Mixed views about radical life extension

Introduction

A number of studies have explored public attitudes toward life extension technologies. A telephone interview survey conducted among 605 members of the Australian public reveals ambivalence on the issue of extending the human lifespan (Partridge, Lucke, Bartlett, & Hall, 2009). A recent study conducted in 2012 among the Canadian public suggests that moderate life extension of up to 120 years is supported by 59% of 1,231 survey participants (Dragojlovic, 2013). That recent study also suggests that individuals’ general orientation towards science and technology may strongly predict support for radical life extension. In another recent (2013) study conducted among 2,012 nationally representative cohorts in the United States by the Pew Research Center, 51% said that radical life extension (RLE) would be a bad thing for society while 41% said that it would be a good thing (Funk et al., 2013). Since the prospect of extending healthy human lifespan beyond 120 years is still a very controversial issue, it would be informative to explore how the cultural values or attitudes of the public are related to their views about RLE, i.e. their support for or rejection of the prospect of radically extending healthy human lifespan. Our current study explored the relation between responses of 326 university students to five key questions on RLE and their cultural attitudes as indicated by their responses to 20 statements derived from the World Values Survey.

Design and Method

An online deliberative survey among university students using the “N-Reasons platform” (Danielson, 2010) was conducted between January 2012 and January 2013. The aim of the survey was to explore attitudes to RLE and compare cultural attitudes with responses to five main survey questions related to biomedical research in RLE, means of life extension, effects of RLE on global population growth, compatibility of deeply held beliefs with RLE and interest in using RLE in advanced years. (See Appendix 1 for details of the five main survey questions). The survey consists of three stages (see Fig. 1 below). In stage 1, five main survey questions were asked. Prior to asking each question, a paragraph (authored by Alvarez) discussing relevant information on life extension research was presented with web links to relevant journal articles. In the invitation page (which was part of stage 1), web links to two journal articles were also provided (in particular, a link to the article by Jim Oeppen and James Vaupel, published in Science in 2002, arguing that life expectancy continues to increase; another by Aubrey de Grey, published in Experimental Gerontology in 2003, criticizing arguments for rejecting foreseeability and desirability of anti-aging medicine)¹. In survey question 1, the first sentence about life expectancy included links to a web article showing current life expectancy averages around the world and a New York Times article reporting the death of the world’s oldest person, Jeanne Calment².  In survey question 3, web links to two articles were provided, one³  supporting the idea that overpopulation could result from using RLE while another⁴ showing the opposite.  In survey question 4, a web link was provided to an article citing surveys around the world indicating that many elderly people want to be resuscitated.⁵  After completing the five main survey questions, participants were then presented two additional questionnaires: one on cultural attitudes using 20 statements from the World Values Survey (WVS)⁶ and another on health attitudes using 12 statements from Dutta-Bergman’s 2004 study  (see Appendix 3 for details).

In stage 2, participants (who were members of a university class) were then engaged in a face-to-face discussion with their fellow students and facilitating instructors (Alvarez, Mendoza and Evangelista)⁷ focusing on the five main questions. They were then invited to take the survey a second time in stage 3 to reconsider their choices and the reasons they posted, giving them the opportunity to change these in the light of the class discussion in stage 2.

Participant Recruitment

Eleven classes were recruited from four universities in Norway and the Philippines, including two public cohorts with participation by students from Canada and public participants who discovered the survey site on the Web. Our participant recruitment follows what is called a non-probability/accidental or convenience sampling technique. We do not claim that the results are generalizable to the population (or country) from which the participants came. Most of the participants who are members of the 11 classes were asked to participate in all three stages of the survey where two of the authors (Alvarez and Mendoza) and one university professor facilitated the face-to-face discussion stage. The classes that participated in Norway consisted of courses in technology and ethics and corporate social responsibility. Both classes consisted of a mix of students from natural sciences, engineering, social sciences and humanities, including philosophy. The classes from the Philippines consisted of two courses in critical thinking, five introductory courses in philosophy and two courses in science and technology studies (see Table 1). All classes consisted of a mix of students majoring in different study programs from the natural sciences, engineering, social sciences and humanities, including philosophy. There were 489 registered participants but only 326 were included in the analysis. One-hundred and sixty-three were excluded due to incomplete responses in the cultural attitudes questionnaire, which is key to addressing one of the main research question on how cultural attitudes relate to views about RLE. We excluded responses that contained inconsistent answers, where participants responded with Agree and Disagree on the same question. This was done using a quantitative analysis software command that automatically excluded those responses.



