Ethical implications of predicting impending natural death
balancing risks and benefits of a powerful tool
20 09 2020
Ethical implications of predicting impending natural death

Approximately 10% of the world GDP is spent every year in health expenditures, half of it during the last year of life. What if we could identify that last year ahead of times? What would be the benefits for doctors, patients and their family? For the economy? And more importantly, what are the risks we would be facing as human societies?

In the past few years, research articles identifying physiological or metabolic parameters enabling 6-8 years high-risk of death from any causes have started to be published. Moreover, work from our team shows the existence of strongly stereotyped end-of-life events broadly conserved through evolution. Taken together, these elements suggest that the ability to predict high-risk of death from any causes at the individual level is within reach.

In this work recently published in BMC Medical Ethics, we discuss and try to outline the most important questions raised by such incoming possibility using philosophy, clinical psychology, actuarial mathematics and Intensive Care Units medecine. From questions and answers brought by philosophy that "has paid much attention to the meaning of the mortal condition" to Psychologists "working with people suffering from life-threatening conditions" we outline the similarity of predicting high-risk of impending death in a healthy adult to the experience associated with Huntington's disease early diagnostics. We also discuss the potential benefits for personalized medicine that could be better fitted to someone's physiological age and counter balance it with possible devastating side-effects regarding "the design of state pensions and long-term care systems [that] could be modified". The most important question we outlined is simple, "which institutions, if any, should have access to information on death predictors?". In addition, who will be in charge of checking on the use of such data, for how long? and shouldn't we address such question in the context of a broader audience?

More details here in a French talk that occured on December 4th, 2019 at the Ministère des Solidarités et de la Santé in the context of the Plateforme Nationale de Recherche sur la Fin de Vie.

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