In contemporary philosophy of medicine, bioethics, and gerontology, a key debate persists: whether aging is a disease warranting treatment or a natural, non-pathological process. This dilemma is increasingly urgent due to lifespan extension projects, revisions of disease classification criteria, and the socioeconomic challenges of population aging. However, the binary “disease – non-disease” framework fails to capture the complexity of age-related changes, risking reductionism, ageism, or passive acceptance of elderly suffering. The authors propose transcending this dichotomy by introducing the concepts of “metastate” and “metaprocess” regarding aging. Aging is reinterpreted not as a separate nosology but as a universal platform for age-associated diseases, a disruption of homeodynamics, and a crisis of biological self-renewal. Using the category of the “measure of life” and the antithesis of the ideal and the real, aging is conceptualized as a chronic narrowing of alignment between ideal physiological parameters and the organism’s actual state, leading to diminished vitality. Health is defined as strong dynamic alignment of the ideal and the real, disease as their misalignment, and aging as the gradual, irreversible accumulation of such misalignment. This approach overcomes the rigid opposition between proponents and opponents of “treating old age”, shifting the debate toward an integrative strategy for managing the meta-process of agеing.
In contemporary philosophy of medicine, bioethics, and gerontology, a key debate persists: whether aging is a disease warranting treatment or a natural, non-pathological process. This dilemma is increasingly urgent due to lifespan extension projects, revisions of disease classification criteria, and the socioeconomic challenges of population aging. However, the binary “disease – non-disease” framework fails to capture the complexity of age-related changes, risking reductionism, ageism, or passive acceptance of elderly suffering. The authors propose transcending this dichotomy by introducing the concepts of “metastate” and “metaprocess” regarding aging. Aging is reinterpreted not as a separate nosology but as a universal platform for age-associated diseases, a disruption of homeodynamics, and a crisis of biological self-renewal. Using the category of the “measure of life” and the antithesis of the ideal and the real, aging is conceptualized as a chronic narrowing of alignment between ideal physiological parameters and the organism’s actual state, leading to diminished vitality. Health is defined as strong dynamic alignment of the ideal and the real, disease as their misalignment, and aging as the gradual, irreversible accumulation of such misalignment. This approach overcomes the rigid opposition between proponents and opponents of “treating old age”, shifting the debate toward an integrative strategy for managing the meta-process of agеing.