The very first sentence published in JAGS was from Willard Thompson's 1953 editorial. “Everyone h... more The very first sentence published in JAGS was from Willard Thompson's 1953 editorial. “Everyone hopes to live to a ripe old age in a state of good health”. To make the aspiration of healthy aging a reality, Thompson maintained that two major problems had to be addressed. The first was the care of the aging population. The second problem required “a concentrated attack on the causes of aging”. From its inception, JAGS encouraged the prioritization of translational gerontology- the development of interventions that target the mechanisms of biological aging in the hopes of extending healthy lifespan. This is now commonly referred to as the Geroscience Hypothesis. Public communication about science is “effective” science communication when it gets the attention of the audience and helps them comprehend enough of the science to motivate them to support taking appropriate action. Attending to the communicative challenges facing translational gerontology is particularly important for geriatricians, as they are charged with the care of older populations but also advocate for scientific innovations that increase healthspan. In communication science a “frame” is a communication that “organizes everyday reality”, and the dominant frames employed by the media typically involve stories relating to human deaths and suffering. Negativity drives online news consumption. However, no one officially dies from aging, which threatens to marginalize the importance of translational gerontology. Some researchers have proposed that aging itself should be classified as a disease, to be added to the ongoing “War Against Disease” frame of public health. But this frame risks pathologizing chronological aging and can perpetuate ageism. A more effective communicative frame is the following two-fold strategy: #1 highlighting the diminishing health dividends of the “War Against Disease” paradigm for aging populations; and #2, highlighting the significant advances made over a century of research on the biology of aging and the potential gerotherapeutics have to help ameliorate the health vulnerabilities of an aging, warming, and unequal world.
On 5 May 2023, the World Health Organization declared that
COVID-19 no longer constituted a publi... more On 5 May 2023, the World Health Organization declared that COVID-19 no longer constituted a public health emergency of international concern. Medical science must now consider how it ought to recalibrate its imagination and idealism in a post- COVID-19 pandemic world. The fact that advanced age was the largest risk factor for COVID-19 mortality and serious illness, as well as for the most prevalent chronic diseases, reveals the urgency and significance of shifting the focus from mitigating each specific pathology risk, one at a time, to targeting biological ageing itself. In his 1910 JAMA Address entitled ‘Imagination and Idealism in the Medical Sciences’, Christian Herter made an important distinction between two ways imagination and idealism can be invoked in the medical sciences: (i) humanitarian medicine, which emphasizes the obvious and direct paths of ameliorating human suffering; and (ii) a curiosity-oriented approach which explores pure science and the experimental laboratory. The latter examines the indirect ways of winning, in Herter’s words, ‘the citadel’ of health promotion. Herter’s reflections on these two contrasting approaches to medicine have significance for both the COVID- 19 pandemic and the aspiration to promote the ideal of healthy ageing in the post-COVID-19 pandemic era.
Canadian Journal of Political Science, Sep 1, 2015
États dont les relations sont sous l’égide des règles du marché et dont l’idéal démocratique ne t... more États dont les relations sont sous l’égide des règles du marché et dont l’idéal démocratique ne trouve aucune place sur la scène internationale et dans les traités internationaux de commerce et de libre-échange. Les populations sont sommées de s’adapter à des règles qui n’exigent aucune remise en question. Cet état de fait entraîne de la résignation. Les « perdants » ne voient plus l’intérêt à participer à la vie politique : c’est le phénomène TINA (« There Is No Alternative ») qui vient réaffirmer l’incompatibilité entre capitalisme et démocratie. L’élément le plus probant de ce changement est certainement, selon l’auteur, la transformation de l’État fiscal en État débiteur. Nous sommes passés d’un État qui finançait les besoins sociaux par le prélèvement d’impôts aux citoyens, mais également aux entreprises, à un État qui fonctionne aux emprunts, à la grande satisfaction des marchés qui y trouvent une nouvelle source de profit. Cette transformation de l’État accélère la désunion. Devant les situations financières précaires des États, les créanciers internationaux jouent le rôle de « seconde constituency » (118) à qui l’acteur étatique est redevable et doit se soumettre. L’ouvrage de Wolfgang Streeck est incontournable afin d’obtenir un meilleur éclairage du dépérissement contemporain. Mais bien que le rôle primordial des ÉtatsUnis soit évoqué, une analyse en profondeur de celui-ci eut été souhaitable. Néanmoins, cela n’enlève rien aux analyses fines et éclairantes que nous propose Streeck et qui ont le mérite de nous sortir de la lecture orthodoxe dominante de la compréhension économique du monde.
