Rewriting the Clock: Aging, Intervention, and the Push to Redefine Disease

If I had an extra hour every day, I would spend it...

This application classic is the Pumpkin Spice Latte of essay prompts: wildly overdone, kind of expected, and weirdly unavoidable. And yet, every time we encounter it, thousands of us pretend that this hypothetical 60 minutes will change the trajectory of humanity. We’ll finally write that novel, discover the cure to an obscure disease, win a Nobel Prize, or maybe even do all three. But let’s be honest: for most of us, that extra hour would dissolve into the background noise of daily life. We’d wake up ten minutes later, scroll through a few more TikToks, and spend a little longer debating whether to go to the gym before deciding to just go tomorrow. That’s the bonus hour, gone before it even knows it’s extra. But what if it wasn’t just an hour? What if you could get an extra month? An extra year? Maybe even ten?

Thanks to breakthroughs in aging research, that question is no longer just a lazy hypothetical. Scientists are beginning to ask whether aging, once considered an immutable force of nature, might actually be something we can delay, manage, or even treat. Drugs like Metformin and Rapamycin, originally developed for diabetes and immunosuppression, are now being repurposed for their potential to slow cellular aging. At the same time, pressure is mounting to reclassify aging as a disease. Together, these shifts have pushed the idea of gaining extra time beyond the realm of wishful thinking that turns bonus hours into Nobel Prizes. But what we do with that time, and who gets access to it, might expose not just what science makes possible but what society is willing, or unwilling, to make fair. Because if time really is the most valuable thing we have, then how we define it, regulate it, and distribute it might say more about us than we are ready to admit.

Despite growing scientific interest, aging has yet to be classified as a disease by the Food and Drug Administration (FDA), which continues to define it as a natural and biological process [6]. Similarly, other influential health bodies, such as the World Health Organization, have taken similar stances, focusing on aging healthily and age-associated decline without calling aging a condition in its own right [4]. This debate goes beyond dictionary definitions; it shapes what gets studied, funded, and ultimately delivered to patients. Such ambiguity has created a regulatory limbo: researchers cannot officially run clinical trials for anti-aging treatments because aging lacks formal recognition as a disease. Without FDA approval pathways, dedicated funding, or clear incentives, progress grinds to a halt, financial support dwindles, and the science remains stuck in preclinical gridlock [6].

Thus, some proponents of the classification of aging as a disease argue that the standstill movement of pharmaceuticals in biogerontology reflects a failure of policy rather than of science [1]. Certainly, the science is ready; we know cellular degeneration can be studied and potentially slowed. However, the FDA’s current system is built for discrete diseases with quick symptom onset and measurable outcomes. Aging doesn’t work like that. It’s gradual, multi-systemic, and notoriously hard to measure, making it incompatible with the approval models we currently use [6]. In a field where innovations are moving faster than the regulatory definitions meant to govern them, a regulatory reclassification would enable researchers to focus on aging itself rather than navigate complex administrative hurdles [5]. Indeed, promising drugs that already show significant efficacy in model organisms, like Rapamycin and Metformin, could finally be tested with long-term, large-scale studies instead of operating in the shadows of off-label use. Aging, defined as a disease, would transform longevity science from a patchwork of workarounds to a legitimate, regulated frontier of innovation.

Until then, scientists and biotech companies are forced to get creative. Consider studies like TAME, Targeting Aging with Metformin, which sidesteps the mention of aging altogether, instead looking at whether Metformin can delay multiple chronic diseases at once [3]. It’s regulatory rule-bending, not to deceive, but to function within a system that is not yet designed to ask the questions scientists are ready to answer. But while the system stalls, time doesn’t. Many of the researchers studying aging don’t have decades to wait for the FDA to catch up. It’s try or die. That’s why some of the same scientists who publicly urge caution about drugs like rapamycin are privately taking it themselves [7]. Simply put, it’s the research equivalent of “Do as I say, not as I do.”

Undoubtedly, such instances of off-label use reveal growing divides. Because aging is not classified as a disease, drugs like Rapamycin, when used preventatively, fall outside FDA-approved indications. As a result, patients must often pay out of pocket, bypassing insurance coverage entirely. These costs, combined with the need for access to longevity-focused physicians and private health networks, place anti-aging interventions firmly out of reach for most people. What emerges is a two-tiered healthcare system, where the wealthy not only receive better treatment, but they also potentially get more years of it [3]. 

