The Written Paper Is Below. the Powerpoint Presentation Can Be Viewed Here

The written paper is below. The powerpoint presentation can be viewed here.

Paper presented to the BSG Annual Conference 2006 The Ageing Jigsaw: Interdisciplinary approaches to understanding old age 7th-9th September 2006, University of Bangor, Wales.

Title: The language and symbolism of death and old age in bio-gerontology

Author: John A. Vincent, Department of Sociology, AmoryBuilding, University of Exeter, Exeter, EX4 4RUUnited Kingdom.

Abstract:

In the twentieth century old age has become increasingly medicalised and associated with the body. As a consequence this gives the science of biology a particularly powerful position in shaping the way old age is discussed and thought about. How do biological scientists who themselves are researching biological ageing speak about ageing; what symbols and metaphors do they use to organise their knowledge. What is the interplay between the specifics of scientific discourse on bio-gerontology and the more general conceptual framework used in Western culture? Language is not just descriptive but is normative containing implicit aesthetic and ethical judgments. An empirical study based on observation of the bio-gerontology sub-culture will be used to examine and critically assess the impact of ‘anti-ageing’ science. The field of bio-gerontology concentrates on intra cellular processes, genes, complex molecules and their transformations. Although it uses standard models of yeast, worms, fruit flies and mice, it concentrates implicitly on human ageing. A potentially interesting starting point is the conceptualisation of different kinds of cell death – apoptosis, senescence and necrosis. Negative cultural constructions of old age spill into biology but are transformed; biological concepts become transformed when used in popular discourse to legitimate ageist practice.

The language and symbolism of death and old age in bio-gerontology

Context by way of introduction

Recent scientific interventions have achieved dramatic increases in longevity amongst nematode worms, fruit-flies and mice. It is suggested that these experiments open the possibility of greatly extended human longevity and such views are reflected in popularising science.

“We are now in the era of emerging ability to control our actuarial destiny in response to the desire in humans throughout history to live comfortably and to delay death (Holliday 2001; Preston et al 1978).” (Carey 2003:220)[i]

This paper examines the impact of the culture of science on the meaning of old age. In particular it examines claims that science can defeat or postpone death, either completely or in the very long term. This examination reveals the methods through which old age is constructed and devalued by reference to death. This paper is a preliminary presentation of research in progress. This research builds on papers in Sociology and in Vincent, Phillipson and Downs (2006)[ii]. These papers are concerned with contemporary changes in the social construction of old age. The ‘biologisation’ of old age raises the prospect of the scientific understanding and the technical manipulation of the ageing process (ageing processes). This has spawned a number of controversies in the bio-gerontological community. One is the desire to distinguish genuine science of ageing from quack or bogus claims to extend life formulated in quasi scientific or medical styles. Another is the plausibility and emphasis to be given to programmes to massively extend the human life span. These controversies provide the opportunity to observe the ways in which science of old age influences and is influenced by wider cultural phenomena and plays a critical part in the social devaluation of the final part of life. In defining the boundaries of the subject - who can count as a bone fides scientist of old age, who can claim knowledge about old age and on what basis and with what consequences - they implicitly define old age. Thus the basic frame of the paper is to look at old age as a cultural category and to look at science as a form of culture to see how that culture constructs what is means to be old.

The sociological significance of the issue

I will initially concentrate on the importance to sociology as a discipline of the issue of the control of ageing. Clearly the social and ethic issues which arise from the scientific knowledge to extend the human life span is of great importance to humanity. However, the topic also facilitates key aspects of social theory and enables a number of critical perspectives for deconstructing the conceptual frameworks used by Sociologists.

Social constructionism has played a key role in dismantling taken for granted concepts of old age and thus exploring the possibilities that there are alternative ways to live a good old age (Von Krondatowitz 2003). In other words social constructionism of old age reveals that ageing not simply a matter of biological determinism. There are important social processes independent of any physiological changes as the body ages. But what are the limits to social constructionism? Surely death and the frailties of the fourth age are not social constructions.

Cross cultural anthropology of ageing enables us to see that different cultures approach ageing and death in very different ways. There are many myths and stories told, and rituals re-enacted through which through notions of resurrection, transformation, re-incarnation and others at some level defeat death. But every one dies. Similarly, despite the ubiquity of nostrums to delay ageing from green tea to exercise regimes, experience tells us that everyone dies of something. Even southern Californian gurus who evangelise against a “deathist” society and suggest you can live for ever if you really want to eventually meet their fate (ref Herb Bowie). Is the natural world, and in particular the human body a procrustean bed on which social constructionism must lie?