Despite unprecedented investments in public health and biomedical research, improvements in life ... more Despite unprecedented investments in public health and biomedical research, improvements in life expectancy and healthy life expectancy have stagnated in the United States. Part of the reason for this development can be traced back to the influence of "Protean" over "Post-Protean" public health, the names that can be given to two contrasting visions of public health advanced in the early twentieth century. Protean public health prescribes "waging a war" against disease and was successful in reducing the early-life mortality risks from infectious disease. But Protean public health has proven less effective in improving the quality of life of older persons. Post-Protean public health prioritizes the experimental method and research into the indirect methods of improving health. It articulated a vision of public heath that was given a more concrete specification by Alex Comfort in what is now referred to as the Geroscience Hypothesis. To improve the health prospects of aging populations the dominance of Protean public health must be relaxed, to enable the benefits of Post-Protean public health to be realized. Doing so means shifting public health's aspirations towards increasing the healthspan vs "saving lives" by extending the duration of time older persons can survive by managing the multimorbidities of late life.
Folkbiology refers to people’s everyday understanding of the biological world. The early twentiet... more Folkbiology refers to people’s everyday understanding of the biological world. The early twentieth-century pioneers of public health C.-E.A Winslow (1877–1957), and his mentor H. Biggs (1859–1923), conceptualized public health as the ‘purchasable’ science of preventing disease and death from unfavorable economic and living conditions. Their ideas were foundational in shaping public health’s strategy of a ‘war against disease’ (Winslow, 1903), a strategy that was very successful in preventing the early-life mortality risks from infectious diseases, and was eventually extended to combating the chronic diseases of late life (like cancer). However, the initial framing of public health, through the lens of sanitation science, was predicated upon folkbiological premises that geroscience must abate in order to direct public health interventions toward the goal of improving the quality of life for older persons in the twenty-first century. Three folkbiological premises of sanitation science’s ‘war against disease’ are identified and critiqued: (i) the belief that health is the ‘normal’ condition of the human mechanism and disease ‘unnecessary’; (ii) the belief that the proximate causes of disease are the only modifiable risk factors public health interventions can alter; and (iii) the belief that the rate of biological aging is universal.
This is an open access article under the terms of the Creative Commons Attribution License, which... more This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
Journals of Gerontology: Biological Sciences cite as: J Gerontol A Biol Sci Med Sci,, 2023
In his 1910 JAMA address, the physician and pathologist Christian Herter (1865-1910) emphasized t... more In his 1910 JAMA address, the physician and pathologist Christian Herter (1865-1910) emphasized the importance of plasticity in science. Herter's insight is significant for understanding how public health's "ecology of ideas" must evolve and change as the health challenges facing populations alter through the different stages of "epidemiologic transition". The foundational moral aspiration (ie, disease control) and intellectual suppositions (eg, that public health is "purchasable") of the early twentieth-century public health pioneers C.-E.A Winslow (1877-1957) and his mentor Hermann Biggs (1859-1923) were shaped by sanitation science and were deployed to mitigate the risks of earlylife mortality. But to meet the health challenges of today's aging world, public health's "ecology of ideas" must be plastic, and thus open to revision and refinement in terms of both its foundational moral aspirations and the intellectual suppositions concerning how to best improve population health. More medical research is needed in rate (of aging) control versus disease control.
