Title: The cultural construction and demolition of old age: science and anti-ageing technologies.
Author: Dr John A. Vincent
Affiliation: Associate Professor, Department of Sociology, University of Exeter, UK.
Abstract: There are at least two perspectives on the dominant role of science in generating knowledge about old age in contemporary western societies. There is the view that science reflects the cultural history of the society within which it is practiced. These approaches include the ‘archaeological’ approach of Foucault and strands within the Sociology of Science. There is also a view that there is a diffusion of knowledge from new science into popular understanding and practice. However, which ever model of scientific knowledge is emphasised, scientists, including biological scientists, creating new knowledge of ageing, reproduce or construct consistently negative understandings of ageing framed around failure. The issue for the cultural re-evaluation of old age is not the effectiveness or otherwise of particular anti-ageing technologies but rather giving positive social meaning to the final part of life before death.
Introduction.
My purpose in the programme of research on which this paper is based, is to try and understand why western culture currently devalues old age so much when compared to many other cultures. Rather than take old age as something which is merely self-evident or commonsense, as exemplified in the words of Aubrey de Gray "everyone knows what 'ageing' means"[i], it is important to understand how such apparently 'natural' or 'commonsense' understandings come to be so culturally dominant that they are taken for granted. The anti-ageing movement, of whom De Gray is a leading exponent, is therefore a very useful exemplar of how old age is seen in such a negative light because those involved in that movement are so explicit about their antipathy.
Ageism can be seen as merely prejudice, a set of attitudes which derive from the cultural traditions or values passed down through society. It can also be considered in terms of socially structured exclusion, institutionalised barriers to participation in society’s benefits. The critical gerontology perspective identifies processes such as the medicalisation of old age as features of ideology - part of the institutional structures confining and limiting the possibilities of old age (Baars 2006, Estes 1984, 1979, 1991, 2003, Phillipson 1998). Should anti-ageing practices be considered as part the problem of ageism by prejudicially acting to segregate off old age and subject it to dissection, manipulation and control? Or, in contradistinction should they be considered as part of the resistance to ageism – acts to overcome the exclusion of the aged?[ii]
In the last quarter of the twentieth century there have been activists and academics willing to challenge the ‘natural’ association of old age with illness and decline (Andrews 1999; Silverman 1987; Laslett 1989; Friedan 1993; Woodward 2003;Thomas 2004). A socialmovement developed in the 1980’s and associated with Cambridge academic, Peter Laslett , known as the Third Age which has sought to confront such assumptions (Laslett 1987). This social movement has attempted to create a positive image for old age as a period of personal development. It has been responsible for many positive developments such as the University of the Third Age which taken as its task the matching of the desire for education amongst the retired with the skill and knowledge of retirees. The idea of human rights, of equality which inspired the civil rights movement, the feminist movement also influenced progressive attitudes of old age. Maggie Kuhn and the Grey Panthers are an example of activists who challenged legal and cultural ascription of roles by age in the US. While this movement has to some extent been successful in establishing the idea of a new positive stage in life, they have failed to over throw the dominant image of old age as one of illness and decline. The concept of the third age can be seen in some circumstances as an attempt to prolong youth not necessarily to create a new attitude to old age as a life stage valuable in its own right. For some retirement is a new desirable life style(Gilleard and Higgs 2000). But it is clear that despite the success of parts of the re-evaluation/ emancipation agenda, the dominant contemporary cultural attitude to later life is that of ‘anti-aging’, predominantly western culture seeks not to celebrate ageing but to avoid it.
Introduction of anti-ageing
To answer the question on the roots of ageism and its persistence we must understand the cultural construction of age and ageing. Thus an important starting point is to examine the knowledge creation processes in Western culture. In the case of ‘age and ageing’ it is to be found in the science of biogerontology. New advances in understanding the biology of ageing, give new potential for control and manipulation of ageing (Bechtel 2006). People have always tried to avoid death and control ageing using the knowledge bases of their historical epoch. But in recent years scientists have now gained the confidence that their knowledge creation institutions can unlock the secrets of ageing andhave created the imminent (or even, as some claim, existing) possibility ofcontrol over biological ageing (Binstock 2004; Benecke 2002; Fukuyama 2002; Butler et al 2004). This knowledge and the techniques of control it facilitates are the basis of what has come to be known rather loosely as the ‘anti-ageing movement’.
Binstock and Post suggest a definition of ‘anti-ageing’ that identifies three types of strategy (Post and Binstock 2004). These are attempts to (a) slow, retard; (b) stop, halt; or (c) reverse, rejuvenate - the ageing process. Other scholars have sought classifications based on the extent of the life span increase proposed – e.g.
1. "Weak" life extension means increased average life expectancy--say, from 76 to 100, combined with compressed morbidity, with maximum lifespan remaining unchanged (at around 120 years).
