This page contains Chapter 8 from
Sustainable Superabundance: A universal transhumanist manifesto for the 2020s and beyond
Note: The text of this chapter of the Manifesto is draft and is presently undergoing regular revision.
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8. Abundant health
[ This chapter is significantly incomplete ]
If there is plenty of clean energy for all human needs, plenty of nutritious food for everyone, and plenty of material goods for all our material needs, but if, nevertheless, our health deteriorates, then human flourishing will be cut short.
So far in history, a deterioration of human health has, sooner or later, been the story of everyone’s life. Either a person’s health has declined precipitously, as in the case of a fatal accident or harsh act of violence, or else it has declined gradually, due to the ravages of one or more diseases that limited mental or physical capability, until the point of death. After a few short decades of life, consciousness has ceased. Loving relationships have been ruptured. Brains have turned to dust. Libraries worth of human experience have, in effect, been burned into ashes.
Transhumanists assert that these brutal “facts of nature” are on the point of being overturned. Thanks to applications of twenty first century science and technology, the restorative biological properties that we presently experience in our youth, when we bounce back quickly from injury or illness, can be extended indefinitely. We’ll be able to live well past the age of 100 without any decline in our health. Indeed, we’ll be able to live well past the age of 1000, without any decline in our health.
Not only will such processes be extended in their duration, but they will gain in their power and effectiveness. Diseases which formerly threatened even the most robust physical constitution will be dealt with quickly, in the not-so-distant future, due to a combination of interventions made possible by progress in regenerative medicine and rejuvenation biotechnologies.
And not only will we remain fit and healthy for as long as we wish, but we will grow even fitter and healthier than we can presently imagine. The transhumanist vision of “better than well” is within our reach – but only if we rapidly alter society’s priorities to give much more attention to this possibility of an unlimited abundance of health.
The naturalistic fallacy
The prospect of unlimited healthy lifespans raises many questions in the minds of people thinking seriously about this topic for the first time. For example, isn’t death natural? And if so, why fight against aging?
Here’s the transhumanist answer. Just because something has been the norm in the past, it does not follow we should accept it and applaud it. The average life expectancy in the past was around 30 years of life. Huge numbers of children died before the age of five. This may be viewed as being “natural”. Transhumanists instead affirm that humans can do better.
It’s similar to how, in the past, the world was full of slavery and caste discrimination. This was even viewed by many as being “natural”. Religious codes seemed to accept such discrimination, as if it were divinely preordained. Transhumanists instead affirm that humans can do better. In this case, the rest of the world tends, nowadays, to agree.
In the past, smallpox was present all over the world, killing huge numbers of people. This may be viewed as being “natural”. Transhumanists instead affirm that humans can do better.
In the past, more than 90% of the population lived in abject poverty, and were illiterate. Starvation was just around the corner. This may be viewed as being “natural”. The Bible even has a verse in which Jesus of Nazareth says, “The poor you will always have with you”. Once again, transhumanists instead affirm that humans can do better.
In short, there is no need to accept the “naturalistic fallacy”.
Indeed, if there is one constant about human nature, it is the desire to do better than our what appears to be our natural allotment. That’s a part of human nature which transhumanists heartily applaud.
Death and meaning
Isn’t the prospect of death required in order to give life meaning?
That claim is no more valid than is the claim that the prospect of divorce is required in order to give a marriage meaning. The purpose of marriage is the development of the relationship itself, not the termination of that relationship. Similarly, the purpose of life is the development of life itself, not the termination of life.
The claim is also like saying that, without the existence of a supernatural God, life would have no meaning, and everyone would pursue utterly selfish behaviours. That view in effect regards humans as being juvenile. In reality, humans have plenty of other reasons for life to become deeply meaningful – and plenty of reasons to transcend egotism – without the need to believe in God, and without the threat of death.
With the advances of science, people will soon be able to choose whether they want to keep living, or whether they prefer to die. If some people, in a sound state of mind, prefer to choose death, that will be their right. But no-one should be able to impose such views on other people against their will.
The threat of overpopulation
Wouldn’t the elimination of aging and death result in overcrowding on the Earth?
Compared to the present, humanity can make far better use of the Earth as a whole. For example, huge swathes of land in some countries are presently devoted to large areas for cattle which are grown to be turned into meat for humans to eat. Improvements in lab-grown meat (using synthetic biology) can soon lead to a massive reduction in that kind of agriculture – and a reallocation of the land formerly dedicated for that purpose.
