The debate over growth hormone replacement in older adults reflects a set of contextual issues that are deeper than clinical concerns over the risks and efficacy of the intervention. One question that is central to the public and professional acceptance of growth hormone replacement asks whether the human aging process is an appropriate target for biomedical intervention in the first place. Researchers and clinicians in the field should be prepared to address this question, and this review surveys the major arguments regarding it. Five points of the debate are examined: the relative virtues of human aging, the notion of a “natural” human life cycle, the pathological status of aging, the fairness of anti-aging medicine, and the problem of the “metaphysical misconception” in recruiting human subjects for anti-aging research.