posted on 10/02/2022 10:39
The death certificate of Queen Elizabeth II, of the United Kingdom, mentioned the old age of the monarch as the cause of death. At 96, she had no health problems. When someone very old dies with no apparent illness, do doctors necessarily need to pinpoint a cause? Or is it acceptable to say that the person died of old age? With the world population getting longer and the advances in medicine, the debate grows around the world.
Old age is not listed in the International Code of Diseases (ICD). This is the list of the World Health Organization (WHO) used worldwide as a diagnostic tool that brings together more than 17,000 conditions. At the beginning of the year, there was a discussion about including the term, but the understanding prevailed that old age is not a disease and, therefore, could not be listed in the CID.
Among some physicians, there is also an interpretation that attributing death to old age is as if the health professional had not investigated in detail what led the patient to death. The custom is that the cause is some condition on the list. Regardless, some countries accept the use of the term on death certificates, such as the United Kingdom and Japan.
In the UK, it is possible to note on the death certificate that someone died of “old age”. This is what happened to the Queen and her husband, Philip, who died at 99 years old in April 2021. But this annotation is acceptable only when the document is signed by a doctor who has been following the patient for many years and there is no record of any illness. .
Among the Japanese, death from old age, also accepted on the death certificate, is already the 3rd most common in the country. Second only to cancer and heart problems. But no other identifiable cause must exist for the term to be used.
IS IT DISEASE?
In Brazil, the understanding prevails that old age is not a disease. Therefore, it should not appear as a cause of death. Experts point out some problems with using “old age” as a cause of death. In addition to the interpretation that old age would be a disease, the use of the term can generate prejudice against the elderly. It can also disrupt statistics on infectious diseases (which commonly cause the death of the elderly).
“It’s not that there is a ban, but a recommendation so that this does not happen, that there are no vague causes on the death certificate”, explains geriatrician Elisa Franco de Assis Costa, professor at the Federal University of Goiás and member of the Technical Chamber of Geriatrics. of the Federal Council of Medicine (CFM). “We need more accurate information to plan our healthcare system, for example, to generate important statistical data.”
But regardless of the official understanding, from a medical point of view, is it possible to die of old age? The issue is also controversial. Some doctors feel that old age alone does not cause death, but some other condition underlying aging.
Other experts, however, think differently. They believe that the body wears out as we age and, at a certain point, begins to fail. For them, this death could be considered old age.
“I wouldn’t use old age as a cause of death, as if it were a disease”, says geriatrician Roberta França, a professor at Universidade Cândido Mendes. “We are all going to be born, grow, develop and die. It’s the natural order of life. Nobody stays for seed. There is a functional decline brought about by age, organs lose their capacity, but that doesn’t mean it’s disease, a pathological process.”
The Japanese have a vision of their own. “It’s not a disease, it’s something natural,” physician Kazuhiro Nagao, a palliative care specialist, told the Wall Street Journal last week. “It’s not a tragic end. It’s the kind of death considered ideal in Japan, part of our culture.”
For Brazilian specialist Veridiana do Nascimento Vieira Bronzon, a neurologist at Hospital Federal Cardoso Fontes and the Senior Network, it is also a cultural issue that makes Brazilians not accept “old age” as a cause of death on the death certificate. “It’s a cultural issue in our country, marked by gyms, the search for the perfect body, facial harmonization, the cult of physical beauty, healthy aging”, she lists.
The information is from the newspaper. The State of São Paulo.