Hacker News new | past | comments | ask | show | jobs | submit login
Our unrealistic views of death, through a doctor’s eyes (washingtonpost.com)
349 points by llambda on Feb 19, 2012 | hide | past | web | favorite | 254 comments

"At a certain stage of life, aggressive medical treatment can become sanctioned torture. "

I just went through a month with a 90 year old friend whose life ended almost exactly like the story in that story. He had one lucid 30 mins when I was there and his family was there (he had been a general physician for almost 50 years). In his brief period when he had the energy to try and communicate whilst almost totally paralysed, it was clear he was telling the attending doctor that he wanted them to stop all medication and let him die. His own family could not face that fact, and said they'd ask him again the following day (unfortunately the cowardly doctor backed them up on this). He was never again lucid or strong enough to insist that treatment be stopped. He lived for another 10 days, struggling to breathe, almost totally paralysed, unable to control his bowels.

This was a man who when I last went on holiday with him at the age of 85, he insisted on carrying his own suitcase and refused a wheelchair, even though he had trouble walking and had blood pressure and angina problems.

I don't blame his family not being able to make that decision (it's so hard to let go of someone one loves). But his last weeks were undoubtedly torture, and they know they refused to follow his wishes. It was just terribly sad and an awful dilemma.

I was really glad of something else I read on HN about 6 months ago, where a doctor had a brain tumouur (or something like that) and instead of treatment, he lived out the remainder of his life doing the things he loved. I think that idea was what meant I could come to terms with the need to respect my friend's last wishes. I just could not convince his family.

I encourage everybody to talk things like this through with their family.

Last year my mom was diagnosed with a terminal brain tumor. She elected to pursue treatment vigorously, but brain tumors being what they are, there were a number of points where she was unable to answer questions about her wishes.

At every one of those points we knew what she wanted because we had discussed it extensively before. I was incredibly grateful for that. It is bad enough to have to make complicated, life-or-death decisions for someone you love. I cannot imagine the horror of trying to do that without a clear understanding of what they would want.

Please talk with your family about this. Right now if possible. Just forward your sibling, parent, or child this article and tell them it made you think. Then tell them what you'd want. Don't just think you'll do it "later"; the right time will never come on its own.

This is great advice, thank you. Despite both of my parents and one of my siblings having had brushes with cancer (thankfully that resulted in nothing), this is all too easy to ignore.

Terry Pratchett created a documentary titled "Choosing to Die" which can be watched here: http://vimeo.com/25239708

It's highly relevant to the difficult questions that come up when dealing with death. I think the documentary does a very good job of exploring options available in the modern world and the issues associated with them.

At first, I was confused by this statement, given the data..

> "...modern medicine may be doing more to complicate the end of life than to prolong or improve it"

    65 -> +12  
    85 -> +4

    65 -> +19  
    85 -> +6
The engineer in me said, but we've improved! But then I realized that evaluating life by measuring in years is like reviewing tech products by looking at spec sheets.

"But it has more megapixels!? Aren't megapixels what we want?"

Reality is far more subtle.

The improvement at the upper end isn't even that much in absolute terms. I guess it's hard to imagine accurately, but I think that when I'm 85, I'm going to be a lot more worried about the quality of my next few years, rather than whether there are going to be 4 or 6 of them. Four high-quality years would be far preferable to six questionable ones. (Of course, six high-quality ones would be even better, but if I had to choose, I'd choose quality.)

Gotta consider cost. If the marginal cost per megapixel is a million dollars, then maybe a few extra aren't so worth it.

Forget cost. The important question is quality. In cameras, extra megapixels can mean the sensor sites are so small that they have a harder time distinguishing electronic noise from actual light, leading to worse pictures. Likewise, what good is getting me 10 more years if I can't do anything with them because they're spent in total agony.

It'd be nice to have the option to choose to spend that million on pursuing a bucket list, or on a horrendous treatment with a single-digit success rate.

You might think "It has improved", which is correct, but people seem to think it has doubled. The numbers show that in reality old age is about as long.

I'm pretty sure it has improved. People don't treat their diseases and accidents at home themselves. Old people can quite often move all their limbs, walk without support, still have at least some teeth and so on. All improvement of modern medicine. It doesn't make us live twice as long but you can't say it only creates suffering either.

Modern medicine, or wealth?

> our culture has come to view death as a medical failure rather than life’s natural conclusion.

Death is a medical failure, just like our inability to cure herpes is a medical failure. That there's no way to overcome the failure yet does not imply that it is not a failure.

Failure implies responsibility. Which is the entire point of the article. We've shifted death from something that just happens, to something that we're responsible for. We've come to believe that we are somehow above death, and that every death is due to a human failure. Which is nonsense.

Similarly taking your position, we could say that computer science's inability to factor numbers in polynomial time is a failure. Clearly the fact that solving the problem may actually be impossible should play a role in assigning the label 'failure'.

Failure implies responsibility.

And I think that's a fair point, actually. Death is a responsibility. Ascribing it solely to medicine is unfair, but it is our responsibility.

Could we extend the average lifespan of adults by 10 years by spending money? Easily. Most people live thoroughly unhealthy lives, many of them because they simply don't know better. Consider the whole "obesity epidemic". A large number of people will die comparatively young because of a complete failure of our society to teach them how to eat decent food.

Beyond simply curing gross mistakes in self-care, what about positives? Could we find ways to get the average healthy person to treat their body even better, and squeeze out some more life expectancy? I'm sure we could. More thorough study of the effects of nutrients and toxins, more efforts to reduce the amount of crap in people's food and other items that they come into daily contact with, etc, those would probably net another few years of improvement.

And that's only looking at western society. If you look at poorer countries, there are countless avoidable deaths there. Some organisations, like the Gates foundation, are trying to address some of the more obvious killers, like Malaria, which have been neglected for decades (if we'd really wanted to get rid of Malaria in the 50s, we would have done so).

Overall, I think it's fair to state that we could raise the life expectancy of almost every human on this earth by 10 years if we really tried. But we choose not to. There are 7 billion humans on this planet, and every day, we, as a society, make a choice, to not bother to create 70 billion man-years of life-expectancy.

It is a choice, or rather a lack of choice, and so yes, it is a responsibility. We all (me included) choose to give up on 70 billion years of human life, every day.

I'm entirely in favor of extending healthy life worldwide, but I worry that you're missing the point: death will still come. We are certainly responsible for not doing the best we can with what paltry time and resources we have.

This may seem like I'm belaboring a meaningless distinction, but it has practical implications. We spend extraordinary sums on futile end-of-life care instead of on the things you name. And people who are unprepared for death, their own or that of loved ones, suffer immensely.

Deciding that every death is a failure is denying a reality that we must confront if we really want to make the most of what we have.

Yes, everything you say there is true. But in the context of the article, and the parent post, we are not talking about preventative healthcare, or first lines of treatment, or stuff that can generally fall under the umbrella of "treating people right".

The context of the article is about extraordinary actions at the end of life. This is not about keeping people healthy, it is about making very ill people live a bit longer. We clearly have a responsibility to keep people healthy. There is no excuse for allowing malnutrition to just happen (though there is an 'excuse' for it to continue while we try to rid it). Those are failures. We are responsible for those.

Those responsibilities are very different from the situations being discussed by the article, and what I thought that mistercow was talking about (which would be death in general).

Not at all. We do teach people how to eat decent food, but many choose not to.

Careful, this is a very dangerous path you're walking down.

This is the same thing as "why don't those homeless people just get jobs?!" - it's a failure to understand the complexities of the situation.

It feels nice though, because their failure is not on us (society as a whole), but wholly on them. Moral responsibility defeated!

swombat nailed it on the head: crap food is way cheaper than good food, to the point where a lot of this country does not have reasonable access to healthy foods. There are also other angles - e.g., single mother of two juggling two jobs - do you find something microwaveable or do you cook something healthy with the time you don't have?

In any case, this whole thing is way more complicated than just "hurr durr stupid plebes".

But swombat specifically referred to obesity, which suggests that you eat too much, not just that you eat the wrong foods.

If you are already eating too many pies, you can afford to replace some of them with cabbage or sprouts (at least here in England; Maybe it's not as cheap/easily available in other parts of the world?)

Don't confuse it with malnutrition, which is a real (but different) problem.

> "obesity, which suggests that you eat too much, not just that you eat the wrong foods."

It suggests no such thing. The obesity epidemic is all about eating the wrong things.

Obesity is not only a problem of quality of food, it also IS linked to quantity. You will never get obese if you only get a small amount of crap food everyday, but eating lots of it will surely put you on the right way. There are some genetic exceptions (some people get fat even when eating reasonably) but this is a tiny minority. Most of the obese epidemic is lifestyle related (no or not enough exercise / too much food ). There's no way you can get away from personal responsibility there. It is nothing like homeless unable to find jobs. You are directly responsible of what you put in your mouth everyday, and how much of it.

I'm a hypothetical poor person, so I must feed myself on cheap subsidized carbohydrates, which leave me feeling hungry, or eat an amount that sates me after working one to two normal jobs and taking care of zero to more children, which conveniently is an amount that will contribute to my obesity. Helpfully, my busy schedule lets me eat one big meal a day instead of several smaller meals.

The problem is that personal responsibility is disproportionately more expensive for poor people - they don't have the time or the money to do it right, and when they do manage an attempt, equal results will cost more time and much more % income.

> "You are directly responsible of what you put in your mouth everyday, and how much of it."

Well, yes, technically. Of course, you're conveniently forgetting about the effects of pricing, geographic proximity (seen many organic produce stands on skid row lately?), culture, education, and most importantly: time.

> "Most of the obese epidemic is lifestyle related"

And yes, you're right, but only in the most technical and of ways. Of course the obesity epidemic is lifestyle-related, but that's not what we're on about. We're on about a system that punishes healthy lifestyles and makes them unreasonably difficult for the poor to attain - harder than any of us pansy-ass rich folk have to contend with.

Let's re-enumerate very quickly:

1 - Eating too much is not the issue. Eating too much of the wrong things is the issue.

2 - Unhealthy foods are cheaper than fresh fruits, veggies, and meat by an almost comically large margin. This is due to a number of causes, most saliently massive government subsidization of unhealthy food industries.

3 - Time is the scarcest resource, and the poor have the least of it, and the least to spare towards maintaining a healthy lifestyle (which, despite what you might insist, is a time-intensive activity).

3a - The poor are disadvantaged in choice of living space. My commute is an order of magnitude shorter than what it'd be from the nearest poor suburb. I pay for the privilege, and it earns me easily an extra 1.5h each day.

3b - The poor are disadvantaged in transportation. While most people simply hop on a car between A and B, the American poor spend an enormous amount of time navigating the clusterfuck that is North American public transit. Here in SF, even with its good-by-American-standards transit system, transit anywhere takes about twice as long as it does in car.

3c - The poor are disadvantaged in just sheer lifestyle. You might live next to a nice park where you can jog after work - what do the poor have except crime-ridden streets?

This is the thing I can't stand about this line of argument, not only does your position fail to account for the many, many ways the cards have already been stacked against the poor, but it also fails to appreciate just how many natural advantages you and I enjoy in every day life. It's a combination that really irks me: the failure to appreciate one's own good fortune, and conversely the willingness to blame others for not having such good fortune.

Side note: time really is the deciding factor in just about anything poverty-related. Part of the reason for the persistence of homelessness (disregarding even bigger fish like mental health and substance abuse) is that the homeless spend the majority of their day queuing for resources. They spend hours lining up for a meal. They spend even more hours lining up for a bed. 98% of their waking hours is spent ensuring the status quo (i.e., homeless, but unlikely to die tonight), with nothing left to make actual, lasting improvements. This same problem applies to the poor and dietary habits.

