Contents

Introduction

1. An Overview

1.1 Introduction

1.2 Optimism about life extension

1.3 Possible methods of life extension and the basic processes of aging

1.4 Is it possible to reverse aging?

1.5 Why slowing aging might be harder than we realize

1.6 Are any life extension methods available right now?

1.7 How long would we live?

1.8 Misconceptions about what life extension would be like

1.9 Not everyone thinks life extension is desirable

1.10 Why worry about this now?

1.11 A survey of the moral issues

2. The Haves—Would Extended Life Be Boring?

2.1 Do you want to live forever?

2.2 A dilemma for the very, very old

2.3 Can you avoid boredom without fading away?

2.4 The boredom pill

2.5 How to survive your survival

2.6 If boredom is unavoidable, is that a reason not to start extended life at all?

2.7 Conclusions

3. The Haves—Death Benefits and the Human Condition

3.1 Introduction

3.2 Making a case for extended life

3.3 General problems with bioconservative arguments

3.4 Accepting death

3.5 Motivation and procrastination

3.6 The meaning of life

3.7 Character and virtue

3.8 Narcissism and transcendence

3.9 Adaptive preferences (sour grapes)

3.10 Unscheduled death and the new human condition

3.11 Conclusions

4. The Will-nots—Life Extension and Suicide

4.1 Introduction

4.2 Would making life extension available reduce the death benefits for Will-nots?

4.3 If you refuse or discontinue life extension, are you committing suicide?

4.4 If refusing or discontinuing life extension is suicide, is it immoral?

4.5 Conclusions

5. Everyone—Social Consequences

5.1 Introduction

5.2 Potential bad social consequences

5.3 Potential good social consequences

5.4 Conclusions

6. Everyone—The Malthusian Threat

6.1 Introduction

6.2 Will life extension cause a Malthusian crisis?

6.3 A policy to prevent a Malthusian crisis: Forced Choice

6.4 Practical problems with Forced Choice

6.5 Reproductive ethics and Forced Choice

6.6 Is Forced Choice an oppressive government intrusion into private reproductive choices?

6.7 What if some countries impose Forced Choice and others do not?

6.8 The demographic formula used in this chapter

6.9 Conclusions

7. The Have-nots—Distress and the Death Burden

7.1 Introduction

7.2 Distress

7.3 The death burden

7.4 Can we avoid making the death burden worse if we avoid developing life extension?

7.5 Conclusions

8. The Have-nots—Equality and Access to Life Extension

8.1 Introduction

8.2 Equality

8.3 Inequality as a reason for collective suttee

8.4 What if other needs are more pressing?

8.5 Who has a duty to subsidize life extension for Have-nots?

8.6 What if it’s possible to provide access to some Have-nots but not possible to provide it to all of them?

8.7 If we are sure that many Haves will breach their duty to the Have-nots, is that a reason to deny it to everyone?

8.8 Conclusions

9. Deciding among the Groups—Maximizing Welfare

9.1 Introduction

9.2 Midlevel principles, moral theory, and doing applied ethics

9.3 What it means to maximize welfare

9.4 Objection: we don’t have enough information

9.5 Maximizing welfare in the long run

9.6 How to argue that a world without life extension has greater net welfare than a world with it

9.7 Peter Singer’s objection

9.8 Conclusions

10. Deciding among the Groups—Which Rights Are Relevant?

10.1 Introduction

10.2 Rights and welfare

10.3 The right to equality favors neither Inhibition nor Promotion

10.4 The right to self-determination favors neither Inhibition nor Promotion

10.5 The right against harm favors Inhibition

10.6 Conclusions

11. Deciding among the Groups—Rights versus Welfare

11.1 Introduction

11.2 How to weigh rights against welfare

11.3 Weighing Have-not rights against welfare

11.4 Weighing Will-not rights against welfare

11.5 Two versions of Promotion

11.6 Conclusions

12. Enhancement Worries

12.1 Introduction

12.2 Risk and the precautionary principle

12.3 Authenticity

12.4 Sandel’s concern about “giftedness”

12.5 It’s not natural

12.6 The value of a natural life span

12.7 Playing God

12.8 Fukuyama, human nature, and human rights

12.9 Is aging a disease?

12.10 Conclusions

13. Policy Recommendations and List of Conclusions

13.1 Policy recommendations

13.2 List of conclusions

Appendix A: The Science behind Life Extension

A.1 Defining aging

A.2 Previous gains in life expectancy

A.3 Aging is puzzling

A.4 Why we age

Appendix B: Bernard Williams, Personal Identity, and Categorical Desires

B.1 Williams’s third life extension scenario

B.2 Categorical desires and why we want to keep on living

B.3 The Tarzan objection to the third scenario

B.4 Two unsuccessful objections to the third scenario

Appendix C: Demographic Tables and Graphs

Notes

Bibliography

Index