Should we be able to know how long we have to live?
A new test, soon to become available to the general public in the UK, can tell people how fast they are aging, thereby allowing them to estimate their life expectancy. The test, which should be available for €500 (£435), is based on an analysis of the telomeres, small protective caps at the extremities of a person’s chromosomes. Short telomeres are associated with a shorter lifespan and indicate a more advanced biological age (by contrast with the person’s chronological age). The test has been described as opening an “ethical Pandora’s box”. Concerns have been raised regarding people’s possible reaction to information about how long they still have to live. Some are also worried that the test might be used by organizations selling dubious “anti-aging” remedies to attract potential customers, and that insurance companies might demand to have access to such information before providing cover, requiring people with shorter telomeres to pay higher premiums. Should the prospect of the public availability of such a test concern us, and should we try and restrict it?
Even though this test needs to be further refined so as to make it more precise, it seems to me that we should welcome its arrival. There are good reasons for wanting to estimate our life expectancy, and the methods available so far are not as accurate as we might wish. The average life expectancy in our country of residence might not apply to us depending on our genetic constitution and individual lifestyle. Looking at how old our parents lived to be is also a somewhat crude method. This new test promises to offer us more reliable data on this matter, allowing us to plan accordingly for the future and to make changes to our lifestyle if necessary (there is indeed evidence that telomere length is not determined just by heredity). It is true that the prospect of insurance companies pressuring people to take such a test when they otherwise would not have wanted to, and requiring those with short telomeres to pay higher rates for their insurance cover, is somewhat disturbing. We might note, however, that insurance companies are already allowed to ask for information about a person’s health that might lead her to pay a higher premium – for instance whether she has diabetes. And while the person might sometimes be held responsible for her condition (e.g. if she is a smoker), in other cases this will not be true. If we wanted to prevent insurance companies from demanding access to the results of this new test, we would thus need to find grounds for treating that case differently from the diabetes one. Admittedly, such grounds might be available if it turned out that people who learn that their life expectancy is shorter than they thought experience a significant decrease in their subjective well-being.
What if it were not practically feasible to prevent insurance companies from using the results of such a test once it became widely available? Rather than trying to simply ban the test, we could promote fairness by having e.g. the insurance fees of people with short telomeres publicly subsidized (provided there were no reason for thinking that their telomere shortening was the result of their own chosen lifestyle). This would be a way of alleviating some of the inequalities resulting from the genetic lottery. Also, while the discovery that they had short telomeres might indeed have a negative impact on people’s subjective well-being and might lead them to turn to the wrong kind of source when searching for assistance, such information could also have positive effects if people were provided with appropriate advice from scientists and medical professionals. It could strenghten public support for serious research into life extension, and incite those at risk to adopt a healthier lifestyle.
The growing availability of genetic information does raise important ethical concerns, but such information can also be used so as to promote health, well-being, and even fairness and equality. It is up to us to try and ensure that the latter happens.