Defining aging as a disease does not just risk changing how we treat older adults—it risks changing what we expect from them. As medical innovation continues to push the boundaries of life extension, choosing not to intervene has become increasingly stigmatized. In the current healthcare system, declining procedures like cardiac bypasses or transplants, even in one’s nineties, are condemned, even deemed as unnatural [3]. As sociologist Sharon Kaufman notes, what was once optional care is now standard, and what was once standard has become morally expected [3]. The technological imperative, the idea that we can intervene, has quietly become an ethical one: that we must. Framing aging itself as a disease would only deepen this shift, making it even harder for individuals to age on their own terms without being seen as irresponsible, irrational, or in decline. In the pursuit of treating aging, we may forget how to respect it.

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Ultimately, it is undeniable that science is ready to treat aging. Rather, the urgent question is whether we are, too. The stakes are higher than simply clinical trials or regulatory reform. When time becomes something to be purchased, prescribed, or postponed, it stops being a shared human experience and starts becoming a new kind of currency, one that not everyone can afford. In chasing longer lives, we risk narrowing down what it means to live well. And if we’re not careful, the future of aging won’t be defined by biology or breakthroughs but by who’s allowed to grow old with dignity and who’s quietly denied the chance.

Reviewed By: Aria Eaddy

Designed By: Sonali Patel

References:  

1. de Grey, A. D. N. J. (2005). Resistance to debate on how to postpone ageing is delaying progress and costing lives: Open discussions in the biogerontology community would attract public interest and influence funding policy. EMBO Reports, 6(Suppl 1), S49–S53. https://doi.org/10.1038/sj.embor.7400399 

2. Kaufman, S. R., Shim, J. K., & Russ, A. J. (2004). Revisiting the biomedicalization of aging: Clinical trends and ethical challenges. The Gerontologist, 44(6), 731–738. https://doi.org/10.1093/geront/44.6.731

3. Lugo, N. (2024, October 8). Breakthrough research: Common medication may hold key to slowing aging. Virtue Recovery Center. https://www.virtuerecoverycenter.com/breakthrough-research-common-medication-may-hold-key-to-slowing-aging/

4. Mendoza-Núñez, V. M., & Mendoza-Soto, A. B. (2024, February 24). Is aging a disease? A critical review within the framework of ageism. Cureus, 16(2), e54834. https://doi.org/10.7759/cureus.54834

5. Newcomb, T. (2023, January 6). Humans can start living longer—Once the FDA does this. Popular Mechanics. https://www.popularmechanics.com/science/health/a42419017/anti-aging-drugs-fda-approval/

6. Tournas, L., & Marchant, G. E. (2019). The fountain of youth revisited: Regulatory challenges and pathways for healthspan promoting interventions. Food and Drug Law Journal, 74, 405–426.

7. Whalen, J. (2024, March 15). A transplant drug shows promise for extending life. Should you take it? The Washington Post. https://www.washingtonpost.com/business/2024/03/15/rapamycin-longevity-drug/

Prison Healthcare and Human Rights: Addressing Medical Neglect in the U.S. Penal System

The U.S. prison system can house about 1.9 million people, making it the world’s largest incarcerated population [1]. However, despite the mandate under the Eighth Amendment prohibiting cruel and unusual punishment, incarcerated individuals frequently experience inadequate healthcare. This issue has raised significant ethical concerns regarding human rights and systemic disparities in access to care. Prisoners, regardless of their crimes, have the right to proper medical treatment. However, a combination of underfunding, staff shortages, and systemic barriers often leads to substandard care.

The Ethical Foundations of Prison Healthcare

Medical ethics is grounded in four key principles: Autonomy, Beneficence, Nonmaleficence, and Justice [2]. While incarcerated individuals inherently have limited personal freedoms, these principles are crucial in the ethics of prison healthcare. Autonomy, in a medical context, refers to a patient’s right to make informed decisions about their own care. However, prisoners often have little to no control over when they receive medical attention, frequently experiencing long wait times for physician visits, dental treatments, and specialist care. Justice means that prisoners, like all individuals, should receive equal access to healthcare. However, the systemic disparities in healthcare between the general and prison populations fail to uphold this ethical standard. Regarding beneficence and nonmaleficence, medical professionals have a duty to act in the best interests of their patients and avoid causing harm. Yet in prison, there are daily reports of delayed treatments, inadequate chronic disease management, and preventable deaths [3].

