Let’s talk: long life versus quality of life

Living a long life is often portrayed as the opposite of having a high quality of life: living longer means abstaining from all earthly goods, popping (medical) pills every day and keeping track of your blood pressure 24/7. But does filling your days with the joys of sweets, alcohol and sitcoms really amount to a quality life?

While appealing, I happen to disagree. Life expectancy has increased dramatically in the last 50 years (from 48 in 1950 to 67 in 2010). Nevertheless, the age at which people begin to experience physical consequences of ageing and chronic diseases has not changed. People now live longer yet struggle with health issues for a longer period of time, which translates into an increasing number of older and sicker people to take care of.

Retirement age

One way to tackle this is by doing research into prevention of ageing-related issues and getting the ageing population more involved in the labour market. How old should a person be before he or she gets to retire? 85? That’s not an impossibility. Here in the Netherlands, the retirement age is currently being pushed back one year every three years. At the moment, the retirement age is 65, but by 2024, it should be raised to 67.

The Dutch approach is to target work-related participation of the aged community. Even though the combination of overall better living conditions and accompanying medical research has led to longer life expectancy, it doesn’t necessarily follow that we ought to spend more time at our work places.

‘Health inequality stands in the way of universalizing retirement age’
Additionally, providing the means to extend the number of healthy years to the whole population, not only to those who can afford it (which is influenced by socio-economic factors), remains a great obstacle: health inequality stands in the way of universalizing retirement age.

Only once that is achieved can we begin to re-negotiate the duties of our citizens and arrive at a better way to ensure participation of ageing segments of society without necessarily keeping people in the office until they eventually have to be carried out in a coffin.

Personal responsibility

The underlying reason behind the changing role of the state in determining health policies is the notion of personal responsibility. The days when the government was prophesying the evils of alcohol consumption and cigarettes are well behind us, but in this modern age where more people suffer from obesity and lack of physical activity than health issues caused by smoking, these ailments are seen as a lack of personal responsibility precisely because those choices do not directly promote the possible extension of ones’ life.

So, in an attempt to make people more ‘responsible’ for their lifestyle choices, seniors are advised to get regular body scans and invest more money in personal health care funds. Focusing on personal responsibility is a good way to proceed, albeit with caution. It is important to keep in mind that we are not all equally capable of taking responsibility for our lifestyle choices and thus promoting the ultimate extension of our lives.


The mere fact that some people can afford better nutrition, better access to medical assistance or simply able to live less stressful lives should be important when promoting the idea of personal responsibility being the sole determining factor for ones’ healthy ageing. There are other undeniable factors at play.

‘The unexamined life is not worth living’
But what does it mean to lead a good life? As Socrates reportedly once said, ‘The unexamined life is not worth living’. If I think about it, this statement can help me to look at the debate about long life versus quality life in a different way. It doesn’t focus on either side in particular, but argues instead for the importance of examining, researching and exploring our time here – the so-called proceduralist approach.

Although intuitively appealing, we have yet to work out how to close the gap between years lived and healthy years. Socrates’ view doesn’t consider the never-ending extension of ones’ life as the ultimate goal, nor does it identify personal responsibility as the main determining factor in whether one will or won’t succeed in reaching that goal. Instead, it focuses on the processes that make ones’ life meaningful and allows each of us to determine what his or her life project should look like. Better yet, by focusing on the processes that make ones’ life worth living, I think that the ideas of living long are not endangered but rather promoted in a better way.