Short Essays on Life and Death
Table of Contents
- 1. Articulating the entitlement to life
- 2. The natural order
- 3. Practical consequences
- 3.1. Undoing status quo bias
- 3.2. Who gets treatment? (I)
- 3.3. Who gets treatment? (II)
- 3.4. Comorbidity is the tiebreaker
- 3.5. It is easier to cure death than sickness
- 3.6. Overpopulation and other costs
- 3.7. Brevitality: a modest proposal
- 3.8. Sic semper tyrannis
- 3.9. The libertarian cold shoulder
- 3.10. Debauched immortals
- 4. The life ethos
- 5. Related reading
1 Articulating the entitlement to life
“To counter the problems that we face, we have to see individual freedom as a social commitment.”
—Amartya Sen, Development as Freedom.
1.1 The entitlement to life
As responsible persons, we are in charge of our own lives. Our flourishing takes root in our ability to exercise control over our own lives: choosing how to express ourselves, and where we live, and what we do, and what we believe is right — without being oppressed or coerced.
The choice to die is (too rarely) acknowledged as an important part of this freedom: our lives are our own, and we alone are entitled to end them. Even more rare — virtually nonexistent — is an acknowledgement of our choice to live. No society today recognizes an unqualified entitlement to life—acknowledging death as unjust whenever it is at odds with a person's will—although certainly many societies are beginning to recognize an entitlement the basic essentials of life such as healthcare. I believe that these freedoms all stem from a fundamental axiom about human lives:
We, as persons, are entitled to a full and flourishing life, to choose when and in what ways we grow old, and to choose how and when we die.
1.2 Newly-enabled rights
It may be that for most of human history, there was no way to supply all of humanity with a decent standard of living — adequate food, water, shelter, education, clothing, and so on. For example, the logistical problem of supplying the whole world with adequate food is daunting even in our modern world — although perhaps the technology and infrastructure for doing so has already, or will soon be, created.
While we acknowledge that people are entitled to certain basic essentials, we have not always been empowered to enforce those entitlements: sometimes, it is a matter of waiting or struggling until the requisite technology and/or infrastructure is in place.
Similarly, I believe that our nature as persons entitles us to live a healthy life for as long as we choose. Without a doubt, this ideal has been unthinkable for most of human history, and will be out of reach for years to come — although there are a few small reasons to be optimistic.
But to say that outright that this entitlement is an unfathomable luxury or an unrealizable utopian dream is to forget that sometimes new technology brings new possibilities. Sometimes progress unearths the potential for unprecedented justice.
1.3 AmorTality: a third alternative
In line with the libertarian tradition, I believe that a proper respect for human existence requires impartiality regarding individuals' lifespan choices. Just as we respect choices of expression, lifestyle, and conscience as the right of an individual to decide, we should respect and uphold the right of individuals to choose how long they live. Governmental systems should be impartial with respect to whether individuals choose to die, to live for a particular length of time, or to live without any end in mind. I've coined the term amortality for this neutrality principle. The analogy is with terms like "amoral" in ethics, which describes indifference towards moral principles — in contrast with the polarized terms moral and immoral.
Amortality occupies the neutral zone between favoring mortality and favoring immortality; it is the principle of allowing individuals to decide their healthy lifespan for themselves.
1.4 Social commitments we can all accept
As a community, even when we differ in our individual opinions, we can support the basic foundations of society that empower us and give us a wide berth to make our own life choices 1 . Thus, for example, we uphold the value of freedom of expression, even when we disagree with what someone is saying. (As Evelyn Hall said, "I disapprove of what you say, but I will defend to the death your right to say it".)
The right to live on one's own terms is a similar right, and we should all defend it regardless of the choices we've made for ourselves in the matter: All people — the person who chooses not to be given CPR after a heart-attack, the person who arranges to be kept on life-support, the person who intends to live for the forseeable future, and the person who wants to die in a way they deem "natural" — can be united in supporting and protecting the right of individuals to choose for themselves how they will live and die.
1.5 Both health and longevity
To have a society which upholds the entitlement to life, we must advance our capacity for both health and longevity. Longevity is beneficial, but longevity alone is not enough, as we can see in the way people nowadays live lives of protracted and undignified senescence2. Health is beneficial, but health alone is not enough, either: health goes only far enough to ensure that you are free of pain and disability for the duration of your life, however short it may be3.
We must therefore strive for both: health, for being capable throughout our lives, and longevity, for having lives that are long enough for us to conduct our life's projects.
1.6 Wellness is only a means to an end
Health and longevity together are required for soundness in body. Yet ultimately, we want soundness in body not for its own sake, but so that we can exercise our capacity for a flourishing, fulfilling life. Thus, as we look for ways to enable individuals to live as they like, we must simultaneously look for ways to empower them to thrive.
This raises a second point: although bringing about the entitlement to life would represent a revolutionary triumph of humanitarian and technological innovation, it addresses nothing more than our most basic human needs: a commitment to alleviating suffering, to promoting choice, and to protecting our welfare as human beings. Only as we protect these fundamentals of survival can we turn our sights towards thriving.
1.7 Asking for more life
On the one hand, we want to face the problems in our life with dignity. We all face challenges, and while we aren't always in control of what problems befall us, we can at least take control of how we respond to them. In such cases, we hope to hope to have the strength to meet our problems with grace.
