Monday, November 4, 2013

Life Extension and Distributive Justice

Life expectancy increased dramatically over the course of the 20th century. In the UK and US — to take two obvious examples — it increased by approximately 30 years. Further increases are projected in the future. In addition to this, advances in medical technology are hoped by many, and demanded by some, to dramatically increase lifespan (a subtly different concept from life expectancy) in the coming century. It may soon come to pass that lifespans of 120 to 150 years are no longer confined to the realms of science fiction.

These increases in lifespan raise interesting issues of distributive justice. The typical life is a sequence of events, strung together under a (usually) common personal narrative. This sequence is broken down into a series of stages. Jaques famous “Seven Ages of Man” speech from As you like it nicely illustrates the idea. Each of these stages is associated with certain goods and opportunities. And a good life is the one that has access to the full suite of these goods and opportunities. In other words, the good life is one in which the goods and opportunities are justly distributed over the course of one’s life.

The problem is that increases in life expectancy and lifespan threaten the just distribution of these goods and opportunities. This has long been recognised. Increasingly aging populations put pressures on the traditional welfare system, and these pressures may have to be paid-off by the younger generation. This means that different age groups will have differential access to goods and opportunities. Is it just/fair for different age groups to be treated in this way?

The purpose of this post is to investigate this question. It does so in three parts. First, I talk generally about the concept of intergenerational justice, and the specific form of intergenerational justice that is at stake here. Second, I talk a bit more about the distributional problem that arises from increases in (life) expectancy and span. Third, I consider possible solutions to the problem, drawn from the pre-existing literature on distributive justice.

A couple of interpretive notes before we start in earnest. This post is inspired by Roberto Mordacci’s article “Intergenerational Justice and Lifespan Extension”, which appears in the book Enhancing Human Capacities. “Inspired” is the operative word here: I found the article quite confusing and so I’ll deviate from it a bit. In addition to this, readers should be aware that the topics of radical life extension and negligible senescence are not necessarily enjoined by this analysis. The distributional issues I discuss arise at relatively modest levels of lifespan extension.

1. Intergenerational Justice
One useful aspect of Mordacci’s article is the way in which he distinguishes between different concepts of intergenerational justice. Obviously, the concept of intergenerational justice is intended to refer to justice between different groups of people, where these groups are determined by diachronic as opposed to contemporaneous relations. The problem is that the notion of a “generation” vague.
In the interests of clarity, we could speak to three different concepts of intergenerational justice:

Justice Between Non-Coexisting Peoples: In other words, justice between persons who are currently alive, and future, currently non-existent, persons.
Justice Between Birth Cohorts: A “birth cohort” is defined as a group of persons born in the same time period, where this time period is more-or-less arbitrarily determined. For example, the “baby boom generation” is a birth cohort consisting of all those born between 1946 and 1964. Likewise, “generation X” is a birth cohort consisting of all those born between the mid-1960s and the early-1980s. (I believe I’m classified as a Generation Y-er or “Millenial”)
Justice Between Age Groups: An “age group” is defined as a group of persons all around the same age. For example, people aged 15-29, or 25-49 and so on. This is distinct from the notion of a birth cohort because people move through different age groups during the course of a single lifetime, whereas they always remain part of the same birth cohort.

Each concept of intergenerational justice raises different issues, some of which are relevant to the life extension debate, some of which are not.

The first concept — that of justice between non-coexisting generation — is perhaps the “classic” sense of intergenerational justice, often associated with environmental ethics. It raises many interesting philosophical puzzles, such as: Can we have duties towards non-existing persons? Are currently non-existing persons ethically “harmed” by our actions in the present? That said, it doesn’t raise any novel issues in relation to life extension. The question of whether we owe future persons a decent life remains roughly the same, regardless of how long that life is going to be.

The second concept is more relevant to the topic of life extension, and indeed we see hints of its relevance already. Debates about the pressures being placed on systems of social welfare often raise issues of justice between birth cohorts. Typically, the concern is that the younger generations (e.g. the Millenials) are being burdened with the costs of the older generations’ (the boomers) healthcare and retirement packages. This is thought to be unfair because it can limit the opportunities available to the younger generations. (Personal Note: I’m sceptical of this claim.)

Despite all this, it is probably the third concept that is of most interest to the life extension debate. For it is this concept of justice which focuses not just on the distributions made available to groups of persons, but to the distributions made over the course of an individual lifetime. We’ll talk about this in more detail now.

2. Stretching out the goods of life?
As mentioned in the introduction, the typical life can be broken down into a series of stages, each of which is associated with a distinct set of goods and opportunities. The ethical question we are concerned with has to do with the distribution of those goods and opportunities across the various life stages.

Of course, the precise characterisation of life stages will always be problematic and contentious. Some people will argue that any proposed division will be arbitrary and culture-specific, or that even if it is broadly true, there are many individual lives that fall outside its scope. Nevertheless, it is worth starting out with some sort of framework, even if we end up rejecting it for sound ethical and empirical reasons.

So we’ll start out with Mordacci’s suggestion that, at least within Western societies, the typical life consists of four stages: (i) the rearing/educational stage; (ii) the professional (and possibly) family creating stage; (iii) the mature/expert stage; and (iv) the retired/reduced activity stage. The kinds of goods and opportunities associated with the first stage relate primarily to leisure and education; with the second stage relate primarily to relationships and employment; with the third stage relate to personal and career fulfillment; and with the fourth stage to leisure once again. Common to all stages are the basic needs for survival (food, shelter, healthcare etc.) and other goods (friendship, knowledge etc.). That said, there is some variance both in how we think those needs ought to be met, and in terms of the volume of need, across the stages. Thus, for example, the middle two stages are often viewed as the “productive” ones, during which people are expected to meet at least some of their own basic needs, and to contribute to the basic needs of others. Similarly, demands on healthcare are typically greater during the fourth stage.