The classes that had face-to-face discussions in stage 2 were shown a short video (seven minutes) on life extension⁸ followed by a discussion of the reasons for and against RLE technologies. All classes that had face-to-face discussions were invited to take the survey again in stage 3 to reconsider the choices and reasons they posted.

Members of the public who discovered the survey site on the Internet or were referred to the survey by their contacts were randomly assigned to the listed classes but were marked in the data tables for exclusion. This mechanism of random assignment of public participants to classes is part of the general design of most N-Reasons surveys to enhance anonymity of responses when participants post reasons.

Results

Quantitative Analysis Aggregated by Question

The aggregated results of all classes indicate a tendency to disagree with statements suggesting that RLE be adopted. Regarding the question on whether RLE is a desirable goal for biomedical research (see Chart 1), 50% disagreed (including 4% who strongly disagreed) versus 13% who agreed (11% strongly) and 37% neutral. When asked if they would avail themselves of RLE in their old age (Chart 1), 56% were neutral and 39% disagreed (26% strongly) versus 5% who agreed (4% strongly). Seventy-nine percent disagreed (59% strongly) that RLE is compatible with their deeply held beliefs.



The overall response to the question related to effects on global population growth (see Chart 2) shows that 83% agreed (including 3% who strongly agreed) that we should be concerned with RLE effects on population growth versus 8% who disagreed (1% strongly) and 9% who were neutral.

Regarding the hypothetical question about which safe and effective method of RLE participants would prefer (see Chart 3), 14% seem to reject any method versus 24% who are willing to use combined natural and artificial methods and an overwhelming 62% who insisted on using only natural means to life extension.

Participants’ cultural values and their responses to survey questions

The World Values Survey (WVS) (Inglehart & Welzel, 2010) has been used in other studies to classify the different cultural attitudes of different populations around the world. Four cultural values are paired in two dimensions/continuum in the WVS. These paired values are mapped in such a way that the Traditional versus Secular-rational values are graphed on the y-axis and the Survival versus Self-expression values on the x-axis.  The values that respondents of the WVS tend to favor can then be mapped where the two dimensions intersect (see WVS wave 5 (2004-2008) in Fig. 2 below).

Our survey adopted four cultural categories from the WVS as a proxy to describe cultural attitudes by which our survey participants could be grouped.  This was not meant to test generalizable theses similar to those made in the original WVS. The 20 statements from the WVS (see Appendix 2) are presented in the survey to ask which cultural values participants are inclined to favor as indicated by a five-point Likert scale (strongly agree, agree, neutral, disagree, strongly disagree).

As presented in the 20 statements, those who favor Traditional values reject divorce, abortion, euthanasia and suicide, and tend to have high levels of national pride and a nationalistic outlook, value religion, parent-child ties, submission to authority and traditional family. Could it be possible that those who have these attitudes would tend to reject RLE as well?

Q4. Avail of RLE in old age

The majority of participants across cultural attitudes were neutral as to whether they would avail themselves of RLE in their advanced years (see Chart 5). The most neutral were Secular-rationalists (63%) followed by Self-expressionists (58%). Traditionalists and Survivalists were equally neutral (both 54%) on the issue. There were also similarities between these groups in terms of being more inclined to disagree (21% to 29% strongly disagree) than agree (3% to 4% strongly agree). These observations show that regardless of cultural attitudes, survey participants tended to have similar responses to the question of whether they would avail themselves of RLE technologies in their advanced years. It is interesting to note that when participants were presented with different reasons for being neutral, the top reason chosen was that they would not know how they would feel (262 votes) when they are in their advanced years  (see Table 3 under the section Analysis of Reasons).

Q5. Compatible with deeply held beliefs

Many participants thought that RLE is not compatible with their deeply held beliefs. There were close similarities in how participants across cultural attitudes responded to the question whether RLE is compatible with their deeply held beliefs (see Chart 6). The majority of respondents from Traditionalists (64%), Survivalists (61%) and Self-expressionists (57%) strongly disagreed. A similar, but small percentage of these three groups chose to be neutral (8%, 8% and 12% respectively); agreed (8%, 10% and 8%) and strongly agreed (1%, 1% and 2%). Less than half but still significantly many (40%) of Secular-rationalists strongly disagreed that RLE is compatible with their deeply held beliefs followed by those who disagreed (25%) and were neutral (18%) with 13% who agreed and 3% who strongly disagreed.

