Map of life expectancy at birth from Global Education Project.

Monday, March 23, 2009

The disconsolation of philosophy

I don't have a big problem with mortality. Death is essential to life -- if organisms didn't get out of the way, they couldn't have progeny, there would be no evolution, and we wouldn't be here. Not to mention no nitrogen cycle or carbon cycle and hence most probably no biosphere of any kind. It's also not necessarily a bad thing that we know our time is limited so we'd better get off our lardbutts and accomplish something. Right now I need quite a few more years but definitely not eternity.

However, what I do have a big problem with is decrepitude. Our real worry should not be dying, but living too long in a helpless state. (While this may seem obvious to my typical reader, I hardly need remind you that it is the opposite of the view of the Christian champions of moral virtue, and the Republican Party.) The goal of medicine and public health should not be the arbitrary extension of life, but rather making sure we can cross the finish line under power. Unfortunately the Rule of Rescue (also see here) forces our research and treatment agenda off of that point. As we (I hope) embark on a new path of comparative effectiveness research and more rational allocation of medical resources, I hope we can find a way to make life, rather than the mere delay of death, the ultimate goal.

No comments: