Somebody once told me they fear that, if we created rejuvenation therapies, they might be forced on people who don’t want them, and in a way, we’d end up forcing people to live ‘forever’. Is this a good reason not to develop rejuvenation? No, of course not. I mean, imagine if we never came up with blood transfusions for fear that Jehovah’s witnesses might be forced to undergo them!

Besides, if rejuvenation therapies shouldn’t be invented because someone is afraid they’d be forced on people who want to grow old and die, let me ask: How about the people who do not want to grow old and die and yet would be forced to, because somebody else didn’t want rejuvenation therapies to be created? Dying despite the existence of rejuvenation therapies is certainly more easily attained than not dying despite the lack of rejuvenation therapies.

Rejuvenation is a set of medical interventions, and as such, a patient has the right to refuse all of them, if they want to. Indeed, the right to refuse or halt medical intervention already exists (see this WHO paper of 1994, page 11, article 3.2, which states this right for European Citizens, for example), so, if one really doesn’t want to undergo rejuvenation treatments, that is in their right already.

You might say that the right to refuse treatment exists on paper, but it is not always honoured. I certainly know there have been cases of treatments being forced onto patients who didn’t want them, but they boil down to two types: Cases of patients who were judged incapable of discernment, and patients affected by an incapacitating but not life-threatening disease who simply wanted to die to put an end to their own suffering.

People in Italy, for example, are probably all familiar with the famous cases of Eluana Englaro and Piergiorgio Welby. In both cases, either the patient and/or their family had to go through all sorts of legal battles to exercise the right to terminate their treatment and be euthanised as they wished. The good news is that they won their battles, which is a sign we’re moving towards a system that respects the patient’s will even when it clashes with the morality of others. (Quite frankly, other people should mind their business; what a terminally ill, or severely disabled, patient wants to do with whatever is left of their life is the patient’s business alone.) Unfortunately, other cases, such as Giovanni Nuvoli’s, did not end equally well.

I can easily imagine how people could end up being wrongfully forced to undergo treatment in situations like the above, and I agree that in such cases the practice is despicable. However, the analogy with rejuvenation therapies is false. Rejuvenation therapies are preventative treatments. It means they prevent you from getting sick. We’re not talking about treatments to keep you alive in a miserable state for the sake of questionable morals; we’re talking about treatments that prevent you from being sick in the first place. Honestly, I can’t imagine how anyone in their right mind would complain that they don’t let them be sick. Then again, there are people complaining about mandatory vaccines—and generally, it’s either people who don’t understand the first thing about vaccines, or believe that a group of space reptiles is secretly ruling the world. I have a hunch these guys and those who would refuse rejuvenation aren’t all that different, but let’s not generalise.

Quite frankly, I think compulsory rejuvenation would be a good thing, just like compulsory vaccines for very dangerous infections. In pretty much the same way infected people are a risk to others, age-related diseases are a huge emotional and economic burden on others. However, if people really prefer getting sick and dying of age-related diseases over being healthy indefinitely, and decide to do so while capable of discernment, I still think they should have the right to make this choice, and that they will indeed have it. Still, if you want my honest, blunt opinion, if such people were frowned upon because of their choice, I would understand why. Allow me to explain.

Suppose ageing was defeated, and rejuvenation was a normal thing. Further suppose there was a chap who would rather grow old and die the ‘natural’ way, and suppose they let him do so without any interference whatsoever. What would happen? Before we try to answer this question, let’s try to examine a simpler scenario. Suppose I’m on a wheelchair for the rest of my days, except you’re willing to pay for a miracle treatment that will put me right back on my feet and give me my health back. If I refused the treatment and asked you to keep pushing the wheelchair, you’d be fully entitled to tell me to go to hell and leave; just like I have the right to refuse treatment, you have the right to refuse pushing the wheelchair, especially if an alternative is available that would make everyone better off.

The case of the chap refusing rejuvenation is completely analogous to the one I outlined above. The diseases of old age prevent this chap from supporting, and taking care of, himself; notwithstanding, not only does he refuse the therapies the State offers him (as I discussed here, it’s reasonable to expect rejuvenation to be fully or partly paid for by the State), but now he also asks the State to pay him a pension, pay for his geriatric expenses (which won’t do much good anyway), and maybe even for a place in an institution where they can take care of him—place which someone else with an actually incurable disease could benefit from. (Remember that, in a world where rejuvenation was normal, care home for the elderly would likely not exist any more.) Why on Earth should the State put up with his whims, when it would be far more convenient for everyone if the State just paid for his rejuvenation every few decades instead? Because the chap ‘prefers’ being sick? Fine, but now that he’s made his bed, he and he alone should lie in it. Being sick is one thing; wanting to be sick is another.

Frankly, I don’t think it’s at all worth dwelling on this. I suspect that who refuses rejuvenation today, when it doesn’t exist yet, will miraculously change their minds as soon as rejuvenation will be a reality. Better yet, I think there will be no minds to change, either, because unlike what the public probably imagines, rejuvenation isn’t an all-curing magic pill that will suddenly pop out of nowhere; it is a series of different treatments, each of which will become available at different times and will prevent only some ailments. Being always biologically young will only be the sum total of all the therapies; this will allow us to grow used to the fact that certain age-related diseases don’t happen any more, or if they do, they do so only much later in life. Eventually, we’ll grow accustomed to the fact no age-related disease happens any more and life is much longer. The first therapies of this kind we can expect to become available are senolytics. These drugs are supposed to prevent chronic inflammation and reduce cancer risk, among others. Now, honestly, can you imagine something like the following? A chap goes to see his doctor, and the latter says: ‘I’m going to prescribe you senolytics to prevent this and that disease. You take them now, and then every ten years; they’ll make you healthier and lower you risk of diseases.’ The chap says: ‘No, thanks. I’d rather run the risk of getting sick.’ I really can’t imagine that happening.