Skip to main content
Top
Published in: Medicine, Health Care and Philosophy 2/2015

01-05-2015 | Scientific Contribution

Aging as Disease

Author: Gunnar De Winter

Published in: Medicine, Health Care and Philosophy | Issue 2/2015

Login to get access

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.
Footnotes
1
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.
 
2
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.
 
3
This debate is reminiscent of the one concerning the disease status of obesity. In that issue as well both proponents (e.g. Jung 1997; Bray 2003) and opponents (e.g. Heshka and Allison 2001; Chaput et al. 2012) can be found.
 
4
Assuming normal segregation during sexual reproduction.
 
5
The intricate issue concerning clonal organisms will be ignored here (see, for example, Sköld and Obst 2011).
 
6
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.
 
7
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.
 
8
But what is natural? See the previous argument from naturalness for more about this.
 
9
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.
 
10
A point proposed to me by Dr. Jonathan Grose.
 
Literature
go back to reference Boorse, C. 1977. Health as a theoretical concept. Philosophy of Science 44(4): 542–573.CrossRef Boorse, C. 1977. Health as a theoretical concept. Philosophy of Science 44(4): 542–573.CrossRef
go back to reference Boorse, C. 1997. A rebuttal on health. In What is Disease?, ed. J.M. Humber, and R.F. Almeder, 3–134. Totowa, New Jersey: Humana Press. Boorse, C. 1997. A rebuttal on health. In What is Disease?, ed. J.M. Humber, and R.F. Almeder, 3–134. Totowa, New Jersey: Humana Press.
go back to reference Bowling, A. 2007. Honour your father and mother: ageism and medicine. British Journal of General Practice 57(538): 347–348. Bowling, A. 2007. Honour your father and mother: ageism and medicine. British Journal of General Practice 57(538): 347–348.
go back to reference Bray, G.A. 2003. Obesity is a chronic, relapsing neurochemical disease. International Journal of Obesity. 28(1): 34–38.CrossRef Bray, G.A. 2003. Obesity is a chronic, relapsing neurochemical disease. International Journal of Obesity. 28(1): 34–38.CrossRef
go back to reference Caplan, A.L. 2004. The “Unnaturalness” of Ageing—Give Me Reason to Live! In Health, disease and illness: Concepts in medicine, ed. A.L. Caplan, J.J. McCartney, and D.A. Sisti, 117–127. Washington: Georgetown University Press. Caplan, A.L. 2004. The “Unnaturalness” of Ageing—Give Me Reason to Live! In Health, disease and illness: Concepts in medicine, ed. A.L. Caplan, J.J. McCartney, and D.A. Sisti, 117–127. Washington: Georgetown University Press.
go back to reference Chaput, J.-P., É. Doucet, and A. Tremblay. 2012. Obesity: A disease or a biological adaptation? An Update Obesity Reviews 13(8): 681–691.CrossRef Chaput, J.-P., É. Doucet, and A. Tremblay. 2012. Obesity: A disease or a biological adaptation? An Update Obesity Reviews 13(8): 681–691.CrossRef
go back to reference Cooper, R. 2002. Disease. Studies in History and Philosophy of Biological and Biomedical Sciences 33: 263–282.CrossRef Cooper, R. 2002. Disease. Studies in History and Philosophy of Biological and Biomedical Sciences 33: 263–282.CrossRef
go back to reference Daniels, N. 1985. Just health care. Studies in philosophy and health policy. Cambridge: Cambridge University Press. Daniels, N. 1985. Just health care. Studies in philosophy and health policy. Cambridge: Cambridge University Press.
go back to reference Daniels, N. 2000. Normal functioning and the treatment-enhancement distinction. Cambridge Quarterly of Healthcare Ethics 9(3): 309–322.CrossRef Daniels, N. 2000. Normal functioning and the treatment-enhancement distinction. Cambridge Quarterly of Healthcare Ethics 9(3): 309–322.CrossRef
