Slides of the talk I've given 9 September in London at HDCA conference. Martha Nussbaum’s first capability starts with the following phrase intended to capture the most fundamental capability of human life: ‘Being able to live to the end of a human life of normal length’. Despite its top position on the list, this capability appears to be under analysed in the literature. In the current study we are trying to partly fill in the gap critically and also extend the approach with another angle of looking at human lifespan. Our conclusion is that the 1st capability should be reformulated as ‘Being able to live a human life of acceptable length’ to incorporate our whole range of capabilities in terms of healthy longevity and lifespan, adjusted to the current scientific/technological trajectory.

1. The problematic openness
behind the first capability
concerning the ‘end of a human
life of normal length’
Attila Csordas
Longevity Politics Global
Cambridge, UK

2. Outline
what am I?
some data
science update
industry update
central capabilities
first capability
interpreting ‘normal’
the conceptual twins
open lifespan
the argument
discussion

3. The puzzle of aging
mass-spec based proteomics
bioinformatics
business
mitochondrial
biology
stem cell
research
14 year old Attila decides
this problem
gives meaning to his life ->
rational life plan
philosophy
of longevity
Open Lifespan
activism in
longevity
community
science
personal narrative
technology
politics

4. Open Lifespan project
openlifespan.org/book/

5. global increase in mean life expectancy
2000-15: 5 years with 4.6 years as healthy
longevity
‘An average 16–20% of life is now spent in
late-life morbidity’ ~ Decades of late-life is
now spent fighting age-associated
diseases, compromising human life and life
plans.
64 95 122
healthspan
US, 2017
80% 65+ 1 chronic
68% 65+ 2+ chronic
lifespan longevity

6. Hallmarks of aging, Cell, 2013
PMID: 23746838
treatments/interventions under
way
we genuinely don’t know how
far we’re going to push lifespan
New scientific consensus

7. 64 95 122
healthspan lifespan longevity
Longevity industry & regulation
billions of dollars invested
ICD/FDA: can aging be classified as a disease???
TAME trial starts this November

8. Central Capabilities
Life
Bodily Health
Bodily integrity
Sense, imagination, and thought
Emotions
Practical reason
Affiliation
Other species
Play
Control over one’s environment
lack of ambition < minimal thresholds < high thresholds, utopianism
‘What does a life worthy of
human dignity require? At a bare
minimum, an ample threshold
level of 10 CC-s is required.’
Martha Nussbaum, Creating
Capabilities
should be enforced by
governments
should be prescribed to all citizens

9. First capability
“Life. Being able to live to the end of a human life of normal
length; not dying prematurely, or before one’s life is so reduced
as to be not worth living.”
Martha Nussbaum
fundamental
explicit quantity
disconnected from more social
capabilities

10. Interpreting ‘normal’
statistical/descriptive
average and typical
acceptable/prescriptive
subjective and indexical
‘the end of a human life of normal length’

11. Statistical, life expectancy
average number of years
remaining for an
individual or a group of
people at a given age
“Although “normal length” is clearly relative to current
human possibilities and may need, for practical purposes, to
be to some extent relativized to local conditions, it seems
important to think of it—at least at a given time in history—
in universal and comparative terms, as the Human
Development Report does, to give rise to complaint in a
country that has done well with some indicators of life
quality but badly on life expectancy.” Martha Nussbaum,
Human Capabilities, Female Human Beings. Note 49.

12. Monako toy example
11 people, age of death: 20, 65, 77, 81, 85, 86, 90, 90, 99, 109, 111

13. Mean age of death: 83
arithmetic mean: (20 + 65 + 77 + 81 + 85 + 86 + 90 + 90 + 99 + 109 + 111)/11 = 83
mean

14. Median age of death: 86
median: middle value: 20, 65, 77, 81, 85, 86, 90, 90, 99, 109, 111
mean
median

15. Typical, modal, most likely age of death: 90
mode: 20, 65, 77, 81, 85, 86, 90, 90, 99, 109, 111
mean
median
mode

16. Not toy numbers: 83, 86, 90
https://medianism.org/2017/06/12/median-vs-mean-life-expectancy/
Numbers of women expected to die at each age, out of 100,000 born,
assuming mortality rates stay the same as 2010-2012, example by David Spiegelharter

17. 1. Central Capabilities should be prescribed to all citizens.
2. Definition of averages makes it impossible for ~50% to reach ‘the end of a human
life of normal length’
Conclusion: 1st capability cannot be tied to default statistical concepts of life
expectancy via a descriptive analysis of ‘normal’.

