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October 4, 1995

The Naturalness of Dying-Reply

Author Affiliations

Berkshire Medical Center Pittsfield, Mass

JAMA. 1995;274(13):1016. doi:10.1001/jama.1995.03530130022021

In Reply.  —Drs Honig and Weiner succinctly summarize the concept that aging itself does not cause physical and intellectual decline. Presumably, these declines are the result of undiagnosed or undiagnosable disease. This belief, which was explored with insight and wit by Goodwin,1 is no longer tenable unless one is willing to reject more than a decade of careful clinical and basic science research, much of which is referenced in my article. Despite the belief that a centenarian who remains entirely healthy should be as physically and intellectually functional as he or she was 50 or 80 years earlier, millennia of careful observations of the process of aging (and, at the risk of being too imprecise, common sense) indicate otherwise. Unfortunately, there are no persuasive data to contradict the observations that decline precedes a natural death and that death eventually comes to all, whether healthy or ill. If there were,

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