Philosophers have long asked profound questions such as “What is knowledge?” and “What is the goo... more Philosophers have long asked profound questions such as “What is knowledge?” and “What is the good life?” Such questions compel us to engage in a deeper level of introspection. The philosophical question contemplated in this chapter is “What constitutes ‘well-ordered science’?” Invoking a virtue epistemological construal of knowledge as “success from ability,” the author argues that the study of pathology must be supplemented by the study of the determinates of exemplary positive phenotypes (e.g., healthy aging and happiness). This requires transcending the limitations of what the author calls “negative biology” and treating “positive biology” as an integral element of well-ordered science. Positive biology can help bring to the fore the importance of understanding the evolutionary and life history of our species, thus helping to provide the intellectual frameworks needed to inspire the development of novel and feasible interventions to improve human health and happiness.
Imagination and idealism are particularly important creative epistemic virtues for the medical sc... more 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 i...
Contemporary legal theory has been dominated by the realist paradigm. The extreme version of real... more Contemporary legal theory has been dominated by the realist paradigm. The extreme version of realism is captured by the slogan of the critical legal studies movement: “Law is politics!” Other heirs to the realist tradition (including normative law and economics, the legal process school, legal pragmatism, and so forth) coalesce around what we might call the instrumentalist thesis—the point of legal institutions (especially courts) is to use the law as an instrument to achieve the goals of some normative theory (such as welfarism or deontology) or a political ideology (of the left, right, or center). There are, of course, opposing tendencies in contemporary legal theory. Some neoformalists emphasize the duty of adjudicators to follow the law and give the parties what they are due; in a rough and ready sort of way, these neoformalists adopt a deontological perspective on legal theory that competes with the consequentialism of contemporary neorealists.
In a world that is inherently indeterminate, a suitable theory of distributive justice must perha... more In a world that is inherently indeterminate, a suitable theory of distributive justice must perhaps itself be indeterminate, and its indeterminacies must accommodate those of the world where relevant. Russell Hardin, Indeterminacy and Society
The very first sentence published in JAGS was from Willard Thompson's 1953 editorial. “Everyone h... more The very first sentence published in JAGS was from Willard Thompson's 1953 editorial. “Everyone hopes to live to a ripe old age in a state of good health”. To make the aspiration of healthy aging a reality, Thompson maintained that two major problems had to be addressed. The first was the care of the aging population. The second problem required “a concentrated attack on the causes of aging”. From its inception, JAGS encouraged the prioritization of translational gerontology- the development of interventions that target the mechanisms of biological aging in the hopes of extending healthy lifespan. This is now commonly referred to as the Geroscience Hypothesis. Public communication about science is “effective” science communication when it gets the attention of the audience and helps them comprehend enough of the science to motivate them to support taking appropriate action. Attending to the communicative challenges facing translational gerontology is particularly important for geriatricians, as they are charged with the care of older populations but also advocate for scientific innovations that increase healthspan. In communication science a “frame” is a communication that “organizes everyday reality”, and the dominant frames employed by the media typically involve stories relating to human deaths and suffering. Negativity drives online news consumption. However, no one officially dies from aging, which threatens to marginalize the importance of translational gerontology. Some researchers have proposed that aging itself should be classified as a disease, to be added to the ongoing “War Against Disease” frame of public health. But this frame risks pathologizing chronological aging and can perpetuate ageism. A more effective communicative frame is the following two-fold strategy: #1 highlighting the diminishing health dividends of the “War Against Disease” paradigm for aging populations; and #2, highlighting the significant advances made over a century of research on the biology of aging and the potential gerotherapeutics have to help ameliorate the health vulnerabilities of an aging, warming, and unequal world.