Good comment. I do not agree with everything you said, so let me elaborate a little.

1 - Eating too much is not the issue. Eating too much of the wrong things is the issue.

No, I assure that even if you eat too much healthy food, you will grow fat and obese the same. Unhealthy food may make it worse for a number of reasons, but excess is anyway going to be a problem, no matter what you eat.

2 - Unhealthy foods are cheaper than fresh fruits, veggies, and meat by an almost comically large margin. This is due to a number of causes, most saliently massive government subsidization of unhealthy food industries.

First, I would not classify "meat" as healthy food. That probably depends on your education and your view of meat, but you get a lot of fat percentage for the amount of calories. 50 years ago people were eating meat probably like 10 times less that we are and were (probably, I dont have numbers with me now) less sick. For your second point, "unhealthy" food is, I think, rather the result of people not considering food as important. Therefore food becomes a commodity. People prefer spending their money on vacation, video games, buying the latest smartphone and so on. Even those who HAVE the money. It's clearly a cultural problem: food has lost "value" per se. I do not know where you live so I cannot comment on that, but in most developped countries governments are also massively subsidizing small-sized farms (true in Europe and some parts of Asia at least).

3a. I agree with the time element, but I disagree in the responsibility. Of course, if one feels like you have to watch 4 hours of dumb TV shows every night to be satisfied with their lives, then there will no time for cooking. But anyone who can spare 30-45 mins a day in the evening can cook something healthy. Of course, it will not be something complex, but it is feasible. Please do not tell you need longer than that, of I will have to film myself cooking to prove my point.

3b. Now if you cannot even afford a car I admit this is a problem, especially in North America. Then it makes access to quality food more difficult. I can't argue on that one.

3c. Allright, of course there are poors who live in the worst conditions ever, and putting good food on the table is far from their priorities. But come on, when we talk about the obesity epidemic, we are talking about something like 33% of the whole US population having this obesity problem. You cannot seriously tell me that 33% of the US is composed of poor people living in crime-ridden suburbs. (http://www.cdc.gov/obesity/data/trends.HTML)

A number of these 33% HAVE the money, HAVE the time, HAVE the means to eat good food, but decide not to. For a lot of these people, this IS a lifestyle choice. There is noway around that, and there would be no epidemic if this was confined to the "poor/rich" rhetoric.

Here we go with the stereotyping again. The point you make has validity, but I simply cannot get behind it for the amount of stereotyping you are doing of the poor.

You are subscribing to the all-too-common "poor people with big screens and iPhones? What's that all about?" fallacy, except you ascribe even more universality to it than most.

> "People prefer spending their money on vacation, video games, buying the latest smartphone and so on"

This is a stereotype, unless you have convincing data to back it up. It is also about as offensive and useful as "black people! fried chicken! watermelons!"

See how far the conversation gets when this happens?

The "poor people are poor because they waste their money on lavish stupid spending" is a refrain we've heard way too many times. It's simply not true, fails to comprehend the complexity of the situation, and is frankly a complete moral cop-out.

I've had the fortunate/unfortunate experience of living on the wrong side of the tracks for part of my college years. I've lived with and befriended many of the people we upper-middles love to stereotype, victim-blame, and mock, and while there's always a sliver of truth to every stereotype, the characterization that the poor are poor, or that the poor are fat, because they're too stupid to act responsibly, is a pernicious and toxic lie.

Let's enumerate, for the record. You seem to believe that the poor:

- Spend their money on vacation, video games, and the latest smartphones instead of being smart about their finances.

- Need to watch 4 hours of "dumb TV shows" every night to be satisfied with their (presumably pathetic and meaningless) lives.

I honestly don't think we can have a discussion about the broader point of diet/obesity while you're chiseling at these points.

> "You cannot seriously tell me that 33% of the US is composed of poor people living in crime-ridden suburbs."

Have you been to the US lately? Despite what you might see in major cities or in the Valley, the majority of this country is poor as fuck. The notion that the vast majority of America enjoys a standard of living lightyears ahead of the rest of the world... is simply not true. Fully 42% of this country has an annual income of under $25,000.

The obesity epidemic in the USA is at its core tied to socioeconomic status. Hell, the fact that state-by-state obesity rates is highly correlated with state economic strength should be very telling.

> The obesity epidemic in the USA is at its core tied to socioeconomic status. Hell, the fact that state-by-state obesity rates is highly correlated with state economic strength should be very telling.

You need to check your numbers, because that's not what studies are saying. http://frac.org/initiatives/hunger-and-obesity/are-low-incom...

Quote: "Among men, obesity rates were fairly similar across income groups, although they tended to be slightly higher at higher levels of income. In fact, among Black and Mexican-American men, those with higher income were significantly more likely to be obese than those with low-income."

Shocking, it says the exact opposite of what you were trying to prove. So there actually ARE people with higher income who are obese, it seems.

> No, I assure that even if you eat too much healthy food, you will grow fat and obese the same.

This isn't true. If you eat lots of healthy food, and get even a little bit of exercise, then you will gain weight, but it'll be muscle instead of fat. If you eat only a little, then you will lose weight, but the quality of what you do eat will determine whether the losses come from fat or from muscle.

> A number of these 33% HAVE the money, HAVE the time, HAVE the means to eat good food, but decide not to.

What has actually happened is that people decide to eat healthy, but society lies to them about what is and isn't healthy.

> If you eat lots of healthy food, and get even a little bit of exercise, then you will gain weight, but it'll be muscle instead of fat.

Seriously, do you have anything to substantiate that claim? I have seen obese people even in countryside where they were eating nothing but so-called "healthy food". Since when "healthy food" becomes muscles ?

Not dangerous, this poster is absolutely right. I know how to eat healty, and I have the means, but I often eat unhealthily anyway. It is not the same class as being homeless.

I'm not saying that everyone is in the position to choose, but many are, and that is all that was said.

We do? Watch this: http://www.youtube.com/watch?v=bGYs4KS_djg

Most people have no clue what constitutes a healthy meal. Moreover, they are strongly incentivised to eat crap by the fact that crap food is (much) cheaper than healthy food. Combine the two, and you have vast numbers of people who basically eat sausage rolls, pizzas, burgers, chips and chinese takeaways (probably not the worst of the bunch), along with epic-size sugary sodas and mega-calorie coffees on a pretty much daily basis.

Many people complain that healthy food is "too expensive." However, a more accurate explanation is "crappy food is cheap."

There's definitely an important difference.

What do you suggest, making them both expensive?

Er, no. But there's an important psychological difference between "X is expensive." and "Y is cheap."

Honda Civic's aren't cheap. A Lexus is expensive.

I had to stop watching this show after 4 or 5 episodes.

It was just too depressing.

Agreed. I find it hard to believe that so many people can be so ignorant of the very basics of healthy eating despite all the public health initiatives and mandatory classes in schools (at least in my country). I think people have the knowledge but just not the incentives to eat healthily. Convenience generally trumps everything else.

Convenience generally trumps everything else.

And taste. Pizza is really good.

Living a healthy lifestyle has many benefits, but there's obviously an upper bound to this as a life extension approach. Who was it who said "Eat right, Exercise Regularly, Die Anyway"? :)

Sure, but if you take all the people who will die before 60 because of their weight (what's that, 1/3 of the population in the US?) you can basically add 15-20 years to their lifespans just by having them eat properly. That's the equivalent of adding 5 years to the US's average life expectancy.

No, that can't be right. Do you have sources to those statistics, as they seem way more drastic than I would have thought.

E.g., after looking around online for a bit, I found this[1] which indicates 300,000 deaths each year are attributable to obesity, which is 12.5% of deaths[2].

Furthermore, the magnitude of the the effect doesn't seem to be 15-20 years. This wikipedia section[3] indicates that being "obese" lowers life expectancy by 2-4 years. Being "severely obese" lowers it by 10 years. But according to these statistics[4], "severely obese" is ~10% of the population.

So I think 1/3 of the US population dying before age 60 because of obesity is way, way off the mark. More like 10% dying at 68 and maybe half the population dying at 75 because of obesity rather than 78.

[1] http://www.wvdhhr.org/bph/oehp/obesity/mortality.htm [2] http://www.cdc.gov/nchs/fastats/deaths.htm [3] http://en.wikipedia.org/wiki/Obesity#Mortality [4] http://www.nber.org/papers/w13181

I frankly don't understand why you were downvoted. I agree with this opinion...

We are responsible for death. We as a worldwide society have enough resources to seriously tackle death but because of our inability to coordinate effectively we don't apply those resource. NIH budget $30 billion Defense budget $700 billion Coordination is the problem web startups exist to solve, and so readers of hackers news are a particularly culpable in failing to address death.

We as a worldwide society MAY MAY have enough resources, that's assuming it's even a solvable problem.

Also "web startups" as a class don't exist to solve anything other than maybe the question "why don't I have more money".

We MAY be able to solve, so why not try it? I'd put avoiding death at the top of any list of priorities.

To make money you should be solving a problem (stealing and monopolies being exceptions). Web startups exist to coordinate people, that's the only thing they are capable of - they cannot "physically" do anything else. (the exception is personal data backup such as dropbox).

Death is a medical failure

No. A thousand times no. Death is part of life. All composite things decay.

Imagine a kindergartener on an ocean beach. They spend hours building a sand castle. They wail as the tide claims it, feeling the sting of failure. Do you agree, telling them that they screwed up in their construction?

I say no. The error isn't in the building, it's in expecting the castle to last through high tide.

For the skeptical, I'd encourage you to watch this documentary: http://www.imdb.com/title/tt0307385/ It really solidified my view that the transitory nature of all things makes them more beautiful, more poignant.

And yet your codebase for needfeed is likely homed on separate redundant storage devices to ensure continuity in the inevitable event of the decay of the composites that store it. You'd probably be aghast at the suggestion that you put it all on one single point of failure and just let fate decide because the transitory nature of the project would make it more beautiful.

Yet how much more valuable is our consciousness than our accrued digital data? I don't understand how people can simultaneously understand that it is extremely unwise to leave their data to the fate of mechanical failure and yet not only accepting death but actually perceiving it as superior in many cases.

Defeating death is a worthy project. Embedding consciousness in a digital substrate or backup to genetically engineered bodies, or nanotech / biotech strategies for preserving existing bodies beyond what is natural are worthy pursuits.

Sometimes I wonder if the reason that this is not accepted is because of religious people in the world who feel like accepting that death is the end of their consciousness would be betraying their faith.

The codebase for my current project is well protected. For the moment. Most of the rest are gone. Their time came and went; this one will go too. As will I, and as will you.

I'm entirely in favor of research into extending human lifespan and maximizing the quality of human life. But this "circuits will save us all" stuff is not materially different than all the people who believe Santa-in-the-sky will let them live forever in happy-shiny-fluffy land. It's pure wish fulfillment, with no significant evidence.

Sure, and maybe some day if you've lived as long as you care to you may choose to allow your consciousness to fade away too, and that is all very well and good. It's the inability to do otherwise that is a problem.

With regards to possibility; it's the difference between hard science fiction and simple fiction, there's nothing ruling out that any of these things as possible, and in light of that fact I think pursuing them is an undeniably good idea.

We know the origins of Santa, we know the origins of god and religion, we understand why they're false and why that's a waste of time. Theoretical future advances in technology allowing fundamentally new paradigm shifts are something completely different.

Our very being, not just consciousness, is inseparable from our physical body. One day you maybe able to create an exact clone of the body to house the mind, but what good that would be? The body would be an exact clone with all its flaws. If you move the mind to a body that does not have those flaws, the mind is bound to change. We experience everything through our bodies and those experiences make our minds what they are. At least IMO.

