Molecular Medicine Israel

Matters of life and death

Modern technology and modern medical practice have evolved over the past decades, enabling us to enhance and extend human life to an unprecedented degree. The two books under review examine this phenomenon from remarkably different perspectives.

Mark O’Connell’s To Be a Machine is an examination of transhumanism, a movement characterized by technologies that seek to transform the human condition and extend life spans indefinitely. O’Connell, a journalist, makes his own prejudices clear: “I am not now, nor have I ever been, a transhumanist,” he writes. However, this does not stop him from thoughtfully surveying the movement.

The book mostly comprises O’Connell’s encounters with transhumanist thought leaders in an assortment of locales ranging from lecture halls to Silicon Valley start-ups to transhumanist conferences and even the campaign trail, where O’Connell interviews Zoltan Istvan, a transhumanist and 2016 U.S. presidential candidate whose goal is “to promote investment in longevity science.”

O’Connell’s interaction with Max More, the president and CEO of the Alcor Life Extension Foundation, the world’s largest commercial cryopreservation facility, is particularly timely, because the legal, social, and ethical issues related to cryopreservation are far from settled. Likewise, as O’Connell notes, the promise of cryonics relies on the improbable notion that science will someday enable reanimation.

More acknowledges the latter reality. “I’m hoping to avoid having to be preserved,” he tells O’Connell, citing his preference to stay healthy long enough for life extension research to achieve a major breakthrough. “[T]he idea of sitting in one of those tanks … doesn’t actually appeal to me very much,” he notes. “It’s just that it’s obviously better than the alternative.”

Sandwiched in between a short exposition on Ray Kurzweil’s “singularity” and a visit to a biohacker community, O’Connell’s extensive discussion of artificial intelligence (AI) and the current state of the art in robotics feels tangential to the book’s initial focus. Nevertheless, the incorporation of AI and robotics into a discussion of human enhancement raises interesting questions relating to civil and criminal liability and even the nature of free will.

Although O’Connell references a number of mainstream researchers, institutions, and initiatives that intersect with life extension, the book would have ultimately benefited from more direct engagement with members of the scientific community, many of whom are justifiably suspicious of transhumanist efforts.

Haider Warraich’s Modern Death is a physician’s well-referenced account of modern medicine’s approach to death. Warraich faults the medical profession for taking a once very personal experience out of the home and into the hospital. Many now common medical technologies that endeavor to prolong life do little if any good in enhancing it, he argues, and often serve to needlessly extend the lives of the terminally ill.

Warraich provocatively argues that, in many cases, patients would be better served by cutting life prematurely short, preempting protracted suffering. His descriptions of his experiences with terminally ill patients and their families support the idea that, at the very least, the medical community needs to be more forthright in its discussions about death.

Although Warraich makes ample use of religious philosophy in examining how different faiths manage death, he skirts the increasingly relevant disconnect between death as defined by science and by religion. This absence is especially apparent as he goes to great lengths to trace medicine’s modern definition of death.

Noticeably, neither book overlaps substantially on the respective subject matter of the other. For example, Warraich’s foray into life extension outside the field of medicine is limited but definitive. He compares the cell’s apparent wisdom with the purported shortsightedness of our species: “A cell also understands better than we humans do the consequences of overstaying one’s welcome. While we aspire to immortality, to a cell, immortality is the worst fate possible.”

Despite their differences, both books advocate for retaking personal control over death. Considering that many medical decisions to extend life are often made when patients are incapacitated and unable to adequately provide consent, Warraich advocates for preparing long in advance through tools like advance directives. Similarly, O’Connell’s subjects seek to take matters into their own hands by artificially enhancing and extending life.

One other important similarity between the two books is that both provide a glimpse into how the communities in question regard the human experience. Warraich offers a perspective shared by a number of medical professionals, questioning the notion that life is always worth maintaining. O’Connell’s transhumanists question whether we even need the bodies that we are born with for us to remain human. Neither vision is trivial, and both encourage further introspection and deliberation.

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