A matter of terminology

Words and expressions we use influence our thoughts more than we think. In particular, some of them are more prone to interpretation than others, or have several meanings that can ‘rub off’ on each other.

The word ‘ageing’ is a good example of what I’m talking about. The first, obvious meaning of the word is that of the passing of time; if you don’t age chronologically, then you cannot possibly age in any other way. The second meaning is the process of physical decay that nearly every living and non-living thing undergoes to some extent. I wonder, though, how many people have been (and still are) thrown off by the word and led to believe that the reason our bodies fall apart as time goes by is exactly the fact time goes by.

Arguably, not many people in the world know that there’s an ongoing process of damage creation and accumulation going on in their bodies all the time. Most people seem to just be used to the fact they’re going to look and feel worse later in life, and the explanation they can provide for this phenomenon is often not much more detailed than ‘they’ve grown old.’ After all, it’s only fairly recently that we found out what ageing really is about; when the term was first adopted, there was no apparent cause of ageing, and people were probably forced to conclude that ageing simply happens with, and possibly because of, time. I wouldn’t be surprised if on some level people actually believed that the passing of time is the cause of ageing; the process of biological ageing is habitually referred to with a plethora of time-themed metaphores, such as ‘the injuries of time’, so it’s quite possible that people passively learnt that what causes the functional decline of their bodies later in life is time. As a consequence, people might well think that the idea of ending ageing is ridiculous, since it would necessarily imply stopping the passing of time.

I have been thinking for a while that biological ageing might need a proper disease-like name, which it will hopefully get when it will be added to the WHO’s list of recognised diseases. However, there are more terms that I think are misleading; ‘life extension’ is one of them. While it is true that the medical interventions we refer to are meant to extend life, this expression can cause several misunderstandings.

First, ‘life extension’ generally pushes people to commit the Tithonus error: They’ think we’re going to extend our lifespans without extending our healthspans. This is of course impossible, but you’d be surprised how many people actually associate ‘life extension’ with ‘living longer in a decrepit state’.

The second, and perhaps worse, side-effect of the term ‘life extension’ is that it may fuel the idea that life has a predefined, ‘right’ length, and that trying to push its length beyond that limit is wrong. There is, of course, no such thing as a predefined length for your life: You’re going to be alive as long as you’re healthy enough to be alive. Still, countless times I’ve had the distinct feeling that people think there are two kinds of death: death by ageing—the ‘natural’ end of your life, which will happen regardless of anything, unless you die ‘prematurely’ of something else—and death that occurs in whatever way before the ‘natural’ one.

It’s a bit as if life was an outdoor show: If it rains it will finish earlier, but the show will come to a conclusion anyway, eventually.

Needless to say, there is only one type of death, which occours if and only if you’re not healthy enough to be alive, be it because of age-related diseases, infectious diseases, or because you’ve been shot in the head. The goal of nearly any kind of medical intervention is to prevent your health from becoming so compromised that you would die, whatever the cause may be. The same is true of rejuvenation biotechnologies: far from trying to push life’s non-existent predefined length beyond a non-existent ‘natural limit’, their goal is no different from that of the rest of medicine: save your life.

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