Intended for healthcare professionals

Observations Life and Death

What do we want to die from?

BMJ 2010; 341 doi: (Published 21 July 2010) Cite this as: BMJ 2010;341:c3883
  1. Iona Heath, general practitioner, London
  1. iona.heath22{at}

    Continuing to fight all causes of mortality offers no hope of success

    Successive governments have been committed to reducing mortality, and the recent white paper shows that the current coalition government is no exception (BMJ 2010;341:c3796, doi:10.1136/bmj.c3796). The problem with such a commitment begins with the word: mortality means both the number of deaths in any given context but also the condition of being mortal and subject to death. We must all die, and so we must all die from something. The mortality rate for the population as a whole will always be 100%; so to what profile of causes of death should we aspire? If we continue to fight all causes of mortality, particularly in extreme old age, we have no hope of success, and we will consume an ever increasing proportion of healthcare resources for ever diminishing returns.

    The World Health Organization’s 2008-2013 action plan for the prevention and control of non-communicable diseases states that these diseases, mainly cardiovascular diseases, cancers, chronic respiratory diseases, and diabetes, “represent a leading threat …

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