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READINESS FOR DEATH: SYBIL SPEAKS

Published online by Cambridge University Press:  12 February 2019

John Shand
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Abstract

While life has been increasing in length an increasing proportion of that life is in a state of poor health and decrepitude. Indeed, an increasing proportion of life is in that poor state because of its increased length. Medicine always fails to catch up, and increasingly so in providing a life of good health overall set by the end point of inevitable death. This requires a change in attitude from the zealous concentration on medical interventions whose chief aim is to increase the length of life, and a move to being able to consider more readily refusing some medical treatments, along with a more resigned attitude to our death, which must come anyway.

Type
Research Article
Information
Think , Volume 18 , Issue 51 , Spring 2019 , pp. 123 - 136
Copyright
Copyright © The Royal Institute of Philosophy 2019 

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References

Note

1 Evidence supporting the empirical claim here is given in The Times and the Office of National Statistics below.

Life expectancy has edged up slightly for both men and women, but we are all likely to spend longer in poor health, according to official projections. A baby boy born in 2013–15 can expect to live 79.2 years, compared with 78.5 in 2009–11. For girls, life expectancy rose from 82.5 to 82.9 years. However, healthy life expectancy remained static for women and increased by 0.4 years for men over the same period, according to the Office for National Statistics (ONS). Women can now expect to spend 19 years of their lives in poor health (up 0.4 years). Men should prepare for 16.1 years of poor health, up 0.3 years.

The Times, 30 November 2016.

And from the Office of National Statistics:

‘Healthy life expectancy at birth and age 65 by upper tier local authority and area deprivation: England, 2012 to 2014.’ Office of National Statistics.

https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/healthandlifeexpectancies/bulletins/healthylifeexpectancyatbirthandage65byuppertierlocalauthorityandareadeprivation/england2012to2014

Males at birth in England could expect to spend a higher proportion (79.7%) of their remaining lives in ‘Good’ health, compared with females (76.9%).

On the basis of mortality and health status rates in 2012 to 2014, a boy born in England could expect to live on average for 79.5 years, of which they could expect to spend 63.4 years in ‘Good’ health. Whilst for a girl, life expectancy (LE) was 83.2 years, of which they could expect to spend 64.0 years in ‘Good’ health.

Therefore, the gender gap between the number of years males and females could expect to spend in ‘Good’ health was narrower at 0.6 years compared with LE at 3.7 years. Despite males expecting to live shorter lives on average compared with females, they could expect to spend a higher proportion of their remaining lives in ‘Good’ health (79.7% compared with 76.9%).

When comparing the 2012 to 2014 data with the latest non-overlapping time period 2009 to 2011, the healthy life expectancy (HLE) estimate at birth for males increased by 0.2 years from 63.2 years to 63.4 years. Although HLE at birth increased for males, it did not keep pace with the increase in LE. Males born in 2012 to 2014 could expect to live a further 0.6 years than those born in 2009 to 2011. For females, HLE at birth declined by 0.1 years, from 64.2 years to 64.0 years whilst LE increased by 0.3 years.

This shows that there has been an expansion of morbidity (the number of years in ‘Not Good’ health) for both males and females as there were larger increases in LE compared with HLE. This results in an increase in the number of years lived in ‘Not Good’ health. Where there are larger increases in HLE compared with LE, this is referred to as compression of morbidity.

The higher increase in both LE and HLE at birth observed for males suggests that over time, the gender gap between males and females for LE and HLE has narrowed.