Our unrealistic views of death, through a doctor’s eyes
washingtonpost.com
washingtonpost.com
I just went through a month with a 90 year old friend whose life ended almost exactly like the story in that story. He had one lucid 30 mins when I was there and his family was there (he had been a general physician for almost 50 years). In his brief period when he had the energy to try and communicate whilst almost totally paralysed, it was clear he was telling the attending doctor that he wanted them to stop all medication and let him die. His own family could not face that fact, and said they'd ask him again the following day (unfortunately the cowardly doctor backed them up on this). He was never again lucid or strong enough to insist that treatment be stopped. He lived for another 10 days, struggling to breathe, almost totally paralysed, unable to control his bowels.
This was a man who when I last went on holiday with him at the age of 85, he insisted on carrying his own suitcase and refused a wheelchair, even though he had trouble walking and had blood pressure and angina problems.
I don't blame his family not being able to make that decision (it's so hard to let go of someone one loves). But his last weeks were undoubtedly torture, and they know they refused to follow his wishes. It was just terribly sad and an awful dilemma.
I was really glad of something else I read on HN about 6 months ago, where a doctor had a brain tumouur (or something like that) and instead of treatment, he lived out the remainder of his life doing the things he loved. I think that idea was what meant I could come to terms with the need to respect my friend's last wishes. I just could not convince his family.
Last year my mom was diagnosed with a terminal brain tumor. She elected to pursue treatment vigorously, but brain tumors being what they are, there were a number of points where she was unable to answer questions about her wishes.
At every one of those points we knew what she wanted because we had discussed it extensively before. I was incredibly grateful for that. It is bad enough to have to make complicated, life-or-death decisions for someone you love. I cannot imagine the horror of trying to do that without a clear understanding of what they would want.
Please talk with your family about this. Right now if possible. Just forward your sibling, parent, or child this article and tell them it made you think. Then tell them what you'd want. Don't just think you'll do it "later"; the right time will never come on its own.
It's highly relevant to the difficult questions that come up when dealing with death. I think the documentary does a very good job of exploring options available in the modern world and the issues associated with them.
> "...modern medicine may be doing more to complicate the end of life than to prolong or improve it"
1900
65 -> +12
85 -> +4
2007
65 -> +19
85 -> +6
"But it has more megapixels!? Aren't megapixels what we want?"
Reality is far more subtle.
Death is a medical failure, just like our inability to cure herpes is a medical failure. That there's no way to overcome the failure yet does not imply that it is not a failure.
Similarly taking your position, we could say that computer science's inability to factor numbers in polynomial time is a failure. Clearly the fact that solving the problem may actually be impossible should play a role in assigning the label 'failure'.
And I think that's a fair point, actually. Death is a responsibility. Ascribing it solely to medicine is unfair, but it is our responsibility.
Could we extend the average lifespan of adults by 10 years by spending money? Easily. Most people live thoroughly unhealthy lives, many of them because they simply don't know better. Consider the whole "obesity epidemic". A large number of people will die comparatively young because of a complete failure of our society to teach them how to eat decent food.
Beyond simply curing gross mistakes in self-care, what about positives? Could we find ways to get the average healthy person to treat their body even better, and squeeze out some more life expectancy? I'm sure we could. More thorough study of the effects of nutrients and toxins, more efforts to reduce the amount of crap in people's food and other items that they come into daily contact with, etc, those would probably net another few years of improvement.
And that's only looking at western society. If you look at poorer countries, there are countless avoidable deaths there. Some organisations, like the Gates foundation, are trying to address some of the more obvious killers, like Malaria, which have been neglected for decades (if we'd really wanted to get rid of Malaria in the 50s, we would have done so).
Overall, I think it's fair to state that we could raise the life expectancy of almost every human on this earth by 10 years if we really tried. But we choose not to. There are 7 billion humans on this planet, and every day, we, as a society, make a choice, to not bother to create 70 billion man-years of life-expectancy.
It is a choice, or rather a lack of choice, and so yes, it is a responsibility. We all (me included) choose to give up on 70 billion years of human life, every day.
This may seem like I'm belaboring a meaningless distinction, but it has practical implications. We spend extraordinary sums on futile end-of-life care instead of on the things you name. And people who are unprepared for death, their own or that of loved ones, suffer immensely.
Deciding that every death is a failure is denying a reality that we must confront if we really want to make the most of what we have.
The context of the article is about extraordinary actions at the end of life. This is not about keeping people healthy, it is about making very ill people live a bit longer. We clearly have a responsibility to keep people healthy. There is no excuse for allowing malnutrition to just happen (though there is an 'excuse' for it to continue while we try to rid it). Those are failures. We are responsible for those.
Those responsibilities are very different from the situations being discussed by the article, and what I thought that mistercow was talking about (which would be death in general).
This is the same thing as "why don't those homeless people just get jobs?!" - it's a failure to understand the complexities of the situation.
It feels nice though, because their failure is not on us (society as a whole), but wholly on them. Moral responsibility defeated!
swombat nailed it on the head: crap food is way cheaper than good food, to the point where a lot of this country does not have reasonable access to healthy foods. There are also other angles - e.g., single mother of two juggling two jobs - do you find something microwaveable or do you cook something healthy with the time you don't have?
In any case, this whole thing is way more complicated than just "hurr durr stupid plebes".
If you are already eating too many pies, you can afford to replace some of them with cabbage or sprouts (at least here in England; Maybe it's not as cheap/easily available in other parts of the world?)
Don't confuse it with malnutrition, which is a real (but different) problem.
It suggests no such thing. The obesity epidemic is all about eating the wrong things.
The problem is that personal responsibility is disproportionately more expensive for poor people - they don't have the time or the money to do it right, and when they do manage an attempt, equal results will cost more time and much more % income.
Well, yes, technically. Of course, you're conveniently forgetting about the effects of pricing, geographic proximity (seen many organic produce stands on skid row lately?), culture, education, and most importantly: time.
> "Most of the obese epidemic is lifestyle related"
And yes, you're right, but only in the most technical and of ways. Of course the obesity epidemic is lifestyle-related, but that's not what we're on about. We're on about a system that punishes healthy lifestyles and makes them unreasonably difficult for the poor to attain - harder than any of us pansy-ass rich folk have to contend with.
Let's re-enumerate very quickly:
1 - Eating too much is not the issue. Eating too much of the wrong things is the issue.
2 - Unhealthy foods are cheaper than fresh fruits, veggies, and meat by an almost comically large margin. This is due to a number of causes, most saliently massive government subsidization of unhealthy food industries.
3 - Time is the scarcest resource, and the poor have the least of it, and the least to spare towards maintaining a healthy lifestyle (which, despite what you might insist, is a time-intensive activity).
3a - The poor are disadvantaged in choice of living space. My commute is an order of magnitude shorter than what it'd be from the nearest poor suburb. I pay for the privilege, and it earns me easily an extra 1.5h each day.
3b - The poor are disadvantaged in transportation. While most people simply hop on a car between A and B, the American poor spend an enormous amount of time navigating the clusterfuck that is North American public transit. Here in SF, even with its good-by-American-standards transit system, transit anywhere takes about twice as long as it does in car.
3c - The poor are disadvantaged in just sheer lifestyle. You might live next to a nice park where you can jog after work - what do the poor have except crime-ridden streets?