However, it is a false distinction to contrast social construction as merely the products of a cultural imagination as opposed to scientific facts which represent the truth about nature. There are more fundamental epistemological issues at stake about how it is possible to have knowledge of nature, and it is clearly not possible to have a knowledge tradition which stands outside of society. Thus social constructions are ‘real’ in at least two senses.There is one sense which is pithily put by Schutz Thomasthat “if people men define situations as real believe that something is real it iI, they ares real in its their consequences” (Thomas and Thomas 1928:572). It is not the reality of the heavenly paradise but their belief in such instant reward that makes it so difficult to deter suicide bombers. But the culture / nature relationship is not a one way process. Cultural concepts are necessary with which to understand and make sense of the world. Thus there is a second, and perhaps more fundamental sense, natural phenomena are social constructions because they cannot be communicated, discussed and understood with out a social basis of common ‘cultural’ concepts. It may also that the natural world cannot even be thought about without the social precursor of language.

It is not sensible to give one or other of these approaches to social construction priority. They are intertwined historical processes. Cultural concepts and language with which they areknowledge is expressed are produced in historical and continuous process in which the social and the natural environment are critical components.These resources for understanding the world are not independent of the social and natural environment. The social environment includes beliefs about reality, and the natural environment regularly forces itself into our lives in unanticipated ways. If aninexplicable or unforeseen natural event is manifest then, if it is too novel to fit the existing cultural schema, then new concepts and language develop to cope with it. Science of course does this routinely all the time.

A critical examination of bio-gerontology can look at the way in which scientific discourse and knowledge making is shaped by its location in a general cultural approach to ageing and old age in the West[iii]. And, it can also look at the way in which old age as it is understood and practiced in the West, is formed through the knowledge making processes of the science of bio-gerontology.The certainties of death, disease and ageing as they are popularly understood (in both the general public and in social gerontology) disappear under close examination. Knowledge of the phenomena ageing, its associated natural processes and their manipulation is progressing in leaps and bounds. The science draws on existing categories but these are being challenged by new discoveries which undermine such fundamental concepts as ageing, disease, life span and death. Thus a careful examination of the science of bio-gerontology through its literature, conferences and disciplinary activities (which the research strategy that I am attempting pursue) offers the prospect of a more fundamental informed understanding of the limits of social constructionism.

There are resources in Sociology which we can use for such critical examination.We can draw on Foucault[iv] (and Bourdieu[v]) but also on the earlier anthropology (both structuralist and ethographic such as Mauss[vi], Levi-sStrauss[vii][viii] and ethnographic theorists such as Evans-Pritchard[ix], Douglas[x] and Geertz[xi], Geertz) from which their ideas stemmed. This line of thought emphasizes that to understand the world we need to classify it – cultures contain structures and patterns of categories which enable people to understand the world and that further these methods of understanding have a historical development, social location and are experienced as part of a social environment which constrain individual actors. Additionally there are interactionist and ethnomethodological perspectives, for example the work of Goffman[xii] and Garfinkel[xiii], and those who followed them in emphasizing the locally situated construction of meaning. That although the cultural framework in any particular moment in history exists as a resource and a constraint it is constantly being acted upon by people in specific and concrete situations interacting with eachother and attempting to communicate. Much less fashionable but also necessary in my view is a harder edge to critical thinkingwhich view culture and knowledge as having an ideological dimension[xiv].The diverse cultures are not merely part of life’s rich tapestry but reflect and function as part of power structures and link to diverse oppressions. There are also somewhat more specific traditions that can be drawn on to look at bio-gerontology. These include science studies. There are the modelsfrom the sociology of science (c.fof both. the hard and soft varieties[xv]).And further there are many good histories of gerontology, and longevity which can provide background to how the contemporary intellectual apparatus of bio-gerontology arose (cite Boia and Huber and von Krondatowitz and Katz)[xvi].

Accessing meanings of old age

Cultural categories occupy a semantic space defined by boundaries. It is the contrasts which demarcate categories and make sense of the world. We can ask about the meanings of death, old age, and disease by looking at their contrasts and boundaries which map out their semantic space. Meanings cannot be established in isolation, categories are part of meaningful systems which interlock. To understand old age it is necessary to know its boundaries, how to recognise it, and thus the markers which indicate the boundaries between what is old age and what is not. If we examine the language and the communications of those involved in this world, we can see how the meanings they create are achieved, what kinds of distinctions are important, what are the key categories used, and what components of the concepts are used to explain and understand old age (c.f. Doyle 1997).

