"Toward a Philosophy of Aging for Public Health: Presented as the Luther Terry Lecture at the 17th Annual Meeting of the
Commissioned Officers Association of the USPHS [United States Public Health Service], Orlando, Florida" [Reminiscence]
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Koop, C. Everett
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Toward a Philosophy of Aging for Public Health: Presented as the Luther Terry Lecture at the 17th Annual Meeting of the Commissioned
Officers Association of the USPHS [United States Public Health Service], Orlando, Florida (October 20, 1982)
Vol. 3 -- # 1
Toward A Philosophy of Aging for Public Health
By C. Everett Koop, MD, ScD
Surgeon General And Deputy Assistant Secretary for Health
Presented as the Luther Terry Lecture at the 17th Annual Meeting of the Commissioned Officers Association of the USPHS
October 20, 1982
The Commissioned Corps of the United States Public Health Service was the object of more accolades from me than any other
part of government. To be their Commander-in-Chief was an honor I cherished every minute I had it and to be asked to give
this lecture was just icing on the cake. In addition to that, I was permitted to choose my own subject.
After thinking it over for some time, I thought something based on all the things that were happening in the various agencies
of the United States Public Health Service on Aging might be summed up at this time under the title of "Toward A Philosophy
of Aging for Public Health".
After acknowledging Luther Terry and his role in the Public Health Service, and my debt to him in three phases of my life,
I began by acknowledging that everyone I talked with who worked in some aspect of the field of aging, was genuinely concerned
for the welfare of America's elderly population and that just about everyone I spoke to came at the subject of aging from
a different perspective - each with value laden data, but each with a different concept of what they hoped to see the government
achieve -- both sufficient reasons to choose the title I did. Naturally I didn't mean that we didn't already have
sort of a philosophy toward aging, but it was not based on usual public health principles, methodologies, insights, etc. We
are used to opportunities for linkage and follow-through, follow-up, cost effective this, and technology intensive that, but
here we were dealing with fundamental notions of compassion, public service, and of human decency
in the problems of the aged. As a matter of fact, I'm proud of that.
I began the background of such a philosophy by pointing out the usual expectation of old age, the problem of self-fulfilling
prophecies, a lack of orderliness to our predictions, the inability of aging folks to keep a pre-conceived schedule.
Attention was also called to the fact that while all the modem technology does make possible certain measures that do prolong
life, at least for a time, we lack any neat definitions for these periods of time. We also have different perceptions about
the appropriateness of any effort made to prolong the lives of elderly folks in decline. I also pointed out that what was
extraordinary care yesterday, is just ordinary care today.
It seemed appropriate discuss cure vs. care, the difference between prolonging life and prolonging the act of dying, retirement
of flag officers, and retirement of civilians.
As with many things, the deeper one delves into the subject, the more complicated it gets. I tried to point out we had to
worry about the aging process biomedically, biobehaviorally, neurophysiologically, and in reference to cardio-respiratory
and musculoskeletal function. Many other disciplines deal with making the aging process what the aging people want that process
to be - electronic engineers, metallurgists, architects, interior decorators, lawyers, educators, labor
leaders, economists, and others. So, our philosophy of aging as far as public health goes will have to be congruent with the
philosophies of these other professions and vocations as well. I'm not sure they are thinking of developing a philosophy
in the sense that we were on this occasion: aging, our own, aging of friends and family, aging of society of itself.
My philosophical thoughts ended with the idea that we have made and need to make more progress in seeking the unity of common
sense with science.