Can you imagine a world without disease but with biological aging? Neither can I

One default philosophical question about counteracting biological aging is whether those interventions would qualify as enhancements or medical therapies/medical preventions. The answer to this question depends on the status of biological aging, whether it can be considered as a natural process or an actual broad-spectra disease.
In what follows I sketch a simple, reductio ad absurdum argument to show that disease and biological aging cannot be conceptually separated from each other. I’ll make the connection between the two clearer throughout argumentation. If they are connected through a conceptual continuum then biological aging cannot be considered a natural process so interventions counteracting it cannot be considered enhancements, but medical interventions, either preventive techniques or therapies.

  1. Imagine a possible world where human (medical) technology eliminated all diseases but where people would still go through biological aging without any specialised medical interventions designed to counteract and undo the effects of the aging processes. Can we succeed in imagining such a world?
  2. If such a world were coherent and perfectly conceivable then in this world people would not die of diseases, either infectious or non-infectious conditions. In this world people would die of external, non-infectious reasons, outside the domain of medically diagnosable pathologies.
  3. Yet, according to our other assumption, in this world people still undergo biological aging, so they still experience functional decline and increased mortality with age due to biological aging.
  4. But increased mortality means people would still die from medical consequences of aging.
  5. Nobody dies directly due to biological aging. Another way to put this: Accumulating biological aging processes are the distant but not the proximal causes of mortality and death. (I’ll write a separate post on proximal/distant causes in this respect.)
  6. Diseases are the proximal causes of death in case of aging associated increasing mortality. For instance people die directly due to cardiovascular diseases (heart attack , stroke).
  7. We arrived to a contradiction in imagining such a world as our main stipulation was that all diseases have been prevented or cured, yet we still need to assume that diseases are killing people due to our other assumption of this world, namely that biological aging still continues to happen.
  8. The conclusion is that we cannot conceptually separate diseases and biological aging from each other. Although biological aging is not classified currently as a disease it clearly leads to the accumulation of age-associated diseases.
  9. Counteracting biological aging cannot be considered an enhancement but a therapy or prevention.
This is my first take on the notorious  enhancement vs therapy/prevention question in the context of aging and open healthspan. I have developed another argument why open healthspan technologies cannot be considered enhancements, I think it is more substantive than the indirect, counterfactual argument above. Will tell you later.

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