On 5 May 2023, the World Health Organization declared that
COVID-19 no longer constituted a publi... more On 5 May 2023, the World Health Organization declared that COVID-19 no longer constituted a public health emergency of international concern. Medical science must now consider how it ought to recalibrate its imagination and idealism in a post- COVID-19 pandemic world. The fact that advanced age was the largest risk factor for COVID-19 mortality and serious illness, as well as for the most prevalent chronic diseases, reveals the urgency and significance of shifting the focus from mitigating each specific pathology risk, one at a time, to targeting biological ageing itself. In his 1910 JAMA Address entitled ‘Imagination and Idealism in the Medical Sciences’, Christian Herter made an important distinction between two ways imagination and idealism can be invoked in the medical sciences: (i) humanitarian medicine, which emphasizes the obvious and direct paths of ameliorating human suffering; and (ii) a curiosity-oriented approach which explores pure science and the experimental laboratory. The latter examines the indirect ways of winning, in Herter’s words, ‘the citadel’ of health promotion. Herter’s reflections on these two contrasting approaches to medicine have significance for both the COVID- 19 pandemic and the aspiration to promote the ideal of healthy ageing in the post-COVID-19 pandemic era.
Canadian Journal of Political Science, Sep 1, 2015
États dont les relations sont sous l’égide des règles du marché et dont l’idéal démocratique ne t... more États dont les relations sont sous l’égide des règles du marché et dont l’idéal démocratique ne trouve aucune place sur la scène internationale et dans les traités internationaux de commerce et de libre-échange. Les populations sont sommées de s’adapter à des règles qui n’exigent aucune remise en question. Cet état de fait entraîne de la résignation. Les « perdants » ne voient plus l’intérêt à participer à la vie politique : c’est le phénomène TINA (« There Is No Alternative ») qui vient réaffirmer l’incompatibilité entre capitalisme et démocratie. L’élément le plus probant de ce changement est certainement, selon l’auteur, la transformation de l’État fiscal en État débiteur. Nous sommes passés d’un État qui finançait les besoins sociaux par le prélèvement d’impôts aux citoyens, mais également aux entreprises, à un État qui fonctionne aux emprunts, à la grande satisfaction des marchés qui y trouvent une nouvelle source de profit. Cette transformation de l’État accélère la désunion. Devant les situations financières précaires des États, les créanciers internationaux jouent le rôle de « seconde constituency » (118) à qui l’acteur étatique est redevable et doit se soumettre. L’ouvrage de Wolfgang Streeck est incontournable afin d’obtenir un meilleur éclairage du dépérissement contemporain. Mais bien que le rôle primordial des ÉtatsUnis soit évoqué, une analyse en profondeur de celui-ci eut été souhaitable. Néanmoins, cela n’enlève rien aux analyses fines et éclairantes que nous propose Streeck et qui ont le mérite de nous sortir de la lecture orthodoxe dominante de la compréhension économique du monde.
Despite unprecedented investments in public health and biomedical research, improvements in life ... more Despite unprecedented investments in public health and biomedical research, improvements in life expectancy and healthy life expectancy have stagnated in the United States. Part of the reason for this development can be traced back to the influence of "Protean" over "Post-Protean" public health, the names that can be given to two contrasting visions of public health advanced in the early twentieth century. Protean public health prescribes "waging a war" against disease and was successful in reducing the early-life mortality risks from infectious disease. But Protean public health has proven less effective in improving the quality of life of older persons. Post-Protean public health prioritizes the experimental method and research into the indirect methods of improving health. It articulated a vision of public heath that was given a more concrete specification by Alex Comfort in what is now referred to as the Geroscience Hypothesis. To improve the health prospects of aging populations the dominance of Protean public health must be relaxed, to enable the benefits of Post-Protean public health to be realized. Doing so means shifting public health's aspirations towards increasing the healthspan vs "saving lives" by extending the duration of time older persons can survive by managing the multimorbidities of late life.