Life and death.

Old age is the stage of life next to death. It takes it place in developmental cycles of organisms from conception and birth to decay and extinction. Ageing is then a concept parallel to maturation defined by contrasting life cycle stages. It is worth noting that many species don’t die. For example simple single cell creatures, simply divide. Mortality comes with sexual reproduction. But death is a necessary boundary marker for the cessation of old age.

Death contrasts with life. What is alive and what is dead and how do we know? This boundary is highly contested and fraught with moral dilemmas as to what is human and what is not. There are a number of social constructionist accounts of death. Classically Glaser and Straus, and Sudnow plus more recent studies of death as practiced in hospital intensive care units[xvii]. There are historical cross cultural studies on the changing medical definitions of death (Lock 1996). The medical definition of death has shifted in recent history – contemporary medical protocols for establishing death tend to use a concept of brain death. Death has ceased to be a ‘natural’ event. If people die of something it must be something that science can, at least potentially, understand and control. Seymour (2000) explains how medical staff in intensive care settings have to deal with this cultural reality.

At the level of the cell, cells were thought to be capable of immortality until the discovery of the Hayflick limit. The loss of telomeres limited the number of times a cell could replicate. A useful defence against tumours, (telomerase restores telomeres and allows the cell to proliferate as in cancer). Thus cell senescence came to mean reproductive senescence; the inability of the cell to divide and replicate itself. (check and demonstrate that with historical texts)[xviii]. Thus tThere was the belief that old age was programmed at the cell level. If we could modify that programme perhaps we would not need to age. However, it turns out to be much more complicated than that. There is no simple association of cellular senescence and organism ageing. Difference species has different telomere lengths and some species do not seem to exhibit such limits. In humans for example neither bone tissue nor brain cells go through the process of cell division and proliferation (mitosis). Landecker (2003), in the course of an excellent article outline the historical development and metaphorical significance of cell death starting with Bichat the French eighteenth century writer used by Foucault in ‘The Birth of the Clinic”, notes:

“In the course of these relocations of life, disease, and death processes, the relationship between life and death has not remained constant. Through analysis of the morphology, genetics, and temporality of the body’s continuous cellular dying, the oppositional relationship between life and death that existed for Bichat and those who came after him was displaced by the vision of a multiplicity of death that maintains tissue homeostasis, shapes development, regulates the formation of the immune system, and serves as a protective mechanism against oncogenesis. Thus, with the localization and spatialization of death in the cell, death has become for biomedicine not necessarily that to which life is opposed but, in many cases, that on which life is dependent, or at least that with which life and disease are inextricably bound.” (Landecker 2003 p.55-6)

In the small number of interviews I have conducted with scientists, particularly bio-gerontologists I have systematically asked about three processes ‘maturation’, ‘senescence’, and ‘apoptosis’. The differences in the manner of response are illuminating. With maturation there is a dismissive approach, respondents invent something plausible but without interest or connection, they do not see it as a relevant and important part of their lexicon – perhaps it might be more relevant to biologist concerned with whole organisms and developmental process – but for the cell scientists it was irrelevant. Apoptosis on the other hand was responded to immediately and with standard textbook answers. This was planned cell death. Many respondents even quoted the standard textbook example of the apoptetic removal of webs between the fingers in embryos. However, the response to ‘senescence’ was interesting because there was not a standard answer but the respondents thought there should be and perhaps they were being caught out. The responses were full of linguistic devises such as hesitation, circumlocution, restatements which indicated unease or uncertainty from the respondents. Clearly the term was less well institutionalized. Most produced the idea of cessation of cell division but were uncertain whether that was sufficient and complete. It was also clear from conversations with the scientist that many particularly non English speakers were aware of the non-scientific origins and use of the term senescence (c.f. Katz 1996, Haber 1984). What I read into these responses is that the much older term senescence (meaning the equivalent of old age) does not fit well into the standard textbook understanding of death at the cellular level which focuses on a binary distinction between apoptosis and necrosis. There are a variety ways in which cells die, and the concept of cell death becomes interesting and contentious. Landecker (2003) has done an excellent job of describing the cultural and symbolic importance of apoptosis. (programmed cell death). I will develop these ideas below.