go back to reference DeVito, S. 2000. On the value-neutrality of the concepts of health and disease: Unto the breach again. Journal of Medicine and Philosophy 25(5): 539–567.CrossRef DeVito, S. 2000. On the value-neutrality of the concepts of health and disease: Unto the breach again. Journal of Medicine and Philosophy 25(5): 539–567.CrossRef
go back to reference Engelhardt, H.T. 1975. The concepts of health and disease. In Evaluation and explanation in the biomedical sciences, ed. H.T. Engelhardt, and S.F. Spicker, 125–141. Dordrecht: D. Reidel Publishing Company.CrossRef Engelhardt, H.T. 1975. The concepts of health and disease. In Evaluation and explanation in the biomedical sciences, ed. H.T. Engelhardt, and S.F. Spicker, 125–141. Dordrecht: D. Reidel Publishing Company.CrossRef
go back to reference Finch, C.E. 2009. Update on slow ageing and negligible senescence–A mini-review. Gerontology 55: 307–313.CrossRef Finch, C.E. 2009. Update on slow ageing and negligible senescence–A mini-review. Gerontology 55: 307–313.CrossRef
go back to reference Gems, D. 2011a. Ageing: To treat, or not to treat. American Scientist 99: 278–280.CrossRef Gems, D. 2011a. Ageing: To treat, or not to treat. American Scientist 99: 278–280.CrossRef
go back to reference Gems, D. 2011b. Tragedy and delight: the ethics of decelerated ageing. Philosophical Transactions of the Royal Society B 366: 108–112.CrossRef Gems, D. 2011b. Tragedy and delight: the ethics of decelerated ageing. Philosophical Transactions of the Royal Society B 366: 108–112.CrossRef
go back to reference Hayflick, L. 2007. Biological ageing is no longer an unsolved problem. Annals of the New York Academy of Sciences 1100: 1–13.CrossRef Hayflick, L. 2007. Biological ageing is no longer an unsolved problem. Annals of the New York Academy of Sciences 1100: 1–13.CrossRef
go back to reference Heshka, S., and D.B. Allison. 2001. Is obesity a disease? International Journal of Obesity. 25(10): 1401–1404.CrossRef Heshka, S., and D.B. Allison. 2001. Is obesity a disease? International Journal of Obesity. 25(10): 1401–1404.CrossRef
go back to reference Hesslow, G. 1993. Do we need a concept of disease? Theoretical Medicine and Bioethics 14(1): 1–14.CrossRef Hesslow, G. 1993. Do we need a concept of disease? Theoretical Medicine and Bioethics 14(1): 1–14.CrossRef
go back to reference Izaks, G.J. & Westendorp, R.G.J. (2003). Ill or just old? Towards a conceptual framework of the relation between ageing and disease. BMC Geriatrics. 3(7), doi:10.1186/1471-2318-3-7. Izaks, G.J. & Westendorp, R.G.J. (2003). Ill or just old? Towards a conceptual framework of the relation between ageing and disease. BMC Geriatrics. 3(7), doi:10.​1186/​1471-2318-3-7.
go back to reference Jin, K. 2010. Modern biological theories of ageing. Ageing Disease 1(2): 72–74. Jin, K. 2010. Modern biological theories of ageing. Ageing Disease 1(2): 72–74.
go back to reference Joaquin, A.M., and S. Gollapudi. 2002. Functional decline in ageing and disease: A Role for apoptosis. Journal of the American Geriatrics Society 49(9): 1234–1240.CrossRef Joaquin, A.M., and S. Gollapudi. 2002. Functional decline in ageing and disease: A Role for apoptosis. Journal of the American Geriatrics Society 49(9): 1234–1240.CrossRef
go back to reference Jung, R.T. 1997. Obesity as a disease. British Medical Bulletin 53(2): 307–321.CrossRef Jung, R.T. 1997. Obesity as a disease. British Medical Bulletin 53(2): 307–321.CrossRef
go back to reference Kincaid, H. 2008. Do we need theory to study disease?: Lessons from cancer research and their implications for mental illness. Perspectives in Biology and Medicine 51(3): 367–378.CrossRef Kincaid, H. 2008. Do we need theory to study disease?: Lessons from cancer research and their implications for mental illness. Perspectives in Biology and Medicine 51(3): 367–378.CrossRef