Folkbiology refers to people’s everyday understanding of the biological world. The early twentiet... more Folkbiology refers to people’s everyday understanding of the biological world. The early twentieth-century pioneers of public health C.-E.A Winslow (1877–1957), and his mentor H. Biggs (1859–1923), conceptualized public health as the ‘purchasable’ science of preventing disease and death from unfavorable economic and living conditions. Their ideas were foundational in shaping public health’s strategy of a ‘war against disease’ (Winslow, 1903), a strategy that was very successful in preventing the early-life mortality risks from infectious diseases, and was eventually extended to combating the chronic diseases of late life (like cancer). However, the initial framing of public health, through the lens of sanitation science, was predicated upon folkbiological premises that geroscience must abate in order to direct public health interventions toward the goal of improving the quality of life for older persons in the twenty-first century. Three folkbiological premises of sanitation science’s ‘war against disease’ are identified and critiqued: (i) the belief that health is the ‘normal’ condition of the human mechanism and disease ‘unnecessary’; (ii) the belief that the proximate causes of disease are the only modifiable risk factors public health interventions can alter; and (iii) the belief that the rate of biological aging is universal.
This is an open access article under the terms of the Creative Commons Attribution License, which... more This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
Journals of Gerontology: Biological Sciences cite as: J Gerontol A Biol Sci Med Sci,, 2023
In his 1910 JAMA address, the physician and pathologist Christian Herter (1865-1910) emphasized t... more In his 1910 JAMA address, the physician and pathologist Christian Herter (1865-1910) emphasized the importance of plasticity in science. Herter's insight is significant for understanding how public health's "ecology of ideas" must evolve and change as the health challenges facing populations alter through the different stages of "epidemiologic transition". The foundational moral aspiration (ie, disease control) and intellectual suppositions (eg, that public health is "purchasable") of the early twentieth-century public health pioneers C.-E.A Winslow (1877-1957) and his mentor Hermann Biggs (1859-1923) were shaped by sanitation science and were deployed to mitigate the risks of earlylife mortality. But to meet the health challenges of today's aging world, public health's "ecology of ideas" must be plastic, and thus open to revision and refinement in terms of both its foundational moral aspirations and the intellectual suppositions concerning how to best improve population health. More medical research is needed in rate (of aging) control versus disease control.
Philosophers have long asked profound questions such as “What is knowledge?” and “What is the goo... more Philosophers have long asked profound questions such as “What is knowledge?” and “What is the good life?” Such questions compel us to engage in a deeper level of introspection. The philosophical question contemplated in this chapter is “What constitutes ‘well-ordered science’?” Invoking a virtue epistemological construal of knowledge as “success from ability,” the author argues that the study of pathology must be supplemented by the study of the determinates of exemplary positive phenotypes (e.g., healthy aging and happiness). This requires transcending the limitations of what the author calls “negative biology” and treating “positive biology” as an integral element of well-ordered science. Positive biology can help bring to the fore the importance of understanding the evolutionary and life history of our species, thus helping to provide the intellectual frameworks needed to inspire the development of novel and feasible interventions to improve human health and happiness.
Imagination and idealism are particularly important creative epistemic virtues for the medical sc... more 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 i...
Contemporary legal theory has been dominated by the realist paradigm. The extreme version of real... more Contemporary legal theory has been dominated by the realist paradigm. The extreme version of realism is captured by the slogan of the critical legal studies movement: “Law is politics!” Other heirs to the realist tradition (including normative law and economics, the legal process school, legal pragmatism, and so forth) coalesce around what we might call the instrumentalist thesis—the point of legal institutions (especially courts) is to use the law as an instrument to achieve the goals of some normative theory (such as welfarism or deontology) or a political ideology (of the left, right, or center). There are, of course, opposing tendencies in contemporary legal theory. Some neoformalists emphasize the duty of adjudicators to follow the law and give the parties what they are due; in a rough and ready sort of way, these neoformalists adopt a deontological perspective on legal theory that competes with the consequentialism of contemporary neorealists.
