Professional Documents
Culture Documents
Age as Disease
Anti-Aging Technologies, Sites
and Practices
David-Jack Fletcher
Online Education Services – Western Sydney Online
Aberglasslyn, NSW, Australia
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Acknowledgments
There are so many people who supported me through this process; not
least of all my PhD supervisor Joseph Pugliese, who patiently assisted and
guided me in the development of my thesis, upon which this book is
largely based. His dedication to my work, and to me, has been tireless,
relentless and perpetually inspiring. In my (several) moments of doubt
and shaky confidence, Joseph inevitably provided some sort of mind-
bending feedback that set me right back on track. I cannot sufficiently
express my gratitude. Thank you, as well, to my associate supervisor,
Nicole Anderson, who was always ready to read drafts and provide con-
siderate and critical feedback at short notice. I do count myself lucky to
have had two extremely supportive colleagues support me.
I am also grateful for a husband whose endless emotional support also
manifested as, at times, housekeeper, personal chef, shoulder to cry on
and a firm hand telling me to believe in myself. His love and support, in
general, spurred me to push myself. Thank you, Paul, for listening to my
endless cultural theory-inspired monologues, helping me relax with ran-
dom renovation shows and, of course, for everything else.
A handful of friends also enabled me through this journey, particularly
my incredible friends Tahnee and Chris, who were there every step of the
way, whether to share a success or pull me out of an abyss of self-pity. My
sister Allisha perhaps spent the most time asking me questions so that she
might understand my topic. These Q&A sessions enabled me to
v
vi Acknowledgments
1 Introduction 1
References317
vii
1
Introduction
Old age is a point of reflection for many of us, though often through a
lens of pathology or medicalization. I say this precisely because of the
ways in which frameworks for elderly1 individuals are established and
deployed. As such, I have often reflected on the ways old age is con-
structed not only as a sort of deficit, but critically, as is argued throughout
this book, as a form of disease-state. Living in an intergenerational rela-
tionship, I am always interested and sometimes perplexed at the reactions
my husband and I receive when it is discovered that we are, in fact, not
father and son. The gasps and double-takes are not borne from the fact
that we are both men. They are instead driven by the fact that we are
clearly of different generations. The categories imposed upon us through
a priori assumptions about age, and romance, sparked within me a curi-
osity. Why, in a society that seemingly seeks to empower older individu-
als, are people still so shocked to hear—and to see—that this man and I,
with an age difference of twenty-four years, live in a monogamous
relationship?
Forms of empowerment that are readily recognizable without the need
for research include the marketing of anti-wrinkle creams, reinvigorated
vibrancy, cosmetic surgery and discursive regimes that insist forty is the
new thirty. Further, ‘by the end of the twentieth century, mid-life
© The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd. 2021 1
D.-J. Fletcher, Age as Disease, https://doi.org/10.1007/978-981-16-0013-5_1
2 D.-J. Fletcher
lifestyles had become late-life lifestyles where 60 was hailed as the new 40
and 80 the new 60’ (Jagger 2005 in Gilleard and Higgs 2013). My curi-
osity was peaked when I began to do further investigation into ways of
seeing old age. Community programs have emerged across Australia, the
United States and the UK designed to keep elderly individuals active;
however, these are often increasingly reliant upon medico-scientific dis-
courses of the inevitability of frailty, decrepitude and illness. Investigations
and experimentations into ‘beating’ or ‘curing’ old age have become com-
monplace within scientific and medical circles, particularly in the field of
biogerontology. Outside the spheres of medicine and science old age has
been increasingly visibilized through various types of media and my ini-
tial research into this project was overwhelmed by frequent news broad-
casts and articles concerned with ‘overcoming’ age. These
spheres—medicine, science, media—converge to present aging itself as a
medical problem. I wondered, then, if there was a connection between
informal gasps of shock when I introduced my visibly older partner and
a broader discourse that positioned old age as a medical issue.
The obvious implication here is the increased value of youth, which of
course is not a new phenomenon. However, with the increased develop-
ment of technology, this anti-aging phenomenon has become a move-
ment, as this book will expose. The question therefore arose: were
anti-wrinkle creams and ‘success’ stories of extending the lifespan of crea-
tures such as mice designed simply to celebrate youth, or was there some-
thing else at stake here? This book will demonstrate that discourses
surrounding age are intertwined in a complex nexus comprised of biopo-
litical, governmental, neoliberal, somatechnological and ethical ideolo-
gies that seek to remove old age in favor of an idealized youthful form. I
contend that old age, and aging more broadly, is currently under
attempted abolition. Through governmental, institutional and medico-
scientific frameworks, there is an attempt to abolish age and aging because
it has been framed as a pathology that needs to be ‘cured’. As such, the
central concern of this book is to expose and critique the myriad ways in
which old age has become pathologized as a disease-state.
