"... I'd type a little faster."

Reason’s science correspondent Ronald Bailey expects to die on September 4, 2027. Well, no, not really. He derived that date from a whimsical little internet site called the Death Clock, according to which I died on July 18, 1995. ("Either this man is dead or my watch has stopped." - Groucho)

Less whimsically, Bailey wrote recently (and spoke today on NPR) about emerging diagnostic technology that will permit individuals to learn their likely life expectancy with far more than mere actuarial probability. Some of these tests for some sorts of likely fatal illnesses exist already. More such tests for more such diseases are on the horizon.

Bailey’s not unreasonable position about such advances is that they are a good thing; that the average individual should both want and have access to such information. The medical community, on the other hand, is a bit more conflicted. Physicians regularly tout the life saving advantages of routine examinations of various sorts designed to provide early detection of illnesses for which, if caught in time, viable treatment options and a more successful prognosis are possible. But doctors don’t like giving bad news, whether the bad news is that you’re going to die in a matter of months or, assuming you would otherwise likely live longer, some five or ten years from now because of some fatal disease or disorder.

I admit to being somewhat conflicted myself about having access to such information. As Bailey correctly argues, the individual who is aware of the time and nature of his likely demise is better equipped to make the most of what time remains. In some cases, he is also better equipped to take whatever measures may be available, if not to avoid, at least to postpone that fate. Eventually, perhaps, a more advanced medical technology will allow us not only to identify such genetic diseases but also to cure them. "Eventually", however, may well be a long time away. The question for now is whether or how to use the information in the meanwhile.

Would the average person really profit from having such information available to him? I don’t know. I remember a television series from the 1960’s called Run For Your Life about a man named Paul Bryan who, being told by his doctors he had at most a year or two to live, set off to squeeze out every moment of his remaining time. Of course, it helped Bryan that he had a lucrative law practice to cash in and make the run possible. A show based on the remaining days of Paula Bryan, former librarian, would have suffered from far fewer exotic locations. (The show, by the way, lasted three seasons. Apparently you can get a temporary reprieve from death with high enough ratings.)

Knowing in one’s youth that one had a shorter than normal life expectancy, say only twenty more years, would indeed drive career, lifestyle and even family decisions. But how would the typical person really react to such news? As matters stand, the only two sorts of people who know the exact time and place of their death are suicides and death row inmates. Neither are role models to which the typical person aspires. Indeed, when doctors do have to break the bad news to patients, their doing so is commonly referred to as “delivering a death sentence.” No wonder physicians shy away from that part of the job.

If the only question is whether people have a right to discover, for better or worse, such information about themselves, I agree wholeheartedly with Bailey that they should. As to whether they should seek such information, well, that’s a bit trickier.

Far more troubling, however, as the technology for such information becomes available (and indeed it increasingly will), is who other than the patient will have, indeed, will require such information. Will life and health insurance companies demand such information as a precondition of coverage? It certainly seems likely that they will and, moreover, that those of us who come up losers already in the genetic lottery will find ourselves doubly stricken as we therefore become unable to secure either health or life insurance sufficient to care for our health needs when the inevitable occurs or for our survivors afterward.

Insurance is, after all, about pooled risks. It is, if you will, a sensible way of dealing with ignorance. Perhaps it will not remain a viable way to finance health care or survivor needs in a future in which such ignorance is increasingly replaced with knowledge. For better or worse, however, this is the system we have for now and these are issues that must be confronted and resolved.

(Title quote from Isaac Asimov: "If my doctor told me I had only six minutes to live, I wouldn't brood...")