operationalization of time in relativity theory. Still time may be less monolithic than he surmised. (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)

Background Scientific and technological advancements in mapping and understanding the interrelated pathways through which biological and environmental exposures affect disease development create new possibilities for detecting disease risk factors. Early detection of such risk factors may help prevent disease onset or moderate the disease course, thereby decreasing associated disease burden, morbidity, and mortality. However, the ethical implications of screening for disease risk factors are unclear and the current literature provides a fragmented and case-by-case picture. Methods To identify key ethical considerations (...) arising from the early detection of disease risk factors, we performed a systematic scoping review. The Scopus, Embase, and Philosopher’s Index databases were searched for peer-reviewed, academic records, which were included if they were written in English or Dutch and concerned the ethics of (1) early detection of (2) disease risk factors for (3) disease caused by environmental factors or gene-environment interactions. All records were reviewed independently by at least two researchers. Results After screening 2034 titles and abstracts, and 112 full papers, 55 articles were included in the thematic synthesis of the results. We identified eight common ethical themes: (1) Reliability and uncertainty in early detection, (2) autonomy, (3) privacy, (4) beneficence and non-maleficence, (5) downstream burdens on others, (6) responsibility, (7) justice, and (8) medicalization and conceptual disruption. We identified several gaps in the literature, including a relative scarcity of research on ethical considerations associated with environmental preventive health interventions, a dearth of practical suggestions on how to address expressed concerns about overestimating health capacities, and a lack of insights into preventing undue attribution of health responsibility to individuals. Conclusions The ethical concerns arising with the early detection of risk factors are often interrelated and complex. Comprehensive ethical analyses are needed that are better embedded in normative frameworks and also assess and weigh the expected benefits of early risk factor detection. Such research is necessary for developing and implementing responsible and fair preventive health policies. (shrink)

Both Medawar and Hamilton contributed key ideas to the modern evolutionary theory of ageing. In particular, they both suggested that, in populations with overlapping generations, the force with which selection acts on traits declines with the age at which traits are expressed. This decline would eventually cause ageing to evolve. However, the biological literature diverges on the relationship between Medawar’s analysis of the force of selection and Hamilton’s. Some authors appear to believe that Hamilton perfected Medawar’s insightful, yet ultimately erroneous (...) analysis of this force, while others see Hamilton’s analysis as a coherent development of, or the obvious complement to Medawar’s. Here, the relationship between the two analyses is revisited. Two things are argued for. First, most of Medawar’s alleged errors that Hamilton would had rectified seem not to be there. The origin of these perceived errors appears to be in a misinterpretation of Medawar’s writings. Second, the mathematics of Medawar and that of Hamilton show a significant overlap. However, different meanings are attached to the same mathematical expression. Medawar put forth an expression for the selective force on age-specific fitness. Hamilton proposed a full spectrum of selective forces each operating on age-specific fitness components, i.e. mortality and fertility. One of Hamilton’s expressions, possibly his most important, is of the same form as Medawar’s expression. But Hamilton’s selective forces on age-specific fitness components do not add up to yield Medawar’s selective force on age-specific fitness. It is concluded that Hamilton’s analysis should be considered neither as a correction to Medawar’s analysis nor as its obvious complement. (shrink)