I surely doubt that we know the origins of religion. And they surely are not a waste of time. Something that has been part of the human culture for as long as we know is bound to have some meaning. And pleas, take a look at some of the proofs for gods existence and nonexistence, some of them are quit elegant.

There's nothing ruling out the possibility of an afterlife either. Ergo, by your logic pursuing them is an undeniably good idea.

As I said before, extending lifespan is worth pursuing. Living longer is technically achievable. But eternal life is pure fantasy. Death comes for us all, and unless we face that fact squarely, we won't use what time we have as well as we could.

Sure, in the same sense that pursuing magic space unicorns (nobody proved that they don't exist) is equal to pursuing pulsed nuclear rocketry as a means of interplanetary transport is an undeniably good idea.

I hate this view so much. How are we better off not having people like Tesla, Newton, Einstein, etc. anymore? They had to give way so we could have Dragonball Z and reality TV? The notion that we gain something by people dying is beyond nonsensical.

The only benefit death will bring is when everyone who has this ridiculous view point is gone and out of the way.

There's no way to know how many of our advances are made because of our mortality.

If you took away the ticking clock and each person had thousands of years to write his novel, prove his theorem, or complete his masterpiece, would we continue to advance--or would we stagnate?

You also assume that a 1000 year old Einstein would still be Einstein. We have no idea what the impact on the brain of living that long would be. More than likely at some point previous memories would begin to fade away, and at some point you've replaced so many parts (memories) that there's nothing of the original left.

Additionally, society changes in large part because the people who make up society change. Would slavery have ever ended if older people hadn't passed away and younger ones with new ideas taken their place? Would we still be ruled by a thousand year old tyrant with a medieval morality?

I agree that we don't know the answers to these questions, but I don't agree that they outweigh the awful, terribly sucky thing which is death. I don't want anyone to die ever again. That people have died a few times since I started typing this is really, really bad!

Look, if you were designing a society and were trying to make the tradeoff of whether people should die or not, how would you weigh the arguments for and against death? "Hmm, on one hand, old ideas die off, so society might progress faster. On the other hand, we will snuff every conscious being out permanently, and they and their family go through years of suffering. Which should we choose?" Are you seriously arguing we would choose the former?

This. Plus "let's have everyone's body and mind gradually deteriorate over several decades before they die".

I don't think they allow, expect, or calculate an unbounded positive as t->infinity. I don't expect we'll get caught in a local minimum - we've done a decent job breaking out of them when the individuals involved haven't had nearly as much at stake...

Well if we want to take it to it's extreme end, death is a certainty. At some point all nature will decay and the universe and all energy will stop, it will all be used up. Nature will be used up and gone, barring the supernatural we will be too, so at that point even if we become naturally immortal we will die, because nature and more importantly energy will be no more. At this point Tesla, Newton et. al. will not matter, not a thing will matter, because the universe will be dead. So if we die in 85 years or x billion of years the final result is the same. Death is part of life and at some point even our contributions, no matter how great they are will be of no value. The old wisdom nothing last forever is true.

Now that I think about it, even this viewpoint is invalid. Perhaps we simply have an insufficient understanding of the universe. In 5000 years, they might ridicule the people of their past (us) for ever thinking that the end of the universe is inevitable. Just because we can't conceive a workaround yet does not mean that there isn't one.

"travelling faster than 40 miles an hour is impossible" "communicate with someone on the other side of the world instantly? Impossible!" "fly to the moon?" "end death?"

I'm sure that if we sat down, we could come up with thirty things that we have daily today, but were 'impossible' a hundred years ago.

This isn't correct. You're falling victim to a fallacy sometimes known as privileging the hypothesis. When you look back and say, "Look at all the things people thought were impossible but are now possible!" you're ignoring all things that people thought were impossible and are still impossible. Moreover, you're looking over all the things people thought were possible but are actually impossible.

The entire frame of your questions shows the fallacy because you explicitly abandon all other notions to just come up with things that were thought impossible but are now mundane.

It's true that we don't know everything, but implying that because we don't know everything we know nothing is absolutely ridiculous. All current knowledge of physics points towards entropy, and moreover the second law of thermodynamics, as being one of the most important and consistent laws of physics. It's so important that one of the most well-known physicists in the world is so well-known because he created a theory of black holes that meshes with our existing theory of entropy, proving that the second law still holds. The idea that we should abandon this knowledge because, well, it's inconvenient strikes me as being disingenuous in the highest order.

Anyone can say, "Well, you don't know everything, so you may be wrong." That doesn't make it an informed or useful comment.

Haha, I guess I wasn't clear enough there; my bad.

In my defense, I was not saying "since we achieved all these awesome things, we'll surely eventually avoid the heat death of the universe". Instead, I was claiming that right now, we're probably still to ignorant to know that with confidence. Perhaps we will find a way to escape into a different universe.

Thanks for the reminder (and good username!)

I can't find any examples of privileging a hypothesis in the grandparent comment. Could you clarify that?

Personally I chose to ignore this point of view as it would imply that absolutely everything is completely without a point. What's the value in following such a line of thinking?

Why? Because one eventually realizes that your conclusion here is incorrect. You have constructed "meaning" as a very particular thing here. There are other ways to see meaning in the world.

And also because it's true. The best science we have tells us that everything decays in the end. If you're going to start ignoring facts just because you don't like them, where do you stop?

>Because one eventually realizes that your conclusion here is incorrect. You have constructed "meaning" as a very particular thing here. There are other ways to see meaning in the world.

But what you're describing sees no meaning in anything ever. Simply because you can say that eventually the sun will burn out and we'll all die anyway doesn't mean we shouldn't try to make things as good as we can while we are here.

>If you're going to start ignoring facts just because you don't like them, where do you stop?

No, I'm ignoring facts that have no relevance or no useful action to take. If everything is going to end in a trillion years, what should I do about that exactly? Does that mean I should try to cure aging now?

Do you have a job? Why, the universe will end in some billions of years. Oh, you want to have as nice a life as you can while you are here? So do I.

You've got me wrong. I agree entirely that we must make the most of what we have. Which is why I think it's important to face the inevitability of death. If you aren't realistic about what you have, you can't make the best use of it.

Which is exactly what this article illustrates. Death comes for us all, and not facing that yields waste and suffering. Not in some abstract sense, either. As the author writes, "At a certain stage of life, aggressive medical treatment can become sanctioned torture." And the amount spent on futile end-of-life care is staggering.

I think you have me wrong as well. I'm not for making deteriorating 90-year-olds suffer in bed for another 10 years to bump some stats. I'm talking about eliminating aging and natural death.

As things stand today, of course it doesn't make sense to hang on when you're only going to get a few more years of agony. But more research could be done in eliminating the effects of aging, etc. We've already lost many great minds but if we can stop this trend or even slow it down then it's worth persuing.

Personally I chose to ignore this point of view

I don't think this is an issue of point of view, entropy and thermodynamics are very real and as of now, the best models of reality point to it being a certainty.

imply that absolutely everything is completely without a point

I personally don't subscribe to that philosophical position, I brought up the topic of the eventual end or the universe as a thought experiment about the acceptance of death and at that point all relevance will be gone, but in saying that, I personally feel that, even if nature is temporal, things can have a point and have meaning now even if they don't have permanent meaning in this nature. Further we cannot rule out the existence of a higher natural order in which there is further purpose. That being said, meaning, point and the eventual lack of both have little to do with the reality that this nature will end, until it does end. Even if purpose is absolutely temporal it is significant in that temporal space, which is enough to give it a point. Acknowledging that a temporal space will end, does nothing to minimize the point of that temporal space and the actors within it. Rather it is a realization that it is a self contained system and that the point or meaning exists within that system, the value is within the system not external to it. Once the system is gone it has no value, but that does nothing to diminish the value inside of the system.

Personally I chose to ignore this point of view as it would imply that absolutely everything is completely without a point.

Who told you there was "a point?"

And why did he tell you that?

The fact that the destination is the same does not mean that the journey doesn't matter. Most people are not indifferent to dying in 6 hours or in 60 years.

Yes, I agree that thinking that we gain by people dying is nonsensical. Which is why I didn't say that.

We live in a universe where all things decay. There is no known exception. Species go extinct. Stars die. As best we know, the universe itself will die: http://en.wikipedia.org/wiki/Ultimate_fate_of_the_universe

You and I will die as well, and pretending otherwise causes a lot of harm. The best we know how to do now is to extend life a little; but we don't even do that as well as we could because we waste fantastic sums on futile end-of-life care. And that money also doesn't make it to the medical research that could help the next generation, or the one after that.

But I think the harm is deeper than that. Who do you think is more likely to be fully aware of how short life is? The next Einstein now toiling in a lab? Or somebody watching their third hour in a row of reality TV?

>Or somebody watching their third hour in a row of reality TV?

Don't throw out the Einsteins because of people like this. People who throw their lives away will end up killing themselves anyway (e.g. through horrible eating habits, smoking, etc.), and even if they don't, they'll be in their living room out of our way.

I find it highly amusing (if sad) that people who argue pro-death always like to point at people they don't think deserve to live...

It's ridiculous to think about surviving the heat death of the universe when 50 % longer life spans would be pretty cool.

In the coming decades, We may or may not be able to significantly extend life, but it's not clear why it's unlikely, or why it causes harm to even think about.

You are completely and utterly missing the point. The point is not "y'kno, death is actually not that bad, maybe we shouldn't try to get rid of it". As you point out, there are a lot of reasons to get rid of death, if we could.

The point is that fantasizing about "curing" death is harmful to people making difficult decisions about their life and that of their loved ones. People need to face the fact that death is inevitable and part of life, and like everything else unpleasant that is part of life, they must handle it like an adult.

It currently is, that doesn't mean it's theoretically impossible that it ever could be otherwise. It's not fantasizing to point that out.

Have you noticed somebody objecting to neutrally pointing out something that might be a theoretical possibility?

Because what I see people objecting to is not the raising of a possibility. It's the indulging of a fantasy that lets people avoid thinking about an empirical certainty.

What about people like Genghis Khan, Adolf Hitler or Joe McCarthy? Et cetera?

The belief that personal death cannot be good for society is just as ridiculous as the belief that it always is.

If the people who lived through the first evil dictator were still around they'd recognized the signs of the next one.

I think in your scenario everyone lives through the evil dictator, including the dictator, and all the people who believed in the word of the dictator as a god. You wouldn't really need to recognize any signs, because the evil dictator would still be there. Dictating.

Or is this a world where only nice people get to live forever?

the evil dictator would still be there. Dictating.

Neither Hitler nor McCarthy were still 'dictating' when they died. Lack of death doesn't mean that everything would remain the same forever.

Hitler wasn't dictating at the time of his death, but Stalin was.

Stalin's death lead to a good change.

When somebody stay in power for too long it leads to stagnation.

Human civilization has other measures against such stagnation (such as 2 terms limit for presidential position).

However limited life span still adds extra protection against society stagnation.

It's not obvious if benefits of unlimited lifespan outweight potential problems.

I think that doubling life span would probably be beneficial overall, but it's hard to say if further life span increase would.

>I think in your scenario everyone lives through the evil dictator, including the dictator

No, I'm talking about the elimination of aging and natural death. People would still be able to kill themselves and others.

That's even worse. No rational person would risk their life in warfare if they otherwise stood to live forever. The only people who would even try to kill someone else, chancing death themselves, would be fanatics and psychotics.

The legions of true believers would be able to dictate terms to enlightened society with the mere threat of violence.

I really don't think you've thought this through.

>That's even worse. No rational person would risk their life in warfare if they otherwise stood to live forever.

Think about what you're saying here. You think no one in Germany was rational? They would have had the same risk of dying we would. Hitler was only powerful because there were people willing to follow his orders.

And there was no shortage of true believers on the Allied side either (think patriotism), in any case.

