The capitalist imagination paints the dregs of society as leeches, sucking vital force out of the social body to survive without paying their dues. Reality, however, confirms that it is the upper classes who are quite literally vampiric. After several less than conclusive studies, a startup in California is now offering a transfusion of the plasma of teenagers and young adults for $8,000. The only medical necessity for the procedure is the grim and inexorable march of time: It turns out that young blood may reverse some hallmarks of aging in older individuals. The studies are contentious and not well replicated yet, but the potentiality of undoing senescence is all that is needed to justify taking the blood of the young to feed to the rich.
The prospect of anti-aging technology — of immortality — is one that more and more biochemists, molecular biologists, and biomedical engineers are focusing their work on. Why shouldn’t they? The university campus in America is quite far removed from things like parasites, malnutrition or cholera. The late capitalist experience is, for the West, one of near omnipotence — instantly available information, the ability to summon a car to take you home after the bar. Why should we have to die? The Great Scientist who has defeated polio and smallpox, can they not defeat death too? With the recent discovery of CRISPR–Cas9, it seems that our potential to change and heal the human body is growing exponentially.
Fighting for the right to death in a mortal society is hard enough as it is
If we indulge these dreams of science enthusiasts and Silicon Valley technocrats to assume that biological immortality is attainable and getting closer every day, we must ask questions about how it will function as a piece of social technology. Fighting for the right to death in a mortal society is hard enough as it is; the legal battle for the right to euthanasia is proof enough of this. It is impossible to imagine how complex the issue will become if immortality is ever achieved.
I’m not interested here in the obvious problems: the logistics and politics of an egalitarian distribution of the right to immortality, assuming that it is a medical procedure; or the organization of labor with an undying workforce, assuming the capitalist mode of production still exists. These are just the fundamental flaws of capitalism with a new paint job.
My interest, instead, is in the utter metaphysical poverty of scientism, which is fundamentally unable to address ethical questions. Adopting science as a worldview, instead of a methodology, means accepting philosophical positions such as physicalist materialism and logical positivism in the same breath that one denies those positions have any meaningful content. Science, the methodology, is a descriptive project. An ethics informed exclusively by this methodology is a twisting, self defeating object — one that denies that ethics exist in a meaningful (i.e. physical) sense, but still tries to manipulate and understand them. This strange project can provide us with only one compelling normative ethical belief — that it is unethical to die — which endows scientific practice, particularly medicine, with the ability to furnish endlessly elastic moral arguments against death. It threatens to use its institutional power to steal from us our right to death.
I would like to address the small leap in logic from discussing immortality to discounting scientifically informed ethics. I raise these concerns most simply because immortality is unethical, and I have a great deal of distrust for any system that argues for its desirability. I don’t mean a transcendent, religious sense of immortality — a passing of spirit or essence from this plane of existence to another where it never diffuses — but rather practical immortality: a ham-fisted attempt to recreate this transcendence using only the physically possible and extant world. This can look like the transhumanist dream of transferring human consciousness into a machine, or the fixation within biological sciences on shortening telomeres, in-vivo gene editing, and vampirism. These proposals pass themselves off as rigorous, physicalist, and rational, and this is fundamentally dishonest. A rational investigation of the mechanisms of aging gives way to the fantasy of injecting oneself with young blood and living forever, like fever-wracked conquistadors in search of the Fountain of Youth.
Natural science alone is unequipped to handle any significant ethical question, least of all that of death. The scientific method is explicitly limited to physical, observable, and replicable entities, events and qualities. Though science can (and has) observed processes in the brain while ethical reasoning is happening, and designed studies to isolate relevant qualities of ethical dilemmas and our decisions about them, it can’t define ethics like it defines gravity. Experiments on (mostly Western, mostly affluent) people showing that they use different areas of their brains to make emotional, rational, and ethical decisions is one thing. Being able to physically observe the quality “ethical good” and the ways it exists in and interacts with the rest of the world is an entirely different order. Since the scientific method is morally relativistic (it leads to the position that there is no absolute good) this observation becomes even more difficult. As good an approximation as you could make would look a bit like this: Ethical good is the sum total of all neural activity in the areas of all human brains that represent desirable outcomes to ethical dilemmas — a definition that is impossible to observe or manipulate and contains billions of contradictory data points.