How are these stages, and their associated goods and opportunities currently distributed between the age groups? The diagram below gives a rough idea.

With this diagram in mind, and assuming we are happy with the current distribution, an obvious solution to the distributive problem presents itself. To address the problem posed by life extension, we should simply extend or “stretch out” the stages of life. Thus, instead of covering the first 25 years of life, the rearing and education stage might cover the first 35 years of life, and so on across the other stages. To some extent, we see this happening already, with an increasing number of people not entering full-time employment until their late twenties, and with compulsory retirement ages creeping gradually upwards.

But there is some reason to be skeptical of this “stretching out”-solution to the problem. For one thing, it may not be practicable. To give an example, reproductive opportunities for women — despite ongoing developments in fertility medicine — are predominantly distributed to those in their 20s and 30s. For another thing, “stretching out” lacks a clear ethical or normative foundation. We should at least consider the relevant ethical principles, and the different possibilities they raise, before we opt for this most obvious of solutions.

3. Distributive Principles and Lifespan Extension
Broadly speaking, distributive problems can be approached from one of three ethical perspectives: egalitarianism, libertarianism, and utilitarianism. Egalitarianism tries to achieve equality of some property or set of properties (e.g. goods/opportunities); libertarianism tries to protect individual liberty; and utilitarianism tries to maximise some property or set of properties. We’ll briefly consider the implications of each for the lifespan problem, though we shall spend most of our time on egalitarianism.

Before doing that, however, I want to reiterate something I said earlier about the nature of the distributive problem. When focusing on justice between age groups, the immediate concern is not necessarily with the distribution across different persons, but rather with the distribution across an average lifespan. Of course, the latter will affect the former, but it will do so in an indirect fashion.

With that in mind, let’s look at egalitarianism. There are many different schools of egalitarianism, usually varying in terms of what is they wish to equalise. If the concern is that everyone gets a equal share of certain goods (e.g. employment, health, family life, leisure time), then we have in egalitarianism a natural ally of the stretching out solution. We maintain the discrete life stages, with their distinctive set of goods, and just give everyone a slightly longer run at each stage.

One problem with this kind of egalitarianism is that it seems to impose a certain view of the good life on the individual. In other words, it smacks of us saying that the only good life is the one that involves education, professional life, family creation, mastery of career, and retirement. Many egalitarians, particularly those with liberal sentiments, are squeamish about imposing such a conception of the good life on individuals. Instead of seeking to equalise goods across the lifespan, they might prefer to equalise opportunities across a lifespan.

But what does that really mean and how can it be justified? Mordacci offers a Rawlsian approach. Rawls, as many people will know, addressed distributive problems with a creative thought experiment. Instead of assessing who should get what from our current position in the world, we should abstract away from that to something Rawls calls the “original position”. In the original position, people make distributive decisions from behind a “veil of ignorance” (i.e. unaware of the social role they will end up occupying). To solve our distributive problem, Mordacci suggests adding age-blindness to the veil of ignorance. In other words, the decision-makers are made aware of the ordinary lifespan, but not of the stage they will be at when the proposed distributive scheme is implemented.

Where would that lead us? Mordacci suggests it would lead us to a “keeping the options open”-principle. In other words, we would ensure that people are not closed off from certain opportunities at the different life stages. Inexplicably, Mordacci thinks that this would still warrant something close to the stretching out solution. He does so because he thinks this principle:

...suggests that the options which need to be open for different age groups can indeed be quite different and that therefore we have to elaborate on an image of each stage of life in terms of specific needs and opportunities. 
(Mordacci, 2013, p. 418) 

I fail to see why this must be the case. Specificity of needs might be fair enough, but opportunities as well? Surely, a rational decision-maker, who is unaware of what their actual age, would not wish to foreclose opportunities simply because they are old? As I see it, the keeping the options open principle mandates something much closer to a libertarian ideal, where choice and freedom are maximised through all stages of life.

Of course, an extreme version of this ideal may not be practicable — there would still need to be an initial rearing/education stage and perhaps some reduced activity/retirement stage — but perhaps something like a biased stretching out solution could work? If we think about the four-stage model given above, the middle two stages are usually those associated with the maximum degrees of freedom and opportunity: with an education in place, you can choose from a full range of life and career options. I think if I were forced to pick a distributive scheme from behind a veil of (age) ignorance, I would like that phase of life to be as long as possible.

Just to be clear, endorsing this libertarian solution does not, necessarily, lead us to endorse libertarianism as a whole. Remember, the focus is on distributions across an average lifespan, not across groups of currently existing peoples. One could (maybe) embrace a libertarian solution to lifespan distributions while at the same time accepting a more egalitarian approach to other distributive problems. (I haven’t taken the time to work this out, but it seems prima facie possible).

What then of utilitarian solutions? They will somewhat similar in that they will focus on the distribution of goods and opportunities that maximise some property. They could also justify biased forms of stretching out. For instance, if it turns out that childhood is the happiest time of life, a utilitarian might favour extending that life stage as much as possible. Or if it turns out that the maximum degree of preference satisfaction takes place during retirement, then that stage should be extended.

Of course, any form of biased stretching out solution will need to confront practical difficulties. I won’t address those right now. Instead, I’ll just conclude with the general point: biased stretching out might be an ethically preferable solution to the distribution problem posed by lifespan extension.

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