This is the thing I can't stand about this line of argument, not only does your position fail to account for the many, many ways the cards have already been stacked against the poor, but it also fails to appreciate just how many natural advantages you and I enjoy in every day life. It's a combination that really irks me: the failure to appreciate one's own good fortune, and conversely the willingness to blame others for not having such good fortune.
Side note: time really is the deciding factor in just about anything poverty-related. Part of the reason for the persistence of homelessness (disregarding even bigger fish like mental health and substance abuse) is that the homeless spend the majority of their day queuing for resources. They spend hours lining up for a meal. They spend even more hours lining up for a bed. 98% of their waking hours is spent ensuring the status quo (i.e., homeless, but unlikely to die tonight), with nothing left to make actual, lasting improvements. This same problem applies to the poor and dietary habits.
1 - Eating too much is not the issue. Eating too much of the wrong things is the issue.
No, I assure that even if you eat too much healthy food, you will grow fat and obese the same. Unhealthy food may make it worse for a number of reasons, but excess is anyway going to be a problem, no matter what you eat.
2 - Unhealthy foods are cheaper than fresh fruits, veggies, and meat by an almost comically large margin. This is due to a number of causes, most saliently massive government subsidization of unhealthy food industries.
First, I would not classify "meat" as healthy food. That probably depends on your education and your view of meat, but you get a lot of fat percentage for the amount of calories. 50 years ago people were eating meat probably like 10 times less that we are and were (probably, I dont have numbers with me now) less sick. For your second point, "unhealthy" food is, I think, rather the result of people not considering food as important. Therefore food becomes a commodity. People prefer spending their money on vacation, video games, buying the latest smartphone and so on. Even those who HAVE the money. It's clearly a cultural problem: food has lost "value" per se. I do not know where you live so I cannot comment on that, but in most developped countries governments are also massively subsidizing small-sized farms (true in Europe and some parts of Asia at least).
3a. I agree with the time element, but I disagree in the responsibility. Of course, if one feels like you have to watch 4 hours of dumb TV shows every night to be satisfied with their lives, then there will no time for cooking. But anyone who can spare 30-45 mins a day in the evening can cook something healthy. Of course, it will not be something complex, but it is feasible. Please do not tell you need longer than that, of I will have to film myself cooking to prove my point.
3b. Now if you cannot even afford a car I admit this is a problem, especially in North America. Then it makes access to quality food more difficult. I can't argue on that one.
3c. Allright, of course there are poors who live in the worst conditions ever, and putting good food on the table is far from their priorities. But come on, when we talk about the obesity epidemic, we are talking about something like 33% of the whole US population having this obesity problem. You cannot seriously tell me that 33% of the US is composed of poor people living in crime-ridden suburbs. (http://www.cdc.gov/obesity/data/trends.HTML)
A number of these 33% HAVE the money, HAVE the time, HAVE the means to eat good food, but decide not to. For a lot of these people, this IS a lifestyle choice. There is noway around that, and there would be no epidemic if this was confined to the "poor/rich" rhetoric.
You are subscribing to the all-too-common "poor people with big screens and iPhones? What's that all about?" fallacy, except you ascribe even more universality to it than most.
> "People prefer spending their money on vacation, video games, buying the latest smartphone and so on"
This is a stereotype, unless you have convincing data to back it up. It is also about as offensive and useful as "black people! fried chicken! watermelons!"
See how far the conversation gets when this happens?
The "poor people are poor because they waste their money on lavish stupid spending" is a refrain we've heard way too many times. It's simply not true, fails to comprehend the complexity of the situation, and is frankly a complete moral cop-out.
I've had the fortunate/unfortunate experience of living on the wrong side of the tracks for part of my college years. I've lived with and befriended many of the people we upper-middles love to stereotype, victim-blame, and mock, and while there's always a sliver of truth to every stereotype, the characterization that the poor are poor, or that the poor are fat, because they're too stupid to act responsibly, is a pernicious and toxic lie.
Let's enumerate, for the record. You seem to believe that the poor:
- Spend their money on vacation, video games, and the latest smartphones instead of being smart about their finances.
- Need to watch 4 hours of "dumb TV shows" every night to be satisfied with their (presumably pathetic and meaningless) lives.
I honestly don't think we can have a discussion about the broader point of diet/obesity while you're chiseling at these points.
> "You cannot seriously tell me that 33% of the US is composed of poor people living in crime-ridden suburbs."
Have you been to the US lately? Despite what you might see in major cities or in the Valley, the majority of this country is poor as fuck. The notion that the vast majority of America enjoys a standard of living lightyears ahead of the rest of the world... is simply not true. Fully 42% of this country has an annual income of under $25,000.
The obesity epidemic in the USA is at its core tied to socioeconomic status. Hell, the fact that state-by-state obesity rates is highly correlated with state economic strength should be very telling.
You need to check your numbers, because that's not what studies are saying. http://frac.org/initiatives/hunger-and-obesity/are-low-incom...
Quote: "Among men, obesity rates were fairly similar across income groups, although they tended to be slightly higher at higher levels of income. In fact, among Black and Mexican-American men, those with higher income were significantly more likely to be obese than those with low-income."
Shocking, it says the exact opposite of what you were trying to prove. So there actually ARE people with higher income who are obese, it seems.
This isn't true. If you eat lots of healthy food, and get even a little bit of exercise, then you will gain weight, but it'll be muscle instead of fat. If you eat only a little, then you will lose weight, but the quality of what you do eat will determine whether the losses come from fat or from muscle.
> A number of these 33% HAVE the money, HAVE the time, HAVE the means to eat good food, but decide not to.
What has actually happened is that people decide to eat healthy, but society lies to them about what is and isn't healthy.
Seriously, do you have anything to substantiate that claim? I have seen obese people even in countryside where they were eating nothing but so-called "healthy food". Since when "healthy food" becomes muscles ?
I'm not saying that everyone is in the position to choose, but many are, and that is all that was said.
Most people have no clue what constitutes a healthy meal. Moreover, they are strongly incentivised to eat crap by the fact that crap food is (much) cheaper than healthy food. Combine the two, and you have vast numbers of people who basically eat sausage rolls, pizzas, burgers, chips and chinese takeaways (probably not the worst of the bunch), along with epic-size sugary sodas and mega-calorie coffees on a pretty much daily basis.
There's definitely an important difference.
Honda Civic's aren't cheap. A Lexus is expensive.
It was just too depressing.
And taste. Pizza is really good.
E.g., after looking around online for a bit, I found this[1] which indicates 300,000 deaths each year are attributable to obesity, which is 12.5% of deaths[2].
Furthermore, the magnitude of the the effect doesn't seem to be 15-20 years. This wikipedia section[3] indicates that being "obese" lowers life expectancy by 2-4 years. Being "severely obese" lowers it by 10 years. But according to these statistics[4], "severely obese" is ~10% of the population.
So I think 1/3 of the US population dying before age 60 because of obesity is way, way off the mark. More like 10% dying at 68 and maybe half the population dying at 75 because of obesity rather than 78.
[1] http://www.wvdhhr.org/bph/oehp/obesity/mortality.htm [2] http://www.cdc.gov/nchs/fastats/deaths.htm [3] http://en.wikipedia.org/wiki/Obesity#Mortality [4] http://www.nber.org/papers/w13181
Also "web startups" as a class don't exist to solve anything other than maybe the question "why don't I have more money".
To make money you should be solving a problem (stealing and monopolies being exceptions). Web startups exist to coordinate people, that's the only thing they are capable of - they cannot "physically" do anything else. (the exception is personal data backup such as dropbox).
