Abstract
In this paper, I will argue that ageing can be construed as disease. First, the concept of disease is discussed, where the distinction is made between two lines of thought, an objectivist and a subjectivist one. After determining the disease conception to be used throughout the argument, it is proposed that senescence could be seen as disease. Three common counterarguments are discussed, none of which appears strong enough to effectively counter the advocated view. In the third section, two potential implications of the view advocated here will be briefly touched upon. These are the quest for a cure or treatment for ageing and the general attitude towards the elderly. It is concluded that, utilizing an objective disease concept, ageing could be seen as a disease. None of the considered counterarguments packs enough of a punch to discard this. The implications are complex and intertwined, but need not be negative.
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Notes
One could also follow the ideas of Hesslow (1993) and Kincaid (2008), who state that a disease concept is not necessary for clinical thinking and decision making. This, however, will not be pursued here, as the goal is to determine whether a certain phenomenon is, or is not, a disease. Some conception of disease is thus required.
Note, however, that this does not impinge upon the increasing relevance of personalized medicine. A different approach to treatment does not mean that the underlying disease can’t be diagnosed according to general standards. For example, while the flu might be treated differently in a person of advanced age (perhaps through medication) and a younger adult (a few days of rest), this does not imply that the diagnosis was based on different standards.
Assuming normal segregation during sexual reproduction.
The intricate issue concerning clonal organisms will be ignored here (see, for example, Sköld and Obst 2011).
This statement by Gems (2011a) actually refers to the first kind of universality, but there is no reason why it can’t be extended to the second type, as the statement is founded in the observation that “ageing is essentially a multifactor genetic disease”. This realization applies to ageing in organisms other than human beings as well.
It is not the goal here to dwell on the complex debate concerning the correct interpretation of biological function (for an overview, see Wouters 2005). For the purpose here, it suffices to understand a biological function as something that can be explained in terms of contributing to survival and/or reproduction.
But what is natural? See the previous argument from naturalness for more about this.
Along this line, Izaks and Westendorp (2003) propose to avoid the distinction between ‘normal ageing’ and processes causing disease later in life. This could be interpreted as stating that normal ageing and age-related conditions are manifestations of the same disease, i.e. the ageing process.
A point proposed to me by Dr. Jonathan Grose.
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Acknowledgments
Many thanks to Dr. Jonathan Grose, whose constructive comments were a great help in improving earlier drafts of this paper.
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De Winter, G. Aging as Disease. Med Health Care and Philos 18, 237–243 (2015). https://doi.org/10.1007/s11019-014-9600-y
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DOI: https://doi.org/10.1007/s11019-014-9600-y