A rational investigation of aging’s mechanisms gives way to the fantasy of injecting oneself with young blood and living forever, like fever-wracked conquistadors in search of the Fountain of Youth
The scientific method is an observational tool — it can only provide descriptive statements. No amount of science can tell us what ethics is; it can only tell you how people behave when they are being “ethical.” But science is often thought of as a complete worldview that could furnish us with some moral reasoning tools: The foundations of modern European biology are rooted in Protestant theology, and most particularly the idea of reproductivity. Our understanding of biology, evolution, inheritance and behavior all touch down onto DNA — the ultimate reproductive machine. Even the earliest formulations of understanding the traits and behaviors of animals, from Mendel to Darwin to Lamarck, are rooted in reproduction and God. In formulations based on reproductivity, biology becomes focused on living and dying. Just as a Christian theology can forgive killing infidels during the crusades but not the mortal sin of suicide, reproductive biology can forgive killing, but not dying.
This axiom becomes an underlying force throughout all of western medicine, as well as our perverse fixation on immortality. We can see its bones and its ethical inadequacies in a few places — one being literal vampirism. Another, more productive case, is that of a patient in an unresponsive, “brain-dead” state. Here, we see clearly the ethical commitment to avoid death, and how it is fraught with contradiction and ultimately untenable, as well as the inscription of what Michel Foucault termed “biopower” onto the unresponsive body. If anything at all happens to this body, it is almost certainly the result of someone else’s actions: an intersection of scientific and medical ethics, clinical gaze and discipline, and the powers of the state flowing through the veins of the medical staff, continually allowing them the power to organize living and dying.
Consider a case in which an unresponsive or “brain-dead” patient has asked for, or not asked for, a Do Not Resuscitate order on their chart. A DNR, increasingly referred to as an Allow Natural Death (AND) order, means that in the case of cardiac arrest or a similar condition requiring CPR, intubation, or defibrillation, medical staff are not to intervene: the patient will be “allowed” to die. Allowing death — where the state allows a doctor to allow death — becomes an intentional act, as if anyone had a choice. It is common for advance directives or living wills to specify a person’s wishes about DNR orders in the case of a medical emergency. However, neither an advance directive nor a living will carries enough authority in the medical field to be legally binding. In the United States, medical professionals are bound to “respect the will of the patient,” but until the doctor signs a DNR, it is non-binding. If, for instance, you have in your living will that you would like to have a DNR order, and you wear a bracelet that says DNR, an EMT is still legally obligated to attempt to resuscitate you until a doctor says otherwise. In several countries, medical professionals are not legally allowed to respect the patient’s wishes regarding DNR orders, and must attempt resuscitation regardless.
Here the medical system is a particularly salient example of Foucault’s biopower at work. The hospital is organized explicitly to distribute life, to organize the conditions allowing life, and it is the doctors and nurses that do the legwork of doling out this life. This also amounts to a management of death and its forms — a DNR is non-binding until a doctor approves it, regardless of the wishes of the patient or their loved ones. Here the medical field is bound to its exercise of biopower — having received this authority from the state — but completely unable to wield it in an ethical way. Because medicine is informed in its techniques and commitments by scientific thought, the prime directive of a medical professional becomes primum non nocere — “first do no harm,” or interpreted otherwise, “it is unethical to allow death.” I am not arguing that the edict itself is unethical per se — merely that it is not, in fact, verifiable through the scientific method. Any claim to an unbiased, objective ethical judgement regarding life, death, or dying hides its bias and subjectivity in the accepted but unstated rules of society through which the practices of biology and medicine have been strained.
Dying, as an experience, is not something that science is equipped to say anything meaningful about. As a work-around, medical ethics lean heavily on inherited Protestant values, which is not wrong: The deeply unsettling and unjust result, however, is purporting to make objective decisions for people who ought to be making subjective ones. Dying is a theological — or at the very least a spiritual — decision, even though a doctor or scientist is wearing a labcoat and is allowed by the state to “let” you die. Scientific reasoning might deny that this kill but don’t die command is based in anything other than observable physical phenomena. We can see this in the legal battle for assisted suicide and one’s right to die, in the fact that if you ask a doctor to let you die, the decision is still somehow the doctor’s.
