What will the coroner write in blank about the cause of death when he dies? Suggestion
Introduction: Global Health Trends
A University of Washington research center has found that, perhaps for the first time in human history, the obesity-related death rate is higher than the malnutrition rate. Translation: more people die from obesity-related diseases than from lack of food. In an editorial last month, a major newspaper proclaimed that this was good news. (Chicago Tribune, Living Longer, With a Hack: Increased Life Expectancy, Despite Some Unhealthy Choices, December 26, 2012).
You may be overlooking something, but it doesn’t seem like it’s news to set off a parade of ticker tapes celebrating human progress. The aforementioned research group, the Institute for Health Metrics and Evaluation (IHME), is funded by the Bill and Melinda Gates Foundation and the state of Washington. Its mission is to improve the health of the population by providing the best possible evidence to guide health policy. I believe that the next IHME project should study and identify the cause of death that more accurately reflects the health of the population. This could be a very effective way to guide health policy.
What is a good cause of death?
Most of us, myself included, consider it better to die of gluttony and satiety than of malnutrition and hunger. It’s not a great choice, but it seems relevant to the IHME investigation that the Chicago Tribute saw as good news. For one thing, you last much longer by eating too much than you can with too little food; on the other, excessive consumption is more satisfactory, at least until the multiple adverse consequences of doing so manifest themselves and the suffering begins. Fortunately, these extremes are not the only candidates for the best mortality indicators in the ranking of healthy populations. Before suggesting a better health status indicator of cause of death for a city, state or nation, a summary of the IHME study seems appropriate.
Advances in chronic diseases, setbacks in infectious diseases
The IHME report showed a worldwide trend of older people dying more and more from heart disease and cancer. These factors are considered diseases of the rich countries, since both causes of death are associated with survival in the last decades of life. This only happens when nations succeed in reducing the incidence of infectious and communicable diseases. These mortality factors (for example, diarrhea, tuberculosis, malaria and measles) are dramatically lower than two decades ago thanks to advances in sanitation, greater availability of medicines and more extensive and effective vaccination campaigns. Furthermore, living standards have improved. Increased food supplies reduce the incidence of malnutrition.
While all of this is good and encouraging, it seems fair enough to point out that the goal of researchers at IMHE and others (i.e., the United Nations) who are concerned about the health status of the population should not be to promote conditions in the death rates due to heart disease and cancer. predominate. (I’m not suggesting that this is the case either.)
The best cause of death
Given that everyone will die at some point, sooner or later and most prefer later, which cause of death best reflects the well-being of the population? For the purposes of collecting data on global health trends, which cause best reflects the positive quality of life experienced?
I think the first thing we can agree on is that starvation / malnutrition rates are definitely not optimal for this purpose. The second point of agreement could be that neither is the rate of deaths from heart disease. Or cancer!
So what?
AIDS? This cause accounts for fewer deaths than a decade ago, but still claims 1.5 million lives worldwide each year. Cancer? Tens of millions still die from lifestyle choices like tobacco use. Diabetes? IMHE researchers still estimate that dietary abuse claims six million lives a year. Sedentary? I made up this cause of death. Why not have an insufficient exercise indicator? We know that laziness kills. It’s a shame there is no vaccine for exercise aversion.
Cause of death in your case
Even if you have extraordinary and random luck throughout life and are favored by nature with fabulous genes and live from cradle to exceptionally late life as a model of a REAL modern wellness general, some or all of your parts will fail. , eventually. When this happens, you will die. But what will happen first? Something, you know, even if you live your life as a wellness model, with incredible luck regarding random events while benefiting from great genetics? (Needless to add, but I’ll do it anyway, there are no such general models of REAL wellness. Life is such that while good genes, good luck with random destiny, and great lifestyles are possible, no one comes close to nothing even remotely like a life that embodies the hypothetical. very model of a very modern important general REAL wellness ideal. I know you knew.)
So think about it. What might a coroner / doctor enter at some point in the future on your death certificate as cause?
There are several broad categories of causes of death now available for doctors to enter on death certificates. These include accidental, violent / homicide, natural, or undetermined / unexplained. Doctors have different ways of determining the cause of death, based on observations, local laws, etc. Autopsies and other tests are commonly performed to determine the cause of death.
Let’s accept that you don’t want starvation / malnutrition to be the cause or, for that matter, heart disease or other chronic conditions brought on by morbid obesity. Also, if you’re like me, and you have to be in some way to read this, you probably don’t want the entry on your death certificate to be AIDS, diabetes, or a sedentary lifestyle.
So what?
An alternative indicator of REAL well-being: completion
How about a new cause of death, one that indicates that the deceased decided enough was enough, a cause we could call termination? This would indicate that there was enough data or other evidence available at the time and place of your death (for example, a note that would allow you to go well) that would allow the doctor who signs your death certificate to consent for you, the deceased, died believing that he had died. he crossed the finish line of life, having traveled the distance and determined that there was no point going any further.
Of course, before completion can catch up locally, let alone globally, a great deal of study (IMHE, please note), discussion, and reflection (pun intended) will have to be undertaken. Also, you can be sure that there will be a resistance based on religion, which will have to be overcome. Personally, I am going to do my part to achieve a vastly improved mortality-based health status indicator by living the remaining days and putting an appropriate end to them, following a lifestyle course (while I hope to get the best genetics and a random chance). ) which will get a completion entry on my death certificate.
As far as I’m concerned, that would be a better cause than anything else I can think of. What’s more, if I could, I would frame it.
Starting towards completion
It may be time to develop a general decision support tool that helps people determine when the time is right.
Let’s immediately start with readings on existential philosophy and discussions with others, especially those who have given some thought to this great topic. Let’s be careful with the metaphors we use to communicate the issues involved. For example, let’s not talk so much about when to disconnect or even if we should disconnect it. There is too much history with this phrase associated with sad, medically based situations of ending the lives of others that no longer seem viable.
Let’s think about completing something like this: that moment when we happily take the proverbial bull by the horns and, with a smile on our face and joy in our hearts, with gratitude to the family and dear friends won along the way, we give it to those horns a Firm but epic and triumphant squeezes and dismisses the life well lived.