Perhaps it is with this mindset that many of us instinctively reject the idea of doing something about our own mortal fragility: we know we must face aging and death eventually, but struggling to live — fighting to retain our diminishing capabilities — seems like too hysterical and undignified an end. 4 We might as well make the best of what we've got while we can.
On the other hand, when we look beyond our own predicaments to the suffering of others, basic human compassion often compels us to do something about it — to ask how we might do better than the generations before us, and to ask what we might do personally to help. It is in this spirit of alleviating the pandemic suffering and indignity of old age, disability, and death that the entitlement to life takes place.
Thus, while you may find it egotistical to fight for your own longer and healthier life, personal enrichment is not the point of the entitlement to life. Instead, it flows from the aspiration to advance the welfare and dignity of all.
1.8 The freedom to die
In these essays, I advocate for a movement to pursue technological and social change that will promote both life and unprecedented capability in one's life choices. However, I do not strive to engineer a society of obligate immortals who are incapable of dying. On the contrary, my goal is to secure the freedom of individuals to choose for themselves exactly how long they would like to live. In particular, the entitlement to life has two parts: individuals must be protected from dying against their will, and they must be protected from living against their will. The inhumanity of living against one's will has been argued cogently elsewhere (e.g. in the death with dignity movement; see Thomas Szasz's concise book Suicide Prohibition, for example), and so here I will only declare my agreement.
I consider lifespan to be a matter of personal choice, fundamentally tied to one's own values and self-determination. A person's rights and dignity can be compromised just as much when that person is forced to live against their will as when they are forced to die against their will. Both transgressions violate the sovereignty over one's own life to which each person is rightfully entitled5.
1.9 More than health care
Part of the entitlement to life calls for the active pursuit of more effective, compassionate, and accessible healthcare. But a well-executed universal health-care system is only a small part of the mission:
- Heath care remains technologically incomplete even if everyone has access to it; for the foreseeable future, there will be some conditions we cannot cure. We should therefore seek alternatives to incremental treatment.
- Health care is often palliaive, aimed at restoring a baseline of human functioning. We should work directly to extend the limits of healthy human lifespans.
- It takes more than health care to keep individuals alive. We should address other threats to life as well, such as homicide, famine, environmental disasters, accidents, and unjust social environments.
- The entitlement protects not only individuals' right to live, but also their right to die. We should establish laws and practices that protect both.
- Finally, even when we address all of the above issues, we will only have gained survival — whereas there is more to a flourishing life than simply staying alive.
2 The natural order
"Nature is not that way and never has been. So it calls, in a very general way, for the gradual supplanting of the natural by the just."
—Martha Nussbaum, Frontiers of Justice
2.1 Preordained death
Isn't natural death the most timely end of life? Aren't all attempts to tamper with it self-destructive? The claim is that to die before your natural end is to cut life short, and to live beyond your natural end is to stretch life too thin.
One reply is that if our lives do have natural ends, we can only guess when they will be: many of us become endangered repeatedly throughout our lives, and caught in the moment, we cannot tell whether this is our natural end, or whether we are called to struggle and overcome it. Mortal peril confronts us with a question, not an answer. The question of whether you have a natural expiration date is superceded by the question of how you would tell the difference between an expiration date and a challenge you ought to survive.
A related reply is to point out that timely death is a matter of plot, not biology. We humans are inveterate storytellers: we package the jumbled events of our lives as narratives, marking them as successful, lucky, regressive, untimely — in other words, as events in a larger story. Deaths can be watershed moments in our lives and turning points in our stories, but some deaths — the unexpected, the painful, the unfair — strain our ability to find a narrative that will contain them. We believe in endings that make sense, in endings that crown the lives they conclude.
As complex living mechanisms, we can be broken, and we wear out over time. But we are not stamped with expiration dates which make it easy to decide when we are supposed to die; instead, deciding when we ought to die forms a part of our incessant self-authoring nature — finding if, and when, to frame an ending. The entitlement to life highlights this deliberative process as an essential part of being human.
2.2 The right time to die
There is only one right time to die, namely when you're ready. We do not always get to choose when we die, but each of us is the only one who can mark an imminent occasion as "the right time to die" — you decide whether the time is right or too soon or too late.
Imagine we have discovered how to innoculate children against senility: by default, people will remain indefinitely healthy and vigorous. Under these circumstances, you can't depend on eventually succumbing to pain or indignity to make dying easy and automatic — so when would be the right occasion for death?
I imagine people would choose to die when, for example, they felt that they had finished all of their projects. The empowering choice to end one's life on one's own terms alone is a paradigmatic exercise of the entitlement to life, and a standard against which we should measure our current levels of empowerment and choice.
With today's less-ideal circumstances, people manage their life and death to a much smaller extent — yet still they do manage it. For example, I know that many elderly individuals who choose to die are making the best choice they have available, but I'm troubled when I wonder whether they would make the same choice if society were better equipped to help them flourish. I wonder whether they are making the choice because it is a perfect expression of their own will, or whether our incapacity to give them a pain-free, healthy, and dignified existence is to blame.
2.3 Premature death
The term "premature death" slips easily off the tongue, and equally easily into our picture of the world: A teenager who is killed in an automobile accident dies prematurely. A nonogenarian who dies of organ failure does not die prematurely. (And I don't know whether people would apply the term to individuals such as Thomas Szasz, who chose to kill himself at ninety-two years old.)