go back to reference Kovács, J. 1998. The concept of health and disease. Medicine, Health Care and Philosophy 1: 31–39.CrossRef Kovács, J. 1998. The concept of health and disease. Medicine, Health Care and Philosophy 1: 31–39.CrossRef
go back to reference Lutz, W., W. Sanderson, and S. Scherbov. 2008. The coming acceleration of global population ageing. Nature 451(7): 716–719.CrossRef Lutz, W., W. Sanderson, and S. Scherbov. 2008. The coming acceleration of global population ageing. Nature 451(7): 716–719.CrossRef
go back to reference Mackey, T. 2003. An ethical assessment of anti-ageing medicine. Journal of Anti-Ageing Medicine 6(3): 187–204.CrossRef Mackey, T. 2003. An ethical assessment of anti-ageing medicine. Journal of Anti-Ageing Medicine 6(3): 187–204.CrossRef
go back to reference Murphy, T.F. 1986. A cure For ageing? The Journal of Medicine and Philosophy 11: 237–255.CrossRef Murphy, T.F. 1986. A cure For ageing? The Journal of Medicine and Philosophy 11: 237–255.CrossRef
go back to reference Nieuwenhuis-Mark, R.E. 2011. Healthy ageing as disease? Frontiers in Ageing Neuroscience 3(3): 1. Nieuwenhuis-Mark, R.E. 2011. Healthy ageing as disease? Frontiers in Ageing Neuroscience 3(3): 1.
go back to reference Nordenfelt, L. 2007. The concepts of health and disease revisited. Medicine, Health Care and Philosophy 10: 5–10.CrossRef Nordenfelt, L. 2007. The concepts of health and disease revisited. Medicine, Health Care and Philosophy 10: 5–10.CrossRef
go back to reference Partridge, L., and D. Gems. 2002. Mechanisms of ageing: Public or private? Nature Reviews Genetics 3: 165–175.CrossRef Partridge, L., and D. Gems. 2002. Mechanisms of ageing: Public or private? Nature Reviews Genetics 3: 165–175.CrossRef
go back to reference Schramme, T. 2007. A qualified defence of a naturalist theory of health. Medicine, Health Care and Philosophy 10: 11–17.CrossRef Schramme, T. 2007. A qualified defence of a naturalist theory of health. Medicine, Health Care and Philosophy 10: 11–17.CrossRef
go back to reference Sköld, H.N., and M. Obst. 2011. Potential for clonal animals in longevity and ageing studies. Biogerontology 12: 387–396.CrossRef Sköld, H.N., and M. Obst. 2011. Potential for clonal animals in longevity and ageing studies. Biogerontology 12: 387–396.CrossRef
go back to reference Sneed, J.R., and S.K. Whitbourne. 2005. Models of the Ageing Self. Journal of Social Issues 61(2): 375–388.CrossRef Sneed, J.R., and S.K. Whitbourne. 2005. Models of the Ageing Self. Journal of Social Issues 61(2): 375–388.CrossRef
go back to reference Vijg, J., and J. Campisi. 2008. Puzzles, promises and a cure for ageing. Nature 454(7208): 1065–1071.CrossRef Vijg, J., and J. Campisi. 2008. Puzzles, promises and a cure for ageing. Nature 454(7208): 1065–1071.CrossRef
go back to reference Walker, F.O. 2007. Huntington’s disease. The Lancet 369(9557): 218–228.CrossRef Walker, F.O. 2007. Huntington’s disease. The Lancet 369(9557): 218–228.CrossRef
go back to reference Wouters, A.G. 2005. The function debate in philosophy. Acta Biotheoretica 53(2): 123–151.CrossRef Wouters, A.G. 2005. The function debate in philosophy. Acta Biotheoretica 53(2): 123–151.CrossRef
Metadata
Title
Aging as Disease
Author
Gunnar De Winter
Publication date
01-05-2015
Publisher
Springer Netherlands
Published in
Medicine, Health Care and Philosophy / Issue 2/2015
Print ISSN: 1386-7423
Electronic ISSN: 1572-8633
DOI
https://doi.org/10.1007/s11019-014-9600-y

Other articles of this Issue 2/2015

Medicine, Health Care and Philosophy 2/2015 Go to the issue

Books Received

Books received

Scientific Contribution

Why comply with a code of ethics?