Subtitled: if you think about the joke long enough, it starts to make sense.
Finally, after a substantial hiatus, your humble amanuensis returns to present to you those proceedings of our illustrious Society’s oh-so-long-ago pharmaceutical debate. On October 20, 2016, we gathered as younger, more youthful Philodemicians in the Philodemic Room to discuss “Resolved: Improving life, and not extending it, should be the primary goal of pharmaceuticals.” On the affirmation was Ms. Taylor Oster (SFS ’17) of North Dakota, and, making his induction, Mr. Brody Ladd (SFS ’19) of Texas. On the negation was Mr. Philip Ma (SFS ’17) of New York (who specifically asked me a month ago when I would actually manage to write this blog post—sorry Philip, I hope you were able to survive this winter of discontent without my blog posts to keep you warm), and, making his induction, Mr. Benjamin Zuegel (COL ’19) of New York.
Setting a rather un-dramatic tone for the evening, Mr. Ladd arose as the hour struck eight to inform us that this debate was no less than a debate about the entire meaning of life. Posing an opening question, Mr. Ladd asked us to consider the purpose of life—does life’s meaning come from being alive or from actively pursuing some greater meaning? Immediately solving this conundrum, Mr. Ladd informed us that the correct answer was the latter; mankind has a telos greater than simple existence, and our medical practices should enable us to pursue that telos, not simply to keep us alive. Finally, preempting an argument of the negation, Mr. Ladd argued that the primary reason to want life-extending drugs is to spend more time with a dying loved one, but that this motivation is selfish because others should not be beholden to our desires for more time with them.
Now Mr. Zuegel approaches the podium to deliver his first opening salvo to our Society. He helped to frame the debate by requesting that speakers ignore the apparent dichotomy of “life-extending” vs. “life-improving” drugs by only focusing on cases of conflict. Mr. Zuegel pointed out that thanks to a pharmaceutical industry which seeks to extend life, our American life expectancies have been risen over 100 years from 45 to 78. Mr. Zuegel also argued that having life is ontologically prior to enjoying life (one imagines—I have yet to see a zombie film which portrays the dead as fulfilled beings actively pursuing their own telos). Finally, Mr. Zuegel decided to mount a pro-choice attack on the affirmation: even if the best case for life-extending pharmaceuticals is to extend lives of suffering, nonetheless these pharmaceuticals can provide sufferers the choice to continue living or end life on their own terms.
Confidently assuming her rightful place in front of the Society, Ms. Oster posed two questions for the debate: first, what does it mean to live a good life? and second, how does a pharmaceutical company factor into this image? She pointed out that our debate tonight should focus on the world today, in a world in which our primary causes of death are from chronic diseases endemic to aging populations. In such an environment, having exhausted the easiest means of simply extending life, shouldn’t we now focus on improving it? And after all, pharmaceutical companies will prioritize medications that people are paying for. Before re-taking her seat, Ms. Oster provided one last thought: “life for life’s sake is no life at all.”
And now the ever-prepared and ever-eloquent Mr. Ma responds with a well-researched speech which was of course subsequently ignored. From the WHO’s list of essential medications for a thriving society, 70 are strictly life-improving (e.g. contraception) while about 250 are strictly life-extending. He further pointed out that a fixation on life improvement excludes the developing world, where most gains from life-extending pharmaceuticals has not been fully realized. Then Mr. Ma brought up some brilliant philosophical points: from a communitarian perspective, we ought to consider what is best for a society when we make normative statements about societal functioning, not what a single individual might prefer; referring to Mr. Zuegel’s pro-choice argument, quality of opportunity is more important than the quality of an outcome, and the necessary is preferable to the desirable; pulling from Sartre and the existentialists, Mr. Ma stated that “existence is prior to essence“; therefore, let us seek to preserve our existence that we might continue to have an essence. Finally, Mr. Ma proposed to questions: first, what is a better measure of healthcare quality—life expectancy or patient satisfaction? And what is more important—vaccines or painkillers? Responding with the former in either questions necessitates a support for the affirmation.
My enjoyment of Mr. Ma’s speech and optimism regarding the debate did not last long, as Mr. Marrow delivered the first floor speech of the evening. Admitting that Mr. Ma’s speech was quite impressive, he then (justifiably?) attacked the resolution for creating a false binary and encouraged all members to abstain in the final vote. Yet Mr. Mullaney retorted that abstaining from the decision implies a desire to not choose between quality or length of life, but not choosing between the two first necessitates that the potential for a choice is established, which in turn necessitates that the chooser be alive in order to have the ability to not choose—thus, by a twist of logic, the abstention disappeared in a puff of smoke and was subsumed into the negation.
