The medicine myth | Denis Noble, Nessa Carey, Guy Brown

foreign to imagine that medicine is gradually expanding lifespan and will continue to do so Dennis would you like to sum it up in three minutes for us the first thing to say is as the Irishman would say when you ask him where the way is to Belfast I wouldn't start from where you are now it's a serious point because unfortunately over the last 20 years or so we've focused on the dots in the print of a message without paying attention to the message itself those dots of the genes and the genomics in which we've spent hundreds of billions as a world in understanding documenting and getting the information on but the trouble is that those dots don't tell us what the message is so the first point I would make is I wouldn't start from where we are how do we now look at the situation going forward though I think we have to reorientate our way of thinking about how to deal with the more complex diseases and I'll illustrate that very briefly with work on the heart if I ask the question where is a heart a rhythmia where is the extraordinary circulation of electricity called defibrillation which unfortunately kills people suddenly and in good health normally where is that it's not in the genes it's actually at the high level even above the level of cells let alone molecules in the way in which the process occurs at the level of the organ as a whole we will have therefore to start paying attention to the different levels of organization in biological systems and focus where the disease is if I want to cure an arrhythmia I'm going to have to focus at a much higher level than the individual molecules that doesn't mean to say that they are not doing something there are mutations in genes that will predispose people to arrhythmia for example but that's not the level at which to understand the arrhythmia and how you may treat it so I think roughly speaking we wouldn't want to start from where we are but we have to the Irishman was right but what now we do is open to a lot of very careful thinking because thinking about the higher levels of organization in biology is much more difficult than thinking about the level of molecules and genes there's my brief statement thank you Dennis Nessa and what do you think is it a mistake to imagine that medicine is going to gradually expand and save us all you can see if you can read my t-shirt I'm very my jumper I'm very clearly a member of Team science here yeah and science has made enormous impacts on human lifespan um that that's incontrovertible sometimes it wasn't just science it was things like soap was created before we understood about germs and that made a huge difference to you but science has made an enormous difference however um lots of those differences have been at the level of childhood diseases so lots of people died very very young which doesn't happen anymore because of vaccination but if there's one thing that science's impact on health has taught us is that we're all going to die of something so we all worry now about why many so many people die from cancer it's because they're not dying from heart attacks things like the statins have made an enormous difference I don't believe you can expand human lifespan indefinitely because I think it makes no evolutionary sense we already live far longer than we should in evolutionary terms we live long beyond our reproductive capacity so we're already stretching things also it's not about how long you live it's about how well you live most people would prefer to die in a good state of health at 85 than to live another 10 years in terrible terrible health and so when we think about longevity we need to think about do we mean actual years or do we mean quality of life up to a certain stage I think though even if then to say a healthy lifestyle to the age of 120 130 would it be morally responsible to do so the massively climbing human population has nothing to do with birth rates birth rates have been dropping for decades it's because people aren't dying as early and now I have no intention as an individual volunteering to take one for the planetary team on that but that is what is driving population growth and if we do start massively extending population age from say 85 to 120 and it's not going to be happening in the lower middle income countries that's going to be because of things we do to ourselves in the highly developed economically developed economically countries yeah that made no sense at all you know what I mean um and we're already the ones driving destruction of the planet because our consumption is so high so I think there are both scientific questions and I don't think we can live forever and there are ethical questions and there are also economic questions everyone talks about we need new antibiotics we have new antibiotics the last two companies to develop new antibiotics went bankrupt within six months we need new economic models to promote greater health for the global population which will lead to longer term healthy life for everybody not just for a few individuals in the developed North thank you thank you so we would end up with the Haves and have-nots becoming worse it would be the lives and lives inequalities the most damaging people would be alive longer to do more and more damage and create greater problems for the have-nots hmm um guy what do you think so the title of this session is medicine myth and I want to talk about three um different but related medical myths the first is that medicine is about preventing Death Or should be about preventing death the problem is that medicine and public health generally has been very successful on this and this resulted in a large extension of lifespan on average it's more than doubled in the last 200 years but the the so that's a good thing but the problem is that we've done nothing about the rate of aging and because aging increases exponentially uh with the age that you live we end up aging much more uh before we die and that's associated with many different age-related diseases such as dementia and extreme aging so you end up with a degenerative end to life the second myth that I want to explore is that aging is natural many people say that aging is natural and therefore we shouldn't do anything about it well the opposite is the case aging is very rare in in the in animals in the wild and it was very rare or extreme aging was extremely rare for humans before civilization up to a few hundred years ago um so aging is not natural it's a product of a culture our culture and it's a culture that has continually targeted acute causes of death resulting in an in large increase in lifespan resulting in extreme aging third myth that I wanted to explore in relation to medicine is the Hippocratic Oath so we should do no harm the issue is that with a degenerative end to life and some people experiencing at the end of life a negative quality of life wanting to die because they have degenerative diseases um it would be rational um to have assisted dying in the specific conditions where you have degenerative uh disease but that is an issue in relation to the Hippocratic Oath so I'd like to also discuss that thank you thank you um since we're all as you said we're all going to die of something what is it that we're going to die of because that we've talked about two different things there's just the mechanical something's going to fall off or stop working presumably there's a finite number of things that can just stop working but then there's things that are nothing to do with us outside diseases like viruses is there an indefinite amount of things that we could die of or is it is is there a list that medicine is going to get through um we'll always see particularly the emergence of new zoonotic diseases coming from the Animal Kingdom and that will only get worse because we're breaking down the boundaries with the Animal Kingdom so unless we have ecosystem restoration at a global level that's going to continue happening however I think science will get much much better at dealing with those um the response to covid is a scientific miracle if such a thing exists you know it's extraordinarily how fast particularly the vaccines were developed but we will constantly see new diseases emerging and we as Dennis said we are extraordinarily complex organisms if you fix one bit it just creates space for another bit to go wrong so I think we we might find new interesting ways to die um but I don't think we'll ever stop it I think we are finding new uh interesting ways to die um your question was is there a fixed number of diseases or or is a potential infinite number one well historically we have targeted as a society whatever is the main cause of death um and we've had increased lifespan and that reveals new diseases because aging is not one it's dozens or maybe hundreds of different processes and you go as you go into extreme aging you reveal more and more processes and more and more diseases so in the last 20 or 30 to do years many new diseases have been seen because people are living to longer and longer years um and that's obviously a problem the main cause of death now in the UK is dementia that is the main cause and has been uh well prior to the pandemic during the pandemic uh covid was the main cause of death but it was closely followed by dementia and dementia is now um again the main cause of death and obviously that is a problem but if you remove dementia then another thing will be removed will be revealed by extreme aging right to continue watching this video click the link in the top left or in the description below or visit iai.tv for more debates and talks from the world's leading thinkers on today's biggest ideas

Channel: The Institute of Art and Ideas

Views: 9,942

Keywords: learning, education, debate, lecture, IAItv, institute of art and ideas, IAI, philosophy, public pensions, FDA regulations, aging process, pharmaceutical companies, government policy, dementia research, drug development, healthcare debate, science in policy making, government funding, biomedical degrees, aging research, healthcare crisis, euthanasia debate, government intervention, pharmaceutical industry, healthcare reform, global aging, government leadership

Id: j3Awhc_95go

Length: 11min 41sec (701 seconds)

Published: Thu May 11 2023