I’ve read many reports of terminal patients who wish that they hadn’t wasted the last few months of their healthspan searching for Hail Mary treatment options. If you were to ask yourself what you would do with 1-3 months of healthy life left, would you spend it in a hospital on chemo?
I think there's a lot of cognitive dissonance on this topic from people like Ray Kurzweil. The overwhelming majority of increases in life expectancy over the past millennia have come from reductions in childhood mortality. It's not like people in the past just hit 40 years old and randomly keeled over. But rather people were quite unlikely to make it out of childhood. If one person dies in childhood and the other at 80, you have a life expectancy of 40 years old but it's rather misleading! In reality the average life expectancy (for those that made it out of childhood) has remained pretty similar for millennia - around 70 years. [1]
So for instance the Founding Fathers died at an average age of 72. John Adams lived to 90, and Sam Adams/Jay/Franklin/Madison died in their 80s. The only two who died before their 60s were Hamilton, who was killed in a duel, and Hancock, who'd had poor health throughout most of his life. This is a nice sample because you had Founding Fathers as young as 18 (Monroe) when the Declaration of Independence was signed, so we're certainly not seeing a surviorship bias. They were certainly wealthier than average, but all the wealth in the world doesn't matter when state of the art healthcare was doing things like treating infections by bloodletting (including by leeches) to get rid of 'bad blood' or 'balance the 4 humors.'
[1] - https://aeon.co/ideas/think-everyone-died-young-in-ancient-s...
Eh, in some ways but not all ways.
The wealthy, for example, were much more likely to receive proper levels of nutrition. They could afford to eat well balanced meals.
If you are poor, you're living off of whatever you can scrounge up or grow.
But in many ways I think this is a desirable bias. Because when we look at past vs present life expectancy, what we're mostly interested in, as far as these topics go, is how medical technology is improving things. The implied question is 'What would ones life expectancy be without modern medicine?' And the upper classes of times past basically answer this for us.
The one thing we need to ensure is that we're not picking a literal survivorship bias. So for instance when looking all the way back to Ancient Greece one again finds an average age of death of about 70 years old. But many people point out that if Plato died when he was 20 instead of when he was 80, then we might never have heard of him. So the sample is somewhat biased. This is kind of true, but it's also true that nearly all of these people we would have known about if they died when 40, but anyhow this is all a really annoying and subjective debate - so things like the Founding Fathers are much nicer because there there's 0 argument of survivorship bias.
Even then though, in e.g. Victorian times, the median (50th percentile) gets skewed by horrendously high infant mortality.
Looking at the 75th or 80th percentile, or the life expectancy for an 18 year old, is a better measure. High scores for the 75th can mask deaths due to inequality to some extent, but because wealth distributions are _so_ skewed at the top, the 75th percentile typically looks more like an average/poor person than a rich person.
It's this context that I think explains things like infant 'exposure' in various cultures over time that we can't even imagine today - parents simply leaving their child out to the wilds, essentially to die - while retaining that cognitive dissonance that perhaps he might be found and raised by somebody, as was a frequent component in the hero legends, such as with Theseus and Perseus.
[1] - https://ourworldindata.org/child-mortality-in-the-past
Because that's the modern definition of life expectancy: the average (mean). Probably because the primary driver behind the production of actuarial tables has always been for insurance, annuities, and similar purposes. For calculating costs and valuations the mean is often a better measure because the distribution of deaths isn't normal. Though in modern actuarial tables you'll often find both.
I would assume popular literature quotes expectancy figures from birth because that's the easiest thing to do when you're just trying to give a single simple figure. But actuarial tables have always been just that--tables. Given a person at age X, what's their life expectancy. The first row will be from birth, but people with money on the line have always understood that number is mostly irrelevant. Here's an actuarial table from the 3rd century which was built for calculating annuities: https://en.wikipedia.org/wiki/Ulpian%27s_life_table Interestingly that table seems to use median life expectancy.
Actuarial science was a significant driver in the development of modern statistics and mathematics, especially as the market for financial products exploded over the past several centuries. The tables and models for life expectancy from 150 years ago were startlingly accurate, even in their forecasts of changing life expectancies. When Social Security was passed in the 1930s the models for how life expectancies would change, both from infancy and across all the age brackets, were spot on with actual changes up to the 1990s.
1. We can already splice up DNA with decent accuracy, so it's just a matter of finding what DNA to splice in/out to have the desired effects, and then a method to apply this to every cell.
2. We're close to being able to disassemble someone's nerves and simulate them with a very high accuracy. So, at the very least we could give people new robot bodies.
Now, it's true that even the wealthiest people in the world several hundred years ago had no hope to get either of these done. But it seems entirely plausible that if everyone came together to work on this now, it could be solved in a few decades. I think it isn't happening because (1) people's discount factors aren't high enough to throw everything to their future; (2) the wealthiest people are older, and have the least chance of success; (3) it's a coordination problem that most people aren't even aware they can coordinate on; (4) a significant number of people don't even think it's a problem (because of the stories their ancestors told about death maybe not being the end). The last two are solvable, but the first are just mismatched preferences that you can't really get around.
In general a lot of the research around aging is more motivated by a desired outcome than a the evidence in question. Telomeres, for instance, are clearly correlational rather than causal with contrary evidence in numerous species such as mice most obviously. In general there seems to be practically a rule that any observation of biological immortality is later met with a refutation. For instance lobsters are observed to eventually stop even trying to moult as they age, which inevitably leads to their death. Senescence manifesting differently in different species obviously does not imply immortality.
People, even very smart people, have a habit of lying to themselves when they want something to be true. Obviously religion is a good example of this in the past. And in the present I think we're largely just replacing religion with pseudo-scientific hypotheses to the same end. For instance I personally am a strong believer in the simulation hypothesis, at least I think I am. I don't know whether I "really" believe it's as sound as it seems, or if it's a coping mechanism to balance a secular worldview and the desire to not die. I mean it's not really even a theory since if it turns out to be true, and one day I simply 'wake up' - is that new reality "real" or just another simulation? But I'm at least aware of the fact I may well be lying to myself with a highly debatable theory.
It's actually a working treatment https://en.wikipedia.org/wiki/Hirudo_medicinalis#Medical_use
Not as much as I should've. You've made a good point, thanks.
Would you accept a 10% decrease in the quality of your life in exchange for an extra year? I probably would. I probably still would if that was a 20% decrease. But I probably wouldn't go for that extra year if I had to accept a 90% decrease in the quality of my life.
The threshold is a personal decision. There are no right or wrong answers. We should even indulge someone who would accept that 90% decrease for an extra year. That should be their choice, and even if I wouldn't make it myself, that's neither here nor there.
The context is _clinical trials_, tho, so that's not generally what's on offer.
If you only want to contribute toward things if they benefit you, then the real cancer is you.
It is heroic to volunteer oneself into a clinical trial.
In fact, if you feel so strongly about it: you can go do so literally right now. I'm happy to help facilitate.