title: [Care for the incurable elderly].
abstract: The goals of medicine encompass the relief of pain and suffering, the promotion of health and the prevention of disease, and the cure of disease when possible and the care of those who can not be cured. Today, closely affiliated with various establishments, medicine sustains an influential but strange subculture in our society. Because of its insistent ideology for cure, medicine is blamed for futility, a misuse of modern technology. The root of the problem lies in the abandonment of the human soul when medicine in the 19th century joined the new-sprung science which identified objectivity as a leading principle forbidding "cogito ergo sum". Accordingly, modern medicine neglected patients for whom the care of the mind is essential and failed to care for those with uncurable conditions. Curiously, the development of life sciences dictates the human soul as a final product of an evolution through a trade-off with aging and death. The human soul and its dignity must be revived at the heart of medicine, and the art of dying must be sought to enable a peaceful death. The concept of Tenju gann or "natural-end cancer", an example for blessed longevity followed by a peaceful death is an ideal goal of palliative care, developing the art of dying for every patient, irrespective of age or disease. Palliative care begins at the irreversible stage of diseases or when treatment impairs the dignity of a dying patient. With public disclosure physicians must be selected by aged patients and their families to promote the art of dying.
authors.affiliation: Dept. of Internal Medicine, Tokyo Metropolitan Geriatric Hosital.
authors.forename: S
authors.initials: S
authors.lastname: Matsushita
mesh_terms: D000368:Aged; D001293:Attitude to Death; D006801:Humans; D010686:Philosophy, Medical; D013727:Terminal Care / Q000592:standards*