In a world that is inherently indeterminate, a suitable theory of distributive justice must perha... more In a world that is inherently indeterminate, a suitable theory of distributive justice must perhaps itself be indeterminate, and its indeterminacies must accommodate those of the world where relevant. Russell Hardin, Indeterminacy and Society
The sequencing of the human genome, the advances of gene therapy and genomic editing, coupled wit... more The sequencing of the human genome, the advances of gene therapy and genomic editing, coupled with embryo selection techniques and a potential gerontological intervention, these are some of the examples of the rapid technological advances of the "genetic revolution". This paper addresses the methodological issue of how we should theorize about justice in the genomic era. Invoking the methodology of non-ideal theory, I argue that theorizing about justice in the genomic era entails theorizing about (1) the new inequalities the genetic revolution could possibly exacerbate (e.g. genetic discrimination, disability-related injustices and gender inequality), and (2) those inequalities the revolution could help us mitigate (e.g. the risks of disease in early and late life). By doing so normative theorists can ensure we develop an account of justice that takes seriously not only individual rights, equality of opportunity, the cultural and socio-political aspects of disability and equality between the sexes, but also the potential health benefits (to both individuals and populations) of attending to the evolutionary causes of morbidity and disability.
In this chapter a virtue epistemological account of toleration is developed and defended that dra... more In this chapter a virtue epistemological account of toleration is developed and defended that draws attention to a cluster of "epistemic virtues" (collectively referred to as "mindsight" (Siegel 2010)) that are integral to exercising toleration as both a personal and public virtue. Virtue epistemology applies a normative analysis to the cognitive lives of individuals and intellectual communities (e.g. democratic country). By bringing to the fore the potential virtues and vices of our cognitive lives, virtue epistemology can offer an account of toleration that is distinct from that provided by autonomy-based arguments. The latter ignores, or at least brackets, our cognitive lives. A virtue epistemological account of toleration can help resolve the so-called "paradox of toleration", as well as elaborate on the limits of toleration as a virtue.
Going back to the Ancient Greeks (e.g. Plato and Aristotle), philosophers have long asked profoun... more Going back to the Ancient Greeks (e.g. Plato and Aristotle), philosophers have long asked profound questions such as “What is knowledge?” and “What is the good life?”. Such questions compel us to engage in a deeper level of introspection and examination than most of us are typically accustomed to in our daily lives. The philosophical question contemplated in this chapter is: “What constitutes ‘“well-ordered science’”?” Invoking a virtue epistemological construal of knowledge as “success from ability”, I argue that the study of pathology must be supplemented by the study of the determinates of exemplary positive phenotypes (e.g. healthy aging and happiness). This requires transcending the limitations of what I call “negative biology”, and treating “positive biology” as an integral element of well-ordered science in the 21st century. Positive biology can help bring to the fore the importance of understanding the evolutionary and life history of our species, thus helping to provide the intellectual frameworks needed to inspire the development of novel and feasible interventions to improve human health and happiness.
Where do the stakes involved in the debates surrounding the ethics of developing novel life-exten... more Where do the stakes involved in the debates surrounding the ethics of developing novel life-extending technologies fit into the picture of justice? More specifically, does justice require we extend the human lifespan by slowing the aging process? Or could such actions actually be considered unjust if they exacerbate existing health inequities or increase problems of population density and climate change? If there are conflicting or competing demands of justice in this context, how can we be begin to disentangle them so that we respond rationally and fairly to addressing the diverse stakes that arise with respect to the aspiration to extend (healthy) life? This chapter hopes to shed some light on these important questions.
