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Lifespan extension and the doctrine of double effect

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Abstract

Recent developments in biogerontology—the study of the biology of ageing—suggest that it may eventually be possible to intervene in the human ageing process. This, in turn, offers the prospect of significantly postponing the onset of age-related diseases. The biogerontological project, however, has met with strong resistance, especially by deontologists. They consider the act of intervening in the ageing process impermissible on the grounds that it would (most probably) bring about an extended maximum lifespan—a state of affairs that they deem intrinsically bad. In a bid to convince their deontological opponents of the permissibility of this act, proponents of biogerontology invoke an argument which is grounded in the doctrine of double effect. Surprisingly, their argument, which we refer to as the ‘double effect argument’, has gone unnoticed. This article exposes and critically evaluates this ‘double effect argument’. To this end, we first review a series of excerpts from the ethical debate on biogerontology in order to substantiate the presence of double effect reasoning. Next, we attempt to determine the role that the ‘double effect argument’ is meant to fulfil within this debate. Finally, we assess whether the act of intervening in ageing actually can be justified using double effect reasoning.

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Notes

  1. The current maximum human lifespan is 122 years [3].

  2. While originally absolutist, non-absolutist accounts of the DDE have also been put forward; see, e.g., [12].

  3. Newer versions of the DDE do exist; see, e.g., [12, 1416]. Our discussion throughout this article is relative to Mangan’s version.

  4. We analyze this line of reasoning in greater detail later in this article.

  5. As we argue further on, deontologists do not (necessarily) consider the act of intervening in ageing as bad in itself.

  6. Beauchamp and Childress appeal to this line of reasoning in their analysis of the craniotomy case [20]. From the fact that the bad effect (the death of the foetus) constitutes a means to the good effect (preserving the mother’s life), they deduce that the bad effect must be intended.

  7. That the good effect is not causally sufficient for obtaining an increased maximum lifespan follows from the fact that in decelerating/arresting the ageing process, one does not protect oneself against non-ageing-related causes of death.

  8. de Grey also characterizes the ‘war on ageing’ as a life-saving act. He states that in (indefinitely) postponing age-related diseases, ‘we are giving the beneficiary a greater remaining healthy potential lifespan than they would have if we held back, which is the beginning and end of what we mean when we say we have saved their lives…’ [44, p. 622].

  9. The high cost of interventions in ageing, one might object, makes it highly unlikely that these will be performed on a large scale. Therefore, one might argue, we should only take into account the small scale scenario and, thus, conclude that the proportionality condition is met. However, the likelihood of the large scale scenario is irrelevant to our analysis. After all, proponents of interventions in ageing argue that the DDE can justify both the small and large scale use of the latter. Therefore, if one of the scenarios (i.e., the large scale scenario) does not satisfy the proportionality condition, their argument no longer holds. The improbability of the large scale scenario does not change this.

  10. One might object that this verdict of non-proportionality is based on a problematic assumption, i.e., the conviction that overpopulation and its detrimental effects will occur. However, whether or not we actually will be confronted with overpopulation and its detrimental effects is irrelevant. We are merely interested here in reconstructing the way in which deontological opponents of biogerontology may assess interventions in ageing against the standard of the DDE. From this perspective, all that matters is that there are deontologists who fear overpopulation and who, on this basis, would reject the idea of the proportionality condition being met.

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Acknowledgments

We wish to thank Prof. Dr. Sigrid Sterckx for her helpful comments on an earlier draft of this article. In terms of funding, Laura Capitaine is a PhD student whose research is funded by the Research Foundation Flanders (FWO). Katrien Devolder is a Postdoctoral Research Fellow of the Research Foundation Flanders.

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Correspondence to Laura Capitaine.

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Capitaine, L., Devolder, K. & Pennings, G. Lifespan extension and the doctrine of double effect. Theor Med Bioeth 34, 207–226 (2013). https://doi.org/10.1007/s11017-013-9257-1

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