Programmed living and dying

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Nobody wants to live at the mercy of others. Is it possible to engineer a series of biochemical events that may lead to programmed cell death? Is it advantageous to know your time of departure? Read on...

Programmed living and dying
It is not uncommon to hear someone say life is full of misery. The paradox is that we also don’t want to die. We know that death is inevitable. No one wants to prolong the dying phase. No one wants to die part by part. If there is an option, one would not like to die gradually over a long period of time. Perhaps many of us would prefer a “sudden death option”. But as Daniel Dennett, professor of Philosophy at Tufts University, writes, “Lightning almost never strikes”. People need time to examine life, as Socrates said; unexamined life is not worth living. A modern day philosopher would agree with Socrates, but would quickly add, “The over-examined life is nothing to write home about either.”

We come to this world for an allotted period. How much time is required to examine life? Do we know when life gets over-examined? The answer varies from person to person. Our understanding of the old is now very much different. We now have three kinds of olds: the “young old”, who despite crossing the retirement age, continue to live vigorous and productive lives; the “old old”, who in spite of slowing down, lead relatively healthy lives; and the “oldest old”, the over-85 group that is mainly or wholly dependent on others for care. Today, life at 65 and beyond is not what it used to be half a century ago. “The defining characteristic of our time seems to be that we are both younger longer and older longer”.

In an ageing society, dying is becoming as important as living is. Deaths due to pneumonia, influenza and septicemia are declining. Deaths due to age-related degenerative diseases are on the rise. We are dying due to the failure of major organs, dementia and stroke. In short, death has made progress as life has. Though we don’t want to, we are dying in parts more than before. At the same time, we don’t want to live at the mercy of others. “We don’t want to end our days wondering if everyone around us is glancing at their watches and sizing up our remaining faculties against some unstated, but all too present, threshold.” Daniel Dennett asks an unusual question: Can we engineer lightning strikes without much chaos by designing and installing a robust system of “whole-body apoptosis”?

Apoptosis is a familiar and orderly process. It is a process of deliberate life reli­nquishment. Apoptosis, the programmed cell death, is the orchestration of a series of biochemical events leading to a characteristic cell morphology and death. It is a process that life has experienced during its development. For example, the differentiation of fingers and toes in a developing human embryo requires cells between the fingers to initiate apoptosis so that the digits can separate. Apoptosis is responsible for the death of between 50 billion and 70 billion cells each day in the average human adult. By installing the whole-body apoptosis system in human beings one can have painless death at some randomly determined time (say between the ages of 85 and 90), if death from some other cause has not already occurred. What are the repercussions if such a system is introduced? What kind of a technical system would be required to be introduced to those already living? Ass­uming that the person would need the system after 20 years, perhaps it would be “a time-release poison capsule of the sort now well known to medicine, but with a 20-year (± 1,800 days) fuse. This could be implanted like a pacemaker, and surrounded by tamper-proofing (if you try to remove it surgically, it blows up prematurely).

Better might be the injection of a bioengineered drug that would begin accumulating something in the bloodstream that would suddenly (after 20 years) go haywire,” writes Dennett. Obviously, such an introduction would have to meet very high standards of reliability and non-toxicity. With the introduction of such a system, it is not difficult to visualise a fierce debate on manipulating death. But it should also be recognised that people are beginning to appreciate the benefits of intervention, and are adjusting their principles and creeds to accommodate it.

Would anybody want to know his exact time of departure, even if switching off life quite abruptly is possible? Perhaps many would. Perhaps some would like to think the way Steve Jobs thought before his final departure: “Remembering that I’ll be dead soon is the most important tool that I’ve ever encountered to help me make the big choices in life. Because almost everything — all external expectations all pride, all fear of embarrassment or failure — these things just fall away in the face of death, leaving only what is truly important. Remembering that you are going to die is the best way I know to avoid the trap of thinking you have something to lose. You are already naked. There is no reason not to follow your heart.” zz

(The writer is a biotechnologist and ED, Birla Institute of Scientific Research, Jaipur)

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