Political Studies, Queen's University, Kingston, Ontario, Canada
J Med Ethics. 2023 Apr;49(4):271-274. doi: 10.1136/medethics-2022-108129. Epub 2022 Apr 21.
Imagination and idealism are particularly important creative epistemic virtues for the medical sciences if we hope to improve the health of the world's ageing population. To date, imagination and idealism within the medical sciences have been dominated by a paradigm of disease control, a paradigm which has realised significant, but also limited, success. Disease control proved particularly successful in mitigating the early-life mortality risks from infectious diseases, but it has proved less successful when applied to the chronic diseases of late life (like cancer). The time is ripe for the emergence and prominence of a supplementary medical research paradigm, the paradigm of 'healthy ageing' which prioritises the goal of rate (of ageing) control rather than disease control. This is the difference between extending the human healthspan versus extending survival by managing (or trying to eliminate) the multi-morbidities, frailty and disability currently prevalent in late life. The idealism of the disease control paradigm is myopic because it ignores the health constraints imposed by the inborn ageing process itself, a biological reality which is already inflicting significant economic and disease burdens on the world's ageing populations. Unless the medical sciences retard the rate of biological ageing, these problems will continue to be amplified as larger numbers of persons survive into late life.
如果我们希望改善世界上老龄化人口的健康状况，那么想象力和理想主义对于医学科学来说是特别重要的创造性认识美德。迄今为止，医学科学中的想象力和理想主义一直由疾病控制范式主导，这一范式取得了显著但也有限的成功。疾病控制在减轻传染病的早逝风险方面特别成功，但在应用于晚年的慢性疾病（如癌症）时则效果不佳。现在是出现和突出补充医学研究范式的成熟时机，即“健康老龄化”范式，该范式优先考虑控制衰老速度（rate）的目标，而不是疾病控制。这是延长人类健康寿命（healthspan）与通过管理（或试图消除）目前在晚年普遍存在的多种疾病、虚弱和残疾来延长生存时间的区别。疾病控制范式的理想主义是短视的，因为它忽略了由内在衰老过程本身带来的健康限制，这是一个已经给世界老龄化人口带来巨大经济和疾病负担的生物学现实。除非医学科学减缓生物衰老的速度，否则随着越来越多的人进入晚年，这些问题将继续加剧。