No. A thousand times no. Death is part of life. All composite things decay.
Imagine a kindergartener on an ocean beach. They spend hours building a sand castle. They wail as the tide claims it, feeling the sting of failure. Do you agree, telling them that they screwed up in their construction?
I say no. The error isn't in the building, it's in expecting the castle to last through high tide.
For the skeptical, I'd encourage you to watch this documentary: http://www.imdb.com/title/tt0307385/ It really solidified my view that the transitory nature of all things makes them more beautiful, more poignant.
Yet how much more valuable is our consciousness than our accrued digital data? I don't understand how people can simultaneously understand that it is extremely unwise to leave their data to the fate of mechanical failure and yet not only accepting death but actually perceiving it as superior in many cases.
Defeating death is a worthy project. Embedding consciousness in a digital substrate or backup to genetically engineered bodies, or nanotech / biotech strategies for preserving existing bodies beyond what is natural are worthy pursuits.
Sometimes I wonder if the reason that this is not accepted is because of religious people in the world who feel like accepting that death is the end of their consciousness would be betraying their faith.
I'm entirely in favor of research into extending human lifespan and maximizing the quality of human life. But this "circuits will save us all" stuff is not materially different than all the people who believe Santa-in-the-sky will let them live forever in happy-shiny-fluffy land. It's pure wish fulfillment, with no significant evidence.
With regards to possibility; it's the difference between hard science fiction and simple fiction, there's nothing ruling out that any of these things as possible, and in light of that fact I think pursuing them is an undeniably good idea.
We know the origins of Santa, we know the origins of god and religion, we understand why they're false and why that's a waste of time. Theoretical future advances in technology allowing fundamentally new paradigm shifts are something completely different.
I surely doubt that we know the origins of religion. And they surely are not a waste of time. Something that has been part of the human culture for as long as we know is bound to have some meaning. And pleas, take a look at some of the proofs for gods existence and nonexistence, some of them are quit elegant.
As I said before, extending lifespan is worth pursuing. Living longer is technically achievable. But eternal life is pure fantasy. Death comes for us all, and unless we face that fact squarely, we won't use what time we have as well as we could.
The only benefit death will bring is when everyone who has this ridiculous view point is gone and out of the way.
If you took away the ticking clock and each person had thousands of years to write his novel, prove his theorem, or complete his masterpiece, would we continue to advance--or would we stagnate?
You also assume that a 1000 year old Einstein would still be Einstein. We have no idea what the impact on the brain of living that long would be. More than likely at some point previous memories would begin to fade away, and at some point you've replaced so many parts (memories) that there's nothing of the original left.
Additionally, society changes in large part because the people who make up society change. Would slavery have ever ended if older people hadn't passed away and younger ones with new ideas taken their place? Would we still be ruled by a thousand year old tyrant with a medieval morality?
Look, if you were designing a society and were trying to make the tradeoff of whether people should die or not, how would you weigh the arguments for and against death? "Hmm, on one hand, old ideas die off, so society might progress faster. On the other hand, we will snuff every conscious being out permanently, and they and their family go through years of suffering. Which should we choose?" Are you seriously arguing we would choose the former?
"travelling faster than 40 miles an hour is impossible" "communicate with someone on the other side of the world instantly? Impossible!" "fly to the moon?" "end death?"
I'm sure that if we sat down, we could come up with thirty things that we have daily today, but were 'impossible' a hundred years ago.
The entire frame of your questions shows the fallacy because you explicitly abandon all other notions to just come up with things that were thought impossible but are now mundane.
It's true that we don't know everything, but implying that because we don't know everything we know nothing is absolutely ridiculous. All current knowledge of physics points towards entropy, and moreover the second law of thermodynamics, as being one of the most important and consistent laws of physics. It's so important that one of the most well-known physicists in the world is so well-known because he created a theory of black holes that meshes with our existing theory of entropy, proving that the second law still holds. The idea that we should abandon this knowledge because, well, it's inconvenient strikes me as being disingenuous in the highest order.
Anyone can say, "Well, you don't know everything, so you may be wrong." That doesn't make it an informed or useful comment.
In my defense, I was not saying "since we achieved all these awesome things, we'll surely eventually avoid the heat death of the universe". Instead, I was claiming that right now, we're probably still to ignorant to know that with confidence. Perhaps we will find a way to escape into a different universe.
Thanks for the reminder (and good username!)
And also because it's true. The best science we have tells us that everything decays in the end. If you're going to start ignoring facts just because you don't like them, where do you stop?
But what you're describing sees no meaning in anything ever. Simply because you can say that eventually the sun will burn out and we'll all die anyway doesn't mean we shouldn't try to make things as good as we can while we are here.
>If you're going to start ignoring facts just because you don't like them, where do you stop?
No, I'm ignoring facts that have no relevance or no useful action to take. If everything is going to end in a trillion years, what should I do about that exactly? Does that mean I should try to cure aging now?
Do you have a job? Why, the universe will end in some billions of years. Oh, you want to have as nice a life as you can while you are here? So do I.
Which is exactly what this article illustrates. Death comes for us all, and not facing that yields waste and suffering. Not in some abstract sense, either. As the author writes, "At a certain stage of life, aggressive medical treatment can become sanctioned torture." And the amount spent on futile end-of-life care is staggering.
As things stand today, of course it doesn't make sense to hang on when you're only going to get a few more years of agony. But more research could be done in eliminating the effects of aging, etc. We've already lost many great minds but if we can stop this trend or even slow it down then it's worth persuing.
I don't think this is an issue of point of view, entropy and thermodynamics are very real and as of now, the best models of reality point to it being a certainty.
imply that absolutely everything is completely without a point
I personally don't subscribe to that philosophical position, I brought up the topic of the eventual end or the universe as a thought experiment about the acceptance of death and at that point all relevance will be gone, but in saying that, I personally feel that, even if nature is temporal, things can have a point and have meaning now even if they don't have permanent meaning in this nature. Further we cannot rule out the existence of a higher natural order in which there is further purpose. That being said, meaning, point and the eventual lack of both have little to do with the reality that this nature will end, until it does end. Even if purpose is absolutely temporal it is significant in that temporal space, which is enough to give it a point. Acknowledging that a temporal space will end, does nothing to minimize the point of that temporal space and the actors within it. Rather it is a realization that it is a self contained system and that the point or meaning exists within that system, the value is within the system not external to it. Once the system is gone it has no value, but that does nothing to diminish the value inside of the system.
Who told you there was "a point?"
And why did he tell you that?
We live in a universe where all things decay. There is no known exception. Species go extinct. Stars die. As best we know, the universe itself will die: http://en.wikipedia.org/wiki/Ultimate_fate_of_the_universe
You and I will die as well, and pretending otherwise causes a lot of harm. The best we know how to do now is to extend life a little; but we don't even do that as well as we could because we waste fantastic sums on futile end-of-life care. And that money also doesn't make it to the medical research that could help the next generation, or the one after that.
But I think the harm is deeper than that. Who do you think is more likely to be fully aware of how short life is? The next Einstein now toiling in a lab? Or somebody watching their third hour in a row of reality TV?
Don't throw out the Einsteins because of people like this. People who throw their lives away will end up killing themselves anyway (e.g. through horrible eating habits, smoking, etc.), and even if they don't, they'll be in their living room out of our way.