The deeply unjust result of Protestant values in scientific fields is purporting to make objective decisions for people who ought to be making subjective ones
This contradiction comes to a head in the case of a non-responsive, “brain-dead” patient. The medicalization of the brain-dead body is two-fold. First it is decontextualized: The person is exhumed from the body in order to justify the denial of autonomy. The body is emptied of response, intelligence, compassion or agency; the person is “already dead.” This is followed by a recontextualization where the person is placed back into the body and it is permissible (or impermissible) for them to die a second time, through the institution of a DNR order. This syllogism is half-baked — the seizure of the right to make a decision is concomitant with the denial of their agency and being, but the decision operates as if the patient has agency and being and would prefer not to die — or at the very least, that it would be unethical for them to die. It becomes clear, then, that the decision is not being made in interest of the patient, who has already been considered without agency or will, dead in every sense but the strictly biological.
Our justification is instead a priori, and tautological: The doctor must make a decision about the life or death of this person because doctors must make life-or-death decisions about people. The state both allows and demands that they do so. They are the synecdochic hands of a puritanical society, excising the unhealthy, the cancerous, pushing death to the margins. The outcome of the decision is entirely unimportant — we have explicitly held that the patient is dead in the first place. What exists is a warm cadaver onto whom all manner of ethical mess and biopower is inscribed. This two-pronged apparatus of science and state would have us all liminally alive, on life support, patiently waiting to be allowed our death.
Why let the body decay when you can just take a transfusion of youthful blood once a month? Why let a doctor decide how you die when you can upload your very self into some grand mechanism that will let you live forever? Forget about those who would be forced to give blood to earn enough money to survive, forget about the bitter janitors who will clean the buildings where our cyber-bodies slumber. Forget that if capitalism is still limping along by the time immortality is discovered it will almost certainly be you and me who are forced to sell blood or clean the computer rooms holding billionaire consciousnesses.
The only ethical norm that scientific reasoning alone provides us does not preclude killing — only dying. Science may profit from your blood or destroy your body in the name of Life and do it with a clean conscience. Even further, the transhumanist idea of immortality — one that claims legitimacy and rationality through appeals to scientific validity — presupposed the death of the biological body. We will upload our minds (read: eternal souls) into computers (read: heaven) and prosper. First, though, we must make sacrifices. Billions of Drosophila and mice have died in the name of knowledge and Life. In the name of understanding how to fight disease and prolong life, people informed by scientific ethics have injected syphilis into patients of color without consent, made billions of dollars from the particularly aggressive cancer of Henrietta Lacks without thinking to pay her family, and countless other disgusting acts. In short, the rational and logical scientific promise of immortality can only be achieved not by dying, but being killed. Our original sin is so great that Jesus’s sacrifice was not enough — each of us must surrender our body should we wish to live forever. Science has such scorn for the religious mindset because it is not extreme enough.
To escape, to survive, we must reject this vision of unending life. It is not unethical to die, or to allow death to exist; it is imperative. Life presupposes death. If the exercise of biopower pushes death to the peripheries of society, as Foucault claims, we must push it back into the center. If we continue to allow scientists the sole authorship of visions of immortality and death, they will not create a gleaming utopia of unrestricted human potential, but a world of vampires and suffering. We must be radically mortal, always-already dead; we must foster personal and intimate connections, reconciliations, and relationships with death. And then we must, after all this, die. In subverting the systems that take from us our right to die — and by extension our choice to live — we work against the combined biopolitical apparatuses of state, clinic, police, and prison.
We may find some hope in the fact that biological immortality is incredibly unlikely — the body has inexorably proven to be more complex and messy than the imaginations of any anatomist, biologist, or surgeon. We are not simple systems. This, however, will not stop scientific inquiry from going to any lengths to create immortality by optimizing, simplifying, and reimagining the human body. Our escape from this scientific dominion can only be in our complexity and the irreducibility of our bodies and minds. Our fight against the vampires must stem from our aliveness and our messiness. Living systems cannot and will not be optimized, nor will their inevitable ends. We must loudly reclaim our death, the means to our death, and the right to die — our lives depend on it.