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Death Is An Outrage

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      DEATH IS AN OUTRAGE
      By Robert A. Freitas Jr.
      November 16, 2002

      http://www.kurzweilai.net/meme/frame.html?main=/articles/art0536.html

      Each year, we allow a destruction of knowledge equivalent to three Libraries
      of Congress with an average value of about $2 million dollars for each human
      life lost. The solution: "dechronification" -- nanomedicine tools that can
      arrest biological aging and reduce your biological age.

      Based on a lecture by the author at the Fifth Alcor Conference on Extreme
      Life Extension (http://www.alcor.org/conferences/2002/), November 16, 2002
      in Newport Beach, CA. Published on KurzweilAI.net Jan. 9, 2003.

      To see the charts referred to in this article, please visit the website
      referenced above.

      .............

      While you were reading this sentence, a dozen people just died, worldwide.
      There. Another dozen people have perished. I think this is an outrage. I
      want to tell you why I think so, and what nanomedicine can do to help.


      FIGURE 1: WORLDWIDE DEATH TOLL IN 2001

      Let's look at the dimensions of the human holocaust that we call "natural
      death ."

      The death toll in the Year 2001 was worst in India. Almost 9 million
      casualties. The bodies were piled nearly as high in China. The United States
      fell in third, with 2.4 million fatalities. 21 nations lost over half a
      million lives, each. These 21 countries represented all cultures, races,
      creeds, and continents. The human death toll in the Year 2001 from all 227
      nations on Earth was nearly 55 million people, of which about 52 million
      were not directly caused by human action , that is, not accidents, or
      suicides, or war. They were "natural" deaths.


      FIGURE 2: NATURAL DISASTERS

      Even the most widely recognized greatest disasters in human history pale in
      comparison to natural death . For example, the typhoon that struck
      Bangladesh in 1970 washed away a million lives. In 1232 AD, Genghis Khan
      burned the Persian city of Herat to the ground. It took his Mongol horde an
      entire week to slaughter the 1.6 million inhabitants. The Plague took 15
      million per year, World War II, 9 million per year, for half a decade each.
      The worldwide influenza pandemic of 1918 exterminated less than 22 million
      people ­ not even half the annual casualties from natural death . But
      natural death took 52 million lives last year. We can only conclude that
      natural death is measurably the greatest catastrophe humankind has ever
      faced.


      FIGURE 3

      Of course we're outraged by natural death because of the obvious personal
      consequences. But the cost to humanity of our individual deaths is rarely
      appreciated, truly staggering, and equally heartbreaking.

      Each one of us carries within us a complex universe of knowledge ,life
      experience , and human relationships. Each individual is gifted with unique
      insights possessed by no one else. Almost all of this rich treasury of
      information is forever lost to mankind when we die. This lost treasury is
      truly enormous. If the vast content of each person's life can be summarized
      in just one book, then every year, natural death robs us of 52 million
      books, worldwide. But the U.S. Library of Congress, the world's largest
      collection of physical books, holds only 18 million volumes. So each year,
      we allow a destruction of knowledge equivalent to three Libraries of
      Congress.

      It is as if in 2001, somebody burned the Library of Congress to the ground.
      Once in January. Then again in May. Then again in September. 52 million
      books go up in flames. And then in 2002, they burn it down again. Three more
      times. And then again in 2003.

      What's even worse is that if you agree with me that the sum total of each
      human mind would really fill many, many books, and not just one, then you
      must accept that the devastation of knowledge is actually far greater than
      I've suggested here.


      FIGURE 4: U.S. VALUE OF LIFE, BY AGE, 2000

      Besides this staggering sacrifice of information, natural death also
      destroys wealth on a grand scale. According to the Lasker Foundation, a
      dozen or so studies since the mid-1970s have found the value for human life
      is in the range of $3 to $7 million dollars, using many different method
      ologies. More recently, Murphy and Topel at the University of Chicago drew
      this chart (which I've updated to Year-2000 dollars) showing the value of
      human life at every age. It recognizes that fewer years remain to us at
      older ages. But this is only half of the equation.