I find it highly amusing (if sad) that people who argue pro-death always like to point at people they don't think deserve to live...
In the coming decades, We may or may not be able to significantly extend life, but it's not clear why it's unlikely, or why it causes harm to even think about.
The point is that fantasizing about "curing" death is harmful to people making difficult decisions about their life and that of their loved ones. People need to face the fact that death is inevitable and part of life, and like everything else unpleasant that is part of life, they must handle it like an adult.
Because what I see people objecting to is not the raising of a possibility. It's the indulging of a fantasy that lets people avoid thinking about an empirical certainty.
The belief that personal death cannot be good for society is just as ridiculous as the belief that it always is.
Or is this a world where only nice people get to live forever?
Neither Hitler nor McCarthy were still 'dictating' when they died. Lack of death doesn't mean that everything would remain the same forever.
Stalin's death lead to a good change.
When somebody stay in power for too long it leads to stagnation.
Human civilization has other measures against such stagnation (such as 2 terms limit for presidential position).
However limited life span still adds extra protection against society stagnation.
It's not obvious if benefits of unlimited lifespan outweight potential problems.
I think that doubling life span would probably be beneficial overall, but it's hard to say if further life span increase would.
No, I'm talking about the elimination of aging and natural death. People would still be able to kill themselves and others.
The legions of true believers would be able to dictate terms to enlightened society with the mere threat of violence.
I really don't think you've thought this through.
Think about what you're saying here. You think no one in Germany was rational? They would have had the same risk of dying we would. Hitler was only powerful because there were people willing to follow his orders.
And there was no shortage of true believers on the Allied side either (think patriotism), in any case.
You would have to be pretty damn patriotic to want to give your life to preserve a nation-state you expect to outlive anyway. If I'm going to die anyway, it doesn't make much difference; it makes sense to risk my life for some things. If my life is eternal, what principle could I possibly, rationally put ahead of my survival?
Eternal life gives the insane an advantage over the sane, and the idea that the insane are as likely to be good as evil seems like a risky bet to me.
We have Dragonball Z because 15 (25) year old punks don't realize that they're going to die some day...
And with that, I'm going to stop scanning HN.
That people are starting to view death as a medical failure is one of the best things that could happen. I personally don't expect to die of old age.
Something said, I suspect, by every young person since the time of Hammurabi. I suppose that expecting to live forever in this world is no more irrational than expecting eternal life in another world.
Feel free to die then
Do you honestly think that was my point? That I'm looking forward to dying?
The current state of affairs is certainly abysmal. Some live over a century, while others die in their childhood. We age before we die. I'd rather die at 75 with a healthy body rather than dying at 75 with 10 years of senescence behind me.
So, a better system (should it be possible), would be to get rid of senescence. Even better, we could get egalitarian about death: no involuntary death before age X, at which point you die instantly. Sounds horrible? But it would be much better than the current system, where we let chance decide on the number of years we can live. Plus, you can actually make preparations for your departure.
So, what value would you chose for X? And of course, it would apply to you as well.
I agree that a world without aging would be better. I also think it would be a better world if the moon were made of cheese and I could get there by building a tall enough ladder. But if I spend all my life building ladders in service of that desire I'm a fool.
We don't live in a world where people live forever or can avoid old age except by dying young. All composite things decay. There are so far no exceptions, and no solid theory that suggests otherwise.
I am entirely in favor of medical research that seeks to improve and extend human life. But by not coming to grips with our impending deaths, we aren't living as well as we could. Take the guy upthread who thinks he will live forever. People like that check into hospitals every day unprepared for the reality they face. As the article makes clear, that wastes a lot of money and causes a lot of suffering.
Shakespeare's sonnets are artfully composed, and I'd say we've done a decent job of keeping them around and finding uses for them.
I agree that few people imagining they can have eternal life think that they will suffer. But that's exactly the problem. They haven't thought it through. They don't yet understand what life is. Which is why they are so woefully unprepared to handle the parts that don't match their fictions.
The bit about Shakespeare's sonnets I take to be a counterargument to "all composite things decay". That we have managed to keep 100k of text around for less than half a millennium seems like poor evidence that immortality will soon be ours. People die. Species die. Planets and suns die.
It's a long way to go, or at least a very long shot, but a long life is possible in principle. Things decay, but they can be fixed or replaced (even the brain: current physics says that copy-paste transportation actually works —in principle). We just don't know how to do that yet. Now, about my personal immortality, I see little hope short of Friendly AI or cryonics, and even those are a long shot.
I also agree with you that the various theoretically possible techno-miracles likely won't mean much for us than a modestly longer old age. So I think everybody should really come to grips with what dying means. E.g., by filling out a living will and discussing end-of-life issues with family. If it turns out that preparation is wasted, I don't think anybody will complain too much.
The first part of this sentence seems strange.
If you assume your healthy 75yr young body doesn't die of external forces (drowning, fall off cliff, etc.), which you don't seem to be implying, isn't this a contradiction?
In this context, the "senescence" is a precondition for death, right?
Being able to get rid of senescence might be nice, but making everyone die at age X does not make sense.
> Something said, I suspect, by every young person since the time of Hammurabi. I suppose that expecting to live forever in this world is no more irrational than expecting eternal life in another world.
One could argue that this is the crux of the world's oldest story, "The Epic of Gilgamesh".
You cannot escape true death. Nothing you could say, do or know will ever change the fact that your life will end. You need to come to terms with that before the inevitable happens. Once you are aware that you will die it becomes easier to really live.
I agree we should try to improve human lives, now and in the future, and extending healthy lifespan is certainly part of that. But there is plenty of reason to face the fact that we will all eventually die.
Well, I hate to use Wikipedia for that, but current observations seem to disagree with this:
http://en.wikipedia.org/wiki/List_of_long-living_organisms
You'll see in that post that there are several species for which we find that mortality does not increase with age, i.e. they do not appear to age.
Now, I am not a specialist on the subject, so I will not be able to go into debate whether this is truth or fiction, but I have heard/seen this mentioned in several sources.
http://www.telegraph.co.uk/earth/wildlife/4357829/Immortal-j...
It is inevitable that a time will come where it will be possible for humans to stave off aging to a significant degree. Whether this is in 100 years or 10,000 years, it is difficult to tell. What measures should be taken because of this is for the future to decide.
My grandmother has osteoporosis and surgery isn't an option. When her bones finally give in and tie her to a bed, that's the end of her life, even if she lives for a few years more.
"For many Americans, modern medical advances have made death seem more like an option than an obligation."
In 1912, F. M. Cornford wrote that the Greeks had a view of fate where life was circumscribed by limits both in length and law, and and where when one stepped outside these limits, the debt of life is repaid in death.
One of the interesting elements of my study of Norse myth is that the exact same pattern shows up there (although the last time I tried to fully expound that it took me 10 pages!). The overall structure seems to be that the foundation of life is a primal lot or layer which is bound by law, and incurs a debt (Old Norse 'skuld,' the name of the third Norn means 'debt') and given back at the end of life. The idea that death repays the debt that was loaned as life is a very interesting one, and it gives a sense of an obligation not only to live well but also to die well as well.
Not only is death necessary for new generations, it kind of gives meaning to the time we do have.
So… I'm open to the idea that we should know how to care for the dying instead of merely prolonging their misery. Everyone reading these words will die one day. Better get used to it!
Why do you think limited time give us meanings?
If you knew you would live until 300 and remained reasonably "young/healthy" during that time you probably wouldn't start a family as soon.