In this typical conception, premature death is wrong and mostly preventable by social programs: safety regulations, satisfaction of basic human needs, medical care, police protection, and so on. In contrast, non-premature death is deemed appropriate and perhaps unavoidable.
But we should question the basis on which we make those kinds of judgements. What could be the line between premature death and non-premature death? From a medical perspective, is there a particular age after which medical problems become unsolvable in principle? More strongly, is there an age after which we should automatically presume that medical intervention is hopeless? From an ethical perspective, is there an age at which an individual switches from one category of personhood to another — an age after which the individual's specialness evaporates? Or perhaps it's a more gradual process: perhaps people and their rights depreciate over time. I don't think so, for people have rights by virtue of being people — and becoming older does not by itself interfere with personhood6.
2.4 Death as society's hygiene
You may be one of the people who believes that death serves a particularly important social function, namely getting rid of obsolete ideas and — some people are heartless enough to say — obsolete people. According to this cool logic, death is perfectly sensible: it's unfortunate that people must die, but of course death is the only means by which society can progress. If it were not so, society would stagnate under the weight of countless outdated doctrines.
But even if death can provide some artistic or intellectual stimulation, humans possess certain rights that must not be violated. Here, the constraint is that we must protect individuals' freedom to die as they wish. No argument for death in the abstract seems able to justify the singular violations of liberty entailed by having people die when they don't want to. Control over one's life is a sacrosanct liberty in the same league as the entitlement to vote, or freedom of conscience, or freedom of expression. Once, I described the situation to a friend as follows: If you would take away elderly individuals' entitlement to life in the name of purging society, why not take away other liberties as well? If you take away the right to vote from the elderly, then they cannot exert their outdated will on society, and if you take away their freedom of speech, they cannot pollute society with their outdated ideas. He thought the idea sounded fantastic.
(Also see: Sic semper tyrannis in the following section.)
2.5 Progeria
I can think of a few reasons why the gradual breakdown of our bodies is not considered a disease.
- Aging doesn't seem like a deviation from the norm, because it's ubiquitous. (Some even take this ubiquity as a sign that aging is "good" or at least a "natural" phenomenon — as if other diseases weren't natural.)
- Aging is an endogenous disorder: it appears to come from within, rather than from any external agent like a virus. In this sense, it is more like a genetic disease or an autoimmune disease than like influenza.
- Aging happens gradually, due to a variety of causes. There's no one single culprit, and the symptoms accumulate slowly over time. (In this sense, it is more like cancer than tuberculosis.)
- When older people are treated as a less-valuable social class, their characteristic problems are deemed less important.
Consider how strange it is that progerioid syndromes, which cause the symptoms of old age in children, are labeled as obvious diseases — yet when those same debilitating symptoms appear in older individuals, they are considered appropriate or inarguable7.
We might ask an evolutionary biologist: Why do our bodies break down as we age? Why don't we simply remain healthy indefinitely? It's not that remaining healthy indefinitely is biologically impossible — certain species of jellyfish and lobster apparently do so, for example. But in the case of humans, we age simply because natural selection did not favor fixing the problems that occur after we are old enough to reproduce.
The passage of time is inevitable, but aging is an accident — and an injustice. We have good reason to classify senesence as a disease, and we ought to. Aging is a debilitating biological condition which can be treated — and we ought to make it a societal priority. Imagine how many lives it would improve, and imagine how many individuals it would enable to flourish.
2.6 Is natural good?
Are natural things good? In one sense, the answer is always yes — because we use the word "natural" to talk about old ways of doing things that we consider beneficial!
Consider people who are understandably worried that large corporations will genetically modify food so as to maximize profits, without taking human health and safety into account. People who worry in this way tend to seek out foods that are more natural — that is to say, foods which have the presumed advantages of an older system.
Or consider people who are understandably worried about the indignity with which some people die in hospitals — a lengthy degeneration into helplessness, enmeshed in life-support systems and painkiller drips. Some of those people prefer the advantages of an earlier, less-medicalized system; they seek a more natural death.
But let us not forget the other definition of natural, which consists of the whole of existence — everything that evolution and culture has produced up to the present moment. The category of natural things includes water and plastic, anthills and skyscrapers. In particular, the category of natural things includes things which are beneficial for humanity, and things that are harmful: lettuce is natural, but so is hemlock; vitamin C is natural, but so are viruses. Sharks, nerve gas, nuclear weapons, plague and illiteracy — all of these are denizens of the natural world. Not everything that is natural in this sense is good, so whenever someone asks if something is good because it is natural, we must evaluate the answer on a case-by-case basis.
2.7 Our evolutionary heritage
You might argue that death is inviolable because we humans are built to age and die. It's true we are built that way. If instead we had evolved to be biologically immortal, presumably you would reverse your claim, saying that life is inviolable because we are built to continue living.
Yet if you believe that death is good not because of its nature but because it is somehow part of our heritage, then you must explain how nature contrived to produce a heritage which is worth preserving. Natural selection has no inbuilt guarantee of justice or a fair status quo — far from it.
