Offering a medical prognosis has always been a nuanced business. Especially when it comes to that difficult question: “How long have I got, doc?”
We are not machines that march to a mechanical tune, and our body parts do not time-expire in the way a car engine might. So you can imagine my consternation when I came across a comment piece in a medical journal recently, asking: “Would you like to know the time of your death?”
Until now, I would have filed questions such as this under science fiction or the paranormal. It might pop up in a fortune-teller’s tent, I suppose, but in medical science? Definitely not.
But there it was. In the online medical journal Medscape, authored by New York University medical ethicist Dr Arthur Kaplan.
“Would you want to know the time of your death? It’s an ancient question. In Greek culture, people asked the Oracle of Delphi when they were going to die. Today, people have an endless fascination with knowing the date or the time of their death. It’s all over Hollywood movies and our literature, and it’s even in our science,” he writes.
His piece was triggered by some 2019 research from the University of Leiden in the Netherlands, published in the journal Nature Communications. According to Kaplan, scientists have come up with a test that uses 14 biomarkers, obtained by analysing a blood sample from an individual, "to predict pretty accurately when you're going to die". He says they now have a more sophisticated way of predicting within the next two or three years whether you are highly likely to die.
Would you line up for this test? I certainly would not. I would hate to have that knowledge hanging over me like a doomsday clock. It would surely make whatever years you have left miserable.
However, Kaplan reckons that many people would be fascinated by the possibility of knowing. "They would want to know because they would change their plans," he says. "They would take that cruise to Alaska this year instead of waiting until later. They might decide to spend more of their savings if they knew they were certain to die."
Insurance companies
He then says that “the moral issue around having a test like this isn’t really whether you or your patient would want to know. It’s the third parties who definitely want to know . . .”
Insurance companies and employers would be hungry for these test results, Kaplan reckons.
In the article responses a GP is sceptical. “If you think about the weather forecast, with elaborate algorithms and decades of extensive research, not mentioning centuries of observational wisdom, practically any prediction for next week gets quite fuzzy”.
Another doctor complained that “once again we are being governed by algorithms to which we have relinquished thinking/thought. We look upon results from algorithms as fact; as immutable truth when, in fact ,the results are statistical and rarely accurate to an individual but rather large samples of subjects.”
And a family doctor made the point that the proposed test cannot predict road traffic accidents, flu epidemics or plane crashes
Interestingly, when I looked up the original Nature Communications study, I discovered it found an association between the 14 biomarkers and five- or 10-year mortality; but an “association” is not the same as accurately predicting when you’re going to die; and it did not look at predicting to the two- or three-year time-frame mentioned by Dr Kaplan.
So it seems he used some artistic licence to tighten up the time-frame he wanted to include in his opening question, presumably for greater impact.
Nevertheless, I’d like to put this question to readers: would you take a blood test that predicted what year you will die?
Please email your answers (with some reasons) to mhouston@irishtimes.com and I will report back in a future column.