This book has four key aims, described below in brief to provide con-
text for the book as it unfolds. The pathologization of old age has been
enabled and legitimized by several scientific and medical discourses and,
1 Introduction 3
What Is Aging?
The aging process is generally recognized as a simple fact of life; we are
born, we live, we get old and we die. It has never been that simple, of
course, for age itself is a social and cultural construct. As Estes and
Phillipson (2002, p. 280) state:
As such, aging has never been solely concerned with reaching a certain
number; rather, it has been centrally preoccupied with a series of entitle-
ments during certain periods of one’s life. For instance, in western societ-
ies, an individual aged five years old is entitled to enter the education
system, an eighteen-year-old is entitled to vote, which in Australia, is a
legal requirement. At age sixty-five, an individual is entitled to retire.
These and other examples demonstrate that aging is not simply a biologi-
cal process, but one that occurs within a nexus of biopolitical and govern-
mental regimes surrounding presupposed aged abilities.
However, ‘age-related demarcations (50+, 55+ or 65+), that are con-
structed in society to distinguish “the aged” from other, seemingly “age-
less” adults, are quite arbitrary’ (Baars and Phillipson 2014, p. 12) and
have shifted over time. Further, what is of interest for me is how individu-
als in later life are constructed as somehow waiting to die. Moreover, how
often these individuals are framed as entitled to die. At the very least, it is
expected that older individuals will die sooner rather than later and as
such, protocols are put in place to alleviate the economic burden they
represent. The manner in which this alleviation takes place has shifted
over time from regimes of care, to regimes of self-care, which, as Nadesan
(2010, p. 15) argues, operate as forms of the ‘neoliberal state relinquish[ing]
paternalistic responsibility for its subjects but, simultaneously, hold[ing]
its subjects responsible for self-governance’. As such, a neoliberal under-
standing of old age has framed a decline in health as not only a personal
6 D.-J. Fletcher
For the above cited authors there are nine hallmarks of aging that need
to be overcome: ‘genomic instability, telomere attrition, epigenetic altera-
tions, loss of proteostasis, deregulated nutrient-sensing, mitochondrial
dysfunction, cellular senescence, stem cell exhaustion, and altered inter-
cellular communication’ (López-Otín et al. 2013, p. 1). In this way, aging
is inseparable from medical understandings of health. The short passage
above provides a clear understanding of the biomedical approach as
underpinned by the assumption that aging is—or at least can be—a
disease-state. Importantly, the biomedical approach can be fragmented
further, specifically based on assumptions of causes for aging. That is,
some biogerontologists (Barja 2008; de Grey 1999, 2004a, b, 2005,
2007; de Grey and Rae 2007; Johnson et al. 1999; Rattan 2010, 2012;
Sinclair and Guarente 1997) argue that aging is caused by oxidative stress,
while others (Gilchrest and Bohr 2001) advocate for the gradual
10 D.-J. Fletcher
Foucauldian Biopolitics
Michel Foucault is generally acknowledged as the father of biopolitics,
coining the term biopolitics in his lectures of 1978–1979. Many scholars
before him had, in fact, identified similar notions. Biopolitical thought
can be traced back to the early 1900s when Rudolph Kjellén first
employed the term to denote the science of life and the ‘laws of life that
society manifests and […] promote’ (Kjellén 1920, p. 4). Foucault re-
imagined biopolitics during the 1970s in order to provide an analytical
interpretation of colonialism and racism, and also a theoretical frame-
work for mechanisms of power which aimed to govern both individual
bodies and a nation’s population. Nadesan (2014, p. 167) acknowledges
these complex regimes of power when she asserts that ‘power may be
centralized in a sovereign figure, or it may be dispersed throughout daily
life in the form of laws, social norms, and personal habits’. Importantly,
too, Nadesan further acknowledges that power can be resisted. While
power in its various forms imposes regimes that shape daily practices, the
possibility for active resistance exists, as will be shown later through a
poignant example of aged care residences speaking back to the violences
they have suffered under care.
Scholars in the years since have reinterpreted what Foucault (1990,
p. 140) originally traced back to the sovereign power over life and death
and what he termed the ‘calculated management of life’. For Foucault
(1990, p. 136), the link between sovereignty and biopolitics meant that
biopolitics was ‘essentially a right of seizure: of things, time, bodies, and
ultimately life itself ’. One of the ways sovereign regimes exercise their
power is to control mortality and the shape of the lives we lead (see
Mbembé 2003). As such, biopolitics can be viewed as an institution of
control: of birthrate, life expectancy, health and so on.