2.8 The fairness of death
Death is fair in the sense that it excludes no one. But is it just? You can imagine, by analogy with the freedom of speech, a society in which no one is allowed to express their opinions publicly. Such a system would be fair — it would apply to everyone equally — but would be arguably unjust because it violates our right to freedom of expression, without which we lack our full capacity for human dignity.
Some people would not mind living in such a society, as they would feel like they have nothing of value to say. Others would mind, but consider it to be vain and presumptuous to complain. ("Why should I fight for my right to speak, when no one else has it either?") A better reaction than both of these, I think, would be to recognize that regardless of whether you would make use of the right yourself, and regardless of whether you consider your own use to be important, everyone deserves the freedom to express themselves. A good principle is to oppose such an unjust system on everyone's behalf.
The same argument holds for the entitlement to life. Death excludes no one8, but unwanted death is unjust for everyone. We should work to oppose unwanted death, not because we consider our own lives to be deserving of special exceptional treatment, but rather because all people deserve ownership of their lives.
3 Practical consequences
3.1 Undoing status quo bias
I believe that people are, as a rule, entitled to live for exactly as long as they want to. Perhaps you think that this goal is unobtainable. But in this essay, I want to speak to you if you believe this goal is undesirable.9
Imagine a world in which the entitlement to life has been attained: society protects and promotes the right of all individuals to live for exactly as long as they wish. In detail, no one is felled by diseases, or accidents, or homicide, or old age. Instead, each person lives in indefinite perfect health. The citizens of this world are not obligate immortals — prohibited from dying; instead, they are simply in control of their own lifespans. Let's call this world the amortal society.
If you belonged to such a civilization, would you consider life there to be so unpleasant and pernicious that you would fight to return society to the state it's in today, where people everywhere die due to sickness, accidents, and old age? Would you campaign to re-introduce unwanted and random death into the world?
Perhaps you would. (Or maybe you can think of a third alternative — different from both our current society and the amortal society I describe — which you would like better still.)
But if you wouldn't — ask why. You don't want our world to become more like the amortal society, but you also don't want the amortal society to become more like our own. Perhaps the result is just status quo bias: our innate comfort with and preference for whichever way things currently are.
3.2 Who gets treatment? (I)
Suppose two people are taken to a hospital with the same imminently fatal condition. The hospital only has one dose of the cure, and it won't be possible to acquire another dose in time to save both lives. How should you administer treatment?
Here's a tie-breaking rule you might suggest: if one of the patients is seventy years old and the other is twelve years old, administer the dose to the twelve-year-old. Why might this be a good rule?
One explanation is that the older person has already "lived a full life" and that the young person has not; the young person still has only a lot of "potential" for a full life. This explanation treats life as a quantity which every person is owed in a standard amount, e.g. sixty years. Thus we should give higher priority to the young person, who has received much less than their full quota, over the elderly person who has nearly met (or exceeded) the full quota.
The problem appears when you ask where the quota comes from, and why it is just. Presumably you would derive the "lifespan quota" by looking at up-to-date lifespan statistics — to determine how long people ought to live, you need to know what's feasible. But lifespan statistics are not timeless principles of justice; they're socially contingent: for example, in many places and time periods, people counted themselves lucky to live past thirty years of age. In a few years' time, we may consider eighty years to be a pitifully short amount of time to live even a healthy life. Only the status quo blinds us to the arbitrariness of our expected lifespans today.
Principles of justice should be universal. A lifespan quota can only summarize the best we can do nowadays; it cannot set a standard for our aspirations. The fact that people on average live for (say) seventy years says everything about society today, and nothing about what people deserve by virtue of being people.
3.3 Who gets treatment? (II)
We can try to decide who should get treatment without relying on the problematic "lifetime quota" principle. Here are some alternatives.
- Standardize life experience
- We could replace a quota of time with a quota of experience: you are owed — or the medical system tries to maintain — a standard quota of life experience. The idea is that you're not owed a life of a particular size, but instead a life that has been filled with the essential contents of a good life. Although an experiential quota has some merits, it retains the same flaw as the lifetime-quota: how do you decide what experiences a person should be given enough time to have? (It also suggests conclusions that some may find counterintuitive: given a choice, should we save the life of to an old person who has lived a long oppressed life devoid of essential experience, rather than saving the life of a prolific and worldly-wise young adult who has attained many important milestones?)
- Prefer big contributors
- We could preferentially treat people who have more to offer society. But human rights arise from human nature — from who we are and what we need to flourish, not what we can pay in return. Certainly we do not limit freedom of speech based on whether or not individuals have something of value to say, and we do not limit the right to vote based on individual's willingness to become politically educated. This seems to be the right idea: human rights acknowledge people as intrisically valuable, entitled to the basic amenities of a flourishing life by virtue of being people, and independently of whether they are willing to trade labor for food, or more generally whether they are willing or able to add something of value to society in return.
- Let people depreciate
- We could discard the idea of quotas altogether, and simply say that the older you get, the less you are deserving of treatment. But why should older people be considered less valuable? — perhaps they're more valuable, because they've accumulated life experience and become more complex beings over time. (Given the choice, would you save the life of your newborn child over the life of your ten-year-old child because the ten-year-old, being older, has depreciated in value?) You might say that young people have more "potential"—but what does that say other than that younger people tend to survive longer than older people? You might say that older people contribute less to society — but our value as human beings, and our profound relations to one another, run deeper than economics10. Despite a prevailing societal bias, I find no reason to consider older people to be intrinsically less valuable or less deserving than younger people.