18. ‘normal’ as acceptable
‘minimally’ or ‘ok’ acceptable
‘Capabilities belong first and foremost to individual persons, and
only derivatively to groups. The approach espouses a principle of
each person as an end.’ M.N.
prescriptive, subjective and indexical
1. How long would you like to live that you think is ‘minimally
acceptable’ for you?
2. How long would you like to live that you think is ‘ok acceptable’
for you?
-> concept ceases to be about a minimal, enforceable threshold the
theory expects it to be.
-> opens up to a different, open interpretation including a range of
values, with an upper limit, maximum interpretation as well.

19. Conceptual twins, separated at
birth
biological life
lifespan/longevityhealth
there’s only health when there’s a quantity of
life and there’s only a quantity of life when
there’s a a threshold, viable amount of health
present.
which is a more fundamental concept? 2 approaches
health
lifespan
life

20. CH ‘capability to be healthy’
’There is something of value in being able to live as long as possible for every
human being. This means that making life prospects relative to each society
denies what is shared across the human species. It should be the case that every
human being would also give value to being maximally unimpaired throughout a
life span that reaches for the upper bounds.’ p206 in Sridhar Venkatapuram:
Doctoral Dissertation, 2007.
• Health is the first and central capability
• Health is a metacapability to achieve a cluster of basic
capabilities and functionings.
• Capability based theory of health causation and distribution
integrates biomedical with social determinants research beyond
clinical disease.
• Lifespan/longevity are parts of the health bundle, not separate.
• Aging is not a separate topic yet within this approach.

21. Open Lifespan, Open Healthspan
what is the theoretical, reachable maximum?
what is as long as possible?
Open Life is a possible world, where people can choose Open
Lifespan, an open-ended, indefinitely long healthy lifespan. Open
Lifespan is achieved via Open Healthspan Technologies developed
and accessible enough that all people can choose to go through
continuous interventions to counteract the biological aging
process and have a fixed, small but nonzero mortality rate due to
external causes of death.
not utopian, only one parameter is changed

22. Open
Life
Actual
World
Less
Probable Worlds
Highly
Probable Worlds
Limiting
Possible Worlds
current
thinking

23. Open
Life
Actual
World
Less
Probable Worlds
Limiting
Possible Worlds
Highly
Probable Worlds
Increasing
Life Expectancy
Closed Lifespan
Breaking Maximum
Closed Lifespan
Barrier
Open Lifespan
Open
Lifespan
thinking

24. Argument
1. Central Capabilities should be prescribed to all citizens.
2. A minimum threshold level of Central Capabilities should be provided.
3.‘normal’ in ‘end of a human life of normal length’ cannot be interpreted statistically as
average life expectancy as it cannot specify, by definition a minimum threshold level accessible
for all.
4. ‘Normal’ cannot be interpreted as ‘minimally acceptable’
5. ‘Normal’ can be interpreted as ‘ ok acceptable’ to capture a wide range of plans in terms of
lifespan including maximising healthy lifespan or specifying maximum lifespan.
6. Science/technology can specify a healthy longevity trajectory with an uncertain/indefinite
Open Lifespan at its theoretical upper limit.
7. Specification/Implementation of Capabilities are up to particular traditions/histories.
8. Science/technology are the particular traditions/histories with relevance to healthy longevity
(Capability 1 and 2).
Conclusion: 1st capability should be reformulated as ‘Being able to live a human life of
acceptable length’ to incorporate our whole range of capabilities in terms of healthy longevity
and lifespan, adjusted to the current scientific/technological trajectory.

25. Conclusion
Conclusion 1.: conceptual problem with statistical
interpretation of ‘end of a human life of normal length’
Conclusion 2: a range interpretation of ‘acceptable’ might
work, including maximising healthy longevity
Conclusion 3: a new theory of health and longevity needed,
that accounts for both at the same level
Conclusion 4: this new theory can re-phrase and possibly
merge the 1st and 2nd capabilities
Thanks!