2. "Strong" life extension means dramatically increased life expectancy--say, from 76 to 200 years, with continued compression of morbidity, and maximum lifespan rising to something like 240 years. (Moody 2002)
Self definition and identification by the subject themselves as involved in anti-ageing is one possible approach. Mykytyn (2006) very usefully describes ‘anti-ageing’ as a social movement indicating self adherence to a set of values and attitudes. However, for the purposes of this paper it is important to have a definition based on practices of those involved and their intentions with regard to those practices. I have found the following four fold classification of anti-ageing, details of which I have published elsewhere (Vincent 2006), a useful tool to think with as it does not presuppose what ageing is.
Firstly there is an approach in which ageing is the appearance of old age, a phenomena of the body’s surface. This ‘anti-ageing’ is thus cosmetic in intention. The practices are intended to alter or disguise aspects of appearance that are linked with ageing. There is a strong consumer led movement for such practices as evidenced by the commercial impetus revealed in data for market growth. Culturally, the dominance of youth in aesthetic judgements of the body beautiful, is overwhelming. But, of course, contrary views are possible, for example views often associated with feminism against the tyranny of the male aesthetic gaze, and ‘alternative’ aesthetics which find beauty and value in all shapes and sizes.
The second approach is to consider ageing to be a disease to be tackled by medical strategies with the intention of cure. Ageing from this perspective is a phenomenon of the body’s interior. The objective of interventions is to stay healthy until the full life-span is completed, and only then to die of old age. This is the very common ‘health span’ argument used by most medical and biological researchers. So dominant is this view of ageing that alternatives struggle to be heard. However, this approach implies (but is very seldom acknowledged) that there could be a healthy death. In the knowledge creation institutions of biogerontology there are disputes as to whether people can die of old age, or merely an age related degenerative disease. Some important figures, such as Leonard Hayflick suggests that if we find cures for cancer and heart disease, etc. we will still die of old age; other dispute this and suggest that there is no evolutionary designed genetic programme for senescence and death at a particular age.
The third view of ageing is that it is a fundamental biological process particularly located in intra cellular bio-chemistry. Biological anti-ageing strategies seek to modify these processes with the intention of extending the life span, for example by altering metabolic process in order to slow down accumulation of molecules adverse to efficient cellular function. The cultural significance of these possibilities has fired the imagination of ethicists, and popular science commentators who have speculated on the social consequences of such developments (President’s Council on Bio-ethics 2002; Turner 2004; Olshansky 2001; Solomon 2006; Juengst 2003; Gems 2003; Mykytyn 2006). The ultimate success of this research programme is usually taken for granted. Indeed it has attracted large amounts of speculative commercial money seeking the enormous profits that would come from a patent governing an effective anti-ageing technology(Hall 2003).
Ageing for some is death, and for them the objective of an anti-ageing strategy is to achieve immortality, or at least something close to it. The practices of this type of anti-ageing include to raising funds for and the design of programmes of research which it is intended will create greatly extended human life span which while not excluding death by accident removes the biological necessity of death. Culturally this links the anti-ageing movement with countless historical attempts at immortality from Faust to Voronoff (Boia 2004), and has engendered great controversy as to the scientific status of such research programmes (Olshansky 2002; Binstock 2003; Technology 2006; Nuland 2005).
It is important not to too sharply differentiate these categories, their function in this paper is to map the field of the anti-ageing phenomenon to be considered. Individual researchers, therapists and activists may fall within one or many of these categories. Culturally, therefore the problem has become what is a satisfactory / healthy body? Does it include the ageing body? Contrasting on the one hand arguments about value of non-standard bodies (for example people whose bodies exhibit dwarfism, deafness, disability, or old age), with on the other a desire to eliminate pain and suffering. By studying the knowledge creation activities within the fields anti-ageing science we can gain an insight into the social forces which give authority to ageist practices.
Alternative models of the relationship between science and culture
We need to understand the power of biological and medical knowledge which is of such power that dominates and makes self-evident the nature of old age. There are at least two perspectives on the role of science in generating knowledge about old age in contemporary western societies. One model identifies science as the key institution for knowledge building in modern society and seeks to study how scientific ideas and concepts diffuse into the wider society and its cultural interpretations. Another model emphasises the way culture dominates what can be thought in a particular society and sees the direction of causation in terms of cultures impact on science and seeks to explore how theorising by scientists and the conceptual frameworks they produce, are influenced by cultural factors. Thus, we can typify two types of explanation.