Many elderly people contract diseases such as senile dementia; such diseases rob us of our personhood and so may alter the sorts of freedoms and entitlements we have. But everyone who has the standard faculties of personhood has the same rights. The amount of time someone has lived is not an intrinsic aspect of their personhood or value.
3.4 Comorbidity is the tiebreaker
There is a way in which our moral principles may lead us to prefer saving younger individuals over elderly individuals, even if we do not believe that old people are less valuable or that young people have more potential.
When you have one dose of treatment and must decide which person to treat, you might adopt the rule where you treat people who will likely benefit the most: if the treatment will completely cure one individual and only incrementally help another, for example, you'll help the person who will be completely cured. We can call this the policy of marginal benefit.
You can see how age enters the picture now: most elderly people are not simply older; they are also more likely to have several medical problems at once. As a result of this trend, the policy of marginal benefit will tend to favor treating younger people over older people.
But this trend will not always be the case: the policy of marginal benefit would sometimes have you treat a ten-year-old over an infant if the infant had a host of other problems which would be difficult to cure. The policy would sometimes have you treat an elderly individual over a young person if the young person were nearly beyond saving, and the elderly person reasonably likely to recover. To be sure, these will be the exceptional cases rather than the rule, but it is important to note that the policy is not intrinsically ageist.
Here, age is just a proxy for comorbidity: the older you are, the more medical problems you are likely to have. Simply because of this trend, we will often preferentially treat young people over old people — yet we always grant all of them equal weight as persons.
3.5 It is easier to cure death than sickness
For the foreseeable future, we will have more diseases than cures. Over time, science makes great progress, to be sure, but all the while individuals run out of time: Imagine that you, or someone you care about, contracts a fatal disease. The prognosis is a few months on the outside, but a cure is at least ten years away. What can you possibly do?
Here's one extreme option: if you cool the body down to the temperature of liquid nitrogen, essentially all metabolic activity stops — diseases do not spread, cells do not replicate or die of oxygen loss, and so on. Not even molecules move very much at such cold temperatures. A mature cooling technology would be a general-purpose medical tool: you could buy time for any individual, almost regardless of their particular medical problem. Simply store the individual in stasis until whatever they need — a surgical specialist, a donated organ, a newly-invented cure — becomes available. Then, restore the individual to room temperature and administer treatment11.
Advances in medicine continually broaden the scope and effectiveness of what we can do. But these incremental improvements are not enough: there will still be patients who are out of time and cures that have not been invented yet. When I quip that it's easier to cure death than sickness, I mean that it is far more feasible to halt the dying process — to buy even large amounts of time for the people we can't treat — than to develop such sophisticated medical technology that there will be no untreatable people.
Cryopreservation is just one idea among many that illustrates the concept. We must start focusing on effective ways to help the people whom we don't know how to treat. After all, incremental progress may fix society's medical problems in the long run, but we must look for new ways to protect the individuals who need help now.
3.6 Overpopulation and other costs
One argument against the entitlement to life is that deliberately enabling people to live longer will exacerbate problems such as overpopulation.
I know that adopting the entitlement to life may be very difficult. It may entail tremendous costs and social upheaval. But the entitlement to life is just, and sometimes bringing about justice is costly. Consider how racial desegregation in the United States has been costly — and not just financially.
I also know that the entitlement to life is not the only virtue worthy of consideration. I simply maintain that it is worthy of being balanced against our highest ideals as a society because it is commensurate with them.
Finally, I note in passing that concerns about overpopulation don't seem in any way to curtail our enthusiasm for police protection against "untimely" death, or for new medical treatments of all kinds.
3.7 Brevitality: a modest proposal
Perhaps we still should abandon the entitlement to life because population growth will be an inevitable and insurmountable consequence. Indeed, if everyone is allowed to choose how long they live, then many will undoubtably choose to live longer. As a result, population growth will spiral out of control, and the world will quickly run out of resources.
We could try to control population growth without interfering with the entitlement to life—for example, through birth control, improved agricultural efficiency, or even colonization of other planets. But these stopgap measures will only postpone the problem, not solve it. Thus we are left with a difficult, but unavoidable, conclusion: without a stable way to support individuals' choice of lifespan, we must actively mandate how long they may live. Once acknowledged, this conclusion raises a host of related issues: how long of a lifespan should we allow? On what factors does the ideal lifespan depend? And have we even now already begun to exceed the ideal?
Crudely put, there are two possible answers: either the present average lifespan is ideal for controlling population growth, or it isn't. Certainly the average lifespan isn't ideal everywhere, because mortality rates are highly location-dependent. Therefore, at least in some places, the average lifespan is too high.
To solve this problem, I propose we engineer humans who live for shorter amounts of time. I call this the brevitality approach to population growth. It would be highly effective at curbing population growth (never mind how reproduction rates factor in) — and it wouldn't even be unethical, especially compared to the suffering and death entailed by idly allowing population growth to continue unchecked. After all, the brevitality approach only affects the people who are genetically selected in this way — and those people aren't worse off due to the procedure because without it, they wouldn't have existed at all! In fact, we may discover that by restricting the amount of time they live, we may be able to trade off for greater health throughout their abbreviated lives; other things being equal, they would certainly require less medical expenditure, and so society would have the surplus resources to treat everyone more effectively. Short and sweet lives harm no one and stand to increase benefits for everyone.