A few months ago, this was one of the biggest quotes around the internet. For a lot of people, death is a catalyst to do something that matters. In the biography, Jobs talks a lot about how he's in a hurry because he feels like he's going to die young.
If we had all the time in the world, literally, we could eventually learn to make decisions that are truly good instead of local conveniences.
Why don't we just choose what's the most meaningful thing to us, right now?
Moreover, I think living for a really long time allows us to be more ambitious.
I have a limited time on earth, yet I chose to spend it with you. Cuddling on this couch. Watching a movie. I think by the finite nature of our existence it imparts a little bit of significance to any sacrifice we might make to our own utilitarian maximizing.
Have there been an earthquake or your place would be ate alive by fire, you would be running away like crazy and the last thing on your mind would be to cuddle on your couch.
Further there is not much you can do to postpone the judgment. Sure you can break up with your loved one and lock yourself in a library for 10 years, grasp some wisdom, perhaps invest money or built a company, sell it ten years later for half a billion $ and invest all your money strictly into life-extension projects, but by now most likely you know the probability of achieving all this is so small, that you would rather cuddle on your couch just for a little bit longer.
this is the extremely short version/recipe to leave forever:
1. clone yourself. work with this guy who is very close to succeed [1]
2. once your clone is 25 years old and therefore stop growing, undergo a brain translation. Now, before you start laughing look here: [2] This is Dr. White [3] undergoing successful monkey brain transplantation in... seventies! I think 40 years later technology got much more advanced.
So the result would be your 80 years old brain (assume it was still quite healthy) in 100% matching DNA body of 25 year old. IF you don't get brain cancer, or other brain disease, you have another 50, 80 years to go. Now, going further only certain parts of the brain makes up for your identity. Most likely only memory. Fast forward another 40 years in the future, knowing how to connect broken nerves again why not cut only small part of your brain that is you therefore transplanting only your identity and limiting size of your old body in the new one.
Now, you can call me a conspiracy theorist, but if to overcome problems here is just a matter of time (by that I mean more time == less money + less engineers working on the problem. less time to resolve problem == more money to throw at the research + more engineers working on it), then I believe it is fairly plausible that elites like Rothschild family having billions of dollars for their disposition already have these technology available. Just ask yourself -- if you already have trillions in the bank, and building another successful company or buying another factory is boring to you AND the same time the only thing you are sure of is that one day you are gonna die, then it is obvious you will spend all your resources to "postpone the judgment".
[1] http://en.wikipedia.org/wiki/Panayiotis_Zavos
[2] http://www.youtube.com/watch?v=xb3Zi0DenaE [viewers discretion advised]
[3] http://en.wikipedia.org/wiki/Robert_J._White
* I didnt want to go into the obvious legal issues here: cloning humans, "stealing" someones body, putting another "human" in 80 years old body therefore shorting their life, etc.
There are no implications to flights of fantasy, there is no soul, the body is a complex biological machine and there's no reason we can't either learn to prevent the machine from breaking or learn to grow another for spare parts.
And I think it's only fair. Though the word "soul" is mostly used in conjunction with dualistic assumptions, it has a deeper meaning that is fairly independent of dualism: Your soul is whatever makes you who you are. Your soul is what really matters about you. Whether the soul is separate from the body and survives it is another question.
I also have a specific reason to use that word: its emotional impact. For instance, one reason I think we should stop death is because it means the destruction of the soul. Even a devout Christian would understand my concerns (and go on to reassure me, but that's another story).
I don't want to let religion hijack this word.
For the same reason, I don't like to say "passed away", "gone", or "departed". Plain "died" is more accurate.
[1]: I'm not the only one. http://www.goodreads.com/quotes/show/191761 (Argument by authority, I know, but really, this view looks sound.)
Imagine that every time you say soul, nearly everyone hears "immortal soul", because that's basically the truth. Find a better word to communicate what you really think, soul is not that word. The truth is what you're describing is "mind", not soul. It may be pretty to redefine a word, or take a different personal meaning, but it does not aid communication, it hampers it and deceives those who aren't willing to dig deeper into a discussion.
Nevertheless, how do I talk about true death to a believer in immortal souls? The best path I found so far is something like "imagine that your soul is actually destroyed when you die". It focuses directly on what I want to talk about: true death, the real deal, not some half-death with an escape hatch.
The advantage with this approach is that it emphasises the common ground between monotheists and transhumanists: true death is simply not acceptable. Therefore if it is a problem, and we have any chance of fixing it, then we must take that chance.
It also avoids some problems: If I say we don't have (immortal) souls, then he may soon draw conclusions I'm totally not about (worst case, he could think I'm a nihilist). If I avoid the word "soul" altogether, he could think I'm afraid of the afterlife.
Conversely, one could believe in the afterlife, and be able to imagine a world without it at the same time. Or a world where there is an afterlife, but where souls can actually be destroyed, or dissipated into the aether. I can recall at least 2 such stories: the anime Bleach, and The Night's Dawn Trilogy novel. I'm sure there are other examples.
Now, I reckon I can't help someone who can't even play the "what if" game.
We are getting really into science fiction now. Perhaps if you could somehow monitor and capture every single signal sent from human brain to its body from the moment brain formed itself (I know there is a flaw here...), then if you could record that transmission for 25 years, perhaps (Im really in year 2350 now, I think) you could program a computer that would re-play that transmission into a growing body (to mimic brain) and as a result at age 25 had a healthy body without human brain. This, I think, would cut-off all skeptics that believe Soul is attached to mind, not body itself.
So, while convoluted, your solution sounds like it is acceptable. Be careful however to play a record of a past life, instead of, say, actually simulating a brain in a silicon chip, Gunm style. Because that simulation would most certainly be a soul as well (I don't believe in philosophical zombies).
Edit: nevermind.
I really don't give a shit if my ego continues to survive forever. I only care about this particular instantiation because under my (to be frank, likely to be flawed) interpretation this is the only "I" I ever perceive.
This gets more complicated because we don't have any guarantees on the continuity of consciousness as it is (when you awoke this morning, are you still the "same" person?)… but barring any more cogent arguments I'm gonna stick to it.
The robots should be identical to the human body at least skin deep. Our skin could be a synthetic material very close to the real thing. We will need none of the organs that currently keep us alive.
[1] http://en.wikipedia.org/wiki/Ocular_prosthesis
ok, eot for me.
ok hang on: second though: I am not sure if I would gave up on a please of fng for an eternity without it :)
edit: so it boils down to question: how long can brain live, given we provide it perfect conditions (lets say: pure perfectly controlled air, all the vitamins it needs in regulated doses, etc etc)
The clone will be you, and you will be the clone. It will be like going to sleep and waking up in the virtual reality environment. From the clones perspective it will feel like the original you since it has all the memories of the original up to the point before you went to sleep. You just have to make sure that the original you is destroyed if and only if the virtual you is created successfully and with no corruptions. Otherwise there might be problems between the real you and the clone.
Side note: I believe there was an episode in Star Trek where something like this would happen. Star Trek made a treaty with an alien race to allow them to visit their planet via teleportation over huge distances. The thing is that they would not really teleport the person but rather they would create an exact clone at the destination and destroy the original.
The question is: who will be waking up?
Basically the same issue is with a hypothetical teleporter. To teleport you from here to somewhere else we scan all the atoms in your body and digitize that information. Now we send the data over the internet to another place on earth. We rebuild you there. At the same moment that we use a defibrillator to put life into the new you, we shoot the old you in the head with a gun.
