Dr. Nuland opens Chapter 2 of How We Die saying, "No one dies of old age, or so it would be legislated if actuaries ruled the world." Later in the chapter he introduces a perspective on aging that can serve Healthy Survivors well.
Nuland has no problem with assigning scientific names to the biologic processes that make up aging, "so long as they do not also insist that assigning a name...means a priori that it is a disease." He warns readers, "To call a natural process by the name of a disease is the first step in the attempt to cure it and thereby thwart it." That is not good.
The vitality and adaptation made possible through continuous renewal -- be it of cells, tissues, systems or species -- depends on the aging and death of what came before. These processes "stabilize our environment and our very civilization." So Nuland urges us to "use our increasing knowledge with increasing wisdom," cautioning us not to destroy the balance.
For Healthy Survivors, perceiving aging and death as the natural order of things can mitigate our grief over the many losses associated with aging and impending death.
For medical researchers and clinicians, this perspective can guide us to strive to enhance quality of life throughout life, and not to aim to reverse aging or lengthen the dying process.
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