Health and happiness still key as we live longer

Originally published in The Ottawa Citizen September 10, 2002
Original Title: Live Long and Prosper: Longevity is for Vulcans

Man would die, though he were neither valiant, nor miserable, only upon a weariness to do the same thing oft, over and over.

– Francis Bacon (1561 – 1626, English essayist, philosopher)

If life were eternal all interest and anticipation would vanish. It is uncertainty which lends it satisfaction.

– Kenko Hoshi (14th century A.D., Japanese Buddhist)

Recent and projected health technology and treatment advances pose interesting dilemmas regarding the human lifespan. Nanotechnology, stem cell research, gene therapy, new drug therapies, cancer vaccines and electromechanical life support devices are just a few of the lines of research and development in our quest to cure disease and maintain our health. These are indeed exciting times.

Medical advances to date have increased the average life span to about 81 in women and 76 years in men respectively (StatsCan). Let us assume that these technological advancements over the next 50 to 100 years will increase the human lifespan to 90 to 105 years of age. Will we attain a long and healthy life?

One hundred years ago no one thought the elimination of Tuberculosis, pneumonia, diarrhea and enteritis (bowel infection and inflammation) and other infectious diseases would lead to unimagined new diseases. Modern day scourges such as breast, lung and colon cancer, heart disease, Type 2 Diabetes and Alzheimer’s require time to develop. As life span increases, so too does the incidence of these diseases. Although women live longer than men in Canada, some of those extra years are spent in disability.

What will happen when we cure them? Can we presume we will live longer still? Living longer does not necessarily mean people will be happier or have a better quality of life. The benchmark for happiness is not entirely based upon how long we will live. Consider the social, economic and health impact of these changes.

From a social standpoint there will be a greater proportion of elderly people living past 100 years of age. Assuming they are in good health, will they continue to contribute to society for a longer interval of time? Younger people may find that the job market becomes tighter as the older folk wish to continue their endeavours. Pension plans would have to compensate for this longer-living population. The mandatory retirement laws (age 65) would have to be reexamined. Would people want to retire with 30 to 40 years left in their lives? They would be just past middle age if compared to present day.

If we achieve long life but now contract an as yet unknown disease at age 90 or 100, how would this affect quality of life? How will families adapt to this rapid change? Our experience to date concludes prolonged life will not be synonymous with complete health and independence. Will 70 year old children have to support their 100 year old parents? If they are unable to do so, will it fall upon their 40 to 50 year old children to support both parents and grandparents alike? If the burden becomes too great, the onus will fall upon the state to provide the care. Yet the state cannot handle today’s demands for long-term care. Already in some small rural villages in Japan, because the young have moved away for jobs, 70 year-olds are looking after 90 year-olds.

In 1900 only half of the population could expect to live to 21 and still have both parents living. In 2002 only half of the population when they are 21 live in a family in which both their parents are still married to each other. How many step-parents and step-grandparents will children have if the older generation live to 100 and divorce as frequently as they do now?

Talk to people who have lived long and full lives. Many remark that they are not afraid of death but of how they will die. They do not wish to live an additional 20 years if it means prolonged suffering. They want to remain healthy and not be a burden their families.

Is the quest for longevity more a desire of younger individuals when life is full of new and exciting opportunities? The idea of a hundred years of excitement and experience is compelling.

Will we see “life fatigue” if we live too long? The idealism of youthful desires may create a self-inflicted purgatory in their future. You cannot go back in time to reduce life expectancy. Rather than living with 20 years of disability after one organ system failed, would the ideal situation be if all organ systems failed simultaneously at 95?

Technological advances would be restricted at first to those who have the ability to pay. Our present health care system does not have the capability to provide these expensive new therapies. Nor does it have provision or adaptability to accommodate rapid technological advances in the forthcoming decades. If we are unable to reduce hospital backlogs with people lying on the floor for lack of beds, a problem that grows worse with time how will the system incorporate state-of-the-art medical care and therapy?

A change in one life variable does not necessarily equate with concomitant improvement in other life variables. For example, how will it affect our criminal justice system’s sentencing decisions? What about RRSPs, life insurance, disability and social assistance programs? How will they change?

In a stochastic system there are many possible outcomes. Isaac Asimov and Arthur C. Clarke among others wrote stories examining the consequences of long life. They caution us about life for life’s sake. What makes us human is our mortality. Our present lives should be as healthy, productive and free of unnecessary hardship, suffering and pain as possible. We have to be careful not to wish for more than we can handle.

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