Modes of control can be seen throughout eugenic regimes, such as
forced sterilization and liquidation. ‘Control is no longer just the
16 D.-J. Fletcher
the general doctrine of the gradual appearance of new forms through varia-
tion; the struggle of superabundant forms; the elimination of those poorly
fitted, and the survival of those better fitted, to the given environment; and
the maintenance of racial efficiency only by incessant struggle and ruthless
elimination. (Wells 1907, p. 695)
Neoliberalism
Initially conceptualized in terms of deregulation of the economy and the
decentralization of power away from the government and toward the
individual (Foucault 2010), neoliberalism establishes and enforces a sys-
tem of regulatory practices, including the legal, social and political. The
term ‘neoliberal’ is actually quite ambiguous, though, as it can be under-
stood in various ways. For this reason, I mobilize the concept of neolib-
eralism within a Foucauldian framework, which constructs the human
worker as capital. The subject is reconfigured as homo oeconomicus, where
‘the populace … was presumed to be governed by the individual pursuit
of liberty and market self-interest, tempered by prudence, and shep-
herded by the pastoral apparatuses of police’ (Nadesan 2010, p. 7).
Further, according to Todd May this reconfiguration seeks to maximize
welfare by means of making the best use of resources and environment.
In short, homo oeconomicus is a capitalist in all aspects of life, viewing the
1 Introduction 21
projects of life in terms of enterprises that require certain inputs and have
the possibility of yielding particular benefits (May 2006, p. 156).
Homo oeconomicus is significant for any discussion of neoliberalism, for
the construction of subjectivity, human use value and notions of the risk
society are all embedded within this framework. Foucault (2010, p. 147)
argues that ‘homo oeconomicus … is not the man of exchange or man the
consumer; he is the man of enterprise and production’, implicating the
emergence of homo oeconomicus as consistent with a discursive rupture
that enabled the rise of neoliberal practice. Moreover, homo oeconomicus
curtails state power through the demonstration of the state’s ‘inability to
master the totality of the economic field’ (Nadesan 2010, p. 7; Foucault
2010, p. 292). Where Foucault characterizes liberalism as formulated
around commodities and consumerism, neoliberalism shifts perspectives
to focus instead on individual enterprise and production. It is seen here,
then, that neoliberal governance forces individual responsibility within
the market, decentralizing the state’s role. Elderly neoliberal subjects are
of vital importance here, because the state’s role appears decentralized in
the maintenance of their health. That is, older individuals are encouraged
to self-assess their health, their needs and their social responsibility to
remove themselves to a nursing home—as will be demonstrated later in
this book.
Importantly, as Mitchell and Snyder (2015) note, neoliberalism for-
mulates the notion of inclusionism, precisely in relation to disability.
While I focus on aging, there is an important intersection between old
age and disability, specifically in terms of the strategies deployed to keep
people ‘abled’ or ‘young’. Carlson (2005, p. 137) states that through a
Foucauldian lens, it is possible to ascertain that ‘new means of producing
knowledge produce distinctly new kinds of individuals’. The reformula-
tion of both old age and disability in medicalized states can enable the
emergence of new kinds of subjectivities. Mitchell and Snyder turn to the
notion of inclusionism, by which they implicate policy surrounding the
care and management of those deemed disabled by heteronormative stan-
dards of corporeal embodiment. They state that ‘inclusionism has come
to mean an embrace of diversity-based practices by which we include
those who look, act, function, and feel different’ (Mitchell and Snyder
2015, p. 4), thus reifying the value of those modes of embodiment coded
22 D.-J. Fletcher
Somatechnics
It is through an ethical inquiry that the problematic dimensions of anti-
aging technologies and their implications for both the elderly and the
wider community are visibilized. The importance of advanced anti-aging
technologies cannot be understated here, precisely because I mobilize sev-
eral emerging anti-aging strategies, some of them technological. I deploy
a somatechnic framework for this reason, where somatechnics can be
understood as the ‘mutual enfleshment of technologies and technologisa-
tion of embodied subjectivities’ (Sullivan and Murray 2009, p. xi); in
other words, the symbiotic relationship between technology and the
body. Somatechnics posits that technology and the body are formed, and
indeed informed by each other. Somatechnologies, then, harbor possi-
bilities for disruptions, counter-actualizations, destabilizations and for
the creation of new selves, affinities, kinship relations and cultural possi-
bilities. Yet, they also contain within them the danger of being reterrito-
rialized, of being dammed up by various apparatuses of capture—the
state, the body politic, the nation, heteronormativity, neoliberalism
(Sullivan and Murray 2009, p. xi).
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