      FIGURE 5: NUMBER OF HUMAN DEATHS BY AGE, IN 2000

      This chart shows estimates from the Census Bureau of the number of people
      that died in the United States in the Year 2000, in each age cohort, year by
      year. If you multiply the death rate at each age, from this chart, by the
      dollar value at each age, from the previous chart, you get the economic loss
      at each calendar age, due to natural death . The sum of these economic
      losses divided by the total number of deaths gives you the average economic
      value of a human life lost.


      FIGURE 6

      The result is an average value of about $2 million dollars for each human
      life lost. If we conservatively assume that the population age structure and
      the age-specific mortality is the same worldwide as in the United States,
      then the worldwide natural death toll of 52 million people in the Year 2001
      represents an economic loss of about $100 trillion dollars. Every year.

      How big of an economic calamity is this? Taking Federal Reserve figures for
      the total tangible wealth of the United States, including all financial
      assets, all real estate, and all consumer durables, net of debt, and
      applying the ratio of U.S. to world GDP gives us an estimate of total global
      tangible net worth of $91 trillion dollars. So this means that every year,
      natural death robs us of human capital equivalent in value to the entire
      tangible wealth of the world.

      It is as if in the Year 2001, someone took out a giant broom and swept up
      all the physical assets of human civilization into a cosmic trash can, and
      then threw it all away. That's $100 trillion dollars of financial assets,
      real estate, and durable goods. Gone. And then in 2002, the giant broom
      sweeps again. Another $100 trillion dollars of human capital is destroyed,
      or three times larger than the $33 trillion dollars of annual economic
      activity represented by world GDP. Then it happens again in 2003.

      But the economic disaster caused by natural death is even worse, if you go
      back through history . Since the modern human species first emerged, perhaps
      25 millennia ago, 34 billion people have ever walked the Earth, and 28
      billion of us have already died. The equivalent total information waste is
      more than 28 billion books, enough to fill almost 2000 Libraries of
      Congress. The equivalent total economic waste is about $60 thousand trillion
      dollars, enough to rebuild our current tangible civilization 600 times over.
      If you carry the tally back a million years, to the very dawn of man, all
      these figures about double. Natural death is a disaster of unprecedented
      proportions in human history.

      So ... what's being done about this? Let's take a statistical look at the
      progress to date.


      FIGURE 7: EXPECTED AGE AT DEATH (EAD) IN THE U.S.

      This chart, compiled from Census Bureau data, shows that for the last
      one-and-a-half centuries, life expectancy at birth has risen dramatically in
      the United States. A newborn child in the Year 1850 could only expect to
      live to 38 years, but should reach almost 75 years today. To measure
      longevity, I'm using the Expected Age at Death, which is just your current
      age plus your remaining life expectancy.

      But 20th century medical technology has mainly improved the longevity of the
      very young. Since 1850, the Expected Age at Death of a 40-year-old has only
      improved from 68 years to 77 years. The Expected Age at Death of a
      70-year-old has only improved from 80 years to 83 years. In other words, a
      70-year-old's chances of living another 10 years were about as good in 1850
      as they are today. Not much progress . But let's take a closer look at the
      data.


      FIGURE 8: DECADAL INCREASE IN U.S. LIFE EXPECTANCY AT BIRTH

      This chart shows the rate of Change in Life Expectancy at birth since 1850,
      as measured in years of extra life expectancy achieved by medical technology
      per decade of calendar time. If we could get to a rate of 10 years of life
      extension per decade, then medical technology would be extending life
      exactly as fast as we're aging, postponing natural death, on average,
      indefinitely. We see from the chart that the Change in Life Expectancy
      improved at only 1 year per decade up until 1890. After 1890, the Change in
      Life Expectancy of newborns jumped dramatically, reaching more than 6 years
      per decade at its peak in 1925. This was due to the rapid introduction of
      several basic medical breakthroughs, like public sanitation, comprehensive
      vaccination programs, and later, antibiotics.