Q3. Concern about effects on global population growth

When asked whether we should be concerned about RLE’s effects on global population growth, a significant majority of participants across all four dimensions of cultural attitudes responded that they agreed (see Chart 7): Traditionalists (82%), Survivalist (81%), Self-expressionists (79%) and Secular-rationalists (72%), with a few who strongly disagreed (between 3% to 4%). A few others chose to be neutral (between 8% to 14%). Even fewer disagreed with the statement (between 5% to 10%). Only a few strongly disagreed.

Q2.  Means to RLE

The majority of Traditionalists (67%) preferred only natural means for facilitating RLE (see Chart 8). Some  (19%)  were open to using artificial means in addition to natural means while others (14%) preferred neither.

Secular-rationalists were divided between those who would allow natural means only (42%) and those who would accept artificial means in addition to natural means (43%). A few (15%) preferred neither option, perhaps, because they reject RLE.

A majority of Survivalists (70%) preferred only natural means to achieve RLE. However, a few (18%) were open to artificial means in addition to natural means. The rest (12%) preferred neither option.

Similarly, the majority of Self-expressionists (54%) also preferred natural means only, but many (30%) were open to artificial means in addition to natural means. The remainder (16%)
preferred neither option.

There seems to be some broad similarities in patterns in the way each cultural group responded to the questions (see Charts 9 – 12).




Analysis of Reasons
We selected the top two reasons per decision in Tables 3 - 7 to explore the reasoning behind the mixed responses observed in the aggregated and group-based decisions. The reasons that were included in the tables were quoted verbatim from the online survey. We chose to present these as they were posted by participants without correcting for typographical or grammatical errors to present the actual words in their original form as written by participants. Adhering to a naturalized presentation of the actual words written by participants allowed us to capture a wealth of information and add rich detail to our analysis of these texts as dialogue between participants.¹⁰  Favoring the natural as opposed to the idealized presentation of these reasons also made our analysis more transparent because it shows what the participants actually wrote.

The top reasons provide some details as to what participants think about ethical controversies surrounding RLE. Perhaps the dominance of disapproval of RLE across cultural groups corresponds to the kind of response that the disruption of well-established moral routines elicits (Swierstra & Rip, 2007), especially among those who may have undergone formal training or education that might have influenced moral routines related to existing technologies. As observed in the 2013 Pew Research study (Funk et al., 2013), those who have more formal education are slightly less inclined to say that RLE is a positive development for society.

‘No’ to RLE research because of overpopulation risk

Question 1 asks about the desirability of RLE biomedical research (Table 3). The top reason for disagreeing with allowing the pursuit of biomedical research on RLE (Q1) concerns the risk of overpopulation (197 votes). The same concern was mentioned in the top two reasons for strongly disagreeing. The top reason for being neutral was because of worries about extending life without quality (103 votes). The top reason for strongly agreeing was based on optimism that if technologies can be developed to extend life, then technologies can also be developed to solve problems associated with overpopulation (69 votes).

Don’t know if I would avail myself of RLE when I am old

Question 4 asks whether participants would avail themselves of RLE in their old age (see Table 4). Most respondents (262 votes) who selected neutral chose the reason “Do not know how I will feel when old.” Could the fact that most respondents were young university students be related to this response? We do not have survey participants in their advanced years so we do not know if age is correlated to this response.¹¹ The next reason chosen by most participants (101 votes) was strongly agreeing because aging is natural and RLE is selfish followed by disagreeing (69 votes) because of the risk of life extension without quality of life. Those who chose reasons to agree and strongly agree were optimistic about the greater opportunities RLE could offer.

To age is natural: accept death!

That aging is natural and death is acceptable was chosen by many (215 votes) as the reason for strongly disagreeing that RLE is compatible with deeply held beliefs (see Table 5). This was followed by responses that highlighted the risk of societal stagnation when lives are radically extended (124 votes). A few who were neutral chose the reason that death is acceptable. The top reasons cited for agreeing and disagreeing expressed optimism about opportunities and the value of freedom to choose.

We should be concerned about overpopulation

Question 3 explicitly asked whether we should be concerned with overpopulation (see Table 6). Many (313 votes) said the reason they agreed was because we should be concerned that sustainable policy be prioritized and quality of life improved first. This was followed by reasons that expressed worry about the risk of further worsening the problem of unemployment (97 votes).  Those who chose reasons to be neutral were unsure whether the benefits could outweigh the risks. Some participants who chose reasons to disagree seemed to disagree with RLE rather than with the statement about being concerned with the effect of RLE on population growth. Those reasons (not shown in the tables) are about the risk of boredom, the risk of increasing the number of retirees due to RLE, and preference of death over RLE.