>>That's even worse. No rational person would risk their life in warfare if they otherwise stood to live forever.

You would have to be pretty damn patriotic to want to give your life to preserve a nation-state you expect to outlive anyway. If I'm going to die anyway, it doesn't make much difference; it makes sense to risk my life for some things. If my life is eternal, what principle could I possibly, rationally put ahead of my survival?

Eternal life gives the insane an advantage over the sane, and the idea that the insane are as likely to be good as evil seems like a risky bet to me.

I don't get it. Why would we want people to wage war to preserve a nation-state? We want people to wage war to protect their own lives and the lives of others. That doesn't stop making sense just because your life expectancy is much higher.

Something about death being a motivator or something like that...

We have Dragonball Z because 15 (25) year old punks don't realize that they're going to die some day...

And with that, I'm going to stop scanning HN.

Death is nature's way if ensuring change.

Death is nature's way OF ensuring change.

Feel free to die then, but don't presume to speak for me. Death is a medical failure, and life doesn't stop being valuable after 75.

That people are starting to view death as a medical failure is one of the best things that could happen. I personally don't expect to die of old age.

I personally don't expect to die of old age.

Something said, I suspect, by every young person since the time of Hammurabi. I suppose that expecting to live forever in this world is no more irrational than expecting eternal life in another world.

Feel free to die then

Do you honestly think that was my point? That I'm looking forward to dying?

Probably not. But then, you're not being very consistent. First, do not conflate the current state of affairs with the desirable state of affairs. Second, if you wish for something for everyone, you wish it for yourself as well.

The current state of affairs is certainly abysmal. Some live over a century, while others die in their childhood. We age before we die. I'd rather die at 75 with a healthy body rather than dying at 75 with 10 years of senescence behind me.

So, a better system (should it be possible), would be to get rid of senescence. Even better, we could get egalitarian about death: no involuntary death before age X, at which point you die instantly. Sounds horrible? But it would be much better than the current system, where we let chance decide on the number of years we can live. Plus, you can actually make preparations for your departure.

So, what value would you chose for X? And of course, it would apply to you as well.

As far as I can tell, I'm being totally consistent. My point is that people are failing to distinguish between what they want (to live forever) and what they can achieve, and that by doing so they are causing a lot of waste and suffering, not achieving as much as they could.

I agree that a world without aging would be better. I also think it would be a better world if the moon were made of cheese and I could get there by building a tall enough ladder. But if I spend all my life building ladders in service of that desire I'm a fool.

We don't live in a world where people live forever or can avoid old age except by dying young. All composite things decay. There are so far no exceptions, and no solid theory that suggests otherwise.

I am entirely in favor of medical research that seeks to improve and extend human life. But by not coming to grips with our impending deaths, we aren't living as well as we could. Take the guy upthread who thinks he will live forever. People like that check into hospitals every day unprepared for the reality they face. As the article makes clear, that wastes a lot of money and causes a lot of suffering.

The article talks about extending suffering, not life. Few people who think they will live forever expect to do so wheezing with every breath.

Shakespeare's sonnets are artfully composed, and I'd say we've done a decent job of keeping them around and finding uses for them.

Let's review the bidding here. Somebody said "death is a medical failure." I said that it isn't; when you fail to achieve an impossible goal, the failure is in the goal, not the work done. I went on to say that all composite things decay, and that to expect that one is going to be the first exception is folly.

I agree that few people imagining they can have eternal life think that they will suffer. But that's exactly the problem. They haven't thought it through. They don't yet understand what life is. Which is why they are so woefully unprepared to handle the parts that don't match their fictions.

The bit about Shakespeare's sonnets I take to be a counterargument to "all composite things decay". That we have managed to keep 100k of text around for less than half a millennium seems like poor evidence that immortality will soon be ours. People die. Species die. Planets and suns die.

Okay. You do not value death, but you do not believe we can defeat it either. Note that in a strict sense, the second law of thermodynamic says you're most probably right. All there's left is a hope of a very long life. (Which you probably don't think we can achieve either, right?)

It's a long way to go, or at least a very long shot, but a long life is possible in principle. Things decay, but they can be fixed or replaced (even the brain: current physics says that copy-paste transportation actually works —in principle). We just don't know how to do that yet. Now, about my personal immortality, I see little hope short of Friendly AI or cryonics, and even those are a long shot.

I agree that a long life is theoretically possible. I personally suspect that even if we overcome the body problems, neither human brains nor human minds will be able to cope with that, so that anything truly long-lived will be a post-human organism.

I also agree with you that the various theoretically possible techno-miracles likely won't mean much for us than a modestly longer old age. So I think everybody should really come to grips with what dying means. E.g., by filling out a living will and discussing end-of-life issues with family. If it turns out that preparation is wasted, I don't think anybody will complain too much.

I'd rather die at 75 with a healthy body rather than dying at 75 with 10 years of senescence behind me.

The first part of this sentence seems strange.

If you assume your healthy 75yr young body doesn't die of external forces (drowning, fall off cliff, etc.), which you don't seem to be implying, isn't this a contradiction?

In this context, the "senescence" is a precondition for death, right?

Human life length is not totally up to chance. A person's choices affect how long that persons lives quite a lot.

Being able to get rid of senescence might be nice, but making everyone die at age X does not make sense.

>> I personally don't expect to die of old age.

> Something said, I suspect, by every young person since the time of Hammurabi. I suppose that expecting to live forever in this world is no more irrational than expecting eternal life in another world.

One could argue that this is the crux of the world's oldest story, "The Epic of Gilgamesh".

Most societies had a better connection to death than modern era societies. Death was seen as a necessary part of life and signs of mortality were presented to encourage people to do better in their lives. Death is inevitable. Even if you somehow gain true immortality our sun will burn out, our galaxy will split apart, our universe will accelerate towards c and render time meaningless.

You cannot escape true death. Nothing you could say, do or know will ever change the fact that your life will end. You need to come to terms with that before the inevitable happens. Once you are aware that you will die it becomes easier to really live.

Most societies had a better connection with slavery and torturen then we do that dosen't make it a good thing. If I can cheat death by a billion years I'll call that good.

Well, there are some species that do not age (at least one specie of turtles is extremely slow to age). Some tiny life forms that do not age and do not die. I may agree to say that "death is part of our paradigm" but that does not mean it should be so. Saying "death is part of life" may be true FOR US, but humans have always tried to reach out to impossible things. And sometimes, succeeded. There's no reason not to keep trying to solve what is, in the end, a technical issue when you consider that everything around us is based on a set of rules and interactions.

There are no animal species that do not age. Some age slower than others.

I agree we should try to improve human lives, now and in the future, and extending healthy lifespan is certainly part of that. But there is plenty of reason to face the fact that we will all eventually die.

About your sentence : "there are no animal species that do not age".

Well, I hate to use Wikipedia for that, but current observations seem to disagree with this:


You'll see in that post that there are several species for which we find that mortality does not increase with age, i.e. they do not appear to age.

Now, I am not a specialist on the subject, so I will not be able to go into debate whether this is truth or fiction, but I have heard/seen this mentioned in several sources.

You realize that's a forest of [citation needed], right?



It is inevitable that a time will come where it will be possible for humans to stave off aging to a significant degree. Whether this is in 100 years or 10,000 years, it is difficult to tell. What measures should be taken because of this is for the future to decide.

Bullshit; it's not a medical failure any more than my car eventually breaking down and needing to be replaced is an engineering failure, or my house rotting away due to erosion. The second law of thermodynamics is a fundamental constraint on the universe, not a failure on our part to circumvent it.

Both your car breaking down and your house rotting away can be more or less easily prevented, if you are willing to pay. If we were unable to replace a rusted exhaust or fix a leaky roof, that would be an engineering failure.

It's not so much the death itself but the fact that we can't really fix falling organs, just put band-aids to keep it running.

My grandmother has osteoporosis and surgery isn't an option. When her bones finally give in and tie her to a bed, that's the end of her life, even if she lives for a few years more.

I thought the following quote from the article made me think back to a rich history:

"For many Americans, modern medical advances have made death seem more like an option than an obligation."

In 1912, F. M. Cornford wrote that the Greeks had a view of fate where life was circumscribed by limits both in length and law, and and where when one stepped outside these limits, the debt of life is repaid in death.

One of the interesting elements of my study of Norse myth is that the exact same pattern shows up there (although the last time I tried to fully expound that it took me 10 pages!). The overall structure seems to be that the foundation of life is a primal lot or layer which is bound by law, and incurs a debt (Old Norse 'skuld,' the name of the third Norn means 'debt') and given back at the end of life. The idea that death repays the debt that was loaned as life is a very interesting one, and it gives a sense of an obligation not only to live well but also to die well as well.

I don't know. We clearly won't be defeating death in our lifetimes (and frankly, I'm not sure I would want to live forever stuck in my 80 year old body).

Not only is death necessary for new generations, it kind of gives meaning to the time we do have.

So… I'm open to the idea that we should know how to care for the dying instead of merely prolonging their misery. Everyone reading these words will die one day. Better get used to it!

Not only is death necessary for new generations, it kind of gives meaning to the time we do have.

Why do you think limited time give us meanings?

You don't need to look too far for examples. Even on this very site, there are quite a few people who want to make a huge difference with their lives in one way or another before they're 30 or 40. Because they know they probably won't have another shot at it later on. What would that number be if they had an infinite number? Many wouldn't probably ever get around to try.

How many people try to make a difference in the world, fail (because it is hard) and then capitulate into working a salaried job managing database queries for MegaCorp...because it is safe and they have a family to feed.

If you knew you would live until 300 and remained reasonably "young/healthy" during that time you probably wouldn't start a family as soon.

I don't think a 20 years old doing startup is thinking "I gottach do this before I die!". No, it's just...let do it man!

Right at the higher levels of human achievement, I believe that it is curiosity and inquisition that drive us. Certainly impending death can focus people, but I do not believe it delivers the spark that lights ingenuity.

“Remembering that I’ll be dead soon is the most important tool I’ve ever encountered to help me make the big choices in life,” - Steve Jobs

A few months ago, this was one of the biggest quotes around the internet. For a lot of people, death is a catalyst to do something that matters. In the biography, Jobs talks a lot about how he's in a hurry because he feels like he's going to die young.

It forces us to choose. Choose what means the most to us.

I say it hurries us into making decisions, wherein after our basic human psychology starts to rationalize the decision as 'meaningful'.

If we had all the time in the world, literally, we could eventually learn to make decisions that are truly good instead of local conveniences.

It forces us to choose. Choose what means the most to us.

Why don't we just choose what's the most meaningful thing to us, right now?

Moreover, I think living for a really long time allows us to be more ambitious.

No it doesn't. The death of young children, or victims of accidents or violent crimes for instance, doesn't force them to chose anything. The notion that you have limited time, might make you want to prioritize. You can hardly speak for anyone else, or what makes them choose anything.

Think about it.

I have a limited time on earth, yet I chose to spend it with you. Cuddling on this couch. Watching a movie. I think by the finite nature of our existence it imparts a little bit of significance to any sacrifice we might make to our own utilitarian maximizing.

Well, you didn't convince me there. We humans are lazy by nature. And you are spending time with him/her cuddling on your couch because your life is not in immanent danger. In other words, you are not assuming you will die tonight, but rather that you will go sleep, like any other night, and wake up next day (although one day you will be mistaken, but then it won't matter anymore).

Have there been an earthquake or your place would be ate alive by fire, you would be running away like crazy and the last thing on your mind would be to cuddle on your couch.

