Reply to Harris.

Abstract

John Harris and I disagree on the implications of a substantially extended human life span for our identities as persons and our prudential concern about our future selves. His incisive critique of my paper underscores the need to further elaborate and defend my main claims and arguments. I cannot address all of Harris' points, but will limit my remarks to those that are the most challenging to my position. Harris says that I advance vague claims about the undesirable effects of increasing population. But an extended human life span of 150±200 years would mean that more people would be living at the same time over a significantly long period. Surely, this would increase competition for resources like clean water and air, as well as food, especially in developing countries. Given the collective effects of everyone living longer, it would not be in each person's best interest to extend his or her life. In developed countries, substantially extended lives would be problematic because people would be using health care services over a much longer period. Since health care is a scarce resource inevitably requiring some form of rationing, health care systems that gave equal weight to the needs of all people at all stages of life would have to limit medical services in the last stage. This would be especially difficult for the very old if an extended life involved a long period of physical and cognitive decline. On the other hand, if priority in allocating scarce medical resources were given to some people in the last stage or stages of an extended life, then the needs of other people in early and middle stages of their lives might not be adequately met. This would be unfair to them. In terms of global justice, there would be another dimension of unfairness in using medical resources to extend people's lives. Ensuring that those who are worse off because of disease have the opportunity for a normal life span of 85 years or so has more moral weight than extending the lives of those who are better off because they are healthy and already able to have a normal life span. These reasons are stronger when one considers that lifeBioethics ISSN 0269-9702 Volume 16 Number 3 2002