By Steven Ooi, website owner and GP tutor (retired)
B.A. (First Class Honours), NUS
Imagine waking up one day with your wife of 32 years. “Good morning, dear,” you say with a smile, as you have every morning for over three decades. Her eyes narrow with suspicion and she asks, “Who are you?”
This tragic circumstance – dementia – is one that befalls more and more people every year even as we celebrate the feats of science in concocting more and better treatments for illness and stretching out our sojourn on this increasingly less mortal coil. It is one of many immense costs that the human race bears – on individual, familial and societal levels – for greater longevity. As biological science strides on towards its likely tipping point into a Brave New World, it is imperative that we examine whether longer life expectancy is more a blessing or a bane. The problems wrought by the constant uptick in our years of life are, in my view, of such magnitude that they have preponderance even over the undoubtedly great advantages that they bring. Thus, I take the position that longer life expectancy does indeed bring us more difficulties than dividends.
It is not possible to deny the boost to the quality of many human lives that more time on earth bestows. Maslow’s hierarchy of needs is a formidable mountain to climb – and the more time we have, the better our chances of reaching the windy summit of self-actualisation. If we consider the typical example of a person born at the start of the 20th century, he would have had only about 40 years to pursue his aspirations as a human being. He would probably have had to marry young if he wanted to see his children’s 20th birthday, which would mean less time to pursue his formal education to empower himself. After the rigours of starting and supporting a family, he would have only at most 10-12 years to pursue other goals and interests. With such a short runway, it is difficult to even ‘find oneself’. Today, however, people live for 60 to 80 years in most countries. They can wait till their mid-20s or later to get married (and society is more open to the option of not marrying at all), and have more time before and after marriage to find the path in life that leads them to happiness. A young adult today is likely to have the luxury of trying out at least three or four different career paths, travel to many more places if he is of reasonable means, move on from bad relationships or marriages to better ones, and essentially explore life and find fulfilment.
However, the passage of the years is not always so kind. Medical science at this point is more adept at increasing our lifespan than our healthspan. It often keeps us alive but in a highly fraught condition where quality of life is, sadly, so poor that the individual may question if it is worthwhile to even go on living. Examples abound, from dementia to diabetes to kidney failure. All are epidemics that are sweeping across the world. Government statistics in Japan, for instance, project that the number of dementia sufferers over 65 is expected to jump from 4.62 million in 2012 to 7 million by 2025. Dementia rises in part because medical science has weaker ability to preserve the brain than the rest of the body – scientific understanding of the brain lags behind that of other organs, as the brain is by far the most complex part of our anatomy. Diabetes is caused by many factors but age is an important one. Kidney failure, which sometimes is brought about by diabetes, is on the rise and as it is difficult to obtain a legal transplant, most patients need to be on dialysis for many years – an excruciatingly painful procedure that lasts for four hours, three times a week. The indignities of ageing have always been with us, but a longer mortal existence prolongs and often aggravates them. It brings immeasurable physical and emotional pain to the aged, and immense heartache to their loved ones watching them suffer.
Some would argue that a longer life allows one to become wiser with the benefit of greater experience. They add that society too profits from the collective sagacity of a larger number of members in their 60s and older. For instance, older workers can guide their younger colleagues through challenging situations with their steady hand and perspicacity and grandparents are around longer to share their insights with their grandchildren.
That being said, I have to question whether longer lives truly lead to wiser heads. If this were the case, then the wise men and women of today would overshadow their predecessors from generations past. But this is widely recognised to not be the case – even today, we often turn to the sayings and writings of Confucius, St. Augustine, Dr Sun Yat-sen, Machiavelli, Aristotle and other great thinkers, leaders and revolutionaries for guidance and enlightenment – no less often than we do the influential minds of today. Very few of these legendary thought leaders lived lives that would be considered long by today’s standards. I also question the value of vast experience in today’s world owing to the exponential rate of change driven by technology. Moore’s Law, which states that the number of transistors that can fit onto an integrated circuit doubles every two or so years, is a good representation of this accelerating change. A doubling of computing power every two years may not have much perceptible impact initially, when it is rising from a low base. However, when it crosses a certain threshold, it has seismic repercussions which then grow faster and faster in absolute terms. In recent years we have begun to see – and feel – the prescience of Gordon Moore. Job security has greatly diminished or even evaporated for hundreds of millions; social media has redefined the way we communicate with others and sometimes even our relationships; and whole industries from retailing to entertainment to medicine are being reshaped by robotics, big data and artificial intelligence. In such a context of exponential change, the lessons from the past become less and less relevant, and possibly even a liability. The longer we live, the higher our tendency to become attached to our familiar ways of doing things. Undoubtedly, there are highly adaptable seniors who are very willing to discard dogma and constantly acquire new ways of doing things but unfortunately, they are the exception rather than the norm.
The prospect of more and more octogenarians, nonagenarians and even centenarians looks even bleaker when we consider the ramifications for societies and nations. While it is unquestionable that human beings love their parents, the cold, hard reality is that the longer we stick around, the more we are likely to burden our children and also society and the state. The oft-prescribed solution of advancing the retirement age is a limited one, for reasons mentioned earlier: medicine is better at raising lifespan than healthspan, and the explosive pace of change in the world that makes it increasingly an uphill task for older workers to stay employable. As parents’ lifespans relentlessly extend, it takes a heavy toll on family finances, with heartbreaking results. South Korea, a society traditionally steeped in reverence for age, today has the highest elder poverty rate in the industrialised world at nearly 50 percent. A Channel NewsAsia documentary revealed that in Myanmar, impoverished families are discarding their elderly folk by the roadside. Increasingly, the onus will fall on the state to help the elderly, but state coffers even in the world’s richest countries are already straining to provide for the legions of retiring baby boomers, to say nothing of the expenses that are to come as retirees live longer and longer. Many experts have spoken of America’s “pension bomb”, as data from Bloomberg shows that half of American states have pension funding shortfalls of 25 percent or more. Illinois, for example, promised its employees US$199 billion in retirement benefits in 2015. It is US$119.1 b short.
Despite the apparent “miracles” of medical science, our improvements in longevity are not the fountain of perpetual youth – or quality of life, or employability. While I unreservedly acknowledge the utility of experiencing life’s joys, personal growth and a pursuit of self-actualisation that a longer life brings, it is most difficult to see these as adequate compensation for the extended years of poor health, suffering and indignity as well as the crippling effects on families and the state to the point that it may bring bankruptcy to many countries in the years to come – and with it, the looming spectre of a longer life for us today coming at the expense of the needs and happiness of future generations.
Therefore, it is my considered opinion that longer life expectancy on balance is more a bane than a blessing to the human race. As scientists urge us to continue funding their relentless quest for yet another medical ‘breakthrough’, we will have to collectively engage in a very hard conversation about the desirability of extending our individual lives ever further into the horizon – and whether those resources would be better expended on other human needs and hopes.
Copyright 2017 Steven Ooi. All rights reserved. No part of this work is to be reproduced without the express written consent of the author. Please feel free to share this essay by providing a link to this page.
Website owner Steven Ooi, a First Class Honours grad from NUS, retired from a distinguished 14-year career as an English and GP tutor in 2016. He continues to blog on issues of concern to GP.
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