Society of Bioethics and Medicine
Written by Madeline Zeron
Edited by Maya Khedr Elkelany
Within the past three years, the world has been running on #TikTokMadeMeDoIt to #DailyMustHaves. TikTok is one of the many media outlets that has become the new and improved “News Station” for generation Z. In an age of content creators, they are either advertising the latest trends with the newest skin care products that make you look and feel 18 and offering inspiring advice on how to live a longer and peaceful life. In turn, it has brought rise to the overconsumption of products and procedures and, overall, a careless amount of spending. The question lies in whether or not the said products or procedures work. Do we take a couple of years off our timeline using the latest “Morning Tightening Cream”? The truth is, it is possible to surpass 100 years of age without the constant need to overuse the newest skin care products or get the latest skincare procedure, and there is evidence to prove it.
Centenarians, associated with longevity, have been blessed to reach 100 years of living and beyond. Some may even say that individuals achieving this group are “escaping death.” According to the US Census Bureau, Statista published data in 2018 showing the number of people aged 100 and over in the United States in 2020 was 92,000. The same study projected that by 2060, approximately 2 billion individuals may be joining the centenarian group. As data continues to be collected proving that individuals can increase their lifespans, the question now is whether this reality is probable and attainable for everyone. How much of your life would you sacrifice to surpass 100? Economically, is it possible to do this without placing a significant strain on an individual's current circumstance? While researchers have not obtained a definitive path and a linear guideline for reaching the centenarian group, many have found numerous factors that coincide with reaching that point.
In Centenarians—A Model to Study the Molecular Basis of Lifespan and Healthspan, editors Annibale Puca and Calogero Caruso both support the idea that “the case and circumstances of life, diet, physical activity, environmental exposure and lifestyle, the burden of natural life pathogens, stress management, and social networking, education, and gender and, obviously, DNA” must all equally be considered when studying the lifespan of centenarians. To highlight two heavily weighted contributors to “escaping death” are how both genes and one’s environment plays a crucial role in aging and longevity. In a New England Centenarian Study conducted by Boston University’s School of Medicine, a study of Seventh Day Adventists at Loma Linda University concluded that due to their excellent lifestyle choices, they were able to have the longest average life expectancy with “88 years for men and 89 years for women”. Such lifestyle choices include being a vegetarian, lack of smoking, obtaining regular exercise as well as spending a lot of time with their families and with their religion. Undeniably, many Americans do not complement this lifestyle in many regards, with the high consumption of meat, inadequate exercise, and smoking, which in turn shortens the lifespan by 8-10 years. In the same study, results showed that an “average American has the genes to reach their mid-late 80s; they just need to take excellent care of themselves with proper lifestyle choices.” Each characteristic mentioned plays an integral role, beginning as early as our childhood developmental periods, in our ability to reach older age, not only to avoid diseases but also to avoid unimaginable pain. While it would be ideal to find direct parallels between ingesting “whole, organic foods” to “exercising every day for at least 30 minutes a day” and assuring it would lead to us living to 100 years of age, it is entirely unrealistic. External factors such as building your own community of people to support you through all stages of life; whether it be reassuring you during times of loss, growth, desperation, and success, is essential. It is innate for humans to want to be social and interact with others, it is what differentiates us from other organisms and most importantly what helps us grow. Thus, how society approaches these activities daily also plays a significant role in determining an individual's longevity.
To spotlight the role genes play in centenarians' lifespan, THE NEW ENGLAND CENTENARIAN STUDY also said that although they only contribute 20 to 30% of our exceptional longevity, genes still play a critical role. Centenarians obtain genetic variants associated with age-related diseases as they age. It is thus concluded by Paola Sebastiani, writer of, Genetic Signatures of Exceptional Longevity in Humans, that centenarians' tremendous “survival advantage may in great part be due to the existence of longevity associated genetic variants that are protective and counter the negative effects of such disease gene variants.” Sebastiani continues to explain, of the 801 centenarians, a result of 90% held 1 of the 27 generic signatures, which are related to the probability of each achieving old age as well as “generating signatures that are useful for better understanding the underlying genetics of protection from age-related diseases, modulators of rates of aging and for the field of predictive and precision medicine.” Centenaries unknowingly offered medicine a new opening for discovery and responses to never asked questions.
