Immortality and Medical Innovation

Lawrence Cranberg, MD
Article Type: 
November/December 1999
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An eminent medical scientist, Prof. Emil J. Freireich of the University of Texas Cancer Center of the M. D. Anderson Hospital in Houston, Texas, tossed off casually over lunch a few months ago the comment, "Of course we are immortal. All we have to do is eliminate all the causes of death."

At the time, I dismissed the remark as a truism that reflected Dr. Freireich's characteristic, bubbling optimism, and thought no more about it. But it recurred to me later when I asked myself if advanced age was in fact a certifiable cause of death. The World Almanac lists the ten leading causes of death, which account for 85 percent of all deaths, and sure enough, age is not among them. Indeed, it is not on any of the more comprehensive lists of causes of death in the U.S. Statistical Abstract. We can die of a host of things, but old age is not among them. That leads us to the inevitable, practical question, "Can we eliminate all the things we die from --- not just the ten leading causes of death, like heart disease and cancer, but all of them, and how should we go about it?" Thus Prof. Freireich's truism, which may have little practical interest, becomes in effect a very practical question of science policy.

Medical researchers have battled with many diseases, often with limited success. But so far as I know, no one has ever concluded that any particular disease is inherently incurable. And of course deaths due to accidents, such as being run over by a motor vehicle, can be indefinitely reduced by eliminating jaywalking, etc.

The real question is how we can improve the rate of advance of medical research so that the ultimate possibility of immortality --- or let us say, more practically, of longer, healthy lifespan --- is not indefinitely postponed by research inefficiency and lack of adequate resources. There are basically two schools of thought on that question. One is to spend more money on publicly funded medical research That school of thought has advocates in Congress today who are proposing to double the budget of the National Institutes of Health in the next ten years. The other school of thought is represented with particular eloquence and effectiveness by Dr. Terence Kealey, a physician and biochemical researcher at Cambridge University.

In 1996, Macmillan published Dr. Kealey's thoughtful, deeply researched, and provocative book, The Economic Laws of Scientific Research, which identifies three basic laws.

The First Law of Funding for civil R&D states that the percentage of national Gross Domestic Product (GDP) spent increases with national GDP per capita. The Second Law of Funding for civil R&D states the public and private funding displace each other. The Third Law of Funding for civil R&D states that the public and private displacements are not equal: public funds displace more than they do themselves provide.

Kealey's work was bound to arouse strong opposition particularly from segments of the academic community which rely heavily on public funding, and indeed there have been very intense exchanges in the science policy literature. But so far as this observer could determine from those exchanges, Dr. Kealey has been holding his ground.

I was so impressed by Dr. Kealey's work that I phoned him in Cambridge (UK), and on June 3-5, he was my house guest in Austin, Texas. It was an invigorating, extremely pleasant encounter with a brilliant, witty and very personable Brit, that hopefully will be followed by many more.

We did not discuss every science policy issue --- for example, clinical trial methodology, which is crucial to the tempo of medical advance, but we agreed about almost everything we did discuss. One issue on which we were not in full agreement was the question of public policy toward the pharmaceutical industry to give extra impetus to pharmaceutical research. Dr. Kealey was neutral-to-against, while I was strongly in favor of extending the present term of pharmaceutical patents of 17 years for several additional years.

Let us hope that question achieves the public attention that this writer has long believed it deserves. If we want to extend the human lifespan by medical innovation, it is reasonable to consider carefully the lifespan of the intellectual property that experience has proven useful to spur that innovation. Abraham Lincoln, a patentee himself, has long been quoted for his words, "The Patent System added the fuel of interest to the fire of genius."

Immortality may not be around the corner, but longer, healthy life-spans assuredly are, and the means by which they are attained warrant a very high, if not the highest place on the agenda of science policy. If Dr. Kealey's Laws do nothing but focus public attention sharply and productively on that agenda, Kealey's Laws would be as fruitful in the medical-biological domain as Newton's Laws of Motion have been in the physical.

Dr. Cranberg is a consulting physicist in Austin, Texas.

Originally published in the Medical Sentinel 1999;4(6):223. Copyright©1999 Association of American Physicians and Surgeons (AAPS).

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