OK if RLE is done in a natural way?

Question 2 tested whether participants were willing to consider natural means to achieve RLE (Table 7). Many chose the reason (230 votes) that expressed willingness to support RLE if the methods to be used were exclusively natural. This was followed by the reason that supported combining natural with artificial means if proven safe and effective (76 votes). Some insisted that RLE couldn’t be natural (36 votes). A significant number of participants (65 votes) said the reason for rejecting RLE whether by natural or artificial means was because improving the environment should be the priority.

The effect of face-to-face discussions

The face-to-face discussion in stage 2 of the N-Reasons survey seems to have had little effect on participants with respect to changing their decisions. The majority seemed to persist in disagreeing with statements and reasons that support RLE. Out of the 40 participants who reconsidered their choice of reasons posted on each of the five questions in stage 3, only five participants changed their responses.

Discussion

Attitudes toward radical life extension did not correspond to cultural attitudes indicated by responses to the World Values Survey questions. The proportion of agreement/disagreement to statements presented in each of the five questions varied across cultural groups and there tended to be more individuals who disagreed with radical life extension in all groups. Changes in responses after the discussion stage were not significant and most respondents maintained their prior views about the technology.

James Hughes (2010) has suggested that in biopolitics technoprogressives will not be able to forge consensus on issues related to human enhancement technologies (such as RLE) with right-bioconservatives because members of this latter group are ideologically opposed to the cultural values that members of the former group hold. Technoprogressives should rather strategically forge alliances with left-bioconservatives (e.g. greens and environmental activists) since this group shares some cultural values that their members favor.  However, as suggested by responses to the five questions in our survey, there tends to be a mix from each of the cultural groups, categorized according to WVS categories, of those who agree and disagree with RLE as enhancement technology. Analyzing group responses, categorized according to certain cultural categories as biopolitical values or ideology, may not be as simple and straightforward as one could expect, since mixed preferences may be observed within groups who are asked to make decisions about certain technoethical issues. This is especially the case with new technologies that have not yet been subjected to the evolving societal response that creates certain moral routines or habits with regard to such technologies (Swierstra & Rip, 2007). As is the case with new and emerging technologies, these will disturb previously created moral routines and elicit opposition across groups who will disagree with such routines and adopt new ones. It remains to be seen whether this kind of disturbance will create new moral routines or the old will be reasserted. The decision might hinge on whichever old or new moral routine emerges as a successful strategy in dealing with the new technology. In any case, the majority might adopt the successful strategy but this does not necessarily mean that the group will adopt pure strategies (Danielson, 2006). Our observation of mixed responses across cultural groups seems to support this possibility and the dominance of opposition to RLE as a new/emerging technology seems consistent with the disturbance of moral routines pattern suggested by Swierstra & Rip (2007).

Conclusion

The categorization of cultural attitudes toward more familiar technologies may not correspond with attitudes to newer technologies since beliefs and values may need to adapt to new imagined situations that new technologies elicit. Moral understandings associated with familiar technoethical habits and beliefs are not necessarily carried over in relation to new technologies. This will depend on how successful these habits and beliefs are in dealing with new technologies. Existing resource-demanding life extension technologies used to treat the terminally ill and very old yield little gains such that people tend to oppose these technologies as wasteful if not lowest priority. When futuristic radical extension technologies appear to resemble the same cost-inefficiencies as are found in existing expensive treatments, similar responses could be expected. However, more cost-effective life extending technologies such as vaccinations, antibiotics, and preventive measures are associated with moral routines that seem to successfully support these technologies such that any resemblance found in new emerging technologies as RLE would be invoked as reasons to support or consider these new technologies.

Acknowledgements

We wish to thank the following professors for giving us the opportunity to engage their students in this N-reasons survey on radical life extension: Dr. Francis Julius N. Evangelista, Dr. Benjamin M. Vallejo Jr., Dr. Rune Nydal and Dr. Siri Granum Carson. Dr. Evangelista helped us further by conducting the face-to-face discussion stage of the survey in his own class. Special thanks to Dr. Dan Weary for his help and suggestions in doing the quantitative analysis. Any errors, however, are our responsibility.