Medical Neglect in U.S. Prisons: Case Studies and Systemic Barriers

Where should we point the blame? Despite the legal requirement to provide healthcare, there is widespread neglect due to systemic deficiencies. Many prisons operate with limited medical staff, which can lead to delays in treating conditions. Prisons also house a disproportionately high number of individuals with chronic conditions such as diabetes, hypertension, and HIV, which can exacerbate health disparities [4]. Another factor is mental health. Over 40% of incarcerated individuals suffer from mental health disorders [5]. Punishments like solitary confinement have been linked to worsening psychiatric symptoms, raising ethical concerns regarding inhumane treatment.

Role of Private Healthcare Providers in Prisons

Many prisons attempt to contract private healthcare companies to provide medical services [6]. While privatization is intended to cut costs, many argue that for-profit companies have incentives to minimize care, reducing expenses at the cost of prisoner health. As a consequence, prisons may fail to provide necessary treatments, delay access to life-saving medications, and refuse specialist referrals due to cost concerns.

International Standards & U.S. Shortcomings

International human rights frameworks support the right to healthcare for incarcerated individuals. The United Nations Standard Minimum Rules for the Treatment of Prisoners state that prisoners must receive the same medical care available to the general population [7]. However, the U.S. has consistently fallen short of these standards, with reports of neglect, medical rationing, and underfunding being common across state prison systems.

Medical neglect in U.S. prisons represents an ethical failure that undermines the principles of justice and human dignity. Although incarcerated individuals have lost certain freedoms, their right to healthcare remains protected under both legal and ethical frameworks. In order to address prison healthcare disparities, we must recognize that access to care is a fundamental human right.

Edited By: Makayla Gorski

Designed By: Eugene Cho

References

[1] Wagner, Wendy Sawyer and Peter. “Mass Incarceration: The Whole Pie 2024.” Prison Policy Initiative, 14 Mar. 2024, www.prisonpolicy.org/reports/pie2024.html. 

[2] - Beauchamp, T., & Childress, J. (2019). Principles of Biomedical Ethics: Marking Its Fortieth Anniversary. The American Journal of Bioethics, 19(11), 9–12. https://doi.org/10.1080/15265161.2019.1665402

[3] - Maruschak, Laura M. “Medical problems of jail inmates.” PsycEXTRA Dataset, Nov. 2006, https://doi.org/10.1037/e500022007-001. 

[4] “The health status of soon-to-be-released inmates: A report to Congress, volume 2.” PsycEXTRA Dataset, Mar. 2002, https://doi.org/10.1037/e514682006-001. 

[5] - James, Doris J., and Lauren E. Glaze. “Mental health problems of prison and jail inmates.” PsycEXTRA Dataset, June 2017, https://doi.org/10.1037/e557002006-001. 

[6] Noga Shalev, “From Public to Private Care The Historical Trajectory of Medical Services in a New York City Jail”, American Journal of Public Health 99, no. 6 (June 1, 2009): pp. 988-995. https://doi.org/10.2105/AJPH.2007.123265

[7] - The United Nations Standard Minimum Rules for the Treatment of Prisoners (the Nelson Mandela Rules), 26 Mar. 2016, https://doi.org/10.18356/9789213589427.

SSRIs in Teens: A Growing Mental Health Dilemma

Teen mental health is in crisis. Although depression and anxiety have long impacted America’s youth, these mental disorders are increasing at an unprecedented rate. Nearly one in seven 10 to 19-year-olds experience a mental disorder, accounting for 15% of the global burden of disease, with depression, anxiety, and behavioral disorders as the leading cause [1]. The COVID-19 pandemic has only exacerbated this crisis. Between 2017 and 2021, diagnosed cases of depression among American youth rose by 60%, while anxiety disorders increased by 31% [2]. 

Yet, as the demand for mental healthcare continues to grow, access to affordable treatment remains limited. In response, more teens than ever are being prescribed selective serotonin reuptake inhibitors (SSRIs) - but is this a necessary solution or an ethical concern?