      Note that the rate of Change jumped from 0.8 to 4 years per decade during
      1890 to 1900, a fivefold increase in a 10 year calendar span. The rate
      soared from 2 to 6 years per decade during 1910 to 1925, a threefold
      increase in a 15 year calendar span. So we know it's possible to see very
      rapid increases in the rate of Change in Life Expectancy, when new
      technology is brought to bear on the problem. In other words, history tells
      us that the current 2.3 year per decade rate of progress could plausibly
      quadruple to the "magic" 10 years per decade threshold, in the space of just
      10-20 years from today, if new resources and new medical technologies are
      focused on improving longevity.


      FIGURE 9: DEATH RATE (DR), U.S. MALES, ALL AGES

      Worried parents and life insurance salesmen often complain that the young
      think they're immortal. Well, in a sense, the young are almost right! There
      are age groups for which it can validly be said that extreme life extension
      has already been achieved, using existing medical technology. To better
      appreciate this accomplishment, we need to talk about death rates for a few
      minutes.

      The chart shows the aggregate death rate for all males, at all ages, in the
      United States, from 1850 to 2000. In 1850, each male had a 2 percent chance
      of dying in the next year. By 2000, each male had a 1 percent chance of
      dying in the next year. So over this 150-year time span, the death rate was
      cut in half. As a result...


      FIGURE 10: ESTIMATED VS. ACTUAL EXPECTED AGE AT DEATH (U.S. MALES, AT BIRTH)

      ...the life expectancy from birth has approximately doubled, from 38 years
      in 1850 to almost 75 years in 2000, as shown by the black curve.

      A very simple formula, written in red below, can be devised for estimating
      the Expected Age at Death. This formula encodes the simple truth that,
      roughly speaking, cutting the death rate in half doubles the life
      expectancy, as measured from the current age of the individual. The formula
      assumes a single net death rate, for a whole population of mixed ages. This
      is an import ant point, because the natural death rate in humans depends on
      our physiological age. Death rates typically rise with advancing age, except
      at the oldest ages.


      FIGURE 11: DEATH RATE, U.S. MALES, AGE 1-4

      Medical technology has had its greatest impact to date in preventing infant
      mortality, especially between the ages of 1 to 4. In the Year 1850, a young
      child in this age cohort had a 2.4 percent probability of dying in the next
      year. Today, the probability of dying in the next year for these children
      has been reduced from 2.4 percent to 0.04 percent. That's a phenomenal
      60-fold reduction.

      What if future medical technologies permit us first to arrest, and later to
      reverse, the biological effects of aging? In such an era, our bodies would
      no longer tumble down a staircase of degeneration and frailty. Instead, our
      statistical death rate would take on some approximately fixed value that's
      appropriate for our physiological-age cohort, not our calendar-age cohort.
      Biological age would no longer march in lockstep with calendar age. So, how
      much longer might we live, if we could just keep the bodies we had when we
      were young?


      FIGURE 12: EXPECTED AGE AT DEATH, ASSUMING AGE-INVARIANT DEATH RATE (MALES,
      AGE 1-4)

      Well, in the Year 1850, the death rate for a U.S. male between the ages of 1
      and 4 implied an Expected Age at Death, according to our formula, of only 31
      years. That is, in 1850, a child that could remain perpetually 1-4 years old
      physiologically, would have died, on average, after 31 calendar years. Early
      childhood was still very unhealthy and dangerous in those days.

      As medical technology slowly improved, childhood became far less dangerous.
      Most of the specific medical causes of early childhood death have now been
      analyzed, and conquered. As a result, a child that could remain perpetually
      1-4 years old biologically today would not die, on average, until he or she
      reached the calendar age of 1800 years. Death would usually come from some
      form of non-medical accident, which is the leading cause of death up to age
      44.

