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Advances in medical care in recent years have enabled many people to live longer and have a good quality of life. Recently I was fitted with a small pump in the left ventricle of my heart. This means that although my quality of life is 100 times improved and I am able to live a reasonably normal life, I do need medical supervision, replacement batteries and equipment on a reasonably regular basis.

I have come to call life that is dependent on a level of continuing support "extra life". It is not quite the same as life before - it is life that would not be available but for help. I find that a number of people who receive continuous medical support agree with me that extra life is something different, a new phenomenon in human experience.

Let us imagine it is the year 2025 - medical advances enable people to live longer and with a good quality of life. Nevertheless they require continuing medical help. What will be the consequences for society of further extension of their life span? There are some people who believe - they are called "transhumanists" - that we will be able indefinitely to postpone death through improved medical technologies. So a longer-living, semi-dependent population may grow. This possibility, signalled as it is with current advances such as my pump, as well as in genetics and biotechnology, needs to be prepared for.

One way of preparing for this kind of future is to see what people in these early stages of life-extension technologies are finding. Five factors govern the appeal of extra life: relatively painless and convenient equipment and prompt and efficient maintenance; quality of life; personal independence; being able to carry on making a useful contribution to society; and the relief of anxiety, including about death. For me, looking death in the eye made me less afraid of it and that gives me a lot of will power to use my extra life well.

But extra life raises questions for the community. The growth of an older population in the last 100 years has had profound effects on society as it is. Now it seems possible we will extend survival and lifespan further. But can society sustain the cost of a growing aged or medically dependent population?

Can we increase and develop the contributions of older people to society, so as to enhance its wealth? How can extra life be a positive advantage to society? If life is prolonged, how are we going to deal with death? Should we have a right to die and, if so, under what circumstances?

These are large questions. With the support of the National Heart Research Fund, I have established a working party on extra life to explore these matters, and we have heard the views of all those engaged in social and community services. I hope that, for once, we can think about the future before it happens.

Peter Houghton is a retired sociologist and psychotherapist. E-mail: PieterVR@aol.com