Further there is not much you can do to postpone the judgment. Sure you can break up with your loved one and lock yourself in a library for 10 years, grasp some wisdom, perhaps invest money or built a company, sell it ten years later for half a billion $ and invest all your money strictly into life-extension projects, but by now most likely you know the probability of achieving all this is so small, that you would rather cuddle on your couch just for a little bit longer.

nobody is going to be stuck in their 80 years old body.

this is the extremely short version/recipe to leave forever:

1. clone yourself. work with this guy who is very close to succeed [1]

2. once your clone is 25 years old and therefore stop growing, undergo a brain translation. Now, before you start laughing look here: [2] This is Dr. White [3] undergoing successful monkey brain transplantation in... seventies! I think 40 years later technology got much more advanced.

So the result would be your 80 years old brain (assume it was still quite healthy) in 100% matching DNA body of 25 year old. IF you don't get brain cancer, or other brain disease, you have another 50, 80 years to go. Now, going further only certain parts of the brain makes up for your identity. Most likely only memory. Fast forward another 40 years in the future, knowing how to connect broken nerves again why not cut only small part of your brain that is you therefore transplanting only your identity and limiting size of your old body in the new one.

Now, you can call me a conspiracy theorist, but if to overcome problems here is just a matter of time (by that I mean more time == less money + less engineers working on the problem. less time to resolve problem == more money to throw at the research + more engineers working on it), then I believe it is fairly plausible that elites like Rothschild family having billions of dollars for their disposition already have these technology available. Just ask yourself -- if you already have trillions in the bank, and building another successful company or buying another factory is boring to you AND the same time the only thing you are sure of is that one day you are gonna die, then it is obvious you will spend all your resources to "postpone the judgment".

[1] http://en.wikipedia.org/wiki/Panayiotis_Zavos

[2] http://www.youtube.com/watch?v=xb3Zi0DenaE [viewers discretion advised]

[3] http://en.wikipedia.org/wiki/Robert_J._White

* I didnt want to go into the obvious legal issues here: cloning humans, "stealing" someones body, putting another "human" in 80 years old body therefore shorting their life, etc.

I hope everyone do see the implication of creating a soul, then kill it 25 years later? Possibly repeatedly? That sounds almost as bad as a horcrux.

> the implication of creating a soul

There are no implications to flights of fantasy, there is no soul, the body is a complex biological machine and there's no reason we can't either learn to prevent the machine from breaking or learn to grow another for spare parts.

Actually, I agree with you. It's just that "soul" is the name I give to that complex biological machine.

And I think it's only fair. Though the word "soul" is mostly used in conjunction with dualistic assumptions, it has a deeper meaning that is fairly independent of dualism: Your soul is whatever makes you who you are. Your soul is what really matters about you. Whether the soul is separate from the body and survives it is another question.

I also have a specific reason to use that word: its emotional impact. For instance, one reason I think we should stop death is because it means the destruction of the soul. Even a devout Christian would understand my concerns (and go on to reassure me, but that's another story).

I don't want to let religion hijack this word.

Religion isn't hijacking the word, it's their word, you seem to be the one hijacking it. You can't take your own personal definition of word and expect to communicate well. That we're even having this discussion proves that. Worse, you admit to using the word for its emotional impact and seem proud that deceiving a Christian by using it would work, this utterly intellectually dishonest.

Okay, I am the one who hijack the word[1]. But I don't think this is deception. I use the greater emotional impact because it is the one that actually match reality. I would say "destruction of the soul" to a Christian because only that would convey the right idea. If I say "death", the guy would think about going somewhere else instead of true death. That would be deception (or at least miscommunication).

For the same reason, I don't like to say "passed away", "gone", or "departed". Plain "died" is more accurate.

[1]: I'm not the only one. http://www.goodreads.com/quotes/show/191761 (Argument by authority, I know, but really, this view looks sound.)

Reasonable response, so let me explain further; it's deceptive because that's not what most people mean by should and by using the word you're giving them a false impression of what you're trying to say. The fact is you're not going to go into this explanation of what you mean by soul in every conversation and many of those people wouldn't grok the implications of what you're saying on their own beliefs; you said soul, and then a bunch of nerdy babble, and they'll just remember you said soul and they agree with that part.

Imagine that every time you say soul, nearly everyone hears "immortal soul", because that's basically the truth. Find a better word to communicate what you really think, soul is not that word. The truth is what you're describing is "mind", not soul. It may be pretty to redefine a word, or take a different personal meaning, but it does not aid communication, it hampers it and deceives those who aren't willing to dig deeper into a discussion.

Point taken. I'll be careful from now on.

Nevertheless, how do I talk about true death to a believer in immortal souls? The best path I found so far is something like "imagine that your soul is actually destroyed when you die". It focuses directly on what I want to talk about: true death, the real deal, not some half-death with an escape hatch.

The advantage with this approach is that it emphasises the common ground between monotheists and transhumanists: true death is simply not acceptable. Therefore if it is a problem, and we have any chance of fixing it, then we must take that chance.

It also avoids some problems: If I say we don't have (immortal) souls, then he may soon draw conclusions I'm totally not about (worst case, he could think I'm a nihilist). If I avoid the word "soul" altogether, he could think I'm afraid of the afterlife.

People who believe in immortal souls don't believe in true death, you can't talk to them about it anymore than you can get them to imagine there's no god; they can't, it's just outside their worldview. These are people that can't be reasoned with because these beliefs aren't based on reason. Adapting their language but meaning different things by the words doesn't help you communicate, it only feels that way, because they're agreeing based on what they think those words mean, not with what you mean by them.

It is one thing to not believe something, and another to not even being able to do counter-factual reasoning. I don't believe in the afterlife, but I can sure imagine it. I've read enough stories about that.

Conversely, one could believe in the afterlife, and be able to imagine a world without it at the same time. Or a world where there is an afterlife, but where souls can actually be destroyed, or dissipated into the aether. I can recall at least 2 such stories: the anime Bleach, and The Night's Dawn Trilogy novel. I'm sure there are other examples.

Now, I reckon I can't help someone who can't even play the "what if" game.

Would you feel different if the cloned body (or body parts) were grown in a fashion such that it was never intelligent or aware? Such as without a full brain or even without a head? Would it then be a soul?

Thats why I didnt want to mention that or answer to loup. I didnt not wanted to end up with religion debate on whether there is God and Soul, and if Soul can be transferred etc. This was pure speculation on how to live forever. That is, if you could live happily ever after knowing you tricked your twin-brother/sister and gave him falling apart body with a 5 years life-expectancy.

We are getting really into science fiction now. Perhaps if you could somehow monitor and capture every single signal sent from human brain to its body from the moment brain formed itself (I know there is a flaw here...), then if you could record that transmission for 25 years, perhaps (Im really in year 2350 now, I think) you could program a computer that would re-play that transmission into a growing body (to mimic brain) and as a result at age 25 had a healthy body without human brain. This, I think, would cut-off all skeptics that believe Soul is attached to mind, not body itself.

Maybe I shouldn't have use the word "soul". My vision is, we do not have souls, we are souls. Body + Brain = Soul, so to speak. Death is when that soul is irrevocably destroyed (meaning, even the information required to reconstruct it is lost forever).

So, while convoluted, your solution sounds like it is acceptable. Be careful however to play a record of a past life, instead of, say, actually simulating a brain in a silicon chip, Gunm style. Because that simulation would most certainly be a soul as well (I don't believe in philosophical zombies).

Err… I don't get the downvotes… feedback please?

Edit: nevermind.

Of course it wouldn't be a soul. I'd be totally okay with that.

Not interested.

I really don't give a shit if my ego continues to survive forever. I only care about this particular instantiation because under my (to be frank, likely to be flawed) interpretation this is the only "I" I ever perceive.

This gets more complicated because we don't have any guarantees on the continuity of consciousness as it is (when you awoke this morning, are you still the "same" person?)… but barring any more cogent arguments I'm gonna stick to it.

I think I rather be uploaded to a virtual reality environment with the ability to download to humanoid robots almost identical to the human body such that the difference in perception is almost negligible.

The robots should be identical to the human body at least skin deep. Our skin could be a synthetic material very close to the real thing. We will need none of the organs that currently keep us alive.

thats very interesting. I dont know what you mean by "rather be uploaded" (I guess you mean your conscious, which sounds just too much of a science-fiction to me since AFAIK we dont exactly know what makes us us and makes us aware we are we) but you made me think about other possibility: instead of stealing someones 100% matching DNAs body, why not to transplant your brain into the machine? Of course this is is still pure science fiction but if we could overcome all difficulties, I could see a robot body totally controlled by your brain. It would be some sort of control-by-wire thing. Your brain sends a signal to lift an arm, computer attached to it recognizes it and replace it with gauged signal that is being sent to your arm. If we could only know how to mimic signals that lets us see or hear or smell ([1] for example) we could have a fully working mechanical body. Then the only risk of dying would be brain injury or disease; nothing else could kill you.

[1] http://en.wikipedia.org/wiki/Ocular_prosthesis

ok, eot for me.

ok hang on: second though: I am not sure if I would gave up on a please of fng for an eternity without it :)

edit: so it boils down to question: how long can brain live, given we provide it perfect conditions (lets say: pure perfectly controlled air, all the vitamins it needs in regulated doses, etc etc)

I was thinking more around the lines of converting the brain connections to software i.e. Scanning the brain and creating a software representation of it. Then put it in a brain simulator (This is a very simplistic example, it will be far more complicated than this). If we can do this then we should be able to replicate everything else, touch, smell, taste. Essentially we would become an artificial intelligent being with the potential to live forever.

How would you propose we do this? Suppose we could scan the state of your brain exactly and transfer it to a simulation on a computer. How would we now transfer your consciousness to the simulation? It seems to me that rather than making you live forever you've made a clone of you live forever. This relates to a basic unsolved question: how does consciousness work?

I honestly have no idea. I believe we will figure it out eventually.

The clone will be you, and you will be the clone. It will be like going to sleep and waking up in the virtual reality environment. From the clones perspective it will feel like the original you since it has all the memories of the original up to the point before you went to sleep. You just have to make sure that the original you is destroyed if and only if the virtual you is created successfully and with no corruptions. Otherwise there might be problems between the real you and the clone.

Side note: I believe there was an episode in Star Trek where something like this would happen. Star Trek made a treaty with an alien race to allow them to visit their planet via teleportation over huge distances. The thing is that they would not really teleport the person but rather they would create an exact clone at the destination and destroy the original.

> It will be like going to sleep and waking up in the virtual reality environment.

The question is: who will be waking up?

Basically the same issue is with a hypothetical teleporter. To teleport you from here to somewhere else we scan all the atoms in your body and digitize that information. Now we send the data over the internet to another place on earth. We rebuild you there. At the same moment that we use a defibrillator to put life into the new you, we shoot the old you in the head with a gun.

So you'd step into such a teleporter?

I haven't seen a convincing answer to these questions of consciousness/soul/identity. Perhaps there really is no difference between going to sleep and dying, it's just that in the former instance the old body is reused for new identity. Perhaps there is no persistent identity at all; in every moment in time there is a single separate identity. Perhaps time itself is an illusion: perhaps the universe is just one single snapshot in time. There are so many possibilities and I have no idea how one would even start to formulate a testable hypothesis. Does anyone have a recommendation for reading more about this topic?

>>The question is: who will be waking up?

An identical copy of you. If it is not identical then it wouldn't be you.

>>So you'd step into such a teleporter?

If the new me is identical to the old me I think I would. The new me is not supposed to notice anything different other than I woke up in a different place. The old me should never wake up once the new me has woken up.

>> consciousness/soul/identity

Being able to create an identical you assumes that you are your brain and nothing else.

> If the new me is identical to the old me I think I would. The new me is not supposed to notice anything different other than I woke up in a different place. The old me should never wake up once the new me has woken up.

As far as I can see stepping in such a teleporter basically amounts to suicide. Whatever is happening in another part of the Earth doesn't change a thing from the perspective of the guy getting shot.

