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Disease & the death rate

April 2004

Reminding us that all the medical research in the world, and every conquest of a lethal disease, has only minimal effect on life and death, at least in advanced nations.
It has been reported that the death rate from cancer is going down. This is good news, I suppose. But what has not been publicly reported is that death rates from other diseases have gone up in compensation. The death rate is constrained by the fact that we must all die. The only variable that determines the overall death rate of a population is life expectancy. The "death rate" reported by social statisticians is "deaths per 100,000 persons per year". This is simply the inverse of life expectancy. That is, if the average life expectancy is 75 years, one-seventyfifth of the population will die each year. The "death rate" then is one-seventyfifth of 100,000, or 1333 deaths per 100,000 persons per year. If life expectancy is raised to 76 years, the overall death rate will be 1316 per 100,000 per year.

So the good news from the cancer front is that fewer are dying of cancer. But the result of this success is that more are dying from other causes. In other words, since we must all die, as we reduce the proportion of deaths from any one cause, we increase the proportion from all other causes. In general, the effect of vanquishing any killer disease is a slight increase in life expectancy, and thus a slight decrease in the annual overall death rate. As we proceed through the catalogue of killer diseases (cancer, heart disease, stroke, etc) we find that we are more and more dealing with terminal diseases of the old. Many of these were formerly known as "dying of old age", something which is no longer allowed. But as we approach the limits of life expectancy decreed by immutable and irreversible changes in our cells, we will soon not be able to change the overall death rate significantly, nor is there any reason why we should expend effort to do so. Therefore, our effort to combat any leading cause of death amounts to a decision that more persons ought to die of some other cause than the one being combatted.

The key point is that everyone who dies, dies of something. Some cause of death will always be our leading cause of death. Vanquishing the current leading cause of death only shifts the emphasis to the next leading cause, since its proportion will have gone up as a result of beating back the previous leading cause. We have now come to the point where it becomes necessary for us to decide what diseases people should be allowed to die from. Many of our current leading causes of death, such as heart disease, are in part a natural result of the aging process. To deal rationally with the problem of aging, disease, and dying, we ought to adopt these principles:

  1. Death is the natural consequence of life. Everyone has a right to die when his time comes.
  2. Research toward the cure of disease should concentrate on diseases which cause premature death, not simply causes of death.

Aging leads to death, as surely and naturally as sunrise leads to sunset. Trying to prevent the sunset is a fool's employment.
© 2004 H. Paul Lillebo

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