Peter Suderman, writing at The American Scene, apparently wishes to analogize radical life extension to ordinary health care:
One of the biggest political debates in the country right now is over health care and health insurance. Read books like Jonathan Cohn’s Sick and you’ll be inundated with stories purporting to show situations in which people died for lack of care. The underlying reasoning here — reasoning that I suspect is shared by the majority of the population — is that no one should die when the technology exists to keep them alive. So why does technology-driven radical life extension spook so many people? I’m honestly baffled by this, and have yet to read anything that amounts to much more than someone’s account of having a vague moral instinct that living that long would be a perversion of human existence.
James Poulos, in response - with a clever way of denominating this hypothetical social order, no less - argues that the objections to radical life extension are "that the ‘perversions’ of human existence with which we’ll have to contend are likely less to be perversions of the human experience of being alive per se as perversions of some of the definitional tenets of what our shared humanity entails." Specifically, the ostensible benefits of radical life extension are likely to be unfathomably expensive, which will necessitate
...a transfer of resources away from two kinds of people: (a) some who are already alive and don’t have the potential or wherewithal to buy into the methuselocracy and (b) a possibly very large number of people who will have to not be born.
Human rights will be fundamentally rejiggered in the methuselocracy, for no more grandiose reason than that people who are alive have a selfish interest in generally not dying for as long as their resources and ingenuity permit.
Suderman is quite probably correct that there does exist, in the general population, a sort of 'reasoning' according to which no one should die if the technology to keep them alive is available. However, contra Suderman, this 'reasoning' really ought not be categorized even as a vague moral intuition. As much as he categorizes the opposition to RLE as grounded in vague intuitions, which he clearly intends to dismiss as being sub-rational, the sentiment that he identifies does not rise to the level of a moral intuition, at least not in the sense he requires. The term 'technology' covers a lot of ground in terms of means, and 'keeping them alive' conflates innumerable particular sets of circumstances, when it is not obvious that the same moral obligations attach to all of them.
With regard to the former, would we really state that because the technology, in the form of chemotherapy, was available, my maternal grandmother ought to have employed it to purchase a few additional months when, in 1987, she was suffering from late-stage colon cancer? I doubt so, and in cases like this I suspect that general public intuitions run counter to Suderman's own. What of real-life cases such as those of people suffering from acute renal failure, such that they must either be on near-constant dialysis or receive transplanted kidneys? Should they all submit to the dialysis, come what may? Again, I don't see that the mere availability of the technology entails much of anything. Finally, consider one or two of the more outlandish RLE proposals, ones I have no doubt are impossible (but let's leave that aside), namely, the Futurama brain-in-a-vat scenario, or the uploading of "consciousnesses" into computers or robotic entities. Would it actually be argued that we would be obligated to submit to such things? In this case, the answer is an obvious no.
Perhaps, however, this is all wrong. It is not that we are obligated to embrace any particular methodology in our circumstances, but that such things must be made available if we desire them. Consistent with the voluntarism of RLE itself, the idea must be that the preferences and desires the individual are paramount and determinative. But even operating under this assumption, it is unclear that we have any such intuition as Suderman supposes. It is vociferously debated, for example - including in my own family - whether it is ethical for physicians to proffer chemo to manifestly terminal patients when, as in my grandmother's case, all it accomplishes is to extend life by a few weeks. Of nausea, vomiting, and absolute misery. Something similar could be said concerning acute renal failure. There is such a thing, in such cases, as diminishing returns, when the slow process of attrition brings the patient to the point of mortality. While I acknowledge that I am eliding some difficult moral questions, I doubt that we truly believe that physicians possess an obligation to deceive their patients about their own mortality, which, at the limit, is what they do when they refuse to admit that in some cases, there really is nothing more that can be done but to wait for the end.
And as regards those RLE scenarios, well, the notion that there would obtain some nonspecific obligation to make them available should people desire them makes a mockery of the notion of obligation. Someone, or some institution, would be obligated to, say, upload a consciousness to a computer in order to perpetuate the illusion of an immanent immortality? Please. This is not ethics, but cynicism.
Moreover, there remains the problem of identifying those to whom such obligations attach, defining their scope and limits, and reckoning with the finances. Again, it is a mockery of the notion of ethical obligation to suggest that society - presumably, in a general sense - is obligated to provide these technologies to the wealthy should the latter wish them, but is under no such obligation to the less-well off, should they desire such methodologies. It would be impossible, however, to socialize the obligation, define it as having a broad scope and a high limit, and actually succeed in paying for it - hence, the fundamentally inegalitarian implications to which Poulos alludes. In the end, the only remaining obligation - the only one we would be capable of honouring - would be that of affording the wealthy whatever they desired, and of acquiescing in the eugenicist state that would assume form gradually, as the product of millions of individual market decisions. If we have any such intuition, intuition is identical with raw, cynical self-interest. For this reason, while it is doubtful that we really have a well-formed intuition of the sort that Suderman posits in the case of ordinary medicine, it is virtually certain that we have no such intuition in the case of RLE. We cannot specify who is obligated to do what, under what circumstances, and under what constraints, except to state that, in effect, what is possible for wealth and privilege should be actualized.
Obligation, then, amounts to saying that the possible must be actualized. What can be done, must be done. I'm positive that we have no such moral intuition at all. In fact, the very notion is the product of a positivist approach to science
However, if Suderman's intuition isn't, neither is Poulos differentiation of the human experience of being alive and the definitional tenets of what this entails entirely persuasive. For consider that the entire logic of RLE is immanent, this-worldly, and utilitarian - geared toward the extension of life so that all of the pleasures thereof may be enjoyed, if not indefinitely, at least for longer lifetimes than any of us have thought possible. There is such a thing as a metaphysical atmosphere, an orientation towards being, derivative of a primal intuition of its nature and character. For the Christian, even the reflective pagan, the present world is merely penultimate, this life not an end in itself. Rather, this life is preparatory, having an end, or a transition to that other state of being: its limits are demarcated, however arbitrarily from our finite perspectives, by death. Death is, under conditions of alienation from God, a mercy, in that it is intended as a stimulus to repentance, spiritual ascent, and virtue. Absent death, we would confront the prospect of an everlasting alienation from the Good, an indefinite extension of our failure to realize the telos of our created nature.
In contradistinction, the intuition of being of RLE is merely utilitarian. RLE is not pursued, or dreamed of, in the expectation and hope that its beneficiaries will utilize the additional time afforded them to acquire the virtues and prepare for beatitude. No, the entire purpose, the low and ignoble dream, is that of enjoying the pleasures of this world and flesh for as long as possible - with the body as the instrumentality of this hedonic endeavour. The dream of RLE is to put death out of mind, to quell the restless stirrings of mindfulness by which we might be turned from the dissolution of our nature in the passionate pursuit of finite things, to dwell in a perpetual presentness of enjoyment that our very finitude tells us we cannot attain. RLE is a grasping at a simulation of the immortality the means of which we moderns are apt to refuse, for they are difficult of practice. Narrow is the way.
RLE does go the heart of the experience of being alive. The evil and entirely foreseeable consequences are merely the outward signs of a perverted, inverted orientation towards being. Being is an analogy, not the thing in itself, and that is why RLE is a moral obscenity.