The Jezebel Assisted Living complex in Pinehurst, Florida is in uproar. More than 20,000 people live here, their daily activities governed and supported by robotic assistants. The youngest person living there is Amy Sauls, at 202.

“They won’t let us die,” growls Robert Matthews, 222. “I have been confined to this bed for 50 years. I can barely move my head. Why should I go on living?”

“Because, it’s the law,” says District Attorney Colin Forbes.

Advocates of assisted dying point to the 270 million people over the age of 180 living in care-homes worldwide. Many are alive only because of the sophistication of modern medical techniques. Almost 50 million are – like Matthews – immobile and entirely reliant on nursing robots.

“We fully expect that we can prevent the onset of death indefinitely,” says Dr Rupert Pinker at the New York Medical Center. “Quality of life may become an issue, but I’m sure we will resolve that eventually. And our patients will certainly live long enough for us to figure it out.”

“Surely, if medical advances can extend our lives indefinitely, we should have an equal and humane choice as to the time of our going? Even if that means assisted dying,” says Diane Ignatius of HUMANE, an advocacy group.

At Jezebel, the robots go about their daily task, keeping alive thousands of people who would rather die.

ANALYSIS >> SYNTHESIS: How this scenario came to be

Background
As the capacity for medicine permits people to be maintained in a state of life – conscious or not – continues to increase, the impact on society – both social and economic – grows. Longer life-spans imply a greater cost for ever-longer retirement, as well as the direct cost of medical treatment for the maintenance of that lifespan. It also has social implications, creating a drag on social change: the elderly vote more, and more often, and usually against the types of policies that would benefit everyone else.

What happens, though, when the elderly living long to die, but may not?

2007-2011: Terry Pratchett has Alzheimer’s
In December 2007, Terry Pratchett – noted author of the Discworld series of fantasy novels and seller of over 70 million books worldwide in thirty-seven languages – announces that he has Alzheimer’s Disease.

In 2008, he commits US$ 1 million to the Alzheimer’s Research Trust, but admits that he does not expect a cure in his lifetime.

In 2010, in the annual BBC Richard Dimbleby Lecture, entitled Shaking Hands With Death, he calls for a tribunal which would oversee a policy of assisted dying. “I would also suggest that all those on the tribunal are over 45, by which time they may have acquired the rare gift of wisdom, because wisdom and compassion should, in this tribunal, stand side-by-side with the law. The tribunal would also have to be a check on those seeking death for reasons that reasonable people may consider trivial or transient distress. I dare say that quite a few people have contemplated death for reasons that much later seemed to them to be quite minor. If we are to live in a world where a ­socially acceptable ‘early death’ can be allowed, it must be allowed as a result of careful consideration.”

The British government rejects his suggestion.

2050: US average lifespan reaches 94
“The economic implications for the US economy are huge. We estimate we will be spending US$ 12.3 trillion per year more than was projected back in 2020,” says Leroy Olshansky, a professor in the school of public health at the University of Illinois at Chicago.

The official retirement in the US, UK and Japan – the world’s most extreme – is only 69. In France and much of Southern Europe, it is still only 65. The World Health Organization estimates that some 115 million people are now institutionalized with advanced forms of dementia.

“The catastrophic cost is driving millions of households below the poverty line,” warns the agency’s director-general, Margaret Chan.

“We’ve been betting against a basket of European currencies for the last six months,” says Harry Burnett, currency trader at China Goldman Sacks, in April. Speculation against Western European countries has been growing amidst the expected default of their 2050 sovereign bond repayments.

GSK Rambaxy chooses exactly this moment to announce a new drug breakthrough. “After 20 years of research, we are able to announce that our new Buckminster fullerene polymer has passed regulatory approval and will be available for sale. We can guarantee that it will double our lifespans.”

Under the name Longlivity, GSK Rambaxy’s new drug is met with unprecedented demand, as well as social outrage. The expectation is that this will place an impossible demand on social services.

US President, Sheila Menendez, makes an unprecedented appearance before Congress in late August to make the following announcement: “We recognize the incredible opportunity presented by Longlivity. We also recognize the potential cost to our society, which is why we are passing the Long Life Act, effective immediately. Anyone taking Longlivity will now only be permitted to retire at the age of 140. This retirement age will be monitored and, if found to be too limited, extended.”

In Europe, in December, French president Dieter Croez admits: “Our pension fund is broke. France is bankrupt.” Outside, stock exchanges go into free fall.

2100: The benefits of 120 years of pension savings>
“I’m the first person to retire at age 150,” says Robert Matthews, an engineer at Samsung Boeing. “I’ve got 120 years of pension savings due me and I expect to live another 60 years. It’s going to be fantastic.”

The economic dividend of sending the elderly back to work is finally bearing fruit. “When 70-year-olds started going back to university 50 years ago, so that they could retrain, we had no idea we were entering such a productive age,” says Maggie Chen, a social historian at Shanghai University. “Life has become extremely precious. I fully expect that, within my lifetime, we will abolish death entirely.”

The World Health Organization now projects that life-expectancy should hit 190 by 2150. “We’re not quite sure what the implications of this are,” says Honway Singh, at the WHO. “Fifty years ago we were worried about pensions running out of money. Now it’s almost impossible for that to happen. The individual investment is just too great. Even the French are now working till 120.”

“I believe the next danger is what happens when our bodies just start wearing out,” says Heidi Fleisch, at the Cato Institute. “Our legislative attitude to assisted dying has become even more antagonistic. Everywhere the expectation is not only that we should be grateful for living longer, but that we should be compelled to.”

2172: Few die and even fewer are born
“The average age is continuing to rise even as the population size stabilizes,” says Newman Watombe, at Nairobi Metropolitan University in Kenya. “I am told there were no new births in all of Kenyatta State in the last six months, and only three deaths.”

“We can keep people alive indefinitely, now,” says Dr Kubule Razza, at Shisonge Hospital in Budapest. “I’m not sure it is something we should be doing, but it is something we can do.”

At the Jezebel Assisted Living complex in Florida, the long-term residents are realizing the implications of such healthcare. “They won’t let us die,” growls Robert Matthews, 222. “I have been confined to this bed for 50 years. I can barely move my head. Why should I go on living?”

“When living forever is a given, surely we should be able to choose for ourselves how long that should be?”