In mid-February, the White House released a statement regarding the establishment of President Trump’s Make America Health Again Commission [3]. The administration points to the fact that, despite the increased prescription of medication (specifically for ADD and ADHD), health burdens for both adolescents and adults remain persistent. The mission of this new Commission is to study childhood chronic disease and assess the threat of identified-risk factors including “potential over-utilization of medication” [3]. This medication includes SSRIs, antipsychotics, mood stabilizers, stimulants, and weight loss drugs [3]. 

SSRI use among minors has increased significantly in recent years. Between 2016 and 2022, the number of people ages 12 to 17 with an antidepressant prescription rose 43% [4]. This rise is partially attributed to growing rates of depression and anxiety following the COVID-19 pandemic. Recently, Health and Human Services Secretary Robert F. Kennedy Jr. expressed concern over the overmedication of children and the risks of antidepressants. 

SSRIs are the most commonly prescribed class of medications for treating depression. They work by inhibiting the reuptake of serotonin, thereby increasing serotonin activity [5]. Variants of these medications have clinically proven to be safe, efficient, and well-tolerated in both adult and pediatric patients. For many children and adults in the U.S. with severe health health disorders, SSRIs can play a critical role in their treatment. Major depressive disorder in adolescents can cause serious morbidities, including difficulties in maintaining social relationships, poor academic performance, risky sexual behavior, and increased risk of physical illness and substance abuse [6]. It is also strongly associated with the rising rate of adolescent suicides, which is now the second leading cause of death among individuals aged 10 to 24. For young adults, SSRIs may then be a life-saving intervention. 

Given their importance, why are SSRIs now under political scrutiny? Much of the concern arises from beliefs that these medications are addictive. During his Senate confirmation hearing, Secretary Kennedy even claimed to know family members who had a harder time going off SSRIs than heroin [4]. However, medical research has shown that SSRIs are not addictive. The most extreme side effects identified among SSRI users is a minor increase (2%) in suicidal ideation in children and teens. Physicians worry that unsupported statements like Kennedy’s could deter patients from accessing antidepressants they need. Therefore, the decision to prescribe these medications should be between a physician in their patient, rather than being in the hands of politicians. 

Despite misconceptions, SSRIs remain a safe and effective treatment for both adolescents and adults. That said, the criticism surrounding these medications does draw attention to another important issue: the need for more accessible and affordable mental healthcare. While therapy is often the preferred first-line treatment, a nationwide shortage of therapists has led many individuals with mild to moderate symptoms to rely on medication instead [4]. If the U.S. ever considers restricting access to SSRIs, it must first ensure that alternative forms of treatment are both available and affordable for those struggling with mental health conditions.

Designed By:

Edited By: Aditi Avinash

References:

[1] World Health Organization: WHO. (2024, October 10). Mental health of adolescents. https://www.who.int/news-room/fact-sheets/detail/adolescent-mental-health

[2] Xiang, A. H., Martinez, M. P., Chow, T., Carter, S. A., Negriff, S., Velasquez, B., Spitzer, J., Zuberbuhler, J. C., Zucker, A., & Kumar, S. (2024). Depression and anxiety among US children and young adults. JAMA Network Open, 7(10), e2436906. https://doi.org/10.1001/jamanetworkopen.2024.36906

[3] The White House. (2025, February 13). Establishing the President’s Make America Healthy Again Commission. https://www.whitehouse.gov/presidential-actions/2025/02/establishing-the-presidents-make-america-healthy-again-commission/

[4] RFK Jr. thrusts antidepressants into the spotlight — unnecessarily, advocates say. (2025, February 21). NBC News. https://www.nbcnews.com/health/health-news/rfk-jr-ssri-antidepressants-children-doctors-risks-studies-rcna192722

[5]  Chu, A., & Wadhwa, R. (2023, May 1). Selective serotonin reuptake inhibitors. StatPearls - NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK554406/

[6] Dwyer, J. B., & Bloch, M. H. (2019, September 1). Antidepressants for pediatric patients. https://pmc.ncbi.nlm.nih.gov/articles/PMC6738970/

[7] Friedman, R. A. (2014). Antidepressants’ Black-Box warning — 10 years later. New England Journal of Medicine, 371(18), 1666–1668. https://doi.org/10.1056/nejmp1408480