So suppose we change the story a bit: we don't create a new copy of you, but we still shoot the old you. For you (the old you) this isn't any different than the previous story. Would you still go for this?

>>As far as I can see stepping in such a teleporter basically amounts to suicide. Whatever is happening in another part of the Earth doesn't change a thing from the perspective of the guy getting shot.

This is true if you include your sense of self as your entire body. However, I think I will have to decide that my sense of self is my memories stored in my brain. If you look at it from that perspective than as long as my memories, and everything else at the sub-conscious level, is persisted across any medium then I'm still alive. The body then becomes a vessel. However, I think I will still like to have my body so I might as well replicate that also.

Of course, I think this is a choice people will have to make themselves since it is true that the original you dies, as you state. The original body of yourself dies, but not your memories. I guess you could think of your memories as your soul. As long as those are alive, you are alive.

>>So suppose we change the story a bit: we don't create a new copy of you, but we still shoot the old you. For you (the old you) this isn't any different than the previous story. Would you still go for this?<<

Of course not. Why would anybody do that? I'm not sure what is the point you are trying to make here. Notice that in this case not only has my body died, but also my memories. So as far as the universe is concerned I'm truly dead.

If for whatever reason a new me cannot be created than I expect the original me to be woken up. The old me must only be terminated if the new me is created successfully.

this is all fascinating, BUT this is not "teleporting" per say. I would rather think true teleporting will be backing you into some small ball and shooting you trough a pipe fast enough so you end up on the other side of Earth in 10 seconds. What you saying here is creating a digital-copy and "reprinting" in a different place after sending via internet :) Yes, the copy of you would be created but your conscious wouldnt "skip" or "travel" to the new body because... why? you still here! Killing source wouldnt make your mind switching to the new body because that body is just a DNA copy of you. What would happen is the "perfect" copy of you would be created somewhere else in space. From that nano-second on, there would be two of "you" but both would think different from a first neuron connected in your brains. I think that would be no different than having twin-brother that thinks similar to you (or in our example: exactly the same) but of course your clone within a time would be gathering different experience from environment and the more time pass the more different conclusion would be drawn between you and "him".

Its still incredibly amazing question: what IS conscious. where is it stored and how can it be transferred. what will happen if you make a copy of it? can you make a copy?

come to think: perhaps teleporting is not possible at all. otherwise, why, if you believe in such, why would there be some info popping up here and there about UFO seeing. IF they would have technology to travel in space and live in planets we dont even see here, they would have use teleportation long time ago, instead of using just a plain dumb saucer :)

>Perhaps there is no persistent identity at all; in every moment in time there is a single separate identity.

That view is known as perdurantism (opposed to endurantism).

> Perhaps time itself is an illusion: perhaps the universe is just one single snapshot in time.

Not sure what you mean here, but if you're assuming determinism then you're scientifically wrong (which is to say that there's now a scientific answer to what was historically a philosophical conundrum). The universe is indeterministic. This is more because of entropy ("determinism is fundamentally a denial of the arrow of time") than chaos theory (which is still deterministic). Ilya Prigonine is notable for emphasizing this worldview as a third departure from Newton, first two being quantum mechanics and general relativity.

> Does anyone have a recommendation for reading more about this topic?



This is a correction to my above post. The actual episode was from The Outer Limits series. Link below.


Sounds like the movie 'The Island'

I will politely disagree with your premise.

>Not only is death necessary for new generations

Not necessarily. Look at the problems in the world. How many of them are because we've forgotten history? Every time I read something new in history I'm struck by how this has all happened before and we're making the exact same mistakes again. I would submit that if we lived forever, we would be colonizing planets by now.

I'm not sure that your analogy works so well, death is a natural condition of the normal life of an organism. Herpes is expressly a virus that could (theoretically) be cured. That said, I do agree with you that it is actually a failure. I just don't think it's medicine that's to blame.

If you were to travel back in time to Aristotle you might be able to say that philosophy fails us when attempting to describe the laws of motion. The concept of physics was wholly contained within this discipline at that point in time and did not exist as a separate venture.

In much the same way in our age the concept of engineered negligible senescence exists within the field of medicine or at a stretch, biotechnology. As physics transitioned from philosophy to science to specialist discipline, this will likely transition from medicine to biotechnology to a specialist discipline all of its own.

I think the sooner we set the parameters for the quest and agree that it's worth pursuing the quicker we're likely to succeed.

There's an ethical question that you're dodging though.

Personally I don't think immortality is a good thing, and I suspect most arguments in its favor our heavily driven by fear of death.

You haven't really justified anything you've said. What is the ethical question? Why must it be fear of death rather than simply wanting more of life -- more time to spend with people you love, to do exciting things, to learn everything there is to know?

> Why must it be fear of death rather than simply wanting more of life

The only thing you are capable of is converting time into something else. Time is always the scarcity factor.

So what if we had unlimited time? Would you pursue greatness and projects that take hundreds of years to complete?


Let's take a look at something that is also scarce and that everybody is familiar with. Money. Would you say that the overwhelming majority of people who have lots of money engage in long-term projects to do interesting things ... or do they spend it on vain things like mansions, expensive cars, yachts, planes, etc?

If you had an infinite amount of time, the first thing you would do is re-watch every episode of Star Trek, not embark on the discovery of warp drive. That's the truth nobody wants to face. The overwhelming majority of humanity is unbelievably vain and the part that isn't, is primarily motivated by scarcity. They understand they have a very limited amount of time to live and they want to get something amazing done within that time. Removing that scarcity factor will make them just as vain as you and me.

EDIT: Fixed my inability to use the English language.

I hate to be "that guy", but you misspelled a certain word three times in your comment. I leave it to you to figure out which one.

But I agree with you, in the sense that having a "deadline" is what motivates people to accomplish things. Like if your boss or teacher doubles the length of time to finish a project, it doesn't mean you'll work twice as hard, but rather that you have more time to put it off.

> misspelled a certain word three times in your comment.

Well, vane is a legit word, so it's more of a misuse. I meant to use vain. I kept thinking vanity, ah well. It was bothering me, but I got sloppy.

>So what if we had unlimited time? Would you pursue greatness and projects that take hundreds of years to complete?

Absolutely. Being an idea guy I'm always coming up with new ideas. It's really depressing knowing that I just don't have time to do them all.

> It's really depressing knowing that I just don't have time to do them all.

If you let go of your ego a little bit, you'll realize that 99% of the ideas you have are moronic. That applies to all of us.

Knowing that you can't pursue all of them forces you to pursue the 1% that aren't absolutely asinine. People don't realize just to what extent our mortality filters out the garbage from our lives.

Easier said than done. How will you know which are the 1% worth pursuing? There have been a lot of ideas that people have thought to be moronic and despite that ended up being extremely important.

So, because people would watch too many star trek episodes, we should have them die? Doesn't sound too ethical. There is no moral argument for death. As Aubrey de Gray explains, will you ever come to a point where you are perfectly healthy and happy and then decide to just die because the date of your birth was "too" many years ago. I don't think you would decide to do that, even if you had been alive a million years.

I would encourage you to be skeptical of arguments of this form, "I can't imagine X, ergo it's probably not true."

There are many things that people at age 10 can't imagine about people at age 20, or 20 imagining 40. There's no particular reason to believe that problem goes away.

Aubrey de Gray's argument is more like - when would you choose to die. You're sitting there, perfectly happy and healthy, your existence has no negative impact on anyone else's. Will you just get up and say - I'll die now, for no apparent reason.

For the record, I'm entirely in favor of serious long-term investment in medical research, and I agree that infinite X (where X is lifespan, health, or any other thing we like) sounds pretty swell.

That said, I'm pretty sure that's the same sort of argument I'm suspicious of. It's not an honest question that "will you"; it's an argument that the answer to that must be no. Not because of any evidence that has been presented, but because you can't think of any answer.

And I think it works because he's assuming an answer to the question he's purportedly asking. We don't really understand what minds are or why bodies age. We don't even understand exactly what happiness is. And he's presuming that a choice like that is possible.

What we do know is that a choice like that is currently unavailable, and I think it's dangerous to build too many sky castles on the assumption that it is.

I'd guess your argument against immortality is one of those covered many many times: overpopulation, overlords yadda, yadda.

If you believe in 1000 years humans are still living to 80 years old, and are STILL bound to ONLY this planet ... well I think you're crazier than your love of death ( the norm ) suggests.

It requires a bit of human insight to realize that the slice of cake religion advertises IS escape from the vast darkness of a perception-less void.

Fear of death is natural and healthy. Death is a bad thing. Arguments otherwise are borne of a desire to rationalize the inevitable.

I'll give you that both arguments are borne of a desire to rationalize. Death is serious business for us. That said, I believe we live and die for a reason, and that death gives life purpose. You don't have to agree with me, but you should at least acknowledge that the statement "death is bad" represents a certain worldview, and can by no means be taken axiomatically.

My argument is that if we could develop functional immortality we could preserve the lives of the next Newton, Einstein, or even some currently living scientific minds like Hawking. Rather than have the great generational risk of losing all the collective knowledge such people accumulate and then suddenly have them die and expect their void to be filled by bright young minds interested in the same material, who then have to commit half a century just catching back up to where their progenitors were, it would be a never ending cascade of innovation and progress.

I agree with your optimistic stance however everyone has at least a small amount of valuable knowledge. I trust we will extend the lives of all those wish to remain alive.

Since you're an optimist, you'll probably be one of them :-)

dasil003 doesn't say what the ethical question is, but I think he's got it the wrong way around with motivation. As Aubrey de Grey has argued, it is the fear of death, coupled with the pessimistic assumption of death's inevitability, which makes talk of life extension taboo in many circles.

('If you can't avoid something unpleasant then embrace it' is a viable psychological strategy.)

One ethical objection to not researching life extension is that huge amounts of healthcare budget go into extending the lives of frail, sick people in their final years. When we know how to keep people healthy indefinitely this problem will be solved, although pessimistic individuals will then have to take the responsibility of choosing when to die (if ever).

The collective knowledge of Newton, Einstein, Lagrange, Maxwell, Bohr, and hundreds of other physicists are written down and more or less distilled into the brains of thousands of physics students within a decade. We already have a never ending cascade of innovation and progress. Getting new perspectives and fresh minds on the problem are more valuable than wringing another year of work out of the aging geniuses of yesterday, which is why many of the greatest physicists like Hawking and Feynman were so focused on teaching and popularizing the field. Yeah, it would be great to still have Newton around, but it turned out to be even more useful to have Lagrange around instead.

Besides, if you look at the actual lives of these people, most of them stopped producing useful output eventually. Newton spent more of his life arguing about theology than inventing calculus and physics.

Given how new models of thought threaten and destroy old models of thought, this might not work out as cordially as you imagine.

we could preserve the lives of the next Newton, Einstein, or even some currently living scientific minds like Hawking

No we couldn't, because its not up-to you or anyone else to decide how long another person should live. How do you know if Newton or Einstein would have wanted to live longer? If a choice was available to increase ones lifespan, the choice should lie with the individual.

Perhaps artificial intelligence is a much saner choice than immortality.

I think quite the opposite. Everyone's lifespan should be increased at birth. Then once they're sentient adults, they can choose to reduce their lives to the so called 'natural' expectancy, or even below it if they wish.

So what would you do if their parents objected on religious grounds?

Under current US law suicide is illegal and so on so forth. Mainly because it is mental illness to want to end ones life in most cases, but mercy killing is also forbidden, so on so forth.

And I do agree, people should have the choice to end their lives whenever they wish it. However, having the potential available for immortality means we don't need to have the upcoming intellectuals spend half their lives catching up to where the last generation died off at. If they don't want to, nobody forces them, but having the option means so much potential knowledge.