While studying the life span of centenarians and learning what characteristics allow one to reach that finish line, consideration must also be placed on how it will affect society, both financially and physically, as individuals begin to consider making changes to their mode of living. As the continued studies on centenarians' lifespan have become highly favored over the past years, some may also greatly oppose the idea of “adding more years to your timeline.” Critics have prosed the question if encouraging this would pose a strenuous issue on the economy both individually and on a broader scale. To oppose this, one may state that the benefits of further studying the lifespans of centenarians heavily outweigh the negatives. Educating and encouraging others to dismantle a centenarian's lifespan from a holistic approach will address current systematic issues, which are often rejected when displaying their association with significantly reducing a population's lifespan.
Juris Doctor Ben A. Rich shares in his journal, A Legacy of Silence: Bioethics and the Culture of Pain, during the late 1970s, there was a surge in patient accusations that physicians were not addressing their patients' pain seriously. He continues to explain that this was not seen as a wrongful act because the
“relief of pain was not considered to be one of the primary goals of medicine and hence one of the primary responsibilities (professional, ethical, and legal) of physicians.” From the narrow physiological perspective of the clinician, pain is not a diagnosis but a symptom.”. The focus of the clinician is to diagnose and treat the underlying disease, not to reify symptoms (even those which cause significant pain) into conditions which must be addressed separately and apart from the primary diagnosis” (p. 239).
While we are indeed living in different periods with improvements in technology and more stringent regard for patient care improvement, consider this idea of reaching an older age and worrying that you will have to spend your late years in constant pain. Opposing the study of centenarians' lifespan would inhibit researchers from discovering the “guide to 100”. Why should we choose to reach old age and be forced to live it in pain?
To further support the study of centenarians and understand the rejections towards these studies, consider these studies used as a #DailyMustHave, to show how to improve one’s daily life. For example, encouraging people to form a community and their “own village” along with improved interpersonal decisions to live a wholesome life, and not necessarily focusing on “escaping death” by passing 100 years old. I will suggest we also allow ourselves to shift the perspective from being “The older you get, the sicker you get” to “The older you get, the healthier you’ve been.” So I must now ask you, how much are you willing to give up, if so, to get a couple of extra years added to your timeline?
Centenarians—A Model to Study the Molecular Basis of Lifespan and Healthspan. MDPI - Multidisciplinary Digital Publishing Institute, 2021, https://doi.org/10.3390/books978-3-0365-0981-5.
Genetic Signatures of Exceptional Longevity in Humans. Paola Sebastiani, Nadia Solovieff, Andrew T. DeWan, Kyle M. Walsh, Annibale Puca, Stephen W. Hartley, Efthymia Melista, Stacy Andersen, Daniel A. Dworkis, Jemma B. Wilk, Richard H. Myers, Martin H. Steinberg, Monty Montano, Clinton T. Baldwin, Josephine Hoh, Thomas T. Perls. PloS ONE 2012. DOI: 10.1371/journal.pone.0029848.
Published by Erin Duffin, US Census Bureau, and Sep 30. “Number of Centenarians in the U.S. 2060.” Statista, 30 May 2018, https://www.statista.com/statistics/996619/number-centenarians-us/.
Rich, Ben A. “A legacy of silence: bioethics and the culture of pain.” The Journal of medical humanities vol. 18,4 (1997): 233-59. doi:10.1023/a:1025697920944
Trotter, G. Why Bioethics is Ill Equipped to Contribute to the Debate about Prolonging Lifespans. HEC Forum 16, 197–213 (2004). https://doi.org/10.1023/B:HECF.0000047577.30205.6f
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