As for how this procedure will be implemented, I expect most intellectuals will appreciate the logic and effectiveness of the brevitality movement, and will accordingly arrange for their own children to be genetically modified in utero. However, if not enough people elect to do so, then perhaps governments can offer financial incentives in exchange — or disincentives12.
3.8 Sic semper tyrannis
Isn't it important that wicked people die? Even if it's too extreme to consider death as society's hygiene, isn't it at least beneficial that the wicked and the power-hungry won't last forever? Wouldn't it be nightmarish if the worst oppressors in history were allowed to live indefinitely — and isn't that just what the entitlement to life might ensure?
To be sure, the death of tyrants has often been beneficial. But universal, random, unwanted death seems to be a steep cost for society to pay for this benefit (after all, we lose heroes just as much as we lose villains; every criminal, but every last innocent person too); perhaps we can find another solution. It is unimaginative to assume that our only choices are between "a way of life, health, aging, and death exactly as it is today" and "eternal tyranny".
What's more, the entitlement to life is a fundamental human right, alongside others such as freedom of expression and freedom of movement. In modern society, we protect these freedoms for everyone — with certain exceptions. In the United States, the government does not protect speech that incites violence, and it prohibits freedom of movement for people in prison. The principle is that entitlements should be made available to all, while potentially allowing exceptions for extreme cases such as tyrants.
It would be strange if instead of protecting freedom of speech, we said "let no one speak, lest someone rally an angry mob." Similarly, we shouldn't say "let everyone die at random and let the state of health care stay as it is, lest tyrants live too long."
3.9 The libertarian cold shoulder
Surely the entitlement to life puts too much weight on individual autonomy: If individuals must not die unless they wish to, then many timid individuals may go on living (even miserably) simply because change and choice are difficult—and we will be forbidden from interfering. Similarly, if individuals must die according to their wishes, then many impulsive, wayward, or demented individuals will kill themselves—and we will be forbidden from interfering here, too. By respecting the autonomy of individuals without limit, we risk causing much human suffering.
Indeed, we may decide that this is a problem worth fixing. Collectively, we should carefully consider the consequences of so much autonomy. We may work toward implementing the entitlement to life while simultaneously choosing to limit its scope for practical or humanitarian reasons, in the same way that some societies choose to exclude hate speech from protected forms of expression.
3.10 Debauched immortals
If we enable individuals to live as long as they like, won't the world become overrun with self-absorbed hedonists who are so saturated with life that they don't care about it — or each other — anymore?
To this worry, I would like to point out that, as far as I can tell, the people I know do not live as if they could die at any moment. Too often, we procrastinate and behave rashly and fail to take advantage of each moment. These are not the actions of individuals who mindfully acknowledge their own fragility.
Certainly I recognize that people do take reasonable precautions to avoid bodily harm and do factor in death into their long-distant future plans. Likewise, I don't expect individuals to live their lives in chronic mortal panic. But still most people behave as if the universe owes them sixty or seventy or eighty years of life, and that nothing will intervene in the meantime. Statistically, this is a reasonable assumption for certain demographics. Allegorically, however: if you want to see how people live when they're confident they'll live as long as they like, just look around you.
It is not inevitable that we'll eventually bring about the entitlement to life. Such a change will require a tremendous social push, born of unprecedented mindfulness and respect for human life. Although I'm not certain of it, I strongly suspect that by deliberately weaving respect for human life into the fabric of civilization, we will create a society in which we cherish each other's lives even more than we do today — not less.
4 The life ethos
4.1 Hard-line opposition
It's difficult, I believe, to directly oppose the entitlement to life as a principle. I wonder if anyone believes, for example, that the precise ways in which humans die now are so essential to human flourishing that regardless of whether individuals disagree with it or would choose otherwise, we must enforce it.
4.2 Control freaks
I aim not to eliminate death, but to restore each instance to its rightful owner. In earlier essays, I argued that this aim is not an ill-advised assault on the natural order. Here, let me address a slightly different disagreement about the value of "letting go".
Control is a delicate psychological matter: we feel most fulfilled when we are in control of our own lives, but our quality of life can suffer if we attempt to micromanage every aspect of our existence or rearrange our lives to avoid every possible danger.
You may worry, then, that the entitlement to life is a disease — or a vector for a disease: Perhaps the people who support the entitlement to life are sabotaging their potential for a happy life by focusing their energies on avoiding death on one hand and enabling autohomicide on the other. Or perhaps as we begin to attain the entitlement to life, society itself will become gripped with this paranoia about living and dying; we will live colorless, isolated lives due to our unwillingness or incapacity to surrender to vulnerability and chance. This cautionary tale carries familiar overtones about how obsession with survival precludes the possibility of thriving, and how hasty technological enthusiasm leads to ruin.
But these stories are just guidelines. It is not clear that attaining the freedom to live and die would be paralyzing in this way — and it is even less clear that the solution is to allow people to continue to live and die exactly the way they do today. As with any humanitarian project, progress with the entitlement to life entails a frank acknowledgement of continual widespread human suffering and injustice. I would gladly shoulder the psychological burden of acknowledging human suffering in exchange for the opportunity to change it.