So you'd step into such a teleporter?
I haven't seen a convincing answer to these questions of consciousness/soul/identity. Perhaps there really is no difference between going to sleep and dying, it's just that in the former instance the old body is reused for new identity. Perhaps there is no persistent identity at all; in every moment in time there is a single separate identity. Perhaps time itself is an illusion: perhaps the universe is just one single snapshot in time. There are so many possibilities and I have no idea how one would even start to formulate a testable hypothesis. Does anyone have a recommendation for reading more about this topic?
An identical copy of you. If it is not identical then it wouldn't be you.
>>So you'd step into such a teleporter?
If the new me is identical to the old me I think I would. The new me is not supposed to notice anything different other than I woke up in a different place. The old me should never wake up once the new me has woken up.
>> consciousness/soul/identity
Being able to create an identical you assumes that you are your brain and nothing else.
As far as I can see stepping in such a teleporter basically amounts to suicide. Whatever is happening in another part of the Earth doesn't change a thing from the perspective of the guy getting shot.
So suppose we change the story a bit: we don't create a new copy of you, but we still shoot the old you. For you (the old you) this isn't any different than the previous story. Would you still go for this?
This is true if you include your sense of self as your entire body. However, I think I will have to decide that my sense of self is my memories stored in my brain. If you look at it from that perspective than as long as my memories, and everything else at the sub-conscious level, is persisted across any medium then I'm still alive. The body then becomes a vessel. However, I think I will still like to have my body so I might as well replicate that also.
Of course, I think this is a choice people will have to make themselves since it is true that the original you dies, as you state. The original body of yourself dies, but not your memories. I guess you could think of your memories as your soul. As long as those are alive, you are alive.
>>So suppose we change the story a bit: we don't create a new copy of you, but we still shoot the old you. For you (the old you) this isn't any different than the previous story. Would you still go for this?<<
Of course not. Why would anybody do that? I'm not sure what is the point you are trying to make here. Notice that in this case not only has my body died, but also my memories. So as far as the universe is concerned I'm truly dead.
If for whatever reason a new me cannot be created than I expect the original me to be woken up. The old me must only be terminated if the new me is created successfully.
Its still incredibly amazing question: what IS conscious. where is it stored and how can it be transferred. what will happen if you make a copy of it? can you make a copy?
That view is known as perdurantism (opposed to endurantism).
> Perhaps time itself is an illusion: perhaps the universe is just one single snapshot in time.
Not sure what you mean here, but if you're assuming determinism then you're scientifically wrong (which is to say that there's now a scientific answer to what was historically a philosophical conundrum). The universe is indeterministic. This is more because of entropy ("determinism is fundamentally a denial of the arrow of time") than chaos theory (which is still deterministic). Ilya Prigonine is notable for emphasizing this worldview as a third departure from Newton, first two being quantum mechanics and general relativity.
> Does anyone have a recommendation for reading more about this topic?
http://en.wikipedia.org/wiki/Think_Like_a_Dinosaur_(The_Oute...
I will politely disagree with your premise.
Not necessarily. Look at the problems in the world. How many of them are because we've forgotten history? Every time I read something new in history I'm struck by how this has all happened before and we're making the exact same mistakes again. I would submit that if we lived forever, we would be colonizing planets by now.
If you were to travel back in time to Aristotle you might be able to say that philosophy fails us when attempting to describe the laws of motion. The concept of physics was wholly contained within this discipline at that point in time and did not exist as a separate venture.
In much the same way in our age the concept of engineered negligible senescence exists within the field of medicine or at a stretch, biotechnology. As physics transitioned from philosophy to science to specialist discipline, this will likely transition from medicine to biotechnology to a specialist discipline all of its own.
I think the sooner we set the parameters for the quest and agree that it's worth pursuing the quicker we're likely to succeed.
Personally I don't think immortality is a good thing, and I suspect most arguments in its favor our heavily driven by fear of death.
If you believe in 1000 years humans are still living to 80 years old, and are STILL bound to ONLY this planet ... well I think you're crazier than your love of death ( the norm ) suggests.
It requires a bit of human insight to realize that the slice of cake religion advertises IS escape from the vast darkness of a perception-less void.
The only thing you are capable of is converting time into something else. Time is always the scarcity factor.
So what if we had unlimited time? Would you pursue greatness and projects that take hundreds of years to complete?
Unlikely.
Let's take a look at something that is also scarce and that everybody is familiar with. Money. Would you say that the overwhelming majority of people who have lots of money engage in long-term projects to do interesting things ... or do they spend it on vain things like mansions, expensive cars, yachts, planes, etc?
If you had an infinite amount of time, the first thing you would do is re-watch every episode of Star Trek, not embark on the discovery of warp drive. That's the truth nobody wants to face. The overwhelming majority of humanity is unbelievably vain and the part that isn't, is primarily motivated by scarcity. They understand they have a very limited amount of time to live and they want to get something amazing done within that time. Removing that scarcity factor will make them just as vain as you and me.
EDIT: Fixed my inability to use the English language.
But I agree with you, in the sense that having a "deadline" is what motivates people to accomplish things. Like if your boss or teacher doubles the length of time to finish a project, it doesn't mean you'll work twice as hard, but rather that you have more time to put it off.
Well, vane is a legit word, so it's more of a misuse. I meant to use vain. I kept thinking vanity, ah well. It was bothering me, but I got sloppy.
Absolutely. Being an idea guy I'm always coming up with new ideas. It's really depressing knowing that I just don't have time to do them all.
If you let go of your ego a little bit, you'll realize that 99% of the ideas you have are moronic. That applies to all of us.
Knowing that you can't pursue all of them forces you to pursue the 1% that aren't absolutely asinine. People don't realize just to what extent our mortality filters out the garbage from our lives.
There are many things that people at age 10 can't imagine about people at age 20, or 20 imagining 40. There's no particular reason to believe that problem goes away.
That said, I'm pretty sure that's the same sort of argument I'm suspicious of. It's not an honest question that "will you"; it's an argument that the answer to that must be no. Not because of any evidence that has been presented, but because you can't think of any answer.
And I think it works because he's assuming an answer to the question he's purportedly asking. We don't really understand what minds are or why bodies age. We don't even understand exactly what happiness is. And he's presuming that a choice like that is possible.
What we do know is that a choice like that is currently unavailable, and I think it's dangerous to build too many sky castles on the assumption that it is.
Since you're an optimist, you'll probably be one of them :-)
dasil003 doesn't say what the ethical question is, but I think he's got it the wrong way around with motivation. As Aubrey de Grey has argued, it is the fear of death, coupled with the pessimistic assumption of death's inevitability, which makes talk of life extension taboo in many circles.
('If you can't avoid something unpleasant then embrace it' is a viable psychological strategy.)
One ethical objection to not researching life extension is that huge amounts of healthcare budget go into extending the lives of frail, sick people in their final years. When we know how to keep people healthy indefinitely this problem will be solved, although pessimistic individuals will then have to take the responsibility of choosing when to die (if ever).
Besides, if you look at the actual lives of these people, most of them stopped producing useful output eventually. Newton spent more of his life arguing about theology than inventing calculus and physics.
No we couldn't, because its not up-to you or anyone else to decide how long another person should live. How do you know if Newton or Einstein would have wanted to live longer? If a choice was available to increase ones lifespan, the choice should lie with the individual.
