The ASBH 9th Annual Meeting (October 18-21, 2007) of ASBH

Saturday, 20 October 2007 - 8:40 AM

How Anti-Aging Clinicians Make Epistemological Connections: Understanding the Rise of a New Medical Specialty

Marcie A. Lambrix, MA and Jennifer R. Fishman, PhD. Case Western Reserve University, Cleveland, OH, USA

The promise of anti-aging medicine has engendered lively debate over its implications in a number of serious scientific, bioethical, and public policy venues. These debates are strongly shaped by the ways in which anti-aging objectives are understood. Our philosophical analysis has categorized these objectives into three interpretive frames: treatment of disease, the prevention or delay of disease, or enhancements that improve on human form and function. If one considers the biological changes of senescence as pathological, one can interpret anti-aging interventions as traditional medical treatments for disease. If one were to interpret efforts to control aging as interventions into a normal biological process undertaken to prevent the onset of the major life-threatening diseases, one can interpret anti-aging interventions as prevention. Finally, if one stresses the importance of extending the maximum human span beyond its historical limits, one can interpret anti-aging interventions as enhancements that go “beyond therapy” in seeking to improve the human condition. For instance, the U.S. President's Council on Bioethics chose to label anti-aging efforts as enhancements, and strongly criticized these endeavors in their 2003 report entitled Beyond Therapy: Biotechnology and the Pursuit of Happiness.

While this debate continues, clinicians are already offering anti-aging products and services to patients. Because of their specialized medical role, we feel that clinicians have an important voice which should be heard in this debate, both as stakeholders and as medical authorities. Capturing their perspective also lends insight into the epistemology that guides their work, allowing for a greater understanding of the field of anti-aging medicine and its ethical implications. This paper will present data from semi-structured interviews with members of the American Academy of Anti-Aging Medicine which provides board certification to clinicians in anti-aging medicine. Our analysis of these interviews employs an empirical sociological lens to analyze how anti-aging clinicians understand the basis of their work, and how their engagement with anti-aging medicine stems from a variety of concerns, including: their own experiences of aging, a changing medical profession, and a response to a perceived cultural demand from a population determined to stay young. As an interdisciplinary project, it is our attempt to understand how these motivations derived from our sociological data intermingle with our aforementioned three philosophical frames. For example, one of the clinician's own experiences with diminishing hormone levels led her to anti-aging medicine as a treatment, for herself and the patients she sees. An emergency room physician told us how the shift to anti-aging medicine represented a move from medical treatment to health prevention, in part spurred by his desire for autonomy and financial remuneration—two things that seem to be in short supply for many practicing physicians today.

This study is important in linking clinicians' epistemological worldviews with their clinical practice, lending insight into how this understanding shapes the discipline for both providers and patients. Furthermore, this linkage will also contribute to developing a responsible framework for better understanding and steering science and medicine more responsibly into the future.

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