4.3 Beautiful fragility
Some people say that our vulnerability — and in particular our mortality — is part of the beauty of life. It is through our vulnerability that care, compassion, and goodwill become meaningful. Our social bonds are catalyzed by the possibility of being hurt, of becoming incapacitated, of dying. We treat our time and each other as precious because time is fleeting.
Let me start by acknowledging that much of our existence does have this ephemeral fragile beauty: think of children attending school for the first time, for example, or the end of an unforgettable summer vacation, or an act of kindness from a stranger on a train, or a singular heart-to-heart with a close friend. But to this list of beautiful things, should we also add watching our parents deteriorate and die? Should we include sickness and starvation, child mortality and fatal accidents? Are these beautiful things, without which our lives would be incomplete? Do we need all of them to have a truly beautiful life, well-spent days, and deep, close connections with others? Are we constitutionally incapable of appreciating life's moments without bloodshed?
To a few, death seems unaccountably romantic in the abstract. But unwanted death is ugly in its particulars.
4.4 Obsolescence
Some people worry that they will outlive their capacity for joy. They worry that, given more time to live, they will run out of fulfilling projects, or find life bland and repetitive, or lose touch with society, or find that they have nothing to contribute and that no one wants what they have to offer.
These are not the problems of age, but the challenges of living. Part of life's task is finding a community where you belong, a way of life which brings you satisfaction, and a means of interacting in mutual reciprocity with others. At all ages, people stumble in this task—not because they are worthless or used up, but because they do not yet see with hope, enthusiasm, and curiosity.
The truth is that you have a singular valuable presence in this world, that the universe is more grand and full of possibilities than can ever be exhausted, and that tomorrow is filled with an ever-growing menu of things you might learn, or become, or do. The entitlement to life secures your capacity to flourish in this way by protecting your health and by promoting your continued ability to self-actualize as part of your life's mission.
4.5 Memoirs of an oracle
How much do we lose when a person dies? Imagine that an oracle has passed away, leaving behind a record of all of their judgements made in life. Some will think of the many small ways in which a person's influence will persist even after death: through their children, for example, or through the people who remember them, their contributions in life, or their timeless connection with nature. Consider the sentiment expressed by the following well-known poem13, for example:
Do not stand at my grave and weep.
I am not there. I do not sleep.
I am a thousand winds that blow.
I am the diamond glints on snow.
I am the sunlight on ripened grain.
I am the gentle autumn rain.
When you awaken in the morning’s hush
I am the swift uplifting rush
Of quiet birds in circled flight.
I am the soft stars that shine at night.
Do not stand at my grave and cry;
I am not there. I did not die.
Our influence persists, in small ways, through our children, and our life's work, and our actions, and the memories we leave behind. But the world loses an irreplaceable artifact and a luminous potential whenever a person dies. Those are not compensated for by the rapidly-fading stories we leave behind.
- Memory is only an unchanging imprint of living existence. How can you capture the way a loved one speaks, or the surprising things that they say, or the way that their actions improve the lives of others, or the unique experiences and worldview which only they possess? Even a vivid memory is as changeless as a photograph.
- Memories are an incomplete picture, and they fade just as legacies do. When we die, the smallest fraction of our selves is conserved by those who knew us directly. When they die, most of that is lost, too — only secondhand memories remain. Even the most famous among us become mostly myth after one generation.
- To lose a person is to lose a one-of-a-kind artifact: an unrepeatable constellations of experiences, upbringing, history, dreams, and world view. When a library is burned or an ancient vase shattered, we do not celebrate how their materials have been recycled into nature. We mourn, because their value was not in what they were made of, but the delicate arrangement of what they were and where they had come from. People are far more complex still, and far more valuable, than any such artifact we have ever made.
- To lose a person is to lose a living potential, to lose a being who had the capacity to become greater, to add more to the lives of others, to become more mature, more wise, more at peace. This is why a person's works are dwarfed by the person's full-blooded existence: we may refer to the memoirs of an oracle to guide our judgements later in life, but how much we lose by being unable to ask any new questions! How much the oracle loses by being unable to acquire more wisdom, to guide more people, or to pursue other projects! Not just oracles and Nobel prizewinners and artists, but all of us have the potential for building more and becoming more in our life's niche. We should build a society in which accidents of poor health or restrictive living conditions no longer inferfere with this capability.
Some may be satisfied to die, having built memories and a lasting impact for the people they know — they do not care to know their great-great-grandchildren, or to see what challenges they might overcome next. Their right to decide the worth and trajectory of their own life and to frame an ending for themselves is, of course, protected by the entitlement to life — and yet, how sad to believe that you are worth no more than what you leave behind.
4.6 "Death gives meaning to life"
I can address the validity of this idea from two standpoints: first, as a principle for running a society, and second as a principle for running your own life.
I do not think it can be a standard for policy, because it is up to the individual to decide what death means to them. Society should not presume to decide how individuals should value their own lives. To legislate the idea that death gives meaning to life is to override the sovereignty of the individual to govern their own life so far as it doesn't disturb the lives of others.
If instead it's your personal philosophy that death gives meaning to life, then officially the entitlement to life upholds your right to arrange your life in accordance with that belief. But speaking to you now as a friend, I ask you to reconsider whether death gives meaning to life. In all ways, people grow out of stages of life, they move away, they move on. Life will always be full of transient seasons and bittersweet endings—and death has never been necessary for that.