Perhaps artificial intelligence is a much saner choice than immortality.
And I do agree, people should have the choice to end their lives whenever they wish it. However, having the potential available for immortality means we don't need to have the upcoming intellectuals spend half their lives catching up to where the last generation died off at. If they don't want to, nobody forces them, but having the option means so much potential knowledge.
And then we overpopulate the planet in a decade and everyone dies of starvation, global warming, or world war 3 nuking everything into oblivion due to the breakdown of society.
"When their loved one does die, family members can tell themselves, “We did everything we could for Mom.” In my experience, this is a stronger inclination than the equally valid (and perhaps more honest) admission that “we sure put Dad through the wringer those last few months.”"
"A retired nurse once wrote to me: “I am so glad I don’t have to hurt old people any more.”"
Makes you stop and think about how we treat end-of-life situations.
I'm conflicted about my participation in this process... CPR is a very brutal process, and all the interventions we use to restart someone's heart are equally traumatic.
So, why do we do this? In most cases, it's because someone doesn't have a DNR, or any other sort of advanced directive. In most (all?) states, if you call EMS and don't have a DNR, you need to actually threaten us to absolve us of our legal duty to start resuscitative efforts (in reality, most of us are human beings, and simply explaining the situation should be enough). The other situation is when a patient _does_ have a DNR, but the family is insistent that we "Do something!"
In both of my recent experiences, our efforts kept the patient 'alive' long enough for out of town family to travel back to say their goodbyes.
Was it worth it though? The financial, emotion, and physical costs are pretty high... I'm not sure...
25 years to re-print entire human body without cancer cells, tumors, perhaps without fat and boldness as well? :)
"I cannot count the number of times fellow physicians have told me, in words that vary only slightly, “Promise me if you find me like this that you’ll kill me.”"
I have a parent who's a medical professional and their response was exactly the same. On a related note I wonder if support for euthanasia is higher among those who work in medicine.
We're talking about reality, here and now. If you want to discuss science fiction, start your own thread.
The article is absolutely right that right now and for at least a few decades, we have to live with death. It does not mean however that death is a good thing.
I mean, who would want to die when they live a life worth living? And who would want their life to stop being worth living?
(And no, I don't buy the saying that says live is meaningful only because it eventually stops.)
You committed the naturalistic fallacy. Also, inevitability isn't a justification for bad things happening.
There are also practical considerations: if death is eliminated, we must stop reproduction too.
I would prioritize existing lives over the yet to be born.
From an evolutionary point of view that makes very little sense.
Even in startup culture, it makes sense that some business (existing lives) have to die in order for new business models (those yet to be born) to emerge.
What's to say that the existing lives won't hinder growth that would happen from new lives being born and re-imagining the world that everyone is used to?
Let me know if find it interesting (or not :))
Oh yeah?. I suppose you wouldn't be afraid of jumping off a cliff, then? Most of the time, fear is very, very useful. Don't underestimate it.
Now, fear of death specifically might be wrong. But fear of whatever causes death sure is not.
So, please keep this in mind and perhaps read up on the complexity of the issues -- from the perspectives of disability rights activists as well as doctors or the caretakers of people who are extremely ill. Our slogan is "nothing about us without us" and yet unfortunately, this article is only from the perspectives of caretakers.
I think I would rather work with elderly people even if comfort is almost all we can give them.
Also, if you went into the field, I bet your educators would try to get you change your opinion. Everybody wants the glamorous job, but most employment is elsewhere. I have heard this phrased as "all the girls want to work with children, and all the boys want to work in ambulances; we need to work a bit to change their minds."
The US hospitals also had plenty of local nationals coming in, either due to trauma, or due to illness. I also got to go out with some teams (i.e. the "other" people) when they did medical outreach. A few of my friends are Army SF medics, I lived with an Air Ambulance company for most of 2005, and dated a (non-US, coalition partner) doctor for a few months. I did combat lifesaver and some other advanced first aid stuff, and dive medic. I did get to help out with trauma a fair bit, and I've been first responder at a bunch of traffic accidents worldwide.
Actually, neuroradiology would be my #1 pick (I hate being around conscious patients, and even talking to people who talk to conscious patients is bad. A rad at least talks to other specialists, and a neurorad is going to talk to specialists (rads, neurosurgeons) who talk to other specialists (surgeons, oncologists) who talk to normal doctors who talk to patients, so you're pretty far removed. ER docs are kind of looked down on by other doctors (for basically being stream of consciousness, get them in, patch them up, pass them along), but trauma surgeons are well respected. There's clearly a lot of money in gerontology, and demand for internal medicine (although badly paid, and often in crappy parts of the country), but I'd hate those things.
However, I'm doing a non-medical startup, and going to med school seems very unlikely to be in my future.
The same sort of dynamics play out with doctors too. People who get better stop spending time in the hospital, and stop being seen by doctors so often. This can lead doctors to a false view of late stage medical care. They see every moment of the pain and suffering, the struggling that turns out to be in vain, the sheer cost of heroic measures, but they often miss out on seeing the benefits. The time given back to patients who then spend happy years with their family away from hospitals and doctors.
If you don't want to spend your last days being tortured to death in a hospital, tell someone you love and trust and write up the legal documents necessary to enforce that decision. It's an incredibly hard decision to make though, and it's sad that not everyone has someone they can trust to make that decision. My dad was lucky to have an only child who followed his wishes. I can't imagine what it would be like to have some hysterical sibling try to undermine my dad's wishes, but that's what a lot of families go through.
Watching how my parents have dealt with my aging parents really puts pause on me and has me thinking about creating a living Will to make my own wishes very clear.
To my mind they embody the different way of handling end of life issues than standard medical treatment.
Many have argued for prolonging the life span of humans to the point of immortality. Its a thought provoking idea to entertain. One comment ponders rhetorically, wouldn't it be nice to have Einstein and Tesla around.
Not only am I ok with right to die, I absolutely covet it. Not just for myself but the entire society. I am not so sure about "right to life", though it might seem such a no-brainer,
Though we use the word "right" they are often privileges and the important question to think over is who gets to exercise the privileges. That is never uniform, it always comes down to who has the wherewithal to secure that privilege. It is this that causes me to worry.
Sure it would be great to have Socrates and Einstein with us if they chose to, we don't know if they would have. Many assholes would, but more seriously, one can conjecture that the dictators who were not defeated but died naturally would probably choose to live. World history would be a lot different. Would authoritarian regimes live longer ? Difficult to answer.
Then there is the question of ideas. Ideas, both good and bad, they often die not because better ideas replace them, but because their champions die. I don't know whether this is an argument in favor of or against prolonging life, but the need to discuss it will only become more urgent over the years.
It's unfortunate we've surrounded it with so much fear.
Our ideas on death must change. Cause frankly, it's killing us. Death is the natural order.
I heard a great line from one of the few TV shows i watch, Supernatural;
"Who came first? The chicken or the egg? We're too old to remember. But I know this, I'll reap god too". - the aspect of Death.
http://www.amazon.com/How-We-Die-Reflections-Chapter/dp/0679...
However, before making end of life decisions, one should be aware that there is a large and growing hospice industry that benefits from people "giving up" (sometimes leading to greater suffering, as treatable conditions go untreated), and weigh one's decisions carefully: http://www.businessweek.com/news/2011-12-06/aunt-midge-not-d...
