Originally published in Medium’s “In Fitness And In Health” on April 27, 2021.
If you could stop a car accident before it happened, would you?
I’m sure most of us would say yes.
But if today you found out that you had a high chance of developing liver cancer due to your genetics, would you still drink alcohol? That’s a much more complicated question.
In the future, it’s entirely possible that biomedical diagnostic tools will be able to predict illnesses years before they occur. This test is already doing that for Alzheimer's, and it’s entirely possible that these types of tests will one day be available for many other health issues, like cancer or even viruses.
If you took a blood test today that told you that you were going to develop Alzheimer's disease within the next decade, what would you do? Would you change your behavior, or would you regret taking the test and pray for the eternal sunshine of a spotless mind?
Do You Trust the Algorithm?
This is the part where I let you know that I am not a doctor and I’ve never been trained to be one, so I’m sorry to the med students and doctors in advance if I botch my interpretation of the latest in biomedical technology. Feel free to yell at me or correct me in the comments section.
I first learned about the ethical dilemma created by these predictor tests from Yuval Noah Harari’s 21 Lessons for the 21st Century, where this idea is used as one of the main points to illustrate that “Big Data” algorithms are not-so-secretly gaining more and more control of our lives.
The book prompted me to go down a deep dive into current biomedical diagnostic tools and how the tools are improving and evolving as we head toward the quarter point of the 21st century.
So let’s go back to those psychic blood tests that predict diseases before they occur. What’s really happening there?
From my understanding of diseases like Alzheimer’s and cancer, these tests would mean that the soon-to-be sufferers would have time to adjust their lifestyle, begin treatment, and make the changes that would hopefully deflect the severe symptoms caused by the diseases.
The technology could save countless lives. Yet, it could also create countless problems.
What Would Happen Next?
If we could predict all illnesses 15 or more years before the onset, what would happen to life as we know it?
Logically, it appears that those who test positive would become more expensive to insure, making it more difficult for them to get access to potential treatments and healthcare resources that could help prevent the onset of their future illness. Worst case scenario, their test results would create a snowball effect that could potentially make them unhealthier.
Suddenly, the results of the tests that determine one’s risk of cancer or Alzheimers will carry the same stigma as obesity does. Obesity makes health insurance more expensive, and you can even be denied coverage due to your weight or BMI.
The problem with these new tests is not going to be whether or not they work, the problem is going to be this: how should we be allowed to use them?
Furthermore, no one is 100% healthy. Not even that “fitness goddess” from your Instagram feed. Heck, especially not her. Perfect health doesn’t exist. Until immortality is biohacked, from the moment we are born, we start dying.
Okay, it sounds a bit cynical, but the point of this article isn’t memento mori, the point is that we’re never going to be 100% healthy. The better the tests get, the easier it is going to be to consider yourself “sick” or “unhealthy”. The future of healthcare will be either a hypochondriac’s wet dream or their worst nightmare, depending on their test results.
The question is, do you want to know just how unhealthy you really are? More importantly, do you want other people to know as well?
Will These Tests Change Our Behavior?
You don’t need a scholarly article or blog post from a Ph.D. to tell you that humans suck at being patient. Here’s one anyway though, for good measure.
It’s pretty common knowledge that eating too much will make you obese and that obesity will lead to heart disease, along with a slew of other health problems. Nevertheless, billions of people worldwide are overweight and several hundred million people are obese.
So what gives? Is it character flaws that cause lifestyle-related illnesses? Are humans meant to do things that kill us? Is pursuing perfect health even a desirable goal?
When given the choice, studies seem to show that most people will prioritize the present over the future when given the option. There’s also a public consensus that being disciplined is healthier, but this isn’t really profound news either. Forgoing instant gratification is a crucial aspect of becoming successful, healthy, and happy.
Or is it?
The desire to become disciplined comes down to individual autonomy. In 21 Lessons, Harari believes that we’re about to lose this as well. Society is conditioning us to become mere objects in an algorithm that is designed to keep society functioning. The humanization of predicting future illnesses is going to be a leading force in the dehumanization of those who are deemed “unfit” to survive.
That is the danger of biomedical technology that is designed with evolution in mind. The “survival of the fittest” means that you might not survive. Do you really want to know your chances?
Closing Thoughts
I don’t know what the right solution to all of this is. I certainly don’t want more people to die from Alzheimer’s or cancer. I already know too many people who have lost their lives to these conditions and the thought of seeing more people go erks me at my core.
Yet, I also see the bright side of these new tools.
My world revolves around sports. In the sports world, improved modern medicine is seen as something that’s going to prevent athletes from getting injured and elongate their careers. Until today, I’d never considered that perhaps in the future, modern preventative medicine could also be the reason that many people choose to not play sports.
It seems that the answer to these scientific problems isn’t only scientific, it’s also ethical. The future is going to be defined by how science and ethics are able to work together to solve problems and improve human life.
I just hope that it’s not too late.
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What I’m Reading
As I mentioned in the article, I’m currently nose-deep in Yuval Noah Harari’s 21 Lessons for the 21st Century. I’m a huge fan of Harari’s writing style and his “no bullshit” approach to the future of humanity. I also enjoyed Sapiens by Harari as well, which I read back in January. All of his books are well-researched and in-depth explorations into the nature of humanity and the intersection between science, fiction, and the future of life on earth.
As always, if you enjoyed what you read, please share, tell your friends, or reshare the article from Medium. It helps me more than you know.
Wishing you the best,
—Chris