4.7 Call to action
In these essays, I argue that we should recognize control over one's own life as a fundamental part of human flourishing, and in particular that we should strive to provide individuals with unqualified control over their own lifespans. Achieving this goal may require our society to change radically; we may have to write new laws and develop new technologies and infrastructures.
But — most challenging of all — we will surely have to change the way we think about life and death. There can be no societal change without a change of heart. If we are to change society, we must begin to think and act in new ways. Here are some concrete goals in that regard:
- Rethink the way we sanction certain kinds of unwanted death as appropriate and inevitable.
- Repudiate unwanted death — whether by disease, homicide, accident, or senescence.
- Repudiate unwanted life — all individuals with the faculties of personhood are entitled to end their lives on their own terms.
- Acknowledge unwanted senescence as an inhumane condition, ammenable to and worthy of prevention.
- Cherish the value of persons and their choices, without limit. In particular, reject the idea that people depreciate in value as they age.
- Avoid squaring the curve: merely longer life may be protracted and undignified, while merely healthier life may be too short.
- Think outside the status quo: the ways in which we now grow old and die are accidents of natural selection which might be improved.
- Champion control over one's life and death as a central virtue.
- Reclassify death as a gradual and soluble process.
- Contemplate the terms under which you would ideally choose to live or die. Compare your terms with others'.
- Understand that advances in science and ethics can yield new levels of justice.
- Believe in your own individual power to alter the progress of society.
I call for us to think about arguments such as those presented in these essays. We should discuss life, aging, and death with our family and friends so that we can decide where we stand, in what sort of society we want to live, and what we can do to help. These are my considered views; I would like to open the conversation to futher improvement.
5 Related reading
Author | Title | Notes |
---|---|---|
Allen Bucchanan | Better than Human | The bioethics of human enhancement. Particularly relevant here is the discussion of whether natural is good. |
Rita Charon | Narrative Medicine | Sickness, disability, death, and healing from a narrative perspective. |
Robert Ettinger | The Prospect of Immortality | Published around 1960, this book introduced the concept of human cryopreservation and launched the first stages of cryonics research. |
Atul Gawande | Being Mortal | A disturbing but compassionate look at the culture and biology of aging and death, from a physician's perspective. |
Martha Nussbaum | Creating Capabilities | Groundbreaking work in ethics and economics, proposing capability as an index of welfare. Relevant here because the entitlement to life flows from the same set of ideas. |
Amartya Sen | Development as Freedom | This book and the above book are companions; both inspired my own views on the entitlement to life. |
Jay Rosenberg | Thinking Clearly About Death | Death and dying from the perspective of analytic philosophy. Relevant here is the discussion of dying as a piecemeal process rather than an instantaneous moment. |
Thomas Szasz | Suicide Prohibition | A radical book discussing society's treatment of suicide. Relevant here because his uncompromisingly individualistic view is one possible interpretation of the entitlement to life. |
Footnotes:
The political philosopher John Rawls called this the principle of overlapping consensus (https://en.wikipedia.org/wiki/Overlapping_consensus).
Let me never be misrepresented as saying that simply more life is better. Survival is just the substrate in which flourishing becomes possible.
In many ways, this is the aim of modern medicine: to provide as healthy a life as possible, with no deliberate ambitions to lengthen the average human lifespan. In gerontology, this policy of exclusively improving health is called squaring the curve.
To say nothing of many other considerations besides dignity: the anguish we might cause our loved ones by being so plainly unhappy with our lot, for example, or the fact that many people believe that fighting against illness, old age, and death is at best wrongheaded and at worst fundamentally futile.
There may be exceptions to this freedom to die as one wishes — but many cases are clear-cut. I think specifically about prisoners who are punished for attempting suicide, or terminally ill patients who are legally and forcibly prevented from taking their own lives.
Do you consider a person's worth as a human being to decrease from the moment they're born for as long as they live? If not, you assign the value of a person's life based on something more complex than just their age.
The fact that senility is not considered a disease is strange specifically because its symptoms are so debilitating. Puberty is another stage of life like senescence, but it's not strange that puberty isn't considered a disease because puberty isn't particularly debilitating.
Although mortality rates are certainly unequal in society.
This argument makes use of the reversal test
Do human beings deserve food only to the extent that they can provide a service in exchange for it? Our ability to provide a service often hinges on whether we are born rich or poor, disabled or "normal", in a nourishing environment or an oppressive one. If these birth circumstances are luck-based — neither deserved nor undeserved — how can they be a fair principle for distributing goods? It is better to acknowledge that all humans have intrinsic worth which entitles them to the basic essentials of a flourishing life, independent of their ability to provide economic benefits.
Surprisingly, cryonics is not just science fiction — in modern heart surgery, for example, cold temperatures allow surgeons to stop the heart for hours at a time without any organs dying from oxygen deprivation (http://www.texasheart.org/HIC/Topics/Proced/), and full-body suspension is an area of active research. Nonetheless, cryonics is not currently considered a high priority for medical research. Just imagine what we could accomplish with greater support for research programs like this.
To be clear, this essay is pure satire.
Mary Elizabeth Frye, Do Not Stand at My Grave and Weep