Arising to save us from our logic, Vice President Fletcher restated the importance of the word “primary” in our resolution and asked us whether life must be long in order to be meaningful. Ms. Provo got up, although I suspect that her purpose in speaking was not so much to make a point as to talk about Viagra extensively on the floor of the Philodemic. President Thanki (the big guns came out early this time around) argued that the profit margin must be considered, and clearly profits favor life-extending drugs. Mr. Rinaudo “began the debate” (his words, not mine—not that I necessarily disagree), by stating that people get to determine for themselves whether their own life is worth living.
And now, to the nonmembers:
Mr. Marshall Webb (SFS ’20) stated that improving the quality of life can in fact lengthen life—as with the mental health patient who is treated for his depression. Mr. Julian Lark (SFS ’20) made a response from a marginal case: if an individual is in a coma with no ability to consent to death (personally, I certainly hope that death operates on a basis of consent), we ought not to make a decision for them—therefore, let us seek to extend their life. Ms. Claire Smith (COL ’19) retorted that doing so provides no reward except to see our loved ones suffer without release. Ms. Sara Castiglia (COL ’18) presented a case of bodily autonomy and stated that true autonomy requires a pre-existing choice to live or die, which relies on the existence of life-extending drugs.
Ms. Logan returned to the issue of mental health to discuss the negative side effects of mental health medication and to argue that we need more investment in drugs that improve life. Ms. Finkenthal pointed out that “life-extending” as a category has been presented as something that only the elderly need—but shouldn’t we also want such drugs to prevent the early death of children? Ms. Li, furious at the bastardization of her resolution, discussed new scientific breakthroughs that could allow us to vastly improve, say, our memories—the affirmation needs to stop pretending that “improving life” just means Advil and Viagra! Mr. Perez-Reyes invoked Nietzsche to argue that that even the loathsome must go on, because existence is the only good thing (thank you, negation, for actually embracing your own position). Ms. Haag responded that it is selfish to want people to remain alive even as they suffer (apparently Nietzsche never considered that—it is nice to see him overturned on the floor).
Yours truly then delivered a nonsense speech about CRISPR, in which they key point was that and physically perfect creations of Man (for those who can afford to be perfect, at least), while “life-extending” may soon be expanded to include timescales of thousands of years for all people. Ms. Fisher responded that we should let more people die off so as to solve the problem of overpopulation. Mr. Bies responded to Nietzsche again with a bit of modified Dostoevsky: “if nothing is true, everything is permitted.” Finally, Mr. Pullin pointed out that one’s health is defined by much more than just the medications that one takes.
Keynoters! You have languished long throughout this debate, now return to us and end our misery!
Mr. Ma provided an argument by analogy by pointing out that individual drugs are like tools in a tool kit—while an individual drug may rightly seek to improve life, the toolbox as a whole is dedicated to extending life. In our prisons & punishment debate, he pointed out that punishment was deemed harmful precisely because it took time that could have been meaningful—why apply a different standard to this debate? Finally, ending on a Jesuitical note, he stated that “cura personalis” is nonsensical if there is no person to care for.
Ms. Oster argued that while life is wonderful, death is inevitable (although I think that her characterization of life, and perhaps of death too, could be disputed). She argued that people should be able to live life without the fear of dying in pain, which is not the same as living without the fear of death.
Mr. Zuegel responded that life is more than medications, and our efforts should be concentrated in curing those diseases which cannot be prevented through healthy living. Ending his closing keynote, Mr. Zuegel again reiterated that this debate is fundamentally about securing the conditions for all people to choose whether or not to continue living or to avoid their suffering by dying. Mr. Ladd responded that while the affirmation believes that research in some life-extending drugs is necessary to prevent premature death, nonetheless death should not be postponed indefinitely.
After a lengthy night, the Society voted, and with a vote of 13 affirming, 4 abstaining, and 30 negating, this resolution was negated. Perhaps the affirmation would have fared better if, noting the suffering of our debate, we had chosen to put it out of its misery before our full two hours elapsed so as to end it with quality, to give it, as it were, a “dignified death.”