And then we overpopulate the planet in a decade and everyone dies of starvation, global warming, or world war 3 nuking everything into oblivion due to the breakdown of society.

Both are views of death are technically correct, but focusing on the former while ignoring the latter is problematic for reasons described at length in the article.

Damn, my life is a big medical failure, too. The day I was born, it came packaged with death.

Two poignant quotes from the article really stood out to me:

"When their loved one does die, family members can tell themselves, “We did everything we could for Mom.” In my experience, this is a stronger inclination than the equally valid (and perhaps more honest) admission that “we sure put Dad through the wringer those last few months.”"

"A retired nurse once wrote to me: “I am so glad I don’t have to hurt old people any more.”"

Makes you stop and think about how we treat end-of-life situations.

Twice in the past month, I've participated in restarting a stopped heart belonging to someone over the age of 75. In both those cases, the patient never regained consciousness, and passed away in the ICU a few days later. This story repeats itself over and over again... I don't know what the actual percentage is, but the number of elderly patients who are 'resuscitated' only to never wake up again is surely north of 99%.

I'm conflicted about my participation in this process... CPR is a very brutal process, and all the interventions we use to restart someone's heart are equally traumatic.

So, why do we do this? In most cases, it's because someone doesn't have a DNR, or any other sort of advanced directive. In most (all?) states, if you call EMS and don't have a DNR, you need to actually threaten us to absolve us of our legal duty to start resuscitative efforts (in reality, most of us are human beings, and simply explaining the situation should be enough). The other situation is when a patient _does_ have a DNR, but the family is insistent that we "Do something!"

In both of my recent experiences, our efforts kept the patient 'alive' long enough for out of town family to travel back to say their goodbyes.

Was it worth it though? The financial, emotion, and physical costs are pretty high... I'm not sure...

I think your timing is plausible, given what we can do now and 15 years ago. I cant remember how astonished I was when I saw this! [1]

25 years to re-print entire human body without cancer cells, tumors, perhaps without fat and boldness as well? :)

[1] http://www.youtube.com/watch?v=9RMx31GnNXY

That TED talk was amazing. Thanks.

sure, no problem, although I dont recall when, but I stumbled upon it on HN as well :)

I think the fundamental misunderstanding is that most people think that people die from diseases, but in reality it's much closer to the other way around; people get diseases when they are about to die. Even if we had the cure to every single cancer the average life expectancy would only go up by about 3 years, because most cancer patients would just die from something else anyway.

True but overly defeatist. Fixing one problem would not solve things. Fixing several problems (cancer, intra-cellular junk, extra-cellular junk, etc etc, Google "SENS" for a suggested list) would actually cure death from ageing - or at minimum, would reveal what other problems we would also need to solve. People get sick because they are damaged, and they are damaged because they are old, but the damage is in principle something that can be repaired.

You make an important point: treating ageing itself is superior to tackling diseases individually. Ageing is a risk factor for practically every major disease. Therefore reversing, halting, or even just slowing the process would reduce the incidence and burden of every major disease.

Related article from a few months ago, "How Doctors Die": https://news.ycombinator.com/item?id=3313570

I wish more people read things like this.

"I cannot count the number of times fellow physicians have told me, in words that vary only slightly, “Promise me if you find me like this that you’ll kill me.”"

I have a parent who's a medical professional and their response was exactly the same. On a related note I wonder if support for euthanasia is higher among those who work in medicine.

We shouldn't inflict unnecessary pain and suffering but we must fight death and continue medical research for the future generation of elders so that they will be able to see their great-great-great grandchildren and beyond and be healthy at the same time.

I'm really sick of transhumanists coming into every fucking discussion about death, or the death of some particular person, or anything at all really and derailing it into an argument about the merits of developing human immortality. It's really starting to become one of the classic HN flamewars, right up there with the Apple and Facebook haters. I don't think there's anything to be gained by another go-around on the subject.

We're talking about reality, here and now. If you want to discuss science fiction, start your own thread.


Why not!

The article is absolutely right that right now and for at least a few decades, we have to live with death. It does not mean however that death is a good thing.

I mean, who would want to die when they live a life worth living? And who would want their life to stop being worth living?

(And no, I don't buy the saying that says live is meaningful only because it eventually stops.)

Agreed, where does this "must" come from?

Death is wrong.

It's not though, death is natural and inevitable. There are also practical considerations: if death is eliminated, we must stop reproduction too.

It's not though, death is natural and inevitable

You committed the naturalistic fallacy. Also, inevitability isn't a justification for bad things happening.

There are also practical considerations: if death is eliminated, we must stop reproduction too.

I would prioritize existing lives over the yet to be born.

> I would prioritize existing lives over the yet to be born.

From an evolutionary point of view that makes very little sense.

Evolution has no desire to make sense, it's a blind natural process with no intent or point of view. From a human point of view, what he said makes perfect sense.

Plus, that is again a naturalistic fallacy.

Insulin and antibiotics also make very little sense from that point of view.

What? How's that relevant?

I don't understand this line of thinking.

Even in startup culture, it makes sense that some business (existing lives) have to die in order for new business models (those yet to be born) to emerge.

What's to say that the existing lives won't hinder growth that would happen from new lives being born and re-imagining the world that everyone is used to?

Nice to see someone that shares my viewpoint. I wrote an essay about death: http://beyond-impossible.blogspot.com/2012/02/atheism-death-...

Let me know if find it interesting (or not :))

Fear is wrong. Fear of death is wrong.

> Fear is wrong.

Oh yeah?. I suppose you wouldn't be afraid of jumping off a cliff, then? Most of the time, fear is very, very useful. Don't underestimate it.

Now, fear of death specifically might be wrong. But fear of whatever causes death sure is not.

On what grounds?

You're right. Death should be illegal. I suggest capital punishment.

When I am clearly near death I would prefer pain relief and hospice-style care at home rather than extreme intervention. And yet, as a wheelchair user (on and off) for the last 20 years and a person in constant pain, I've had people tell me to my face they'd rather be dead than be "disabled". I would like to at least mention the importance of listening to people with disabilities on this issue. Because of societal prejudice against people with disabilities, often people's judgement is that we would be better off dead than suffering or impaired. When a disabled person is depressed or suicidal, they are encouraged to die by fans of the likes of Peter Singer or Kevorkian, rather than treated for depression, and helped to have the medical and personal care, and societal infrastructure, that might improve their enjoyment of life.

So, please keep this in mind and perhaps read up on the complexity of the issues -- from the perspectives of disability rights activists as well as doctors or the caretakers of people who are extremely ill. Our slogan is "nothing about us without us" and yet unfortunately, this article is only from the perspectives of caretakers.

If I were in medicine, I'd sure rather be working on trauma on a healthy patient population (soldiers, young adults, etc.) than illnesses of the elderly or already sick -- vastly simpler, sort of like developing new software (even if it is doing something difficult) vs. working in a complex legacy system with no documentation and lots of hidden mines.

Are you sure you have a realistic view of working on trauma, especially with soldiers, in the current era? The combination of modern bulletproof helmets and clothing with the almost immediate availability of good medical care allow the survival of some horrendously wounded people for whom we can do a lot, but not, by far, enough. For example, a soldier can loose al his limbs due to a IED, be burnt over large parts of the rest of his body, and survive.

I think I would rather work with elderly people even if comfort is almost all we can give them.

Also, if you went into the field, I bet your educators would try to get you change your opinion. Everybody wants the glamorous job, but most employment is elsewhere. I have heard this phrased as "all the girls want to work with children, and all the boys want to work in ambulances; we need to work a bit to change their minds."

Yes. I worked in US military hospitals in Iraq and Afghanistan from 2008-2010, as well as spending some time in them in 2003-2007. I also spent a fair bit of time in third world clinics (in North Africa, Middle East, Southwest Asia, and also Iraq/Afghanistan), where the main care was for sickness or maternity, including working with NGOs.

The US hospitals also had plenty of local nationals coming in, either due to trauma, or due to illness. I also got to go out with some teams (i.e. the "other" people) when they did medical outreach. A few of my friends are Army SF medics, I lived with an Air Ambulance company for most of 2005, and dated a (non-US, coalition partner) doctor for a few months. I did combat lifesaver and some other advanced first aid stuff, and dive medic. I did get to help out with trauma a fair bit, and I've been first responder at a bunch of traffic accidents worldwide.

Actually, neuroradiology would be my #1 pick (I hate being around conscious patients, and even talking to people who talk to conscious patients is bad. A rad at least talks to other specialists, and a neurorad is going to talk to specialists (rads, neurosurgeons) who talk to other specialists (surgeons, oncologists) who talk to normal doctors who talk to patients, so you're pretty far removed. ER docs are kind of looked down on by other doctors (for basically being stream of consciousness, get them in, patch them up, pass them along), but trauma surgeons are well respected. There's clearly a lot of money in gerontology, and demand for internal medicine (although badly paid, and often in crappy parts of the country), but I'd hate those things.

However, I'm doing a non-medical startup, and going to med school seems very unlikely to be in my future.

These sorts of things strike me as a bit off. One of the problems of being a doctor, much like being a police officer, is that you tend to get exposed to the worst experiences. Good folks may have the occasional run-in. With police but by far the bulk of encounters a police officer has will be with the worst parts of humanity, again and again. Which can lead them to become jaded, depressed, etc.

The same sort of dynamics play out with doctors too. People who get better stop spending time in the hospital, and stop being seen by doctors so often. This can lead doctors to a false view of late stage medical care. They see every moment of the pain and suffering, the struggling that turns out to be in vain, the sheer cost of heroic measures, but they often miss out on seeing the benefits. The time given back to patients who then spend happy years with their family away from hospitals and doctors.

I watched my father die last year, and I'm thankful I did the dignified thing and let him go when he was obviously at the end. The metaphor of "checkmate" is quite apt--once you're old enough and you've developed enough problems, every plausible means of escape from one problem is blocked by the next.

If you don't want to spend your last days being tortured to death in a hospital, tell someone you love and trust and write up the legal documents necessary to enforce that decision. It's an incredibly hard decision to make though, and it's sad that not everyone has someone they can trust to make that decision. My dad was lucky to have an only child who followed his wishes. I can't imagine what it would be like to have some hysterical sibling try to undermine my dad's wishes, but that's what a lot of families go through.

This is one of the reasons I find it hard to talk to my mother. She is beholden to grief about her father and is doing everything to prolong the life of my grandmother even though she can't walk, needs help eating, and constantly falls asleep. On top of that she hardly knows who is around her. it's sad.

Watching how my parents have dealt with my aging parents really puts pause on me and has me thinking about creating a living Will to make my own wishes very clear.

My uncle recently passed away (pancreatic cancer) and the people from Hospice were all amazing in helping him and the family.

To my mind they embody the different way of handling end of life issues than standard medical treatment.

Well worth reading and really considering before people assume 'death' is a fact of life:


I went straight to the HN discussion rather than the WP page and on my way was thinking to myself, hope some one brings up the issue of "right to die". To my pleasant surprise that is the central topic of the discussion.

Many have argued for prolonging the life span of humans to the point of immortality. Its a thought provoking idea to entertain. One comment ponders rhetorically, wouldn't it be nice to have Einstein and Tesla around.

Not only am I ok with right to die, I absolutely covet it. Not just for myself but the entire society. I am not so sure about "right to life", though it might seem such a no-brainer,

Though we use the word "right" they are often privileges and the important question to think over is who gets to exercise the privileges. That is never uniform, it always comes down to who has the wherewithal to secure that privilege. It is this that causes me to worry.

Sure it would be great to have Socrates and Einstein with us if they chose to, we don't know if they would have. Many assholes would, but more seriously, one can conjecture that the dictators who were not defeated but died naturally would probably choose to live. World history would be a lot different. Would authoritarian regimes live longer ? Difficult to answer.