Transhumanists also look forward to improved construction methods which enable the building of large skyscrapers that are environmentally healthy, as well as being beautiful and inspiring to live in. In the longer term, transhumanists anticipate space stations.
For further discussion of these particular points, the material of the previous two chapters is worth reviewing.
Rejuvenation and social fluidity
If people no longer grow old and die, won’t dictators hold onto power indefinitely? Won’t career progression to positions with more responsibility be blocked, on account of the incumbents retaining their positions indefinitely?
Such views presuppose that only the physical aspects of bodies will be rejuvenated, and that mental structures and social structures will stagnate. Transhumanists instead foresee elevation, not only of physical health, but also of mental capability and social dynamics. As conscious life evolves beyond the surface of the physical earth, there will be an abundance of new possibilities to be created and explored.
A matter of timing
It’s one thing to find reasons to significantly extend healthy longevity – reasons why involuntary death is bad. It’s another thing to find and deploy actual mechanisms to turn that desire into practical medical treatments. After all, people throughout history have searched in vain for an elixir of life. If their search has been fruitless, why should things be changed in the next few decades?
The transhumanist answer is that it’s a matter of time. Compare the long-held aspiration of humans to be able to soar through the air like the birds, controlling navigation and defying gravity. The thought was thrilling, but seemed to be ludicrous. Societies around the world told cautionary tales, like the myth of Icarus, that suggested any such aspiration was foolish. It would not be possible to overcome the downward pull of gravity. Anyone entertaining such a thought was deluded.
However, after millennia in which people could only dream of such an accomplishment – and in which naive pioneers from time to time perished as a result of reckless aviation experiments – finally enough knowledge and expertise was assembled. Thanks initially to the genius and endeavour of the Wright brothers, and subsequently to countless other engineers and craftspeople, rapid progress with powered flight took place from the early years of the twentieth century. Aeroplane journeys quickly became longer, faster, and more comfortable. Less than seventy years later, men were walking on the Moon.
Causes of illnesses
Humanity, thankfully, has a long history in which at least some progress has been made in extending healthy lifespans. This progress has resulted from a better understanding of the causes of illness, and with the associated development of treatments and therapies allowing at least the partial restoration of health.
This progress can be split into three great phases. In the first great phase, dating from prehistory, illnesses were understood as resulting, at least some of the time, from bad behaviour. Too much gluttony, too much anger, too much sloth, too much lust, too much avarice – all could raise the likelihood of ill health. The solution, therefore, was good behaviour – coupled with repentance.
In the second great phase, illnesses were understood as resulting, at least from of the time, from bad hygiene. People learned to beware, not only visible signs of dirt and decay, but also microscopic antagonists known as germs. By overturning bad hygiene practice – and by promoting an awareness of the roles of bacteria, viruses, vaccinations, and antibiotics – large numbers of different infectious diseases could be impacted in parallel. In this second great phase, life expectancy rose from around 30 years, at the dawn of recorded history, to around 70 years.
Of course, people still fall ill and die. There are diseases whose primary cause is neither bad behaviour nor bad hygiene. The modern world is seeing more and more people die from chronic diseases such as cancer, heart failure, dementia, diabetes, lung failure, and stroke. As people become biologically older, they become more prone to affliction from these illness, and the effects of these illnesses become more serious.
Accordingly, the third great phase of extending healthy lifespans – which is in the process of building up momentum – is to recognise and treat aging as the common cause of large numbers of diseases. By fixing aging – and by promoting an understanding of the roles of cellular damage and extracellular damage in the development of chronic diseases – a huge impact can be made on the prevalence of these diseases.
As it happens, it turns out that some animals appear not to age. As these creatures become chronologically older, there is no increase in their likelihood of falling ill and dying. Such creatures are said to exhibit “negligible senescence”.
Accordingly, there is nothing in biology itself which requires living creatures to age. Nature already possesses mechanisms for bodies to repair themselves in response to damage.
Transhumanists foresee that science and technology can adapt, extend, and augment such mechanisms to provide the equivalent of negligible senescence to humans.
