It's plausible that medical advances will mean that, probably at a huge cost, we will be able to extend our lives a lot longer than people used to expect to live. I'm thinking something like 500 years or so of quality life. Presumably limited resources and things would mean that less children would be born, or that most people on earth would be stuck with poor and shorter lives. Would it be wrong to make use of such an opportunity?

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If the very expensive life extension you envisage is available to all, one might defend it as a permissible collective choice. Of course, there would be fewer births, and fewer deaths, each year -- perhaps just 20 million annually instead of 125 million on the assumption of a steady human population of 10 billion. (Currently, there are about 131 million births and 57 million deaths each year.) Such scarcity of children would change our social world considerably. But I do not see how it would be wrong for humankind to move in this direction.

Serious moral problems arise when we envisage the (more likely) possibility that such expensive life extension would be available only to a minority while its great cost would contribute to most people on earth leading short and miserable lives. To a large extent, this sort of dramatic inequality in health and life expectancy is already a reality today. About one fifth of all human lives are cut short by poverty-related causes before the age of 5. One important causal factor here is that pharmaceutical research is incentivized by offering inventor firms monopoly pricing powers as a reward. The foreseeable result of such a scheme is that new medicines are priced out of reach of poor populations and that pharmaceutical companies ignore the special health problems of the poor populations.

Both problems would be solved if research and development of any new medicine were rewarded, out of public funds pooled globally, in proportion to its health impact which, in the context of your question, might be defined in terms of healthy years of life. Under such a scheme, the intellectual achievement embedded in medicines would be freely available as a public good, and competing pharmaceutical manufacturers would drive the prices of medicines down to near their marginal cost of production.

If pharmaceutical inventor firms were incentivized in this way, they would concentrate their efforts on the most cost-effective health improvements. Given that it is much cheaper to secure additional years of life to children and young adults among the global poor than to prolong the lives of people in their 80's and 90's, pharmaceutical companies would give priority to the former task. These efforts would cause the average human life expectancy to increase sharply and inequalities in life expectancy to drop dramatically. As the cheaper life-extension opportunities get exhausted, pharmaceutical inventor firms would then gradually be drawn toward developing medicines that would prolong life beyond the 90's. Humankind would progress toward your 500-year milestone -- together.

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