| |
|
|
Controlling Human Aging:
Alternative Rationales & Implications
Department of Bioethics, Case Western Reserve University
Whether a given research project, clinical intervention, or commercial product is interpreted as a medical treatment, a form of prevention, or an elective “enhancement” directly influences its evaluation on a number of scales.
We are particularly interested in framing anti-aging interventions as prevention against late-life disease, since this interpretation appears to have unique ethical and policy implications, and illustrates issues that “personalized genomic medicine” will have to face in many other areas as well, given its emphasis on risk detection and prevention.
The interpretation given to a particular effort to control aging is a rhetoricaldecision. Almost all of the strategies, practices, or products that we define below as “anti-aging interventions” could be conceptualized as treatment, enhancement, or prevention. Rhetorical decisions, however, have practical consequences—i.e., they can change the way things get done in the real world.
The fact that all three of these interpretations are used by both sides in debates over the value, morality, or promise of different anti-aging interventions suggests that each interpretation has multiple practical implications that can affect the interpretation’s rhetorical utility differently in different circumstances.
The overall goal of this project is to better understand those implications. The project is based on the belief that definitions matter in sound science policy development and ethical analysis, and that clarifying the practical consequences of different accounts of what it means to “control human aging” can help all concerned steer science and clinical practice more responsibly into the future. Understanding those consequences means, in turn, pursuing both empirical and analytic research aims in an integrated fashion.
Specific Aims
|
To describe and document the interpretations that both professionals and consumers give to efforts to control human aging in three settings, with an eye towards uncovering the social, commercial, political, and ethical considerations that influence those choices.
A. Anti-aging researchers and physicians who describe their specialty as “anti-aging medicine.”
B. Providers of dietary supplements that are marketed for their “anti-aging” effects and consumers of these products.
C. Investigators and human subjects involved in the NIA-sponsored CALERIE trials of caloric restriction in humans at Tufts University.
The purpose of this study is to test and explore our observation that the interpretations that people give to efforts to control human aging influence the ways they use these interventions and how they think about aging more generally, and vice-versa. By moving beyond the literature in which we have observed this rhetoric out into the variegated world of people becoming involved in aging control efforts, we can learn about the origins and impact of these perspectives in practice.
To describe and document the interpretations given to anti-aging interventions by scientists and scholars involved in debating the moral and social merits of attempting to control aging, and analyze their ethical implications.
Using traditional philosophical, legal, and social scientific methods of critical textual analysis as well as correspondence and conversations with protagonists, we will examine the rhetoric and arguments of three overlapping camps in these debates:
- “Life cycle traditionalists,” like Leon Kass and Francis Fukyama, who oppose most attempts to control the human aging process;
- “Prolongevists,” like John Harris and Aubrey deGrey, who celebrate most attempts to control human aging;
- “Meliorists,” like Christine Overall and Richard Miller, who endorse anti-aging research, but primarily as a means to human goods other than rejuvenation and longevity.
The goal of this analysis will be to assess the rhetorical and evaluative role that the interpretive frames we have identified play in the explicit efforts these commentators make to advance their own positions and undermine the others, with particular attention to the uses to which the concept of “prevention” is put across the three camps.
To use our empirical findings and ethical analyses to compare and analyze the social and public policy implications of the different interpretations given to anti-aging research, with particular attention to the “prevention” interpretation..
- Using the analytic methods of qualitative political science, medical sociology, and jurisprudence, we will draw out the implications of interpreting different efforts to control human aging as ways to prevent late-life disease as opposed to either medical treatments or elective enhancements for a series of five social policy issues:
- The extent of public regulatory oversight appropriate for anti-aging interventions.
- The challenge of designing responsible and feasible studies to evaluate proposed anti-aging interventions.
- The risk of “off-label” uses of anti-aging interventions in the face of current approval policies
- The level of public access to and insurance coverage for anti-aging interventions.
E. The degree to which anti-aging interventions should be identified and deployed as public health tools.
The purpose of this part of the project is to articulate the concrete lessons of the first two aims for policy-makers at two levels of resolution: those charged with steering the course of American scientific efforts to control aging specifically, and those planning for the advent of personalized genomic medicine more generally.
|
|
