24 
1, 
TA 
MAJORITY REPORT : RESERVATION. 
here is not, strictly speaking, a medical one. Ultimate victory 
may come from the sanitary side of medical science. In other 
cases where the individual is cured the cause of public health 
may, or may not, be promoted. ‘‘ Postponement of the event of 
death,” which is sometimes cited as proving an advance in public 
health, may in fact tend in the opposite direction. We do not 
here refer to one factor, obvious although frequently overlooked. 
in which medical attendance, even while improving the health 
of the community, must tend towards an increase in the actual 
volume of sickness. very one who is sick and recovers lives to 
be sick later on, and prolongation of life means, among other 
things, that in the age distribution of the population, a larger 
proportion fall within those groups which are more exposed to 
the risk of illness. Without considering remoter consequences, 
““ postponement of the event of death ’’ may therefore mean, in 
many cases must mean, an increase in the number of illnesses 
requiring medical attention. 
8. In this possible direct increase in the volume of sickness, 
there is, however, nothing to cause perturbation from the point 
of view of public health, but it is different when we turn to con- 
sider the possibility of those remoter consequences which do in 
fact exist. Apart from occasional and fortuitous illnesses which 
may befall the healthiest, and those due to environment, it is @ 
matter of common knowledge that a large volume of illness is 
due to constitutional predisposition and to a diminished power of 
resistance which is an inalienable part of the sufferer’s equipment 
for life. There are many of whom it can be predicted even 
before birth that they will probably be ill for the greater part of 
such life as may be granted to them, and perhaps even the nature 
of the illness from which they may be expected to suffer—unless 
in the interval medical science has made notable advances—can 
be broadly foretold. Clearly when those who have a lessened 
immunity from disease are enabled, as a result of the postpone- 
ment of the event of death, to leave behind them heirs to their 
weaknesses, the general cause of public health will in many cases 
have been frustrated and not promoted by the medical attention 
which they have received. In such matters it is difficult to 
obtain; strict proof one way or the other, but when we are inclined 
to be complacent over the postponement of the event of death, 
we should remember that there is at least a prima facie possibility 
that over a considerable part of the field, the application of 
medical science—however immediately advantageous to the 
individual—may not in its ultimate results be wholly free from 
certain consequences disadvantageous to the community at large. 
Tt is the honourable and charitable foundation of the medical pro- 
fession that suffering, wherever it exists, is to be relieved; that 
life, so long as it may be, is to be strengthened and continued, 
even if the doctor may be convinced in his mind that it is being 
strenothened only to meet vears of labour and sorrow.