Leaving no one behind: Ethical guardrails for geroscience research

If geroscience research delivers on its promise to increase healthy life years, societies around the globe will face profound moral questions. Unlike research addressing diseases such as cardiovascular disease, cancer, or diabetes, biological targeting of the process of senescence has a far wider, almost unprecedented sweep, potentially benefiting all people across the lifespan and future generations. This paper proposes that geroscience products must be allocated in a way that enhances global health equity, which requires setting an attainable, if difficult, goal of bringing everyone up to a minimal health span. After introducing the topic (in Section I), Section II responds to a range of ethical concerns geroscience research raises and argues that pursuing research in this area is a priority. Section III focuses on how to justly distribute possible future products of geroscience research and examines egalitarian, sufficientarian, and priority to the least well-off approaches. Section IV proposes a path forward that prioritizes ensuring people everywhere can attain health span sufficiency. Section V concludes that implementing the proposed approach will require large, collaborative efforts to be set in motion proactively, before inequities materialize. In this rapidly advancing field, there is an opportunity now to apply ethical forethought and planning.