Uploads
Papers by Colin Farrelly
COVID-19 no longer constituted a public health emergency of
international concern. Medical science must now consider how
it ought to recalibrate its imagination and idealism in a post-
COVID-19 pandemic world. The fact that advanced age was the
largest risk factor for COVID-19 mortality and serious illness,
as well as for the most prevalent chronic diseases, reveals the
urgency and significance of shifting the focus from mitigating
each specific pathology risk, one at a time, to targeting
biological ageing itself. In his 1910 JAMA Address entitled
‘Imagination and Idealism in the Medical Sciences’, Christian
Herter made an important distinction between two ways
imagination and idealism can be invoked in the medical
sciences: (i) humanitarian medicine, which emphasizes the
obvious and direct paths of ameliorating human suffering; and
(ii) a curiosity-oriented approach which explores pure science
and the experimental laboratory. The latter examines the
indirect ways of winning, in Herter’s words, ‘the citadel’ of
health promotion. Herter’s reflections on these two contrasting
approaches to medicine have significance for both the COVID-
19 pandemic and the aspiration to promote the ideal of healthy
ageing in the post-COVID-19 pandemic era.
pioneers of public health C.-E.A Winslow (1877–1957), and his mentor H. Biggs (1859–1923), conceptualized
public health as the ‘purchasable’ science of preventing disease and death from unfavorable economic and
living conditions. Their ideas were foundational in shaping public health’s strategy of a ‘war against disease’
(Winslow, 1903), a strategy that was very successful in preventing the early-life mortality risks from infectious
diseases, and was eventually extended to combating the chronic diseases of late life (like cancer). However,
the initial framing of public health, through the lens of sanitation science, was predicated upon folkbiological
premises that geroscience must abate in order to direct public health interventions toward the goal of improving
the quality of life for older persons in the twenty-first century. Three folkbiological premises of sanitation
science’s ‘war against disease’ are identified and critiqued: (i) the belief that health is the ‘normal’ condition of
the human mechanism and disease ‘unnecessary’; (ii) the belief that the proximate causes of disease are the
only modifiable risk factors public health interventions can alter; and (iii) the belief that the rate of biological
aging is universal.
COVID-19 no longer constituted a public health emergency of
international concern. Medical science must now consider how
it ought to recalibrate its imagination and idealism in a post-
COVID-19 pandemic world. The fact that advanced age was the
largest risk factor for COVID-19 mortality and serious illness,
as well as for the most prevalent chronic diseases, reveals the
urgency and significance of shifting the focus from mitigating
each specific pathology risk, one at a time, to targeting
biological ageing itself. In his 1910 JAMA Address entitled
‘Imagination and Idealism in the Medical Sciences’, Christian
Herter made an important distinction between two ways
imagination and idealism can be invoked in the medical
sciences: (i) humanitarian medicine, which emphasizes the
obvious and direct paths of ameliorating human suffering; and
(ii) a curiosity-oriented approach which explores pure science
and the experimental laboratory. The latter examines the
indirect ways of winning, in Herter’s words, ‘the citadel’ of
health promotion. Herter’s reflections on these two contrasting
approaches to medicine have significance for both the COVID-
19 pandemic and the aspiration to promote the ideal of healthy
ageing in the post-COVID-19 pandemic era.
pioneers of public health C.-E.A Winslow (1877–1957), and his mentor H. Biggs (1859–1923), conceptualized
public health as the ‘purchasable’ science of preventing disease and death from unfavorable economic and
living conditions. Their ideas were foundational in shaping public health’s strategy of a ‘war against disease’
(Winslow, 1903), a strategy that was very successful in preventing the early-life mortality risks from infectious
diseases, and was eventually extended to combating the chronic diseases of late life (like cancer). However,
the initial framing of public health, through the lens of sanitation science, was predicated upon folkbiological
premises that geroscience must abate in order to direct public health interventions toward the goal of improving
the quality of life for older persons in the twenty-first century. Three folkbiological premises of sanitation
science’s ‘war against disease’ are identified and critiqued: (i) the belief that health is the ‘normal’ condition of
the human mechanism and disease ‘unnecessary’; (ii) the belief that the proximate causes of disease are the
only modifiable risk factors public health interventions can alter; and (iii) the belief that the rate of biological
aging is universal.