Old age, sickness, death and immortality: A cultural gerontological critique of bio-medical models of old age and their fantasies of immortality. by John A. Vincent

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Old age, sickness, death and immortalityA
cultural gerontological critique of bio-medical
models of old age and their fantasies of
immortality.by John A. Vincent
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Old age is the stage of life that ends with death.

• The meaning of social categories is established
  in the process of transition.
• It is through the practices, symbols and rituals
  which mark inclusion in and removal from social
  categories including life stages that the
  meaning of the category is established.

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Social constructionist approaches have
concentrated on the transition to old age

• The markers and social processes by which old age
  is distinguished from middle age have been
  examined.
• Excellent historical work has identified the
  establishment of retirement as a key marker of
  old age at 60 or 65.
• Much less researched is the transition out of old
  age. There is only one way to leave old age (at
  the moment) and that is through death.

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Old age has always ended in death but in the past
death was not the exclusive domain of the old.

• Death by act of God, or at the hands of our
  fellow man, or through disease before we are old
  happens, but is increasingly unlikely
• Thus premature death takes on new meanings and
  death is marked by spectacle, horror, outrage
  and hysteria

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There are two academic traditions from which to
understand modern death and its significance for
old age.

• We can use the sociology of science and
  specifically the medicalisation of old age as an
  aid to understanding the cultural construction of
  death.
• The sociology of the body has become an important
  part of modern sociology and can make a
  contribution to understanding the modern meaning
  of death.

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Medicalisation of death and old age.

• Western scientific medicine transforms old age
  from a natural event to a disease. Successful old
  age is not seen as it was in the 18th and 19th
  century as the outcome come of a moral life but
  as the absence of disease. Old Age has become an
  object of scientific and rational knowledge
  controlled by experts.
• You are not only old as you feel when there
  is a scientifically trained expert waiting to
  tell you the basis of your feelings, your
  probabilities of survival, and which drug will
  make it all bearable.

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Science is the principle method through which old
age is understood

• Modern death means
• Death of the body
• Caused by biological failure
• Unredeemed by medical intervention
• Certified by a medical practitioner

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What is the link between science as culture and
the search of anti-ageing medicines and bodily
immortality?

• Are attempts to achieve immortality the result or
  the cause of the medicalisation of old age?
• Are the research efforts to avoid the devalued
  status of old age the cause of the medicalisation
  of old age. Or, does science as progress and
  perfectibility medicalise old age and thus lead
  to its low status?
• Is the immediate cause of the cultural
  de-valuation of old age its association with
  bodily failure?
• Or, does this devaluation stem from the failure
  of science understand and control old age?

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What cultural processes are involved in
bio-gerontology?

• The model for looking at this question is the
  feminist history of science, particularly Haraway
  (1991, 1997)
• Her work deconstructs gendered discourses on
  reproduction within bio-medical science.
• Ageist metaphors are replete in the literature
  and mission statements of the biology of ageing.
  They use imagery in which some cells and their
  bio-chemical components appear as personalised
  images of old age and senescence.

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Aging and the biochemistry of life Robin
Holliday (2001)
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• The paradox of evolution is that those forces
  which gave rise to animals with all their
  adaptations for successful life also gave rise to
  aging and the ending of that life.
• One reading of this sentence draws its meaning
  from an equivalence
• Success Ageing
• Life Death.
• i.e. ageing is the opposite of success - a
  failure.
• An alternative reading of the same sentence
  might be
• successful life successful ageing successful
  death.
• i.e. ageing is not contrasted with life, it is
  life, and thus evolution makes sure all parts of
  life are successful.
• However, the paradox is only present if you
  intend the first reading that ageing is
  failure.

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Science fiction imagines the future of old age as
immortality.

• fantasies of super-longevity and immortality
  reflect the technology of their time.
• immortals are inevitably imagined as being the
  age that is the appropriate cultural prime of
  life.
• the development of super longevity and
  immortality are only a matter of time.