      Of course, most of us aren't 1-4 years old. How long would we live if we
      could halt any further biological aging of our bodies right now, at our
      current age?


      FIGURE 13: EXPECTED AGE AT DEATH. ASSUMING AGE-INVARIANT DEATH RATE (MALES,
      AGE 1-44)

      Here's the answer for various biological age cohorts up to 44 years old.

      The 10-year-olds among us would fare the best, reaching an average Expected
      Age at Death exceeding 3000 calendar years. The 20-year-olds would make it
      to 600 calendar years. Life has even become less dangerous for the
      40-year-olds, who could survive to an average calendar age of 300 years in
      today's medical environment, if further biological aging could be
      immediately halted. These are remarkable achievements of medical technology
      compared to the Year 1850, a time when none of these groups would have
      survived more than 80-100 calendar years. Note that all of these curves --
      and most especially the youngest cohorts -- began their steep climbs into
      extended longevity during the latter half of the 19th century.


      FIGURE 14: EXPECTED AGE AT DEATH, ASSUMING AGE-INVARIANT DEATH RATE (MALES,
      AGE 35-84)

      If you're over 45, the picture is not yet so bright. Non-aging biological
      50-year-olds would live to a calendar age of 178 years. Non-aging
      60-year-olds could only expect to survive to 113 calendar years in the
      current medical environment.

      But the news is not all bad for the elders. The death rate for 80-year-old
      U.S. males fell by 45 percent during the last century. So some progress is
      definitely being made. The problem is that the absolute natural death rate
      is still so high among the elderly that the Expected Age at Death has not
      yet significantly improved.


      FIGURE 15: AGE DISTRIBUTION OF U.S. POPULATION, 1850-2030

      Now, you remember those Expected Age at Death curves for the youngsters that
      began their steep climb into extended longevity in the late 19th Century?
      The biggest gains were in the 1-10 year old cohorts, where death rates fell
      30- to 60-fold. These gains began at a time when this age cohort made up 20
      to 30 percent of the U.S. population. Early deaths in this gigantic
      demographic bulge were of great concern to medical researchers at the time,
      who lavished their resources on solving this problem.

      I think history is about to repeat, this time at the opposite end of the age
      scale. In the United States, people over 60 years of age already make up the
      single largest cohort at 16.5 percent, and this cohort grows to 20 to 30
      percent of the U.S. population after 2015, and for decades beyond. As
      before, this demographic bulge will focus research scientists and research
      dollars towards solving the problem of premature death among the very old.


      FIGURE 16: BIRTH/DEATH RATIO, DEVELOPED COUNTRIES

      And there's another societal motivation to reduce death rates. As nations
      become more industrialized, their birth rates go down. In the developed
      world, the birth-to- death ratio has been declining for decades. In many
      countries, there are already more deaths each year than births, which, in
      the long run, is a prescription for national extinction. To avoid a
      Population Implosion, these nations must get busy and reduce their death
      rates to below their falling birth rates.


      FIGURE 17: WHAT IS NANOMEDICINE

      The greatest advances in halting biological aging and preventing natural
      death are likely to come from the fields of biotechnology and
      nanotechnology. That is, nanomedicine. Nanomedicine is most simply and
      generally defined as the preservation and improvement of human health, using
      molecular tools and molecular knowledge of the human body.

      In the near term, say, the next 5 years, the molecular tools of nanomedicine
      will include biologically active materials with well-defined nanoscale
      structures, such as dendrimer-based organic devices and pharmaceuticals
      based on fullerenes and organic nanotubes. We should also see genetic
      therapies and tissue engineering becoming more common in medical practice.

      In the mid-term, the next 5 or 10 years or so, knowledge gained from
      genomics and proteomics will make possible new treatments tailored to
      specific individuals, new drugs targeting pathogens whose genomes have now
      been decoded, stem cell treatments to repair damaged tissue, replace missing
      function, or slow aging, and biological robots made from bacteria and other
      motile cells that have had their genomes re-engineered and re-programmed. We
      could also see artificial organic devices that incorporate biological motors
      or self-assembled DNA-based structures for a variety of useful medical
      purposes.