I get that gender neutral language like this is the norm these days, but the way it's used in this particular statement, it isn't helping!
That doesn't have to be a matter of luck. If we allowed people the dignity to choose, while still lucid, to end their life, or to set up a strict set of conditions upon which their life will end, we could drastically reduce the suffering involved in death, both for the dying and for their families and friends.
[someone] 2/18/2012 9:16 PM GMT+0100 [Implying they removed a feeding tube]
My response:
You didn't feed him? He died of starvation? That could be painful. You should kill him using exit-bag with helium gas. I'm being serious.
My response was replaced with:
postmoderator responds:
This comment has been deleted by a moderator for violating the site's discussion policy.
I guess that's the normal way of being though. It seems like it is every child's fate to not appreciate their parents enough until it is too late, and to repeat this same cycle when they have children of their own.
Unfortunately, the motivation for these kinds of testimonials is not sentiment or reasonableness. Its profit. Its just not profitable for health insurance companies to treat old people -- that's where they lose all of their money.
http://badcripple.blogspot.com/2012/02/mainstream-media-disc...
A family brings an elderly patient suffering from stroke, diabetes, etc. into the ER. The patient is in a coma. Before asking them what they want to do, take the family into the NICU and tell them: we have limited resources, and we can either save a baby in here, giving him a chance for a healthy productive life, or we can perform heroic measures on your loved one, almost certainly doing nothing but prolonging his suffering. What is your choice?
The time to educate people on these choices is years before you have to make them. The solution isn't to take people thrust into tragedy and threaten to kill babies if they don't do the "right" thing. It's to change our culture such that people consider these hard choices much earlier and life, and feel comfortable discussing these issues with their families.
Families need to sit down and have an honest discussion about death before it's necessary. It's a hard conversation to have, but it can save constantly questioning and second guessing yourself what your loved one would want to happen.
If we all lived forever, where would we put all the people?
"Bridgman committed suicide by gunshot [at age 79] after living with metastatic cancer for some time. His suicide note read in part, "It isn't decent for society to make a man do this thing himself. Probably this is the last day I will be able to do it myself." Bridgman's words have been quoted by many on both sides of the assisted suicide debate."
http://en.wikipedia.org/wiki/Percy_Williams_Bridgman#Death
http://en.wikipedia.org/wiki/Synthetic_diamond#GE_diamond_pr...
EDIT: I forgot to end with: Mr. SENS, FTW.
The article miss the probably most interesting aspect.
In fifteen years, there will almost certainly be organs grown from stem cells, which allows transplants without immunity problems.
What would happen to the first example in the article when the hearth and kidneys are replaced? When growth factors and (more or less) young stem cells start repairing the brain damage and the Parkinsons?
It might take twenty years. It will still be in time for most people on HN when you grow old.
Anyway, it is probably only of academic interest to me (old health problems will probably get me).
As a biologist, I can tell you that home-grown organs are waaay more than 15 years away.
Currently, we can grow skin pretty well. Mostly because skin likes to grow and is very simple in structure. We are making progress on growing liver tissue, again because liver cells are particularly robust and the liver is not a strongly organized tissue. It is (mostly) a big blog of heterogeneous cells that does not require complicated geometry and organization.
Anything past those two are wishful thoughts. I'm not discounting the advances that we have made in growing organs. We've done some very cool work, but it is certainly a long way away. Once the basic science is established, it will still take a long time to get widespread medical approval.
Re: "repairing" the brain makes growing an organ look trivial. The difference is like building a house vs repairing CERN's LHC.
Did that not pan out, or are there other major hurdles that would prevent this from being viable within a couple decades?
side note: your Cloudera job post has cudazi tags visible.
The challenge is to get all the right cells in the right places. Heart cells need to be arranged specifically so that the heart can pump. Wikipedia has a good animated gif of how the conduction wave flows through the heart [1].
Fortunately, this is a surmountable challenge. You can throw progenitor cells into a pre-built scaffold and they tend to organize like they should. This is because most organs in your body are built of relatively interchangeable parts. E.g. Most of your heart is the same kind of muscle cell.
The brain is a bit different. First, the type of damage is very dependent on the disease state. Have we lost entire neurons? What regions are affected? Are our neurons de-mylenating?
Second, your brain is unique to you. Sure, we both share stereotyped architecture: we both have a hippocampus, a cerebral cortex, a cerebellum, etc etc. The structure inside each region is pretty stereotyped too - we both have cortical bundles in our neocortex.
But when you drill down to the cellular level, we are very, very different. Each neuron I possess in my brain has a unique (and dynamic) synaptic arbor that connects to thousands of other, unique neurons.
If I suffer a stroke and a portion of my brain dies, you can't simply throw more neurons in to compensate. Effectively, neurons are not interchangeable parts like heart muscle cells. You need to coax those neurons to:
A) live in relatively hostile environment
B) synapse to appropriate neuronal populations
C) weight those synapses correctly.
[1]http://en.wikipedia.org/wiki/File:ECG_Principle_fast.gif
Side note: Thanks for the heads-up on the Cloudera post - I just migrated themes and servers last night :)
Another way to look at it is the information theoretic perspective: when organ X is damaged? what information do you need to grow it back? If X is anything but the brain (and maybe part of the spine), the information you need can almost always be picked from somewhere else (Stem cells plus standard human anatomy). We can't do that now, but in principle it should work.
But if you lose part of your brain, then it's a tougher challenge, because your personal memories, skills and more are stored in it. The only way to recover that would be to use the redundancy your brain might feature. Otherwise, it's lost. Sometimes, you cannot recover a code from a burned piece of paper.
Now, if your brain just suffers a terminal illness, but the information is still there, then healing you may be as difficult as copying your whole soul into a computer, synapse per synapse. (Or it may not: we do have way to slow down —not heal— Parkinson, for instance.)
That said, I'm not holding on to life for its own sake. At some point I will either become incapable of any real physical activity OR too stupid to live. I've gotten a little taste of both when I've needed to get a baseline reassessment of my condition (which is not a typical presentation of anything, but seems to be more like Parkinson's than anything else on the menu). It's a bit of a race, really. I'm hoping that stupid wins, and that when it happens I do something so spectacularly stupid on the way out that it will make the news the world over (and perhaps win me a Darwin award).
hardly just skin and liver!
It is easy to find information about e.g. therapies for horses' joints. This link is about humans, just a few years from patients.
http://news.bbc.co.uk/2/hi/health/1809322.stm
There are people walking around with bladders and (built with a scaffold) throats. There are grown muscle patches for hearts, etc. (I didn't mean to replace parts of the brain surgically of course, stem cells rebuild damaged areas after strokes.)
(I assume you aren't claiming that Parkinson won't be cured in 20 years?)
Do you have any references? What are the show stoppers to scale to more complex tissue? The field obviously moves fast. Muscles like the heart and "simple" organs like kidneys should probably be possible. Is blood supply not solvable?
Edit: Sorry for coming back a few hours later. (I was downvoted a while? :-) )
I know my grandparents didn't fear or refuse to believe in death in the same way as people do now (and they had seen a lot of it). I hope I'm strong enough and happy enough with myself that I will gladly relinquish my hold on the reins of life when its properly time to do so, and not fear it or be sad.
It might not work but it is a _much_ better use of our tax dollars than blowing up brown people in the middle east.
We all are afraid of death and the reason humans invented religion was to cope with this fear.
If you're going to downvote...
Instead say something so we can discuss!