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Ageing is a process, old age a category.

• Attractiveness, health, and youth are linked and
  contrasted to old age, disease, and repulsion.
  Hence the distinctions between techniques to
  preserve youthful appearance and techniques to
  control biological ageing become problematic.
• The enterprises selling youthful appearance are
  highly lucrative.
• There is no shortage of scientific research into
  ageing and there is a plethora of anti-ageing
  medicines. So many that there are wars raging
  within bio-gerontology as to legitimate practice
  and the boundaries of genuine science

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The Juvensa Group say that their

• For the first time in history we have an
  increasing understanding of the fundamental
  biological processes of aging and how to mitigate
  their effects. The market opportunity for new
  ventures to address these needs will be measured
  in the billions of dollars.
• " all the key components of mammalian aging are
  indeed amenable to substantial reversal (not
  merely retardation)." Aubrey D.N.J. de Grey,
  Ph.D. (et al), Department of Genetics, University
  of Cambridge

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The Alcor Life Extension Foundation has been
providing immortality since 1972.

• Cryonic suspension is an experimental process
  whereby patients who can no longer be kept alive
  by today's medical capabilities are preserved at
  low temperatures for medical treatment in the
  future. Although this procedure is not yet
  reversible, it is based on the expectation that
  future advances in medical technology and science
  will be able to cure today's diseases, reverse
  the effects of aging, and repair any additional
  injury caused by the suspension process. These
  superior technologies could then resuscitate
  suspended patients to enjoy health and youth
  indefinitely.

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The debate about the efficacy of anti-aging
medicine.

• Three key papers are
• (i) No truth to the fountain of youth. by S.
  Jay Olshansky, Leonard Hayflick And Bruce A.
  Carnes published in the Scientific American
• (ii) The War on Anti-Aging Medicine by Robert
  H. Binstock in the Gerontologist and
• (iii) Whos afraid of life extension? by Harry
  Moody in Generations.
• They raise the issue of whether the objective of
  Gerontology should be life extension.

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Old age is denied by the construction of bodily
immortality

• The sociology of the body tell us preservation of
  the body in perfect/ youthful/ healthy condition
  is a supreme modern value.
• The cultural dominance of science tells us death
  is a medical problem solvable by the techniques
  of science. If it cannot do so now, it will do so
  in the near future.

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What would a successful mature bio-medical
gerontology achieve?

• The cultural dominance of medical knowledge which
  is seen scientific truth and an infallible
  practice aligns medicine with the goal of
  defeating of death. A goal which implicitly
  devalues old age and turns it into a realm of
  failure. Success becomes the use of science to
  create immortality.

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Alternative cultural tools for a good death

• At the point that we can celebrate death, we will
  know a good old age preceeded it. The cultural
  tools for a good death may be anti-modern,
  post-modern or traditional
• Traditional theocratic, lifes duty fulfilled
• Postmodern going out with a bang original,
  creative and spectacular
• Anti-modern humanistic, celebration of social
  relationships

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Old age as a problem waiting for a solution

• Science plays a key cultural role in modern
  society in authenticating knowledge and is
  presumed in modern cultures to be an omniscient
  problem solver. Hence reports of dramatic new
  discoveries on ageing reinforce the view of old
  age and death as technically soluble problems.
  However this set of understandings inevitably
  condemns old age and older people to the status
  of failure and to meaningless social roles.

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Fantasies of immortality are bad for older people.

• The great investment of time, resources, and
  cultural ingenuity to find ways to live longer
  and if possible for ever, have consequences for
  old age. These attitudes
• postpone action on current problems of old age
  seek technical solutions to cultural problems
• waste resources in pursuit of undesirable goals
• inhibit research into death as a natural event
  and the final stage of the life course as a
  positive meaningful coda.

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The presentation, and two papers can be viewed
at

• http//www.exeter.ac.uk/JVincent/Tampere
  Symposium