Issue 19 / 23 May 2016

“We’ll be able to play tennis with our great-grandkids. People won’t spend the last years of their lives in nursing homes; they’ll be able to be productive members of society right up to the end.”
    – Dr David Sinclair quoted in McMahon B. The new ageless. Weekend Australian Magazine 2015; 31 Jan: 13 

RECENTLY I heard of a very eminent doctor who said that he did not need to prepare for dying because modern technology would soon be able to stop him dying until he was over 150. Pending the results of safety and efficacy drug trials, this seems unlikely.

However, it is appropriate to take just a few minutes to ponder the issue. It is immediately clear that there would be some very complex individual and communal repercussions – think social ecology – from a further doubling of the human life span.

With life expectancy in the developed and affluent world currently at about 80 years, and a generation time of 30 years, about 3.5 generations are alive at any one time. In other words, most newborns have parents and grandparents, and many also have great-grandparents. With a generation time of 20 years, a newborn may also have a great-great-grandparent.

If, hypothetically, we extended our life expectancy to 150 years and maintained a generation time of 30 years, a newborn would also have great-great- and great-great-great-grandparents. If the generation time was 20 years it would be great-great-great-great-great-great-grandparents, and all stops in between to a total of 504 individuals.

Until about 200 years ago we lived with high infant and childhood mortality, a life expectancy of about 65 if you had survived to the age of 10, and fewer elderly people.

This was the demographic reality within which our various cultures evolved. Community structure and values supported and were supported by small numbers of the elderly who were the repository of knowledge and accumulated wisdom. When the elderly (or anyone else) got sick they died quite quickly.

This holds true today for the few remaining hunter-gatherer communities and for communal mammals, such as killer whales and elephants. The vast bulk of the increase in life expectancy has been achieved by avoiding death in childhood. Any significant future gains will have to come from delaying death in the elderly.

So what would happen if we were to extend our life span to 150 years?

First, even if everyone (recognising that distributive justice would require access for all) remained healthy and active to 150 and then all rapidly died without prolonged morbidity, it would not be cultural business as usual; we would be creating a novel cultural challenge of great complexity.

Without stringent controls on reproduction, doubling the average life span means doubling the population – think pharmacokinetics. If a living population is suddenly extended to eight, or even just six, generations living concurrently, quite some time would be necessary for a new steady state to develop.

In the short term, the world would become grossly overcrowded with even greater environmental repercussions, unless most young adults were stopped from having any children. They might object, and we would have to sacrifice our successors.

The new retirement age would be about 140 because the small minority within what we now consider to be the normal working-age group would not be willing or able to support their older relatives for 80 years.

Our longer lives would soon generate a surfeit of mature adults pottering around looking for meaning and something to do. There would be too few (if any) children to satisfy the doting instinct of their vast numbers of parents, grandparents, great-grandparents, and so on to great-great-great-great-great-great-grandparents.

The young would come to resent the elderly who blocked access to their future by occupying jobs and positions of authority, denied the “right” to reproduction, further degraded the environment and demanded that they play tennis.

I do not think that our evolved biology and culture, not to mention the economy, could deal with that level of challenge. As with all complex systems under severe stress, it is really just not possible to predict the outcome.

Of course, all this talk about living for 150 years is a self-indulgent distraction from the urgency of the challenges that we face. As we run into the wall that is our individual maximum life expectancy, we are expending large quantities of resources in an effort to squeeze a few drops out of the end of a life.
There is no dignity in the futile pursuit of time for its own sake and without consideration of quality. Our long-term biological interests are fulfilled by improving the future for our offspring, not by hoarding resources for ourselves.

Perhaps we can learn from the equanimity about death that we see in some of our dying patients to help our community to rediscover the universality of death and integrate that reality into the ways we lead our lives and experience our dying.

I think that my great-great-great-great-grandchild may have better things to do than play tennis with me, and anyway I may not be able to get time off work.

Associate Professor Will Cairns is a palliative medicine specialist in Townsville and author of the eBook Death rules: how death shapes life on Earth, and what it means for us.

5 thoughts on “Rediscovering the universality of death

  1. CKN Queensland Health says:

    Dying is like getting audited by the tax office–something that only happens to other people … until it happens to you.
    All of us will die, better die when you have fulfilled the chores you were sent to the world for, make space for the younger people,try an have a good and fruitful life spreading love and peace. To be a physician is good, we can truly and really help people.
    My only one question is – do we know what happens after death? or we truly become dust lost in the universe?

  2. Ian Maddocks says:

    Well done, Will. It can only be within the sequestered privilege of a country like Australia that such expressions of healthy extended life find a place. It is a fantasy looking inwards at a society so different from the rest of the world where disorder, disease and dying mark every day existence. Like you, many encounters with the death of others through work in palliative care has madam curious about end of life – for our society and for myself. If I am offered any choice, shall I be ready to embrace death as and when it presents for my consideration? I hope that I shall be able to take full awareness of its approaching realities – what disease, what frailties and discomforts it presents, and allow myself to avoid much of the possible options for treatment that medicine, and, I may guess, my family will propose for me. I hope to retain a sense of gratitude for life already lived, an awe and thankfulness for the universe and the human beings with whom I have shared this small space of time, but then a willingness to let be. I rejoice in Robert Louis Stevenson’s epitaph: Glad did I live, and gladly die And I lay me down with a will.

  3. Carolynne Bourne says:

    As humans, we each grow upon the earth and create our own unique mark on the lives that surround us and the environment in which we live.

    We age, grow frail and may loose neuronal capacity and become dependent upon those with whom we live, on families and on society.

    In days long ago, when one could no longer provide for oneself through injury, illness or age, one could not survive – we were abandoned.

    A time came when human life was highly valued. Humans began to empathise, to put aside self-interest, to love and to care.

    The roots of humanity grew and flourished … but what of us now!

    Statements such as “Our long-term biological interests are fulfilled by improving the future for our offspring, not by hoarding resources for ourselves” diminishes us all – whatever our age, ethnicity, language, religion, gender, health and socio-economic status we are equal – it is this that site at the core of humanity and civil liberty.

     

  4. Michiko Parnell says:

    Carolyne (comment) has touched on a relevent point. Love and care. Some lives are highly valued, but not by all. One advantage I would get from extending life would be to continue to provide care for my dependent disabled child that is much loved.  It’s hard to think about dying when someone so vulnerable is left behind to the reality of low-paid carers, shift workers, and no real relationships with anyone, and possible high rates of mental and physical abuse in institutioalised care,being female she is much at risk, and no one who truly loves her like her mum and dad.  Just to live long enough till she passes, and continue to be able to love her and ensure she is well cared for, is all I ask. ‘glad I live, but not glady I die… who will love my child?’ I worked out to ensure her love and care for her entire natural assumed lifespan, because I had her when I should have known better,  I would need to live to be about 120 but still  have my cognition intact!

  5. Ian Maddocks says:

    Dear anon, you have the best of all possible reasons to look to a long life, and I thank you for reminding me that each of us faces a personal situation which cannot be understood through generalisation. Stay well, so that you and your child may continue in the love which is so important for both of you.
    Ian

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