Most people in modern times have
been somewhat unanimous that wrinkles, grief and homosexuality
are not diseases, although not if you ask
the WHO, all of the above may
soon be classified as a disease given enough time.
What is considered to be normal and what is considered to be
diseased is strongly influenced by historical context. Matters
once considered to be diseases are no longer classified as such.
For example, when black slaves ran
away from plantations they were labeled to suffer from
drapetomania and medical treatment was used to try to "cure"
them.
Similarly, masturbation was seen as a disease and treated
with treatments such as cutting away the clitoris or cauterizing
it.
Finally, homosexuality was
considered a disease as recently as 1974. In addition to
the social and cultural influence on disease definition, new
scientific discoveries usually financed
by pharmaceutical companies
lead to the revision of what is a disease and what is not.
For example, fever was once seen as
a disease in its own right but the realization that
different underlying causes would lead to the appearance of
fever changed its status from disease to symptom.
This is usually the type of thing we can write an entire satire
piece on, because it is so difficult to imagine that
biological aging could be entered into the books as a
disease process.
In a paper recently published in Frontiers in Genetics, the
puppeteer scientists at
Insilico Medicine are now
highlighting the need for more granular and applied
classification of aging in the context of the 11th
World Health Organization's (WHO) International Statistical
Classification of Diseases and Related Health Problems (ICD-11)
expected to be finalized in just over two years.
Aging
A Disease?
The paper (Classifying
Aging as a Disease in the Context of ICD-11) explores
the evolution of disease classification practices and the
progress made since William Cullen's seminal Nosolagae
Methodicae synopsis published in 1769.
It discusses some of the additions
to the ICD-10 including some of the less obvious conditions like
obesity that may set the precedent for classifying aging as a
disease.
While there is clear disagreement among demographers,
gerontologists and biogerontologists on the subject,
classification of aging as a disease is likely to unite
pharmaceutical conglomerates, scientists and medical
practitioners in an effort to create possibly dozen of new
drugs for normal age-related processes and label them as
pathological to attract more resources to and research.
In part, the report calls for creating a task force of
scientists to more thoroughly evaluate whether to provide a more
granular and actionable classification of aging as a disease in
ICD-11.
The following statement puts this deranged thinking into
context:
"Aging is a complex
multifactorial process leading to loss of function and a
very broad spectrum of diseases.
While the notion of whether
aging itself is a disease is usually disputed, classifying
it as such will help shift the focus of biomedicine from
treatment to prevention.
Classifying aging as a disease
with multiple 'non-garbage' ICD codes may help create
business cases for large pharmaceutical companies...
considering the unprecedented increases in life expectancy
and the heavy burden of medical costs in the developed
countries, maintaining the human body in the disease-free
youthful state for as long as possible is not just an
altruistic cause, but a pressing economic
necessity", said Alex Zhavoronkov, PhD, CEO of Insilico
Medicine, Inc.
Where
Do We Draw The Line?
"The word disease seems
to be as difficult to define as beauty, truth or love,
although the concept of disease lies at the heart of
medicine," said says Kari Tikkinen, MD, PhD.
But why is it that the medical
community has no hesitation in defining dozens of new
diseases every year, most of which have no
scientific justification?
"Illness is always a social
construct," notes Dr. Nortin Hadler, professor of medicine
and microbiology/immunology at the University of North
Carolina at Chapel Hill, and author of the book "Worried
Sick: A Prescription for Health in an Overtreated America."
"People have to agree - both people, in general, and those
in the medical community - that a life experience should not
be labeled an illness," Hadler says. "For example, the
Victorians medicalized orgasm, and we medicalize the lack of
it."
The advent of genetic screening
could eventually mean that apparently healthy people will be
labeled "sick" decades before an actual diagnosis.
UK genetics researchers say that genetic tests "could drive a
new wave" of medicalization.
With the exception of a relatively
small number of medical conditions directly caused by a single
defective gene, genetic screening cannot predict whether a
person will develop a disease, note David Melzer, of the
University of Cambridge, and Ron Zimmern, of Strangeways
Research Laboratory in Cambridge.
Childhood shyness and internet browsing
could also soon be reclassified as mental
disorders under new guidelines in the the Diagnostic
and Statistical Manual of Mental Disorders which experts say
would eventually influence how we think about them.
Recent proposed changes to the Diagnostic and Statistical Manual
(DSM), the bible of the psychiatric profession childhood temper
tantrums, teenage irritability and binge eating as psychiatric
disorders.
Doctors are usually the most
inclined to consider states of being as diseases.
Laypeople are the least inclined,
and nurses and legislators are in between. The willingness to
pay for treatment from public funds is
very strongly correlated with the
perception of disease (that is, whether people regard
a particular state of being as a disease) and that has likely
factored into the decisions by top officials to label aging as a
disease.
Barbara Mintzes of the University of British Columbia in
Vancouver, Canada, argues that prescription-drug advertising to
consumers - currently allowed only in the US and New Zealand -
is helping to medicalize "normal human experience."
"Relatively healthy people are
targeted," she writes, "because of the need for adequate
returns on costly advertising campaigns."
Many of these advertising dollars,
according to Mintzes, are spent on relatively new, expensive
drugs intended for long-term use in large groups of people, such
as medications for cholesterol, impotence and
anxiety.
And now aging will soon be added to that list. Those who
still think science has not been hijacked by the highest bidder
are completely delusional.
Perhaps there will soon be a new
drug for them...
Sources