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Healthcare and inequality
In many parts of the world, healthcare costs are currently so high that only a minority of people can afford them. Rather than costs falling for drugs and treatments, in some cases these costs are rising. This raises the prospect that therapies such as the abolition of aging will be available only to the wealthiest members of society. The existing “longevity gap” – the difference in life expectancy between the well off and the poor – may be exacerbated.
Such an outcome would be the result, not of bad technology, but of poor politics, and the breakdown of a market economy that would otherwise prioritise reducing the costs of healthcare.
Technoprogressives uphold the principle that society as a whole can set the priority that everyone will be able to enjoy an abundance of health and longevity.
The regulation of healthcare
Access to many medical treatments is highly regulated. Many drugs are available only on prescription. Before becoming available for prescription, drugs need to pass through lengthy and expensive testing procedures, checking for both safety and efficacy. Companies are only allowed to manufacture drugs if they possess certain licenses or meet demanding standards.
These regulatory systems were introduced in order to protect patients from treatments that were ineffective or unsafe. Without such systems, many patients would have died as a result of unsafe drugs, or would have spent large amounts of money unnecessarily. Another problem would have been the spread of resistance to antibiotics (if antibiotic drugs are used too often). In other words, these systems have the intention of protecting the general health of the population from bad medical practice (whether that bad practice is intentional, as in the case of fraud, or accidental, as in the case of incompetence).
However, an unintended consequence of regulatory systems is that access to new potential life-saving drugs can be delayed for long periods of time. Lacking the funding for extended trials, companies terminate investigations into various drugs before there is a chance to establish their true capabilities.
Technoprogressives anticipate a number of changes in healthcare that will preserve the intended benefits of the regulatory systems but diminish their drawbacks. The first category of changes is in improvements in testing new treatments. Advanced computer models can reduce the need for in-vivo trials. Improved understanding of variations between patients, in terms of their genetics, epigenetics, biome, and so on, can make it clearer which patients will actually benefit from a given treatment, and in which cases the same treatment would be dangerous. Other computer models can rapidly identify new uses for drugs which have already been proven to be safe from prior use treating other ailments.
Another category of change is in informed consent – when patients are fully aware of the risks and issues with a new drug, but decide to join a trial of it, whilst waiving their normal rights to sue for damages in case of adverse effects.
Finally, increased sharing of information between pharmaceutical companies, that normally carefully guard their research data (especially regarding failed approaches), will help society as a whole to avoid repeatedly wasting money essentially duplicating trials.
Public policy should prioritise all such steps, for the sake of greater human health, even though individual companies may fear some loss of revenue as a result.
It is also necessary to carry out searching reviews on a regular basis of the effects of regulatory systems, to determine options for improvements – especially in the light of new information. Any intrinsic tendency of regulatory systems towards self-preservation (inertia) should be met by powerful public counterforce. In parallel, any hidden vested interests of the regulators – such as prejudicial commercial ties to commercial companies – should be exposed and unwound.
Prevention rather than cure
The huge financial pressures faced by healthcare systems around the world can be alleviated by switching effort to prevention rather than cure. Rather than people adopting bad diets, bad lifestyles, or addictive drug regimes, and thereby becoming ill and requiring expensive treatments, it is preferable for people to adopt healthy diets and healthy lifestyles. Timely scanning for early signs of looming health issues, provided they avoid risks of numerous false positives, can also enable smaller interventions that cost less and have greater chance of success.
The switch from cure to prevention needs to overcome three issues. First, many companies will earn less revenues if the population remains healthier, since they can no longer provide expensive medical treatments on a long-term basis to people who have chronic conditions. Second, considerable confusion surrounds information about which diets and lifestyles are indeed healthy – since companies are skilled in marketing their products as being healthy even when that fact is debatable. Third, people often adopt bad diets and lifestyle, regardless of the information available to them.
In reverse order, these three issues can be overcome as follows. With greater emotional intelligence, psychological maturity, and a supportive social network, people will be less prone to making self-sabotaging choices. With better systems of collective intelligence, including the application of penalties for communications that are deliberately misleading, the existing fog of confusion can be lifted. And with wise steering of the economic environment, companies will be incentivised to provide services for prevention or early detection, rather than services that keep people chronically ill for long periods of time.
In parallel, the design of healthcare treatments need to consider human factors as well as technological ones. Factors that need greater attention include simplicity of use, respect for wide variations in expectation and habit between different patients, ease of incorporating treatments into diverse lifestyles, and sustainable business models.
[ More material to be added here ]