      In the farther term, perhaps somewhere in the 10 or 20 year time frame, the
      first fruits of molecular nanorobotics should begin to appear in the medical
      field. My own theoretical work in nanomedicine has concentrated on medical
      nanorobotics using diamondoid materials and nanoparts. This area, though
      clinically the most distant, and still mostly theoretical, may hold the
      greatest promise for health and life extension.


      FIGURE 18: DECHRONIFICATION

      The end result of all these nanomedical advances will be to enable a process
      I call "dechronification" -- or, "rolling back the clock." I see no serious
      ethical problems with this. According to the volitional normative model of
      disease that is most appropriate for nanomedicine, if you're physiologically
      old and don't want to be, then for you, oldness and aging are a disease, and
      you deserve to be cured. After all, what's the use of living many extra
      hundreds of years in a body that lacks the youthful appearance and vigor
      that you desire? Dechronification will first arrest biological aging, then
      reduce your biological age by performing three kinds of procedures on each
      one of the 4 trillion tissue cells in your body.

      First, a nanodevice will be sent to enter every tissue cell, to remove
      accumulating metabolic toxins and undegradable material. Afterwards, these
      toxins will continue to slowly re-accumulate as they have all your life, so
      you'll probably need a whole-body cleanout to prevent further aging, maybe
      once a year. Second, chromosome replacement therapy can be used to correct
      accumulated genetic damage and mutations in every one of your cells. This
      might also be repeated annually. Third, persistent cellular structural
      damage that the cell cannot repair by itself such as enlarged or disabled
      mitochondria can be reversed as required, on a cell by cell basis, using
      cellular repair devices. We're still a long way from having complete
      theoretical designs for many of these machines, but they all appear possible
      in theory, so eventually we will have good designs for them.


      FIGURE 19: EXPECTED AGE AT DEATH AFTER DECHRONIFICATION

      Using these annual checkups and cleanouts, and some occasional major
      repairs, your biological age could be restored once a year to the more or
      less constant physiological age that you select. I see little reason not to
      go for optimal youth -- though trying to maintain your body at the ideal
      physiological age of 10 years old might be difficult and undesirable for
      other reasons.

      A rollback to the physiology of your late teens would be easier to maintain
      and more fun. That would push your Expected Age at Death up to around 900
      calendar years. You might still eventually die of accidental causes, but
      you'll live ten times longer than you do now.


      FIGURE 20: NANOMEDICAL LIMITS TO BIOLOGICAL LIFE EXTENSION

      How far can we go with this? Well, if we can eliminate 99 percent of all
      medically preventable conditions that lead to natural death, your healthy
      lifespan should increase to about 1100 years. It may be that you'll find it
      hard to coax more than a millennium or two out of your original biological
      body, because deaths from suicides and accidents have remained stubbornly
      high for the last 100 years, falling by only one-third during that time .

      However, one can hope that the rate of suicides might be greatly reduced,
      with so much to look forward to, and with new nanomedical treatments for
      unhealthy mental states. Nanotechnology can also improve the overall safety
      of our material environment, leading to far fewer deaths from accidents.

      Finally, genetic modifications or nanomedical augmentations to the human
      body may extend healthy lifespans still further, to a degree that cannot yet
      be accurately predicted.

      In closing, I hope you'll agree with me that natural death is an outrage.
      Indeed, it is humanity's, and history's, greatest outrage. Now, at long
      last, maybe we can finally do something about it. So let's get on with it!

      Thank you.

      For more information about my writings on nanomedicine , please
      visit the following websites:

      NANOMEDICINE:
      http://www.nanomedicine.com/

      NANOMEDICINE AT THE FORESIGHT INSTITUTE:
      http://www.foresight.org/Nanomedicine/

       
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