Then there is the question of ideas. Ideas, both good and bad, they often die not because better ideas replace them, but because their champions die. I don't know whether this is an argument in favor of or against prolonging life, but the need to discuss it will only become more urgent over the years.

When we are born, nature promises us nothing except death. It's just that simple.

It's unfortunate we've surrounded it with so much fear.

Our ideas on death must change. Cause frankly, it's killing us. Death is the natural order.

I heard a great line from one of the few TV shows i watch, Supernatural;

"Who came first? The chicken or the egg? We're too old to remember. But I know this, I'll reap god too". - the aspect of Death.

For a book length treatment of this topic, see "How we Die", one of the most amazing books I've read.


The article seems to be part of a trend where people are made aware of the value of letting go, rather than engaging in futile medical care.

However, before making end of life decisions, one should be aware that there is a large and growing hospice industry that benefits from people "giving up" (sometimes leading to greater suffering, as treatable conditions go untreated), and weigh one's decisions carefully: http://www.businessweek.com/news/2011-12-06/aunt-midge-not-d...

I think this underestimates our most primal of instincts, survival. Those people who died at 48 a century ago had no less want or determination to live longer, than did those who die today at 78. In those times, their options were extremely limited, so as a culture, our norms prepared them better to accept death. Nowadays we have many options, and modern medicine has become the ultimate tool of our survival. Yet another profound ability that separates us from other animals.

"According to the Centers for Disease Control and Prevention, a person who made it to 65 in 1900 could expect to live an average of 12 more years; if she made it to 85, she could expect to go another fouryears. In 2007, a 65-year-old American could expect to live, on average, another 19 years; if he made it to 85, he could expect to go another six years."

I get that gender neutral language like this is the norm these days, but the way it's used in this particular statement, it isn't helping!

This brings to mind the following article, in which doctors place greater emphasis on quality of life when making decisions themselves: Physicians Recommend Different Treatments for Patients Than They Choose for Themselves, Study Finds, http://www.sciencedaily.com/releases/2011/04/110411163904.ht...

> very few elderly patients are lucky enough to die in their sleep.

That doesn't have to be a matter of luck. If we allowed people the dignity to choose, while still lucid, to end their life, or to set up a strict set of conditions upon which their life will end, we could drastically reduce the suffering involved in death, both for the dying and for their families and friends.

My comment on article was deleted by washingtonpost moderator.

[someone] 2/18/2012 9:16 PM GMT+0100 [Implying they removed a feeding tube]

My response:

You didn't feed him? He died of starvation? That could be painful. You should kill him using exit-bag with helium gas. I'm being serious.

My response was replaced with:

postmoderator responds:

This comment has been deleted by a moderator for violating the site's discussion policy.

I think one of the things he mentions, people not living with their elderly parents, is responsible for a lot of our bizarre attitudes towards old age and death. How much of the "just a couple of more years" attitude is to help assuage the guilt of ignoring the person for the last 10-20 years of their lives?

I agree. You try to do everything because you realize you've done so little during the time you've had.

I guess that's the normal way of being though. It seems like it is every child's fate to not appreciate their parents enough until it is too late, and to repeat this same cycle when they have children of their own.

This all sounds reasonable to many people.

Unfortunately, the motivation for these kinds of testimonials is not sentiment or reasonableness. Its profit. Its just not profitable for health insurance companies to treat old people -- that's where they lose all of their money.

I don't think insurance companies care much one way or another. If people prefer to prolong their life as long as possible, then insurance companies would just increase premium payments and pay for these procedures.

For more on death and disability and "right to die" issues, here's a great post by Bad Cripple.


Yes. Now what doctors need is an effective, compassionate way to communicate the simple fact that we need to let old people die. Here's one way:

A family brings an elderly patient suffering from stroke, diabetes, etc. into the ER. The patient is in a coma. Before asking them what they want to do, take the family into the NICU and tell them: we have limited resources, and we can either save a baby in here, giving him a chance for a healthy productive life, or we can perform heroic measures on your loved one, almost certainly doing nothing but prolonging his suffering. What is your choice?

Having recently been an advocate for an elderly patient with severe medical problems, I can say with confidence that this is a terrible idea twice over. Not only would it not work well, but it's also so lacking in compassion as to be horrific.

The time to educate people on these choices is years before you have to make them. The solution isn't to take people thrust into tragedy and threaten to kill babies if they don't do the "right" thing. It's to change our culture such that people consider these hard choices much earlier and life, and feel comfortable discussing these issues with their families.

What I'm trying to get at is that doctors need some sort of tools to help explain the situation to their patients and their patient's families. It doesn't have to be my suggestion, but some way of making the twin points that: a) prolonging life at any cost is not compassionate to the patient, and b) prolonging life at any cost is not compassionate to people who actually can be healed to go live a happy remainder of their life.

I can't think of a worse idea.

Families need to sit down and have an honest discussion about death before it's necessary. It's a hard conversation to have, but it can save constantly questioning and second guessing yourself what your loved one would want to happen.

Honest Question

If we all lived forever, where would we put all the people?

Space. Maybe silicon.

Ray Kurzweil should read this article.

This reminds me of Percy Bridgman, whose work with high pressure got him a Nobel Prize in physics, and which led to the creation of synthetic diamonds at GE.

"Bridgman committed suicide by gunshot [at age 79] after living with metastatic cancer for some time. His suicide note read in part, "It isn't decent for society to make a man do this thing himself. Probably this is the last day I will be able to do it myself." Bridgman's words have been quoted by many on both sides of the assisted suicide debate."



EDIT: I forgot to end with: Mr. SENS, FTW.


I haven't studied medicin, but have a smattering of chemistry so I follow the subject a bit.

The article miss the probably most interesting aspect.

In fifteen years, there will almost certainly be organs grown from stem cells, which allows transplants without immunity problems.

What would happen to the first example in the article when the hearth and kidneys are replaced? When growth factors and (more or less) young stem cells start repairing the brain damage and the Parkinsons?

It might take twenty years. It will still be in time for most people on HN when you grow old.

Anyway, it is probably only of academic interest to me (old health problems will probably get me).

Edit: I don't think everyone should be downvoting the parent. It's a logical statement from someone outside the field - you see "organs grown in XYZ lab!" all the time in the press.

As a biologist, I can tell you that home-grown organs are waaay more than 15 years away.

Currently, we can grow skin pretty well. Mostly because skin likes to grow and is very simple in structure. We are making progress on growing liver tissue, again because liver cells are particularly robust and the liver is not a strongly organized tissue. It is (mostly) a big blog of heterogeneous cells that does not require complicated geometry and organization.

Anything past those two are wishful thoughts. I'm not discounting the advances that we have made in growing organs. We've done some very cool work, but it is certainly a long way away. Once the basic science is established, it will still take a long time to get widespread medical approval.

Re: "repairing" the brain makes growing an organ look trivial. The difference is like building a house vs repairing CERN's LHC.

I seem to remember some promising experiments that grew replacement hearts on an existing extracellular matrix. While they were still a long way from being true replacements, they showed enough functionality to look like a promising direction.

Did that not pan out, or are there other major hurdles that would prevent this from being viable within a couple decades?

interesting. can you explain bit more why repairing brain would be that complicated (asked by someone that never touched biology [me])

side note: your Cloudera job post has cudazi tags visible.

Sure. With a lot of organs, the function is a relatively mundane process. The heart pumps. The liver filters. The skin grows and dies and grows some more. This simplifies things a bit.

The challenge is to get all the right cells in the right places. Heart cells need to be arranged specifically so that the heart can pump. Wikipedia has a good animated gif of how the conduction wave flows through the heart [1].

Fortunately, this is a surmountable challenge. You can throw progenitor cells into a pre-built scaffold and they tend to organize like they should. This is because most organs in your body are built of relatively interchangeable parts. E.g. Most of your heart is the same kind of muscle cell.

The brain is a bit different. First, the type of damage is very dependent on the disease state. Have we lost entire neurons? What regions are affected? Are our neurons de-mylenating?

Second, your brain is unique to you. Sure, we both share stereotyped architecture: we both have a hippocampus, a cerebral cortex, a cerebellum, etc etc. The structure inside each region is pretty stereotyped too - we both have cortical bundles in our neocortex.

But when you drill down to the cellular level, we are very, very different. Each neuron I possess in my brain has a unique (and dynamic) synaptic arbor that connects to thousands of other, unique neurons.

If I suffer a stroke and a portion of my brain dies, you can't simply throw more neurons in to compensate. Effectively, neurons are not interchangeable parts like heart muscle cells. You need to coax those neurons to:

A) live in relatively hostile environment

B) synapse to appropriate neuronal populations

C) weight those synapses correctly.


Side note: Thanks for the heads-up on the Cloudera post - I just migrated themes and servers last night :)

(I'm a programmer, I know little about biology)

Another way to look at it is the information theoretic perspective: when organ X is damaged? what information do you need to grow it back? If X is anything but the brain (and maybe part of the spine), the information you need can almost always be picked from somewhere else (Stem cells plus standard human anatomy). We can't do that now, but in principle it should work.

But if you lose part of your brain, then it's a tougher challenge, because your personal memories, skills and more are stored in it. The only way to recover that would be to use the redundancy your brain might feature. Otherwise, it's lost. Sometimes, you cannot recover a code from a burned piece of paper.

Now, if your brain just suffers a terminal illness, but the information is still there, then healing you may be as difficult as copying your whole soul into a computer, synapse per synapse. (Or it may not: we do have way to slow down —not heal— Parkinson, for instance.)

That's exactly the sort of thing I'm coping with right now. The best currently available treatments can only mask and slow the progression of symptoms; the only really effective therapy at the moment is to try to build redundancy into the system at a rate approaching the loss of "primary storage". That includes nutrition, aerobic exercise (which, admittedly, looks a little bit silly when performed by someone who has difficulty controlling his limbs and maintaining posture) and keeping the ol' mind as active as it can be. That's hard, too -- it is very easy to let frustration overcome you and decide to lie down and die. But as long as there's a life worth living after the grunt work, it's something I'll keep on doing.

That said, I'm not holding on to life for its own sake. At some point I will either become incapable of any real physical activity OR too stupid to live. I've gotten a little taste of both when I've needed to get a baseline reassessment of my condition (which is not a typical presentation of anything, but seems to be more like Parkinson's than anything else on the menu). It's a bit of a race, really. I'm hoping that stupid wins, and that when it happens I do something so spectacularly stupid on the way out that it will make the news the world over (and perhaps win me a Darwin award).

interesting, thank you. I dont want to go so much off topic but I am interested in challenges upon regrowing parts of brain -- can you point me to some good (pref online) read?

>>Anything past those two are wishful thoughts.

hardly just skin and liver!

It is easy to find information about e.g. therapies for horses' joints. This link is about humans, just a few years from patients.


There are people walking around with bladders and (built with a scaffold) throats. There are grown muscle patches for hearts, etc. (I didn't mean to replace parts of the brain surgically of course, stem cells rebuild damaged areas after strokes.)

(I assume you aren't claiming that Parkinson won't be cured in 20 years?)

Do you have any references? What are the show stoppers to scale to more complex tissue? The field obviously moves fast. Muscles like the heart and "simple" organs like kidneys should probably be possible. Is blood supply not solvable?

Edit: Sorry for coming back a few hours later. (I was downvoted a while? :-) )

Here is a group working on muscle with 3D printers. As I wrote in previous comment, building simple organs (hardly eyes) seems to move quite fast.


Registration is open for Startup School 2019. Classes start July 22nd.

Guidelines | FAQ | Support | API | Security | Lists | Bookmarklet | Legal | Apply to YC | Contact