1. Science comes first – culture follows:
1.2 Naïve version – science is truth inevitably revealed
1.3 Knowledge as power – institutional control of knowledge mediates what knowledge becomes culturally dominant.
2. Culture comes first – science follows.
2.1 Antipathy to ageing directs scientific endeavour.
2.2 Cultural concepts loaded with ageist preconceptions permeate into scientific thought.
Of course sophisticated models of the relationship between knowledge and society seek to explain not simple causation but a complex dynamic historical relationship (Turner 2007). But I will use this framework to look at anti-ageing knowledge building activities as a way of understanding changing sources of authority for ageism and effective ways of resisting it.
1. Science comes first – cultural follows:
The dominant view of ageing in modern western culture is that it is a natural biological process. It is conceptualized as an impersonal biological force that happens to people creating a variety of changes to appearance and bodily competence and ultimately leading to death. Science is understood to be outside of culture as a special kind of knowledge making procedure which gives it a uniquely valid insight into phenomena of the natural world such as ageing.
1.1 Naïve version – science is truth inevitably revealed
De Gray and other leading activists in the anti-ageing movement have a sociologically naïve, but commonly held, view of science. They self define themselves as scientists, and like many other scientists see the products of their research as simply the truth. Science is seen as steadily and predictably revealing the hidden truth of nature and is, consequently, an inevitable and predetermined progression. It is about the elimination of error, and takes on, as its does for many ‘hard’ scientists the mantel of truth and virtue against sin and error. Such approaches are ahistorical and usually extremely naïve about the philosophy of science and the problems of a theory of knowledge. Many, probably most, social scientists would not adopt this prescriptive approach. However, this attitude is an important part of the motivations and life world of those in the anti-ageing movement. They see their work as the necessary precursors of inevitable “progress”.
This position can be clearly illustrated by the work of Aubrey de Grey
“The cure of aging must now be taken seriously by responsible gerontologists, because it is no longer science fiction. It is patently not yet science fact either, but it has crossed the boundary into science foreseeable. Its elevation to science fact is a foregone conclusion, but the timeframe of that elevation is not: it depends critically on analysis and creative manipulation of the available technology, to mould it into interventions that actually work.” (de Grey 2003: 934)
His presentations regularly include a graph used to illustrate his contention that within ten years there will be people who will live over a thousand years. His point being that the inevitably accelerating science of life extension will at some point soon push the gains in life expectancy beyond the individuals decreased chances of survival with age. De Grey is not alone in this approach to science, ‘Reason’, the name the author of the Longevity Meme newsletter gives himself, has a similar vision of science:
HEALTHY LIFE EXTENSION IS INEVITABLE
I can say with fair confidence that the development of any technology allowed under the laws of physics is inevitable. The burning question in this case is whether or not it will happen soon enough to benefit those of us reading this today:
Longevity Meme Newsletter, October 01 2007
De Gray presents himself, as do Klatz and other anti-ageing leaders from the American Association of Anti-Aging Medicine (A4M), as the persecutedavante garde, the forefront of the new science excluded by the reactionary establishment. In rhetorical terms they construct themselves in a “scientist as hero story” drawing parallels to past rejections of scientists and their ideas which have subsequently become publicly acclaimed. Their claims to legitimacy are grounded in a particular view of the nature of scientific progress.
The development of the sociology of science has lead to studies of how what has been considered to be scientific knowledge has changed. Some scientists consider this perspective as some how anti-science and that to locate science within a historical and cultural context is to challenge scientific authority (Latour 1999, Fuller 1999). However social scientists examining empirically what scientists actually did rather than proclaiming the absolute and timeless nature of scientific knowledge has led to important insights to the role of science in society (Gieryn 1999; Barnes 1985; Barnes et al1996). Ironically many of the best sociologists of science, are themselves former scientists with a bent for rigorous empiricism.
The scientist as ‘misunderstood hero’ approach can be critiqued from science and technology studies. Even those kinds of sociology of science which start from similar empiricist premises and which by and large accept the progressive nature of science but which examine the historical and social institutional frameworks that structure the activities of scientists, are able to give rather more informed accounts of how particular controversies arose and were resolved. Binstock (2003) in discussing the politics of the opposition to the rise of ‘anti-aging’ in the form of A4M essentially uses such a model. While he does not cite Thomas Kuhn directly, Kuhn’s (1962) discussion of ‘normal science’ would complement his description of the routine activities of gerontologists. Kuhn uses the term ‘paradigm’ to describe the complex of ideas and practices which form the taken for granted back ground to the practice of normal science. He suggests that only with difficulty and limited historical occasions do paradigms get challenged and then overthrown by ‘revolutionary’ new approaches. Fuchs (1993) presents a theory of scientific change based in the social organisation and institutional structures of different sciences. Gerontology fits into his typology as a science which is high on uncertainty [having a limited central core of knowledge] and low on mutual dependence [pursued in variety of settings with limited social integration] and thus he would predict scientific innovation would proceed not by accumulation but fragmentation: